Dataset Information

Self-efficacy and embodiment associated with Alexander Technique lessons or with acupuncture sessions: A longitudinal qualitative sub-study within the ATLAS trial.

ABSTRACT:

Background and purpose

A large randomised controlled trial found that the provision of either Alexander Technique lessons or acupuncture, for those with chronic neck pain, resulted in significantly increased self-efficacy when compared with usual care alone. In turn, enhanced self-efficacy was associated with significant reductions in neck pain at 6 and 12 months. In this analysis we explore the perspectives of participants within the trial, with the aim of gaining a better understanding of how these interventions had an impact.

Methods

We used a longitudinal qualitative approach; in-depth interviews, informed by a topic guide, were conducted with a sample of the trial population. Participants were interviewed twice: at around six months (n?=?30) and twelve months (n?=?26) after trial entry. Analysis was guided by the principles of grounded theory, and key themes were developed.

Results

Five key themes emerged: pre-trial experiences of biomedical treatment against which subsequent interventions were compared; emergence of tangible benefits from the interventions; factors that contributed to the observed benefits, notably growing self-care and self-efficacy; a developing sense of embodiment as an integral part of the transformative process; and contribution of these factors to sustaining benefits over the longer term.

Conclusions

In-depth interviews revealed a rich array of experiences. They gave insight into the positive impact of the interventions on development of self-care, self-efficacy and embodiment. These findings complement the quantitative trial data, providing a more nuanced understanding of the factors that underpin the previously quantified improvement in self-efficacy and its association with longer-term reductions in pain.

SUBMITTER: Wenham A

PROVIDER: S-EPMC5941320 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Self-efficacy and embodiment associated with Alexander Technique lessons or with acupuncture sessions: A longitudinal qualitative sub-study within the ATLAS trial.

Wenham Aniela A Atkin Karl K Woodman Julia J Ballard Kathleen K MacPherson Hugh H

Complementary therapies in clinical practice 20180315

<h4>Background and purpose</h4>A large randomised controlled trial found that the provision of either Alexander Technique lessons or acupuncture, for those with chronic neck pain, resulted in significantly increased self-efficacy when compared with usual care alone. In turn, enhanced self-efficacy was associated with significant reductions in neck pain at 6 and 12 months. In this analysis we explore the perspectives of participants within the trial, with the aim of gaining a better understanding ...[more]

PMID: 29705473

Similar Datasets

Project description:BackgroundCurrent technology innovations, such as wearables, have caused surprising reactions and feelings of deep connection to devices. Some researchers are calling mobile and wearable technologies cognitive prostheses, which are intrinsically connected to individuals as if they are part of the body, similar to a physical prosthesis. Additionally, while several studies have been performed on the phenomenology of receiving and wearing a physical prosthesis, it is unknown whether similar subjective experiences arise with technology.ObjectiveIn one of the first qualitative studies to track wearables in a longitudinal investigation, we explore whether a wearable can be embodied similar to a physical prosthesis. We hoped to gain insights and compare the phases of embodiment (ie, initial adjustment to the prosthesis) and the psychological responses (ie, accept the prosthesis as part of their body) between wearables and limb prostheses. This approach allowed us to find out whether this pattern was part of a cyclical (ie, period of different usage intensity) or asymptotic (ie, abandonment of the technology) pattern.MethodsWe adapted a limb prosthesis methodological framework to be applied to wearables and conducted semistructured interviews over a span of several months to assess if, how, and to what extent individuals come to embody wearables similar to prosthetic devices. Twelve individuals wore fitness trackers for 9 months, during which time interviews were conducted in the following three phases: after 3 months, after 6 months, and at the end of the study after 9 months. A deductive thematic analysis based on Murray's work was combined with an inductive approach in which new themes were discovered.ResultsOverall, the individuals experienced technology embodiment similar to limb embodiment in terms of adjustment, wearability, awareness, and body extension. Furthermore, we discovered two additional themes of engagement/reengagement and comparison to another device or person. Interestingly, many participants experienced a rarely reported phenomenon in longitudinal studies where the feedback from the device was counterintuitive to their own beliefs. This created a blurring of self-perception and a dilemma of "whom" to believe, the machine or one's self.ConclusionsThere are many similarities between the embodiment of a limb prosthesis and a wearable. The large overlap between limb and wearable embodiment would suggest that insights from physical prostheses can be applied to wearables and vice versa. This is especially interesting as we are seeing the traditionally "dumb" body prosthesis becoming smarter and thus a natural merging of technology and body. Future longitudinal studies could focus on the dilemma people might experience of whether to believe the information of the device over their own thoughts and feelings. These studies might take into account constructs, such as technology reliance, autonomy, and levels of self-awareness.

Project description:IntroductionDepression and pain frequently occur together and impact on outcomes of existing treatment for depression. Additional treatment options are required. This study aimed to explore patients' experiences of depression, the processes of change within acupuncture and counselling, and the elements that contributed to longer-term change.MethodsIn a substudy nested within a randomised controlled trial of acupuncture or counselling compared with usual care alone for depression, semistructured interviews of 52 purposively sampled participants were conducted and analysed using thematic analysis.ResultsDifferences were reported by participants regarding their experience of depression with comorbid pain compared with depression alone. Along with physical symptoms often related to fatigue and sleep, participants with depression and comorbid pain generally had fewer internal and external resources available to manage their depression effectively. Those who had physical symptoms and were receiving acupuncture commonly reported that these were addressed as part of the treatment. For those receiving counselling, there was less emphasis on physical symptoms and more on help with gaining an understanding of themselves and their situation. Over the course of treatment, most participants in both groups reported receiving support to cope with depression and pain independently of treatment, with a focus on relevant lifestyle and behaviour changes. The establishment of a therapeutic relationship and their active engagement as participants were identified as important components of treatment.ConclusionsParticipants with and without comorbid pain received acupuncture or counselling for depression, and reported specific identifiable treatment effects. The therapeutic relationship and participants' active engagement in recovery may play distinct roles in driving long-term change. Patients who present with depression and physical symptoms of care may wish to consider a short course of acupuncture to relieve symptoms prior to a referral for counselling if needed.Trial registration numberISRCTN63787732.

Project description:IntroductionThe National Institute for Health and Clinical Excellence guidelines recommend acupuncture as a clinically effective treatment for chronic back pain. However, there is insufficient knowledge of what factors contribute to patients' positive and negative experiences of acupuncture, and how those factors interact in terms of the acceptability of treatment. This study used patient interviews following acupuncture treatment for back pain to identify, understand and describe the elements that contribute or detract from acceptability of treatment.MethodsThe study used semi-structured interviews. Twelve patients were interviewed using an interview schedule as a sub-study nested within a randomised controlled trial of acupuncture for chronic back pain. The interviews were analysed using thematic analysis.Results and discussionThree over-arching themes emerged from the analysis. The first entitled facilitators of acceptability contained five subthemes; experience of pain relief, improvements in physical activity, relaxation, psychological benefit, reduced reliance on medication. The second over-arching theme identified barriers to acceptability, which included needle-related discomfort and temporary worsening of symptoms, pressure to continue treatment and financial cost. The third over-arching theme comprised mediators of acceptability, which included pre-treatment mediators such as expectation and previous experience, and treatment-related mediators of time, therapeutic alliance, lifestyle advice and the patient's active involvement in recovery. These themes inform our understanding of the acceptability of acupuncture to patients with low back pain.ConclusionThe acceptability of acupuncture treatment for low back pain is complex and multifaceted. The therapeutic relationship between the practitioner and patient emerged as a strong driver for acceptability, and as a useful vehicle to develop the patients' self-efficacy in pain management in the longer term. Unpleasant treatment related effects do not necessarily detract from patients' overall perception of acceptability.

Dataset Information

Self-efficacy and embodiment associated with Alexander Technique lessons or with acupuncture sessions: A longitudinal qualitative sub-study within the ATLAS trial.

Background and purpose

Methods

Results

Conclusions

Publications

Self-efficacy and embodiment associated with Alexander Technique lessons or with acupuncture sessions: A longitudinal qualitative sub-study within the ATLAS trial.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets