title: Acupuncture for hot flashes: decision making by breast cancer survivors.
abstract: OBJECTIVE
  Hot flashes (HFs) are a particularly common and distressing symptom among breast cancer survivors (BCSs). Given its low rate of side effects, acupuncture shows promise as a therapeutic approach for HFs, but little is known about BCS's decision making about the use of acupuncture. This study seeks to identify attitudes and beliefs about using acupuncture for HFs by BCSs.
  
  
  METHODS
  Using the Theory of Planned Behavior (TPB) as a conceptual framework, we conducted semistructured interviews among women with stage I-III breast cancer who had finished primary treatment and were currently experiencing HFs. Interviews were taped, transcribed, and coded. We used a modified grounded theory approach to analyze the data.
  
  
  RESULTS
  Twenty-five BCSs (13 whites/12 African American) participated in the study. Respondents stated that their intended use of acupuncture for HFs would be dependent on (1) expected therapeutic effects (eg, pain relief, energy); (2) practical concerns (eg, fear of needles, practitioner experience, time commitment); and (3) source of decision support/validation (eg, family members, physicians, self). Although constructs in the TPB accounted for many decision factors, respondents identified 2 major themes outside of the TPB: (1) viewing acupuncture as a natural alternative to medications, and (2) assessing the degree of HFs as bothersome enough in the context of other medical comorbidities to trigger the need for therapy.
  
  
  CONCLUSIONS
  BCSs expressed varied expected therapeutic benefits, practical concerns, and decision support, emphasizing the "natural appeal" and symptom appraisal as key determinants when using acupuncture for HFs. Incorporating these factors in counseling BCSs may promote patient-centered communication, leading to improved hot flash management and quality of life.
authors.affiliation: Department of Family Medicine and Community Health, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. maoj@uphs.upenn.edu
authors.forename: Jun J
authors.initials: JJ
authors.lastname: Mao
authors.forename: Rana
authors.initials: R
authors.lastname: Leed
authors.forename: Marjorie A
authors.initials: MA
authors.lastname: Bowman
authors.forename: Krupali
authors.initials: K
authors.lastname: Desai
authors.forename: Manuel
authors.initials: M
authors.lastname: Bramble
authors.forename: Katrina
authors.initials: K
authors.lastname: Armstrong
authors.forename: Frances
authors.initials: F
authors.lastname: Barg
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications* / Q000473:pathology / Q000523:psychology; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D019584:Hot Flashes / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007406:Interview, Psychological; D008875:Middle Aged; D017741:Survivors; D013997:Time Factors; D016387:Women's Health