title: Patients' preconceptions of acupuncture: a qualitative study exploring the decisions patients make when seeking acupuncture.
abstract: BACKGROUND
  Like any other form of healthcare, acupuncture takes place in a particular context which can enhance or diminish treatment outcomes (i.e. can produce contextual effects). Patients' expectations of acupuncture might be an important component of contextual effects, but we know relatively little about the origins and nature of patients' expectations or wider preconceptions about acupuncture. Our aim was to identify the processes the underpin patients' decisions to try acupuncture and thus begin to tease out the origins and nature of patients' preconceptions.
  
  
  METHODS
  One-off semi-structured interviews were conducted with a purposive, varied sample of 35 adults who had tried acupuncture for various conditions. Interviews explored people's experiences of acupuncture treatment and techniques from framework and inductive thematic analysis were used to relate the data to the research question.
  
  
  RESULTS
  We identified four distinct processes within participants' accounts of deciding to try acupuncture: establishing a need for treatment, establishing a need for a new treatment, deciding to try acupuncture, and finding an acupuncturist. Family, friends and health care professionals played a role in these processes, providing support, advice, and increasing people's general familiarity with acupuncture. When they came to their first acupuncture appointment, participants had hopes, concerns, and occasionally concrete expectations as to the nature of acupuncture treatment and its likely effects.
  
  
  CONCLUSIONS
  Existing theories of how context influences health outcomes could be expanded to better reflect the psychological components identified here, such as hope, desire, optimism and open-mindedness. Future research on the context of acupuncture should consider these elements of the pre-treatment context in addition to more established components such as expectations. There appears to be a need for accessible (i.e. well-disseminated), credible, and individualised, patient-centred materials that can allay people's concerns about the nature of acupuncture treatment and shape realistic hopes and expectations.
authors.affiliation: Centre for Applications of Health Psychology, Faculty of Social and Human Sciences, Building 44 Highfield Campus, University of Southampton, Southampton, SO17 1BJ, UK. F.L.Bishop@southampton.ac.uk
authors.forename: Felicity L
authors.initials: FL
authors.lastname: Bishop
authors.forename: George T
authors.initials: GT
authors.lastname: Lewith
mesh_terms: D015670:Acupuncture Therapy / Q000523:psychology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology; D036301:Qualitative Research; D016896:Treatment Outcome