title: "I Felt Like It Was God's Hands Putting the Needles In": A Qualitative Analysis of the Experience of Acupuncture for Chronic Pain in a Low-Income, Ethnically Diverse, and Medically Underserved Patient Population.
abstract: OBJECTIVE
  To examine the experience of patients from a low-income, ethnically diverse medically underserved population receiving acupuncture for chronic pain.
  
  
  METHODS
  Qualitative analysis using inductive thematic analysis of interviews with participants from an acupuncture trial.
  
  
  METHODS
  Four community health centers in the Bronx, New York.
  
  
  METHODS
  Thirty-seven adults with chronic neck or back pain or osteoarthritis who participated in a previous acupuncture trial.
  
  
  METHODS
  Up to 14 weekly acupuncture treatments.
  
  
  METHODS
  Pain and quality of life were examined in the original trial; this study examines qualitative outcomes.
  
  
  RESULTS
  The themes grouped naturally into three domains of the acupuncture experience: the decision-making process, the treatment experience, and the effect of acupuncture on health. Regarding decision-making, important factors were a willingness to try something new even if you do not necessarily "believe" in it or have specifically positive expectations; a sense that medications were not working for their pain, that they also caused significant adverse effects, and that natural strategies might be preferable; and a feeling of desperation. Cost and access were significant barriers to acupuncture treatment. Regarding the process of acupuncture, the open and personal communication with the acupuncturist was an important factor, as were the sense that the process of acupuncture related to a natural process of healing or correction within the body and that part of making acupuncture successful required being open to the power of the mind to generate a positive outcome. Regarding the effect of treatment, notable aspects were the deep sense of rest and relaxation participants reported during treatment as well as the benefit they experienced for conditions other than pain.
  
  
  CONCLUSIONS
  The themes that emerged in this ethnically diverse, low-income population were very similar to those that have emerged over the past decade of qualitative research on the acupuncture experience in other patient populations.
authors.affiliation: 1 Department of Integrative Medicine, Mount Sinai Beth Israel Medical Center , New York, NY.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kligler
authors.affiliation: 2 Albert Einstein College of Medicine , Bronx, NY.
authors.forename: Michele
authors.initials: M
authors.lastname: Buonora
authors.affiliation: 2 Albert Einstein College of Medicine , Bronx, NY.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Gabison
authors.affiliation: 3 Mount Sinai St. Luke's Roosevelt Medical Center , New York, NY.
authors.forename: Emilie
authors.initials: E
authors.lastname: Jacobs
authors.affiliation: 2 Albert Einstein College of Medicine , Bronx, NY.
authors.forename: Alison
authors.initials: A
authors.lastname: Karasz
authors.affiliation: 2 Albert Einstein College of Medicine , Bronx, NY.
authors.forename: M Diane
authors.initials: MD
authors.lastname: McKee
mesh_terms: D015670:Acupuncture Therapy / Q000523:psychology* / Q000706:statistics & numerical data*; D059350:Chronic Pain / Q000628:therapy*; D003151:Community Health Centers; D006801:Humans; D008507:Medically Underserved Area; D009519:New York City; D011203:Poverty