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Ear acupuncture as an adjunct in a treatment protocol for anorexia nervosa : utilization rate and nurses’ experience

Landgren, Kajsa LU orcid (2022) In Acupuncture in Medicine 40(4). p.322-332
Abstract

Background: Anorexia nervosa (AN) is a life-threatening illness. Sometimes long inpatient treatment is necessary, increasing the anxiety that comes with hospitalization and the necessary weight gain. Safe, non-pharmacological adjunctive therapies that improve subjective health are called for. Objective: The aim of this non-randomized, mixed-methods observational study was to describe the utilization rate and nurses’ experiences of ear acupuncture in a highly specialized clinic for eating disorders in Sweden, in which acupuncture had been implemented as part of routine clinical care. Twenty-five patients with AN-treated voluntarily or by law were included. The semi-standardized National Acupuncture Detoxification Association (NADA) ear... (More)

Background: Anorexia nervosa (AN) is a life-threatening illness. Sometimes long inpatient treatment is necessary, increasing the anxiety that comes with hospitalization and the necessary weight gain. Safe, non-pharmacological adjunctive therapies that improve subjective health are called for. Objective: The aim of this non-randomized, mixed-methods observational study was to describe the utilization rate and nurses’ experiences of ear acupuncture in a highly specialized clinic for eating disorders in Sweden, in which acupuncture had been implemented as part of routine clinical care. Twenty-five patients with AN-treated voluntarily or by law were included. The semi-standardized National Acupuncture Detoxification Association (NADA) ear acupuncture protocol, sometimes combined with needling at 2 traditional acupuncture point locations on the body, had been implemented as a voluntary adjunct to usual care, twice weekly. To evaluate the acceptance of acupuncture, the study examined how often patients chose acupuncture when offered on schedule, and how often they asked for extra acupuncture sessions. Patients rated their subjective health using the hospital anxiety and depression scale (HADS) and visual analogue scale (VAS), treatment satisfaction with usual care and acupuncture, and health-related quality of life with the RAND36 instrument. A credibility/expectancy questionnaire (CEQ) was used to measure confidence in treatment. Body mass index (BMI) was calculated to follow the patients’ recovery. Nurses’ experiences of giving acupuncture as a part of routine care were captured in interviews, and analysed with content analysis. Ethical approval was obtained. Results: Despite an initially moderate level of trust in acupuncture, the utilization rate of the scheduled acupuncture was 89% and patients asked for extra acupuncture sessions on 28 occasions. No serious side effects were reported. Nurses’ experiences of providing acupuncture were positive. They were generally enthusiastic, although they reported finding it difficult to organize group treatments and to find time for acupuncture sessions if they were not scheduled. Conclusion: Further research into the effectiveness and costs of acupuncture in psychiatric care is needed. This study provides relevant information for clinicians as well as researchers planning future randomized controlled trials.

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Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
anorexia nervosa, ear acupuncture, eating disturbances, NADA, nurses’ experience, utilization rate
in
Acupuncture in Medicine
volume
40
issue
4
pages
322 - 332
publisher
BMJ Publishing Group
external identifiers
  • pmid:34894769
  • scopus:85121150337
ISSN
0964-5284
DOI
10.1177/09645284211056948
language
English
LU publication?
yes
id
7ea057d4-3bb7-4fe7-8d7e-5cbc7726ba15
date added to LUP
2022-01-31 15:12:31
date last changed
2024-09-08 09:00:37
@article{7ea057d4-3bb7-4fe7-8d7e-5cbc7726ba15,
  abstract     = {{<p>Background: Anorexia nervosa (AN) is a life-threatening illness. Sometimes long inpatient treatment is necessary, increasing the anxiety that comes with hospitalization and the necessary weight gain. Safe, non-pharmacological adjunctive therapies that improve subjective health are called for. Objective: The aim of this non-randomized, mixed-methods observational study was to describe the utilization rate and nurses’ experiences of ear acupuncture in a highly specialized clinic for eating disorders in Sweden, in which acupuncture had been implemented as part of routine clinical care. Twenty-five patients with AN-treated voluntarily or by law were included. The semi-standardized National Acupuncture Detoxification Association (NADA) ear acupuncture protocol, sometimes combined with needling at 2 traditional acupuncture point locations on the body, had been implemented as a voluntary adjunct to usual care, twice weekly. To evaluate the acceptance of acupuncture, the study examined how often patients chose acupuncture when offered on schedule, and how often they asked for extra acupuncture sessions. Patients rated their subjective health using the hospital anxiety and depression scale (HADS) and visual analogue scale (VAS), treatment satisfaction with usual care and acupuncture, and health-related quality of life with the RAND36 instrument. A credibility/expectancy questionnaire (CEQ) was used to measure confidence in treatment. Body mass index (BMI) was calculated to follow the patients’ recovery. Nurses’ experiences of giving acupuncture as a part of routine care were captured in interviews, and analysed with content analysis. Ethical approval was obtained. Results: Despite an initially moderate level of trust in acupuncture, the utilization rate of the scheduled acupuncture was 89% and patients asked for extra acupuncture sessions on 28 occasions. No serious side effects were reported. Nurses’ experiences of providing acupuncture were positive. They were generally enthusiastic, although they reported finding it difficult to organize group treatments and to find time for acupuncture sessions if they were not scheduled. Conclusion: Further research into the effectiveness and costs of acupuncture in psychiatric care is needed. This study provides relevant information for clinicians as well as researchers planning future randomized controlled trials.</p>}},
  author       = {{Landgren, Kajsa}},
  issn         = {{0964-5284}},
  keywords     = {{anorexia nervosa; ear acupuncture; eating disturbances; NADA; nurses’ experience; utilization rate}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{322--332}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Acupuncture in Medicine}},
  title        = {{Ear acupuncture as an adjunct in a treatment protocol for anorexia nervosa : utilization rate and nurses’ experience}},
  url          = {{http://dx.doi.org/10.1177/09645284211056948}},
  doi          = {{10.1177/09645284211056948}},
  volume       = {{40}},
  year         = {{2022}},
}