Acupuncture Treatment Of Qualitative Interviews In Patients With Mild To Moderate Depression

Objective:To discuss,by qualitative interview,physical and psychological changes of the 13 depression patients before and after being acupunctured;to clarify what's bothering them,how they think acupuncture as a treatment for depression and what benefits they expect from the treatment;to understand whether they are satisfied with the treatment and gather their opinions and suggestions,thus to offer reference to future research and treatment.Method:qualitative interview:by means of purposive and saturated sampling,semi-structured interviews were conducted respectively before and after treatment(in week 0 and after week 6)to the interviewees.Data collection and analysis started when each interview finished,with the former by word transcription and repeated reading,and the latter by the grounded theory to extract its essential theories.Combination of qualitative and quantitative analysis:quantitative data were included into the 7-factor structure of HAMD-24 scale;the data gathered before treatment was compared with the scores in 0 week,and the data after treatment then compared with the ones after 6th week.Results:13 patients were included,5 males(38.46%)and 8 females(61.54%),at the age of 24 to 60,with a mean age of(37.77±10.93).Four patients(30.77%)had concomitant disease(s),one(7.69%)suffered from drug addiction,three(23.08%)had an experience of self-injured,seven(53.85%)had a family history of depression,and another seven(53.85%)had gone through(at least)a major adverse event.Results of quantitative interviews:10 factors are selected:reason for visit,obsession,cognition,attitude for acupuncture,expectation,attitude of people around him/her,suggestions,symptom alleviation,satisfaction,and social support,among these,obsession and symptom alleviation as the key factors.Results of Combination of qualitative and quantitative analysis:total score in 0 week is(22.92±6.184),and(6.69±5.879)after 6 weeks.9 interviewees(69.23%),numbered as 2,3,5,6,7,9,11,12 and 13 got a point less than 8(which meant being cured),whose total scores of HAMD and scores at anxiety/somatization,cognitive impairment,retardation,sleep disturbance and feeling of despair,before and after treatment were significantly different(P<0.01).Inclusion of quantitative interviewing data into the 7-factor-structure of HAMD-24 shows that the frequently stated factors are retardation,anxiety/somatization and sleep disturbance,mentioned respectively by 13(100.00%),10(76.92%),and 8(61.54%)interviewees.Moreover,before treatment,5 interviewees(38.46%)mentioned feeling of despair,and 4(30.77%)mentioned cognitive disorder.No one mentioned the factors weight and diurnal variation,of which no significant difference had been seen(P=0.129,P=0.380).Conclusion:quantitative interview:about the factor "reason for visit",interviewees have strong intention to pour out their reasons for visiting a doctor,and they are unanimous in the feeling of being lost before visit,most words of their expression negative,description comparatively specific,and the reason relatively univocal.About "obsession",interviewees are willing to pour out their problems which are commonly described as multifaceted ones,and using narrative-actual-life language,to give specified symptoms and obsession.In response of "cognition",interviewees are professional;they understand depression based on their experience or thinking.Analysis shows that more than half of the interviewees worry about the side effects of chemical drug or demonstrate that acupuncture has little side effects.Their attitude towards acupuncture comes more from the experience of those who have been treated by TCM around them.Only 5 patients responded in the factor "expectation",and their responses are active.Because the patients accepted the research voluntarily,they do not reject acupuncture,but may have doubt about the curative effect.Described by most of the interviewees,their feeling of special care comes mainly from their lovers,families,mates and colleagues.And there are a few other interviewees are not clear whether or not the special care results from depression.Three people demonstrated they hadn't been treated specially.Two patients chose not to tell other people they suffered from depression because they just didn't want people around them to know it.Interviewees,after treatment,became more aware of depression,and gave a lot of feasible suggestions of how to treat it well.Most interviewees expressed that they expected to have more tolerance,care,and connecting with other people.Moreover,some interviewees wished depression propagandized more,thus increasing social cognition and understanding of the disease;others then showed expectation that various treatments would be developed.Interviewees need more "social support",the confliction reflects in the mismatching between the lack of social awareness and support and the patients'expectation to have more care and support.We suggest that we should pay more attention to the development of joint forces in the future treatment of depression,giving patients an all-dimensional care and treatment,which means the society,family and hospital work together,to increase the curative effects of depression.Combination of qualitative and quantitative analysis:interviewees numbered as 1,3,4,5,7,8,12 and 13 are unanimous in the results of both qualitative and quantitative analysis,mutually proved by each other;numbers 2,6 and 11's quantitative data and be supplemented by the qualitative ones,and as for interviewees numbered as 9 and 10,their quantitative data then perfectly supplement the qualitative ones.