Cargando…

Patients’ experiences of acupuncture and counselling for depression and comorbid pain: a qualitative study nested within a randomised controlled trial

INTRODUCTION: Depression and pain frequently occur together and impact on outcomes of existing treatment for depression. Additional treatment options are required. This study aimed to explore patients’ experiences of depression, the processes of change within acupuncture and counselling, and the ele...

Descripción completa

Detalles Bibliográficos
Autores principales: Hopton, Ann, Eldred, Janet, MacPherson, Hugh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4054660/
https://www.ncbi.nlm.nih.gov/pubmed/24902735
http://dx.doi.org/10.1136/bmjopen-2014-005144
_version_ 1782320536439750656
author Hopton, Ann
Eldred, Janet
MacPherson, Hugh
author_facet Hopton, Ann
Eldred, Janet
MacPherson, Hugh
author_sort Hopton, Ann
collection PubMed
description INTRODUCTION: Depression and pain frequently occur together and impact on outcomes of existing treatment for depression. Additional treatment options are required. This study aimed to explore patients’ experiences of depression, the processes of change within acupuncture and counselling, and the elements that contributed to longer-term change. METHODS: In a substudy nested within a randomised controlled trial of acupuncture or counselling compared with usual care alone for depression, semistructured interviews of 52 purposively sampled participants were conducted and analysed using thematic analysis. RESULTS: Differences were reported by participants regarding their experience of depression with comorbid pain compared with depression alone. Along with physical symptoms often related to fatigue and sleep, participants with depression and comorbid pain generally had fewer internal and external resources available to manage their depression effectively. Those who had physical symptoms and were receiving acupuncture commonly reported that these were addressed as part of the treatment. For those receiving counselling, there was less emphasis on physical symptoms and more on help with gaining an understanding of themselves and their situation. Over the course of treatment, most participants in both groups reported receiving support to cope with depression and pain independently of treatment, with a focus on relevant lifestyle and behaviour changes. The establishment of a therapeutic relationship and their active engagement as participants were identified as important components of treatment. CONCLUSIONS: Participants with and without comorbid pain received acupuncture or counselling for depression, and reported specific identifiable treatment effects. The therapeutic relationship and participants’ active engagement in recovery may play distinct roles in driving long-term change. Patients who present with depression and physical symptoms of care may wish to consider a short course of acupuncture to relieve symptoms prior to a referral for counselling if needed. TRIAL REGISTRATION NUMBER: ISRCTN63787732.
format Online
Article
Text
id pubmed-4054660
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-40546602014-06-13 Patients’ experiences of acupuncture and counselling for depression and comorbid pain: a qualitative study nested within a randomised controlled trial Hopton, Ann Eldred, Janet MacPherson, Hugh BMJ Open Complementary Medicine INTRODUCTION: Depression and pain frequently occur together and impact on outcomes of existing treatment for depression. Additional treatment options are required. This study aimed to explore patients’ experiences of depression, the processes of change within acupuncture and counselling, and the elements that contributed to longer-term change. METHODS: In a substudy nested within a randomised controlled trial of acupuncture or counselling compared with usual care alone for depression, semistructured interviews of 52 purposively sampled participants were conducted and analysed using thematic analysis. RESULTS: Differences were reported by participants regarding their experience of depression with comorbid pain compared with depression alone. Along with physical symptoms often related to fatigue and sleep, participants with depression and comorbid pain generally had fewer internal and external resources available to manage their depression effectively. Those who had physical symptoms and were receiving acupuncture commonly reported that these were addressed as part of the treatment. For those receiving counselling, there was less emphasis on physical symptoms and more on help with gaining an understanding of themselves and their situation. Over the course of treatment, most participants in both groups reported receiving support to cope with depression and pain independently of treatment, with a focus on relevant lifestyle and behaviour changes. The establishment of a therapeutic relationship and their active engagement as participants were identified as important components of treatment. CONCLUSIONS: Participants with and without comorbid pain received acupuncture or counselling for depression, and reported specific identifiable treatment effects. The therapeutic relationship and participants’ active engagement in recovery may play distinct roles in driving long-term change. Patients who present with depression and physical symptoms of care may wish to consider a short course of acupuncture to relieve symptoms prior to a referral for counselling if needed. TRIAL REGISTRATION NUMBER: ISRCTN63787732. BMJ Publishing Group 2014-06-05 /pmc/articles/PMC4054660/ /pubmed/24902735 http://dx.doi.org/10.1136/bmjopen-2014-005144 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 3.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/3.0/
spellingShingle Complementary Medicine
Hopton, Ann
Eldred, Janet
MacPherson, Hugh
Patients’ experiences of acupuncture and counselling for depression and comorbid pain: a qualitative study nested within a randomised controlled trial
title Patients’ experiences of acupuncture and counselling for depression and comorbid pain: a qualitative study nested within a randomised controlled trial
title_full Patients’ experiences of acupuncture and counselling for depression and comorbid pain: a qualitative study nested within a randomised controlled trial
title_fullStr Patients’ experiences of acupuncture and counselling for depression and comorbid pain: a qualitative study nested within a randomised controlled trial
title_full_unstemmed Patients’ experiences of acupuncture and counselling for depression and comorbid pain: a qualitative study nested within a randomised controlled trial
title_short Patients’ experiences of acupuncture and counselling for depression and comorbid pain: a qualitative study nested within a randomised controlled trial
title_sort patients’ experiences of acupuncture and counselling for depression and comorbid pain: a qualitative study nested within a randomised controlled trial
topic Complementary Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4054660/
https://www.ncbi.nlm.nih.gov/pubmed/24902735
http://dx.doi.org/10.1136/bmjopen-2014-005144
work_keys_str_mv AT hoptonann patientsexperiencesofacupunctureandcounsellingfordepressionandcomorbidpainaqualitativestudynestedwithinarandomisedcontrolledtrial
AT eldredjanet patientsexperiencesofacupunctureandcounsellingfordepressionandcomorbidpainaqualitativestudynestedwithinarandomisedcontrolledtrial
AT macphersonhugh patientsexperiencesofacupunctureandcounsellingfordepressionandcomorbidpainaqualitativestudynestedwithinarandomisedcontrolledtrial