Delivery of acupuncture in clinical trials: Research acupuncturists' perspectives / 中西医结合学报

Delivery of acupuncture in the setting of a clinical trial is a unique practice that diverges significantly from the delivery of acupuncture in a real-world clinical setting. Research acupuncturists, particularly those trained in traditional Chinese medicine (TCM), are often required to set aside valued precepts of traditional care, including diagnosing imbalances, individualizing treatment, and forging a therapeutic relationship with patients. TCM-trained acupuncturists express mixed feelings about participating in clinical trials. Many are eager to play a vital role in the advancement of acupuncture science and appreciate the need for strict protocol adherence to minimize bias. However, the acupuncturist(s) may also have concerns about clinical trial methodology, including but not limited to the delivery of a control condition, e.g., sham acupuncture. Investigators should anticipate certain questions and even a level of resistance to the requirements of research among acupuncturists and be prepared to address them. This manuscript presents a brief review of the subjective experience of the research acupuncturist within the available scientific literature as it pertains to the delivery of active and sham clinical research protocols. Our goals are to better understand the perspectives of acupuncturists who may participate in clinical research, so that their concerns may be addressed in study design and methodology. To that end, we suggest the creation of a novel training program specifically for clinical trial acupuncturists, intended for qualified TCM- and Western-trained practitioners, that would help to standardize the research acupuncturist's role and help to strengthen the design and execution of acupuncture studies. Please cite this article as: Anastasi JK, Capili B, Neumaier J, Hackett L. Delivery of acupuncture in clinical trials: Research acupuncturists' perspectives. J Integr Med. 2023; 21(4):315-319.

Metodologías cualitativas de lo sensible en contextos de salud pública / Metodologias qualitativas do sensitivo no contexto de saúde pública / Qualitative methodology of sensitive topics in public health contexts

Resumen: La subjetividad siempre se encuentra presente en las metodologías cualitativas, en que se vinculan las emociones, sentimientos, cultura e historia de los participantes e investigadores. Esto es especialmente relevante en el área de la salud, donde lo sensible está presente en muchos de los temas estudiados. Según Lee los temas sensibles son aquellos en que la investigación invade la esfera privada, escarba dentro de alguna experiencia personal profunda, hace referencia a la desviación o control social, afecta a los intereses de personas poderosas o el ejercicio de la coerción y la dominación. Este artículo se divide en dos apartados; el primero tiene relación con la fundamentación teórica del estudio de temas sensibles en salud pública, desde la perspectiva de los participantes y del equipo de investigación, relevando la importancia de la seguridad e integridad física, psíquica, moral y legal de todos los actores involucrados. En la segunda parte, la autora reflexiona en torno a su experiencia en la investigación en temas sensibles, presentando algunas estrategias de abordaje del trabajo de campo. El objetivo de esta investigación fue describir la producción del conocimiento en relación a la investigación de temas sensibles en salud.

Abstract: Subjectivity is always present in qualitative methodologies where emotions, feelings, culture and background of participants and researchers are involved. This is especially relevant in the health area, where sensitivity is present in many of the topics addressed. According to Lee, sensitive topics are those where research invades the private sphere, digs into some deep and personal experiences, addresses deviation or social control, and affects the interests of powerful people and/or the execution of coercion and domination. The following article is divided in two parts: the first one is related to theoretical foundations of the study of sensitive topics in public health, from the perspective of participants and the research team, revealing the importance of safety and physical, psychological, moral and legal security of all the members involved. In the second part, the author reflects upon her experience in investigation of sensitive topics, and, finally, methodological strategies are proposed to address the study of these subjects.

Resumo: A subjetividade está sempre presente nas metodologias qualitativas, onde se vinculam as emoções, os sentimentos, a cultura e a história dos participantes e pesquisadores. Isto é especialmente relevante na área da saúde, onde o sensível está presente em muitos dos temas abordados. Conforme com Lee, se considera uma questão sensível quando a pesquisa invade a esfera privada ou examina, indaga alguma experiência pessoal profunda. Refere-se ao desvio ou controle social, afeta os interesses de pessoas poderosas ou o exercício da coerção e dominação, se lida com coisas sagradas para as pessoas estudadas e não querem ser profanadas. Ele é dividido em duas seções; a primeira está relacionada com a fundamentação teórica do estudo de questões sensíveis na saúde pública, a partir da perspectiva dos participantes e da equipe de investigação, relevando a importância da segurança e da integridade física, mental, moral e legal de todos os atores envolvidos. Na segunda parte, o autor reflete sobre sua experiência em pesquisa sobre questões sensíveis, apresentando algumas estratégias de enfrentamento trabalho de campo.