The confirmation of treatment effects in Japanese acupuncture.

BACKGROUND: Japanese acupuncture is gaining international recognition. However, previous research has failed to comprehensively describe the characteristics of Japanese acupuncture by not investigating it within the Japanese clinical environment. This qualitative ethnographic study aimed to identify unique and routine elements of Japanese acupuncture, describe these in detail and examine how they related to treatment principles. METHODS: Between August 2012 and December 2016, ethnographic fieldwork was conducted in Japan. Participants were recruited by chain referral and emergent sampling. Data were collected through participant observation and interviews as well as by analyzing documents. A total of 38 participants were recruited. A total of 22 agreed to clinical observation; 221 treatments were observed with 172 patients. Seventeen participants consented to participate in formal interviews and 28 to informal interviews. Thematic analysis was used to evaluate data. RESULTS: That practitioners tended to confirm perceived effects of interventions during treatment, was a major theme interpreted from the data. Confirmation was performed continually throughout treatment and at three different levels of timing and anatomical areas (micro, meso and macro). Many markers signified treatment effects which were in general, perceived by observing and/or palpating body tissue. Belief in the instantaneous effects of treatment and the value of effect through technique exemplify the philosophical foundations of confirmation. Continually monitoring treatment results at a range of time and body location increments is an important element of Japanese acupuncture. CONCLUSION: This effect confirmation practice model promotes a system of constant feedback gained by repeated intervention and confirmation. This may be a unique feature of Japanese acupuncture.

Contact Tools in Japanese Acupuncture: An Ethnography of Acupuncture Practitioners in Japan.

This study aimed to identify procedural elements of Japanese acupuncture, describe these elements in detail, and explain them in terms of the key thematic category of treatment principles. Between August 2012 and December 2016, ethnographic fieldwork was conducted in Japan. In total, 38 participants were recruited by chain referral and emergent sampling. Data was collected through participant observation, interviews, and by analyzing documents. A total of 22 participants agreed to clinical observation; 221 treatments were observed with 172 patients. Seventeen consented to formal interviews and 28 to informal interviews. Thematic analysis was used to critically evaluate data. One especially interesting theme was interpreted from the data: a variety of contact tools were applied in treatment and these were manipulated by adjusting elements of form, speed, repetition, and pressure. Tapping, holding, pressing/pushing, and stroking were the most important ways contact tools were used on patients. Contact tools are noninvasive, painless, can be applied in almost any environment, and may be easily accepted by patients worldwide. Contact tool theory and practice may be successfully integrated into acupuncture curricula outside of Japan, used to inform clinical trials, and contribute to an expanded repertoire of methods for practitioners to benefit individual patients in international contexts.

Beliefs and values in Japanese acupuncture: an ethnography of Japanese trained acupuncture practitioners in Japan.

BACKGROUND: Japanese acupuncture is gaining international recognition. However, previous research has failed to comprehensively describe the characteristics of Japanese acupuncture by not investigating it within the Japanese clinical environment. This study aimed to identify unique and routine elements of Japanese acupuncture, describe these elements in detail, and examine how the current beliefs and attitudes of Japanese acupuncture practitioners related to philosophical concepts in their practice. METHODS: Between August 2012 and December 2016, ethnographic fieldwork was conducted in Japan. Japanese trained acupuncture practitioners were recruited by chain referral and emergent sampling. Data were collected through participant observation, interviews, and by analyzing documents. Thematic analysis was used to critically evaluate the data. RESULTS: Thirty-eight participants were recruited. Of these participants, 22 agreed to clinical observation; 221 treatments were observed with 172 patients. Additionally, 17 participants consented to participate in formal semistructured interviews and 28 to informal unstructured interviews (fieldwork discussion). Besides "knowledge," "beliefs and values" was a major theme interpreted from the data. Subthemes-including Zen Buddhism, effect through technique, instant effects of treatment, anatomical areas of significance, resolution of abnormalities, minimal stimulation, and patient comfort and customer service-were identified. CONCLUSION: Beliefs and values are an underrepresented, yet extremely important aspect of philosophical concepts influencing acupuncture practice in Japan. Uniquely Japanese beliefs and values that do not rely on a commitment to any spiritual or religious affiliations or proprietary knowledge of traditional or biomedicine may be successfully exported from Japan to advance acupuncture education, research and practice in international contexts.