Validation of the Korean version of the Acupuncture Expectancy Scale.

OBJECTIVES: Expectancy has been shown to affect patients' responses to acupuncture therapy. However, no validated measure of expectancy for acupuncture is available in the Korean language. The Acupuncture Expectancy Scale (AES), a 4-item self-reporting questionnaire, is the validated instrument for measuring expectancies regarding acupuncture therapy. We translated the AES into Korean and examined its test-retest reliability and construct validity. METHODS: The AES was translated using a forward and backward translation procedure. Internal consistency was assessed in 275 participants with item-total correlations. Construct validity was also assessed by performing principal component analysis and correlating scores on the scale with the participants' intention to receive acupuncture therapy. Test-retest reliability was assessed in 33 participants by calculating Cronbach's α and Spearman rank correlation coefficients. RESULTS: Internal consistency was high (Cronbach's α=0.910). Principal component analysis showed that expectancy of acupuncture treatment accounted for 79.2% of the variance. The AES was positively correlated with participants' intention to receive acupuncture treatment (r=0.695, p<0.001). Test-retest reliability in 33 of the 275 participants was adequate, with the Spearman rank correlation coefficient ranging from 0.500 to 0.737 (p<0.001). CONCLUSIONS: The Korean version of the AES is a valid and reliable instrument for measuring patients' expectancies regarding acupuncture treatment in the Korean population.

Development and validation of acupuncture fear scale.

Objectives. Strong aversions to acupuncture have been an obstacle to understanding its intrinsic action of acupuncture. Thus, it is necessary to evaluate the nature and extent of fear of acupuncture treatment. Our study aims to develop and validate an instrument that evaluates a patient's fear of acupuncture treatment. Methods. We have developed an acupuncture fear scale, a 16-item instrument which assesses the acupuncture fear score and uses it to survey 275 participants in South Korea, thus testing the reliability and validity of the instrument. Results. Internal consistency was high (Cronbach's alpha = 0.935). Test-retest reliability (Spearman's rank correlation coefficient) among 33 participants out of 275 ranged from 0.565 to 0.797 (P < 0.001). Principal component analysis revealed two factors accounting for 68% of the variance, which are painful sensation and possible adverse events, respectively. The acupuncture fear scale was positively correlated with the total of fear of pain questionnaire-III (r = 0.423, P < 0.001). Conclusions. The acupuncture fear scale can be a valid and reliable instrument that can measure fear of acupuncture treatment. These results strongly suggest that it would be a clinically useful tool to assess fear of acupuncture in the acupuncture clinic setting and an important instrument to understand the complex social-behavioral component of acupuncture modality.

Down-regulation of RalBP1 expression reduces seizure threshold and synaptic inhibition in mice.

Idiopathic epilepsy is characterized by seizures without a clear etiology and is believed to have a strong genetic component but exhibits a complex inheritance pattern. Genetic factors seem to confer a low seizure threshold to susceptible individuals and thereby enhance epileptogenesis. However, the identity of susceptibility genes and the mechanisms regulating seizure threshold are still poorly understood. Here, we describe that reduced expression of RalBP1, a downstream effector of the small GTPases RalA and RalB, lowers the seizure threshold in mice. The intraperitoneal injection of the chemoconvulsant pentylenetetrazol induced more severe seizures in RalBP1 hypomorphic mice than in their wild-type littermates. The reduction of RalBP1 in the brain has no effect on neuronal excitability, but does decrease the inhibitory synaptic transmission onto CA1 pyramidal neurons. This impaired synaptic inhibition was associated with the loss of GABAergic interneurons in the CA1 subfield of the hippocampus. The present study identifies RalBP1 as a gene regulating the seizure threshold in mice and provides direct evidence for the role of RalBP1 in synaptic inhibition in vivo.

Doctor's attire influences perceived empathy in the patient-doctor relationship.

OBJECTIVE: This study investigated whether doctors' attire influences the perception of empathy in the patient-doctor relationship during a therapeutic encounter. METHODS: A total number of 143 patients were divided into four groups when they were consulting a Traditional Korean Medicine doctor. Depending on the group, the same doctor was wearing four different attires--Casual, Suit, Traditional dress, White coat--when having a clinical consultation with the patients. RESULTS: The patients preferred white coat and traditional dress more than other attires, giving highest scores to white coat in competency, trustworthiness and preference of attire and to traditional dress in comfortableness and contentment with the consultation. The "Consultation and Relational Empathy (CARE)" score was significantly higher in the "White coat" and "Traditional" groups, compared to the "Casual" and "Suit" groups. CONCLUSION: The strong association between the patients' preference of doctors' attire and the CARE score indicates that the doctor's attire plays not only an important role for establishing confidence and trustworthiness but also for the perception of empathy in the patient-doctor relationship. PRACTICE IMPLICATIONS: The doctor's attire can function as an effective tool of non-verbal communication in order to signal confidence, trust and empathy and establish a good patient-doctor relationship.

Pre-existing beliefs and expectations influence judgments of novel health information.

The present study examined whether health information is judged differently depending on pre-existing beliefs and expectations. People's initial beliefs and expectations were assessed by a questionnaire about acupuncture and a trustworthiness and preference rating task of doctors' faces. Then, newspaper headlines about novel acupuncture treatment were shown and rated for their feasibility in a normal and framed condition. The judged feasibility of the newspaper headlines correlated strongly with initial beliefs about acupuncture in the normal condition, and with initial expectations towards a doctor's face in the framed condition. Thus, as suggested by Bayes Theorem, pre-existing beliefs and expectations influence judgments of novel health information.