Development of a Scale for Measuring Medical Communication Skills of Acupuncturists / 全日本鍼灸学会雑誌

[Objective]In recent years, communication skills have been recognized as an essential competence for acupuncturists. This study proposes to develop a scale for measuring the medical communication skills of acupuncturists.<BR>[Materials and Methods]A questionnaire of 20 items was used to measure medical communication skills. These items were adopted from a concept analysis conducted in a previous study.<BR>Cronbach's alpha was used to examine the scale's reliability. The scale's validity was examined by correlation analysis and multiple regression analysis comparisons with normal communication skills subscale scores (ENDCOREs, Encode, Decode, Control, Regulate) and a Japanese version of characteristic trait anxiety scores (STAI, State-Trait Anxiety Inventory).<BR>[Results]Factor analysis, using a principal extraction method and promax rotation, was conducted on responses from 443students and therapists. As a result, the original 20 items were reduced to 16, and the following three factors were extracted:I. Acceptance of patients and self-control;II. Appropriate explanation to patients;and III. Understanding of patient's feelings. These three factors had high degrees of internal consistency (Cronbach's alpha =.872 -.892).<BR>The scores of the three factors correlated significantly with the scores of the six factors of ENDCORE, and with the anxiety scores. Although the results of multiple regression analysis showed that each factor of ENDCORE explained the three factors, the anxiety scores did not influence medical communication skills. The scores for the three factors correlated significantly with self-evaluation scores of medical interview skill. In addition, these three factors were affected by the degree of clinical experience.<BR>[Conclusion]These results suggest that this scale may be a reliable instrument for assessing medical communication skills among Japanese acupuncturists.

Effects of Electro-Acupuncture Therapy (EAT) to the Lower Limbs of Young Women who Suffer from Chilly Constitution (‘<I>Hie</I>’symptoms)—As judged by bodily pain (BP) score of Medical Outcomes Study Short-Form-8 / 日本温泉気候物理医学会雑誌

<B>Objective</B><br> We examined the effects of low frequency electro-acupuncture therapy (EAT) on young women who suffered from‘<I>Hie</I>’symptoms, which were judged according to the national normal value of bodily pain (BP) scores from a ”Medical Outcomes Study Short-Form-8 Survey“ (SF-8).<br><B>Subjects and Methodology</B><br> The experimental subjects were 20 women (mean age: 21.2 years old; range: 18-26 years old) who exhibited symptoms of ‘<I>Hie</I>’ symptoms (vasomotor dysfunction) and whose toes’skin temperature increased or showed a different reaction between right and left during apostural change test. A stainless steel acupuncture needle (length: 40 mm; diameter: 0.2 mm) was inserted approximately 15 mm deep at SP6 (Sanyinjiao, Saninko). EAT using an active electrode (the needle) at SP6 and a reference electrode (surface electrode) at the lateral-anterior aspect of the lower leg was applied at a frequency of 1 Hz for 20 minutes. The therapy was provided one session per week for a total of five sessions. Effects of the therapy were evaluated by using an original questionnaire (‘<I>Hie</I>’diary), which consisted of six categorical of 14 symptoms (including of‘<I>Hie</I>’) and Visual Analogue Scale (VAS) of‘severity of <I>Hie</I>’. Moreover, changes in health-related quality of life (HRQOL) by acupuncture were evaluated by using the SF-8 Standard Edition.<br><B>Results</B><br> Subjects were grouped according to their SF-8 BP scores before the therapy: 12 subjects (L group) whose scores were less than the national normal value (42.75 points), and eight subjects (H group) whose scores were more than the national normal value. For both groups VAS levels showed no statistically significant changes, but for the L group the total score of 14 symptoms significantly decreased after the second therapy session compared with scores before the therapy. Moreover, the statistically significant decrease in the total score lasted for one month after the therapy had been finished. Compared with before therapy, the score of ‘vitality’ (VT) significantly increased for the L group one month after the therapy, and those of BP and ‘mental health’ (MH) significantly increased for the L group just after and one month after the therapy.<br><B>Conclusions</B><br> EAT at SP6 on young women with ‘<I>Hie</I>’ symptoms (vasomotor dysfunction) contributes to improvement in overall condition and health-related QOL, and it is occluded that the effect of the EAT was high, because HRQOL was low (the score of BP was low).

Effects of Electro-Acupuncture Therapy to Lower Limbs on Chilly Constitution (‘Hie’Symptoms) —Comparison by the presence or absence of vasomotor dysfunction— / 日本温泉気候物理医学会雑誌

<B>Objective:</B> We examined the effects of low frequency electro-acupuncture therapy (EAT) in young women with‘Hie’symptoms, which were classified according to the presence of the vasomotor dysfunction as determined by the postural change test.<br><B>Subjects and Methods:</B> Subjects were 43 women (mean age, 21.2 years) who exhibited‘Hie’symptoms. The postural change test was performed in five-minute-loads in a standing position after a rest period of 10 minutes in a spine position. The skin temperature in the lower limbs was measured before and after the test. A stainless steel acupuncture needle (length, 40 mm; diameter, 0.2 mm) was inserted approximately 15 mm in depth at SP6 (Sanyinjiao, Saninko). EAT using an active electrode (needle) at SP6 and a reference electrode (surface electrode) at the lateral-anterior aspect of the lower leg were carried out at a frequency of 1 Hz for 20 minutes. The therapy was provided in a total of 5 sessions, with 1 session per week, and the postural change test was performed after 5 sessions. Thermal images from the medial aspect of the foot to the tibial aspect of the lower leg were captured using a thermography device, and mean skin temperature was calculated in selected regions of the toes and tibial aspect of the lower leg. Effects of the therapy were also evaluated using an original questionnaire (‘Hie’diary) concerning‘Hie’symptoms, which consists of six categorical scales of 14 symptoms including‘Hie’and severity of‘Hie’on a Visual Analogue Scale (VAS) was used. Moreover, changes in health-related quality of life by acupuncture were evaluated using the SF-8 Standard Edition.<br><B>Results:</B> Subjects were classified according to the results of the postural change test: 23 people (no vasomotor dysfunction group; non-vd group) whose skin temperature in the toe decreased after the postural change and 20 people (vasomotor dysfunction group; vd group) whose skin temperature in the toe increased after the load or showed a different reaction between right and left. In the vd group, the total score of 14 symptoms in the‘Hie’diary was significantly higher, and subjective‘Hie’symptoms showed a more severe score than that in the non-vd group. The bodily pain score in the SF-8 in vd group was significantly lower than a national reference value. After an EAT session, the vd group’s skin temperature on the tibial aspect of the lower leg at 20 minutes after completion of the load was significantly higher than that before the load. Moreover, changes in the VAS score and SF-8 score showed no statistical significant in both groups, but the total score of 14 symptoms decreased significantly in the vd group.<br><B>Conclusions:</B> We suggested that normalization in the blood vessel reaction in lower limbs by EAT at SP6 contributed to the improvement in the systemic condition that was determined by the postural test. The issue of further investigation is to elucidate the pathogenesis andor establishment of the treatment in the subjects with‘Hie’symptom whose vasomotor function was within normal limits.

Effects of Electro-Acupuncture Therapy (EAT) to the Lower Limbs of Young Women who Suffer from Chilly Constitution (‘Hie’symptoms)—As judged by bodily pain (BP) score of Medical Outcomes Study Short-Form-8 Survey (SF-8)— / 日本温泉気候物理医学会雑誌

Objective  We examined the effects of low frequency electro-acupuncture therapy (EAT) on young women who suffered from‘Hie’symptoms, which were judged according to the national normal value of bodily pain (BP) scores from a ”Medical Outcomes Study Short-Form-8 Survey“ (SF-8). Subjects and Methodology  The experimental subjects were 20 women (mean age: 21.2 years old; range: 18-26 years old) who exhibited symptoms of ‘Hie’ symptoms (vasomotor dysfunction) and whose toes’skin temperature increased or showed a different reaction between right and left during a postural change test. A stainless steel acupuncture needle (length: 40 mm; diameter: 0.2 mm) was inserted approximately 15 mm deep at SP6 (Sanyinjiao, Saninko). EAT using an active electrode (the needle) at SP6 and a reference electrode (surface electrode) at the lateral-anterior aspect of the lower leg was applied at a frequency of 1 Hz for 20 minutes. The therapy was provided one session per week for a total of five sessions. Effects of the therapy were evaluated by using an original questionnaire (‘Hie’diary), which consisted of six categorical of 14 symptoms (including of‘Hie’) and Visual Analogue Scale (VAS) of‘severity of Hie’. Moreover, changes in health-related quality of life (HRQOL) by acupuncture were evaluated by using the SF-8 Standard Edition. Results  Subjects were grouped according to their SF-8 BP scores before the therapy: 12 subjects (L group) whose scores were less than the national normal value (42.75 points), and eight subjects (H group) whose scores were more than the national normal value. For both groups VAS levels showed no statistically significant changes, but for the L group the total score of 14 symptoms significantly decreased after the second therapy session compared with scores before the therapy. Moreover, the statistically significant decrease in the total score lasted for one month after the therapy had been finished. Compared with before therapy, the score of ‘vitality’ (VT) significantly increased for the L group one month after the therapy, and those of BP and ‘mental health’ (MH) significantly increased for the L group just after and one month after the therapy. Conclusions  EAT at SP6 on young women with ‘Hie’ symptoms (vasomotor dysfunction) contributes to improvement in overall condition and health-related QOL, and it is occluded that the effect of the EAT was high, because HRQOL was low (the score of BP was low).

Effects of Electro-Acupuncture Therapy to Lower Limbs on Chilly Constitution (‘Hie’Symptoms) —Comparison by the presence or absence of vasomotor dysfunction— / 日本温泉気候物理医学会雑誌

Objective: We examined the effects of low frequency electro-acupuncture therapy (EAT) in young women with‘Hie’symptoms, which were classified according to the presence of the vasomotor dysfunction as determined by the postural change test. Subjects and Methods: Subjects were 43 women (mean age, 21.2 years) who exhibited‘Hie’symptoms. The postural change test was performed in five-minute-loads in a standing position after a rest period of 10 minutes in a spine position. The skin temperature in the lower limbs was measured before and after the test. A stainless steel acupuncture needle (length, 40 mm; diameter, 0.2 mm) was inserted approximately 15 mm in depth at SP6 (Sanyinjiao, Saninko). EAT using an active electrode (needle) at SP6 and a reference electrode (surface electrode) at the lateral-anterior aspect of the lower leg were carried out at a frequency of 1 Hz for 20 minutes. The therapy was provided in a total of 5 sessions, with 1 session per week, and the postural change test was performed after 5 sessions. Thermal images from the medial aspect of the foot to the tibial aspect of the lower leg were captured using a thermography device, and mean skin temperature was calculated in selected regions of the toes and tibial aspect of the lower leg. Effects of the therapy were also evaluated using an original questionnaire (‘Hie’diary) concerning‘Hie’symptoms, which consists of six categorical scales of 14 symptoms including‘Hie’and severity of‘Hie’on a Visual Analogue Scale (VAS) was used. Moreover, changes in health-related quality of life by acupuncture were evaluated using the SF-8 Standard Edition. Results: Subjects were classified according to the results of the postural change test: 23 people (no vasomotor dysfunction group; non-vd group) whose skin temperature in the toe decreased after the postural change and 20 people (vasomotor dysfunction group; vd group) whose skin temperature in the toe increased after the load or showed a different reaction between right and left. In the vd group, the total score of 14 symptoms in the‘Hie’diary was significantly higher, and subjective‘Hie’symptoms showed a more severe score than that in the non-vd group. The bodily pain score in the SF-8 in vd group was significantly lower than a national reference value. After an EAT session, the vd group’s skin temperature on the tibial aspect of the lower leg at 20 minutes after completion of the load was significantly higher than that before the load. Moreover, changes in the VAS score and SF-8 score showed no statistical significant in both groups, but the total score of 14 symptoms decreased significantly in the vd group. Conclusions: We suggested that normalization in the blood vessel reaction in lower limbs by EAT at SP6 contributed to the improvement in the systemic condition that was determined by the postural test. The issue of further investigation is to elucidate the pathogenesis andor establishment of the treatment in the subjects with‘Hie’symptom whose vasomotor function was within normal limits.

Effects of Acupuncture Electrotherapy to Lower Limbs on Hie Symptom (Vasomotor Dysfunction) / 日本温泉気候物理医学会雑誌

<b>Objective</b><br> We examined the effects of acupuncture electrotherapy in young women with hie symptoms (excessive sensitivity to cold), presented in conjunction with vasomotor dysfunction as determined by the postural change test.<br><b>Subjects and Methods</b><br> Subjects comprised 20 women (mean age, 20.6 years; range, 18-26 years) who exhibited symptoms of hie, evaluated as toe skin temperature after standing for 5 mins or a temperature difference between the right and left toes as compared to before standing. A stainless steel acupuncture needle (length, 40 mm; diameter, 0.2 mm) was inserted approximately 15 mm in SP6 (Shangqui). Acupuncture electrotherapy connected an acupuncture electrode to SP6 and a non-feeling electrode to lateral of the tibial tuberosity, and was undertaken at a frequency of 1 Hz for 20 mins. Therapy was provided as a total of 5 sessions, with 1 session each week, and the postural change test was performed before and after therapy. Thermal images from the medial aspect of the foot to the tibial aspect of the lower leg were captured using a medical thermography device, and mean skin temperature was calculated in selected regions of the toes, metatarsals, ankle, and tibial aspect of the lower leg. Therapy was evaluated using a questionnaire with two originally designed scales: a categorical scale of 14 symptoms including hie; and degree of hie on a visual analogue scale (VAS). Subjects completed the questionnaire every day during a period from 1 week before therapy sessions began until 1 week after completion of all 5 sessions. Scores for hie symptoms were calculated as mean values from the total score of the 14 symptoms and VAS each week. Changes in health-related quality of life with acupuncture were evaluated using the SF-8 Standard Edition.<br><b>Results</b><br> Toe skin temperature just after standing was not significantly increased by therapy as compared to before standing. Skin temperature on the tibial aspect of the lower leg 20 mins after standing was significantly increased as compared to the adaptation period. In terms of hie, VAS and SF-8, no significant changes were seen before and after therapy, but total score for the 14 symptoms decreased significantly.<br><b>Conclusions</b><br> Acupuncture electrotherapy to SP 6 did not appear to exacerbate hie symptoms after reductions in air temperature, while normalizing the postural vascular reflex and improving hie-related symptoms.

Practice and Educational Effects of a Simulated Randomized Controlled Trial for Acupuncture School Teachers / 全日本鍼灸学会雑誌

[Objective]To motivate acupuncture school teachers to introduce higher-quality methodology in clinical acupuncture research.<BR>[Methods]Twenty-eight teachers from 18 acupuncture schools participated in the simulated randomized, subject and evaluator-blinded, and sham-controlled trial of acupuncture for low back pain. Twenty of them played a role as subjects, four of them were raters, and another four were therapists. Before and after conducting the trial, all the participants were asked several questions using the Visual Analogue Scale (VAS) regarding necessity of Evidence-Based Medicine (EBM) in acupuncture and their level of understanding of several terms related to a Randomized Controlled Trial (RCT),<BR>[Results]After the simulated RCT, the understanding level of all terms related to RCT increased significantly ("RCT":from 58.0 ± 27.2 to 75.5 ± 25.7, "informed consent":from 88.1 ± 15.4 to 99.2 ± 10, "recruitment":from 43.0 ± 41.0 to 74.8 ± 31.3, "random allocation":from 55.5 ± 35.0 to 78.7 ± 25.8, "masking":from 54.7 ± 35.0 to 79.0 ± 26.0) (mean ±SD). Nineteen teachers answered that they would try to conduct RCT and introduce it to their education program.<BR>[Conclusion]The results suggest that the practice of simulated RCT is effective in understanding RCT and motivating acupuncture teachers to introduce it to their education program.

Actual Condition and Difficulty in Using the Objective Structured Clinical Examination (OSCE) in the Education of Acupuncture Students / 全日本鍼灸学会雑誌

Acupuncturists should have clinical competency, including knowledge, skill and humanity, such as attitude.<BR>In acupuncture and moxibustion educational institutions, educational objectives and strategies have been established to develop competency as a therapist. Therefore, an evaluation was performed in order to confirm the achievement of the learners, and whether the established initial objectives and strategies were appropriate or not.<BR>As a matter of course, the National Examination for Acupuncture and Moxibustion Therapists is an evaluation standard which assesses the social competency oftherapists completing the educational course, namely they must have significance.<BR>However, the current National Examination can only estimate the aspect of knowledge. Each educational in-stitution should, therefore, responsibly evaluate other acupuncturists' competency including skills and attitudes toward their competency insociety.<BR>In the Objective Structured Clinical Examination (OSCE), an adequate method to evaluate clinicians has widely been introduced for medical education.<BR>The OSCE was introduced to educational circles of acupuncture in Japan because OSCE can evaluate competency; i.e. the psychomotor and affective domain, that is difficult to measure using a paper test.<BR>Various difficulties still remain using OSCE for the education of acupuncture students in the view of both its adequacy and objectivity.<BR>In the present paper, the actual condition and difficulty in using OSCE in education of acupuncture students are reviewed based on the reports presented atthe educational session of the conference.