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Journal of Chinese Integrative Medicine ›› 2010, Vol. 8 ›› Issue (10): 928-943.doi: 10.3736/jcim20101004

Special Issue: Traditional Chinese Medicine

• Original Clinical Research • Previous Articles     Next Articles

A qualitative study of exploring the therapeutic components of traditional Chinese medicine as a complex intervention through grounded theory

He Yua,b, Jian-Ping Liua   

  1. a Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
    b Department of Clinical Foundation, Preclinical School, Beijing University of Chinese Medicine, Beijing 100029, China
  • Received:2010-02-23 Accepted:2010-06-10 Online:2010-10-20 Published:2010-10-15

Objective

To explore and identify the therapeutic components of traditional Chinese medicine (TCM) as a complex intervention through grounded theory, and the correlation and interaction within this model and the possible effects that they may have on the therapeutic effects of TCM.
Methods

Data were collected through 41 half-day participant observations and 7 in-depth interviews, and the study design and data analysis were based on the grounded theory.
Results

The components of TCM practice that emerged were: prescribed Chinese medicinal herbs, doctor’s medical advice, psychological intervention, doctor-patient relationship, and patient adherence. There were some overlaps in the TCM diagnosis and treatment process, and there were underlying therapeutic effects associated with diagnosis. TCM herbal intervention was considered as a main therapeutic component which might dominate patients’ outcome. We summarized this process as a process of problem finding and solving from macroscopic and microcosmic perspectives, which embodies the concept of a holistic approach and highly individualized pattern through syndrome differentiation and treatment.
Conclusion

TCM is a complex whole system, and all therapeutic components of TCM may contribute to global treatment effect. In the future, we need more participants to test and improve the model of grounded theory through qualitative and quantitative methods such as randomized controlled trials so as to identify and explore the relevance of each therapeutic component of TCM with the treatment effect.

Key words: Traditional Chinese medicine, Intervention study, Qualitative research, Grounded theory, Holistic medicine

Table 1

Basic information of practitioners of traditional Chinese medicine"

Table 2

Number of cases observed and interviewed among practitioners of traditional Chinese medicine"

Figure 1

Holistic diagnosis process and content model of traditional Chinese medicine"

Figure 2

Model about categories, core-category and their interaction"

Figure 3

Interaction among doctor-patient relationship, adherence and curative effect"

Figure 4

Interaction among doctor-patient relationship, adherence, Chinese herbs, doctor’s medical advice, and psychological intervention"

Figure 5

Interaction among curative effect, adherence, Chinese herbs, doctor’s medical advice, and psychological intervention"

Figure 6

Interaction among doctor-patient relationship, curative effect, Chinese herbs, doctor’s medical advice, and psychological intervention"

Figure 7

Consultation process model of traditional Chinese medicine"

Figure 8

Consultation process theoretic model of traditional Chinese medicine"

[1] Medical Research Council.A framework for development and evaluation of RCTs for complex interventions to improve health[M].London: Medical Research Council, 2000: 1-18
[2] Paterson C, Briten N . Acupuncture as a complex intervention: a holistic model[J]. J Altern Complement Med, 2004,10(5):791-801
doi: 10.1089/acm.2004.10.791 pmid: 15650468
[3] Draucker CB, Martsolf DS, Ross R, Rusk TB . Theoretical sampling and category development in grounded theory[J]. Qual Health Res, 2007,17(8):1137-1148
doi: 10.1177/1049732307308450 pmid: 17928484
[4] Corbin J, Strauss A . Grounded theory research: procedures, canons and evaluative criteria[J]. Qual Sociol, 1990,13(1):3-21
doi: 10.1007/BF00988593
[5] Holloway I .Basic concepts for qualitative research[M].Oxford: Blackwell Science, 1997: 82-83
[6] McLellan E, MacQueen MK, Neidig LJ . Beyond the qualitative interview: data preparation and transcription[J]. Field Methods, 2003,15(1):63-84
doi: 10.1177/1525822X02239573
[7] Walker D, Myrick F . Grounded theory: an exploration of process and procedure[J]. Qual Health Res, 2006,16(4):547-559
doi: 10.1177/1049732305285972 pmid: 16513996
[8] Charmaz K .Constructing grounded theory: a practical guide through qualitative analysis[M].London: Sage Publications Inc, 2006: 45-80
[9] Bradley EH, Curry L, Devers KJ . Qualitative data analysis for health services research: developing taxonomy, themes, and theory[J]. Health Serv Res, 2007,42(4):1758-1772
doi: 10.1111/j.1475-6773.2006.00684.x pmid: 1955280
[10] Thompson EA, Quinn T, Paterson C, Cooke H, McQuigan D, Butters G .Outcome measures for holistic, complex interventions within the palliative care setting[J]. Complement Ther Clin Pract, 2008,14(1):25-32
doi: 10.1016/j.ctcp.2007.10.001 pmid: 18243939
[11] Frankel RM, Sung SH, Hsu JT . Patients, doctors, and videotape: a prescription for creating optimal healing environments?[J]. J Altern Complement Med, 2005,11(Suppl 1):S31-S39
doi: 10.1089/acm.2005.11.s-31 pmid: 16332185
[12] Zhang YH. Transforming emotions with Chinese medicine: an ethnographic account from contemporary China[M]. New York: State University of New York Press,2007: 105-137
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