Understanding the Traditional Chinese Medicine (TCM) consultation: Why do patients adhere to treatment?

Discursive Positioning in Practitioner-Parent-Child Communication in Traditional Chinese Medicine Consultations

This study examines practitioner-parent-child communication in Traditional Chinese Medicine (TCM) consultations. Employing the theoretical framework of positioning theory, this discourse study investigates the interactions among Chinese medicine practitioners, parents, and child patients. The data, recordings of 21 pediatric consultation sessions, were gathered from the Department of Chinese Medicine at a hospital in China. The findings reveal that parents position themselves as representatives of their child patients, who, conversely, play a passive role with limited participation in consultations. This phenomenon is consistent with previous studies on doctor-parent-patient communication in Western medicine settings. As caretakers, parents also position themselves as experts in their child's health, articulating the child's health conditions and demonstrating some familiarity with TCM. Emphasizing the importance of lifestyle changes for the child's health and recovery, practitioners strategically position themselves as both medical professionals and parenting advisors and give direct advice to parents. This study argues that the positioning of parents may diminish child patients' participation. The study enhances our understanding of doctor-parent-child communication in the context of TCM by elucidating the positioning of the participants. It concludes by discussing the significance of child patients' engagement and the implementation of a patient-centered approach in TCM consultations.

Relationship chains of subhealth physical examination indicators: a cross-sectional study using the PLS-SEM approach

Subhealth is a transitional state between health and disease, and it can be detected through routine physical check-ups. However, the complexity and diversity of physical examination items and the difficulty of quantifying subhealth manifestations are the main problems that hinder its treatment. The aim of this study was to systematically investigate the physical examination performance of the subhealthy population and further explore the deeper relationships between indicators. Indicators were obtained for 878 subjects, including basic information, Western medicine indicators, inquiries of traditional Chinese medicine and sublingual vein (SV) characteristics. Statistical differences were analysed using R software. To explore the distribution of symptoms and symptom clusters in subhealth, partial least squares-structural equation modelling (PLS-SEM) was applied to the subhealth physical examination index, and a structural model was developed to verify whether the relationship chain between the latent variables was reasonable. Finally, the reliability and validity of the PLS-SE model were assessed. The most common subclinical clinical symptoms were limb soreness (37.6%), fatigue (31.6%), shoulder and neck pain (30.5%) and dry eyes (29.2%). The redness of the SV in the subhealthy group was paler than that in the healthy group (p < 0.001). This study validates the establishment of the directed acyclic relationship chain in the subhealthy group: the path from routine blood tests to lipid metabolism (t = 7.878, p < 0.001), the path from lipid metabolism to obesity (t = 8.410, p < 0.001), the path from obesity to SV characteristics (t = 2.237, p = 0.025), and the path from liver function to SV characteristics (t = 2.215, p = 0.027). The innovative application of PLS-SEM to the study of subhealth has revealed the existence of a chain of relationships between physical examination indicators, which will provide a basis for further exploration of subhealth mechanisms and causal inference. This study has identified the typical symptoms of subhealth, and their early management will help to advance the treatment of diseases.

Factors Affecting Tendency and Adherence to Traditional Persian Medicine: A Qualitative Study

Background: Adherence to medications is crucial for them to be effective. Traditional Persian Medicine (TPM) is an ancient medical discipline originated from old Persia and is currently used along with modern medicine in Iran. Evaluating the factors affecting adherence to TPM can have far-reaching implications for policymakers to make informed decisions. Objectives: This qualitative study investigates the factors affecting tendency and adherence to TPM among Iranians. Methods: We collected data from stakeholders in TPM using a focus group involving 13 participants and by conducting four in-depth interviews. The saturation point was reached at the 4th interview. We recorded all the interviews and then transcribed them verbatim for thematic content analysis. Results: We obtained 297 codes and 29 sub-themes for the factors affecting adherence to TPM, including the factors affecting compliance and tendency. Then we extracted the main themes. People’s beliefs, the inherent characteristics of traditional medicine and its status quo, attempts to bring about positive changes to TPM, and the problems facing the modern health system were the main factors affecting adherence to TPM. Conclusions: Despite many strenuous efforts in Iran to study TPM along with the lines of evidence-based medicine, policymaking, financing, patients’ and healthcare providers’ education, popular beliefs, and administrative transparency are needed to be addressed more adequately to promote adherence to TPM and help build integrative medicine in Iran’s healthcare system.

The Use of Traditional Korean Medicine (TKM) by Children: A Correlational Study between Parent's Perception and Their Children's Use Reported by Parents

This cross-sectional study investigated the correlation between parents’ perception and their children’s traditional Korean medicine (TKM) use reported by parents in order to discover policy intervention points and provide a reference for establishing generalized TKM policies. Participant data from a 2017 national survey on TKM usage was divided into two groups based on the children’s TKM use reported by parents. The female participants’ children had a higher rate of experience in using TKM (8.1%; p = 0.029). Additionally, 91.4% of the parent group with a child who used TKM turned out to have used TKM, which was higher than 71.9% of the parents whose children never used TKM (p < 0.001). As for the awareness on the use of TKM, 44.0% of the parents with a child who experienced TKM answered they were aware of it, while only 35.3% of the parent group whose child never experienced TKM did so (p = 0.033). The present study suggests that parental experience in using TKM could have an impact on the children’s TKM use reported by parents. Further study is necessary to assess which parental factor (awareness level, medical disorder to be treated, therapy, therapeutic efficacy, the purpose of visit, sex, age, etc.) has a close relationship with TKM usage experience of their children.

Testing the Traditional Chinese Medicine Consultation Model for Adherence in Complementary and Alternative Medicine

The Traditional Chinese Medicine (TCM) Consultation Model for Adherence conceptualises the consultation process specific to patient adherence. It can be used to improve patient persistence with treatment by TCM practitioners and possibly other health professionals. The aim of this research was to determine the applicability of the TCM Consultation Model for Adherence in the wider complementary and alternative medicine (CAM) setting. A survey containing validated questionnaires and items developed specifically to test the model was administered online in the United Kingdom. SPSS 25 was used to perform Spearman's correlations and Mann–Whitney U tests on the data. In total, 101 patients completed the survey. The results showed that patients having a therapeutic relationship and trusting in their practitioner was associated with overall adherence to CAM, while patients feeling supported was associated with all types of adherence to CAM. Specific behaviours of the TCM Consultation Model for Adherence that were positively correlated with adherence to CAM were identified. They could potentially be used by CAM practitioners to improve their patients' adherence with treatment.