Abstracts 2011 Volume 6 Issue 1

Acupuncture Education Standards in Australia: A Critical Review (Janz and Adams)

An Examination of Therapeutic Alliance in Chinese Medicine (Miller and Greenwood)

Acupuncture Research Protocol: Feasibility of Use of Acupuncture for Treatment of Arthralgia Secondary to Aromatase Inhibitor Therapy in Women with Early Breast Cancers (Oh, McLean, Kimble and Beith)

Janz S and Adams J. Acupuncture Education Standards in Australia: A Critical Review. Aust J Acupunct Chin Med 2011;6(1):3–15.
The implementation of the National Registration and Accreditation Scheme for the Health Professions incorporates the registration of acupuncturists under the Chinese Medicine Board of Australia from 1 July 2012. Other registered health professionals will still be able to use the title acupuncturist if their board determines that they are suitably qualified to have their registration endorsed for acupuncture. This paper aims to identify the various education and training standards underpinning the practice of acupuncture among the health professions in Australia and create a reference point to determine the impact of registration on future acupuncture education standards. A literature search was conducted to identify scholarly works on acupuncture education standards as well as a search of standard setting bodies and course providers. Results were tabulated for comparison. There is very little literature on acupuncture education standards in Australia despite its practice by a diverse range of health professions. Acupuncture practitioners can be categorised into four groups: Chinese medicine practitioners, medical practitioners, registered allied health practitioners and non-registered health practitioners. The highest education standards are demonstrated by Chinese medicine practitioners who typically complete at least a four year undergraduate degree, whereas the latter two groups appear to favour two or three day continuing professional development courses despite the availability of post-graduate programs. The standards for medical practitioners are obscured by a non-transparent accreditation process. Restriction of title registration in Victoria has coincided with a trend for these short courses to be described as ‘dry needling’ rather than acupuncture, thus circumventing the education standards, regulatory processes and protection of public health and safety which underpins occupational regulation. National boards will need to collaborate and carefully consider their acupuncture accreditation standards if they are to fulfil the objectives of the National Registration and Accreditation Scheme.
KEYWORDS: acupuncture, dry needling, Chinese medicine, education standards, regulation, Australia.

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Miller S and Greenwood K. An Examination of Therapeutic Alliance in Chinese Medicine. Aust J Acupunct Chin Med 2011;6(1):17–22.
Background: In psychotherapy, positive client/therapist relationships are often associated with good therapeutic outcomes. However, little research has been conducted in different health professions and the effect of therapist experience on alliance is not clear. Aims: This study aimed to examine therapeutic alliance in experienced and novice Chinese medicine practitioners and to compare these results to those reported for experienced and novice psychologists. Subjects and Settings/Outcome Measures: A total of 27 experienced and student therapists in the field of Chinese medicine and their clients completed the Working Alliance Inventory (WAI). Results: Chinese medicine clients and therapists reported higher scores on the WAI compared to psychology clients and therapists. As expected, experienced therapists scored higher on the WAI than student therapists, both when rated by themselves and by their clients. Discussion and Conclusion: These findings suggest the therapeutic alliance is relevant in the field of Chinese medicine with further research required into other professions with similar dyadic relationships. Levels of experience also appear to be an area requiring further research. The higher alliance scores found in Chinese medicine may reflect differences in the clients of this discipline and not reflect a superior ability to develop an alliance. Therapeutic alliance seems strong in clients of Chinese medicine practitioners.  Further work should focus on how client variables may influence the development of the alliance.
KEYWORDS: therapeutic alliance, Chinese medicine. 

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Oh B, McLean A, Kimble B and Beith J. Acupuncture Research Protocol: Feasibility of Use of Acupuncture for Treatment of Arthralgia Secondary to Aromatase Inhibitor Therapy in Women with Early Breast Cancers. Aust J Acupunct Chin Med 2011;6(1):23–27.
Background: Breast cancer is the most common cancer in females in Australia. Aromatase-inhibitors (AIs) are recommended as adjuvant hormone therapy for postmenopausal women with early breast cancer. A substantial proportion of women taking AIs experience joint pain and stiffness. This AI induced arthralgia does not respond to conventional analgesics and can greatly reduce a woman’s quality of life. Studies have suggested that acupuncture may be effective in treating osteoarthritis. Method: This is a randomised double blind phase 2 pilot trial.  Participants will be randomised to receive sham or electroacupuncture (EA). Participants in the real electroacupuncture group will receive electroacupuncture twice weekly for six weeks. Patients in the placebo group will receive sham electroacupuncture for the same duration of time via specially designed non-skin penetrating needles placed at points close to the real acupuncture points in the study. Outcomes of joint pain and stiffness will be measured with BPI-SF, WOMAC, quality of life and cognitive function with FACT-G, FACT-Cog, hand strength by a grip test, and serum markers of inflammation (CRP) by a blood test. Discussion: In this article, we report the acupuncture pilot study protocol and design of a randomised clinical trial to reduce joint pain caused by chemotherapy. We expect this pilot study will provide information about the potential efficacy of acupuncture on arthralgia caused by aromatase inhibitor chemotherapy for women with breast cancer. Further, if this study’s results are positive, the data will be used to support grant applications to conduct a large RCT to provide the scientific evidence of acupuncture on arthralgia. Trial registration: This clinical trial obtained ethics approval from the Royal Prince Alfred Hospital, Sydney and is registered with The Australian New Zealand Clinical Trials Registry (ANZCTR).
KEYWORDS: acupuncture, cancer, pain, randomised clinical trial, research protocol.

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