Classical Chinese Medicine in Community Health with a Focus on Self-Care: Participant, Staff and Practitioner Perspectives on a Pilot Program
- Publication Type:
- Thesis
- Issue Date:
- 2021
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𝗜𝗻𝘁𝗿𝗼𝗱𝘂𝗰𝘁𝗶𝗼𝗻: This thesis examines the experience of participants, staff and practitioners of a community-health program based on the concepts of classical Chinese medicine (CCM), delivered in rural Scotland. The classical texts of Chinese medicine highlight the primary importance of lifestyle recommendations and self-care techniques for illness prevention and health maintenance. Such recommendations include aligning daily activities with cycles observed in the natural environment and adopting moderation and balance in relation to: exercise and resting periods, dietary intake, alcohol consumption and emotional outlook. This advice reflects concepts incorporated into many traditional cultures and aligns with contemporary World Health Organisation guidelines developed in response to the global rise in chronic and lifestyle illness. The potential application of CCM concepts as a core intervention to enhance community health outcomes and contribute to health behaviour change has been largely unevaluated in a Western context. 𝗠𝗲𝘁𝗵𝗼𝗱𝘀: A CCM community health program delivered in rural Scotland was evaluated using qualitative methods. Eighteen in-depth, semi-structured, interviews were conducted with program participants (n=11), staff and practitioners (n=7). A Framework Approach was applied in the analysis of the two sub-samples separately to derive emergent themes. 𝗥𝗲𝘀𝘂𝗹𝘁𝘀: Themes were identified from the program participant data in four key areas: 𝘐𝘮𝘱𝘳𝘰𝘷𝘦𝘮𝘦𝘯𝘵𝘴 𝘪𝘯 𝘩𝘦𝘢𝘭𝘵𝘩 𝘢𝘯𝘥 𝘴𝘦𝘭𝘧-𝘢𝘸𝘢𝘳𝘦𝘯𝘦𝘴𝘴; 𝘚𝘦𝘭𝘧-𝘥𝘪𝘳𝘦𝘤𝘵𝘪𝘰𝘯, 𝘢𝘥𝘢𝘱𝘵𝘢𝘣𝘪𝘭𝘪𝘵𝘺 𝘢𝘯𝘥 𝘱𝘳𝘪𝘰𝘳 𝘦𝘹𝘱𝘰𝘴𝘶𝘳𝘦; 𝘗𝘦𝘳𝘴𝘰𝘯𝘢𝘭𝘪𝘴𝘦𝘥 𝘴𝘶𝘱𝘱𝘰𝘳𝘵, 𝘴𝘦𝘭𝘧-𝘳𝘦𝘧𝘭𝘦𝘤𝘵𝘪𝘷𝘦 𝘵𝘰𝘰𝘭𝘴, 𝘴𝘶𝘴𝘵𝘢𝘪𝘯𝘪𝘯𝘨 𝘦𝘯𝘨𝘢𝘨𝘦𝘮𝘦𝘯𝘵; and 𝘊𝘶𝘭𝘵𝘶𝘳𝘢𝘭 𝘣𝘢𝘳𝘳𝘪𝘦𝘳𝘴, 𝘢𝘤𝘤𝘦𝘴𝘴𝘪𝘣𝘪𝘭𝘪𝘵𝘺 𝘢𝘯𝘥 𝘴𝘵𝘳𝘦𝘯𝘨𝘵𝘩𝘦𝘯𝘪𝘯𝘨 𝘯𝘦𝘵𝘸𝘰𝘳𝘬𝘴. Themes derived from the staff and practitioner interviews were: 𝘊𝘶𝘭𝘵𝘶𝘳𝘢𝘭 𝘤𝘩𝘢𝘭𝘭𝘦𝘯𝘨𝘦𝘴 𝘸𝘪𝘵𝘩𝘪𝘯 𝘵𝘩𝘦 𝘭𝘰𝘤𝘢𝘭 𝘳𝘦𝘨𝘪𝘰𝘯; 𝘐𝘯𝘵𝘦𝘨𝘳𝘢𝘵𝘪𝘰𝘯 𝘸𝘪𝘵𝘩 𝘵𝘩𝘦 𝘦𝘹𝘪𝘴𝘵𝘪𝘯𝘨 𝘭𝘰𝘤𝘢𝘭 𝘩𝘦𝘢𝘭𝘵𝘩 𝘤𝘢𝘳𝘦 𝘯𝘦𝘵𝘸𝘰𝘳𝘬; and 𝘛𝘦𝘢𝘮 𝘥𝘺𝘯𝘢𝘮𝘪𝘤𝘴, 𝘤𝘰-𝘤𝘳𝘦𝘢𝘵𝘪𝘰𝘯 𝘢𝘯𝘥 𝘤𝘰𝘮𝘮𝘶𝘯𝘪𝘤𝘢𝘵𝘪𝘰𝘯 𝘪𝘯𝘵𝘦𝘨𝘳𝘪𝘵𝘺. Central to topics from both samples were issues of cultural alignment; consistency, clarity and professionalism of communication; connection and networking; balanced team dynamics; and the alignment of timelines and resources to project scope. 𝗖𝗼𝗻𝗰𝗹𝘂𝘀𝗶𝗼𝗻: This thesis presents the first known evaluation of a CCM community health program that teaches practical daily skills for illness prevention and health maintenance within a whole system of care and delivered in a Western setting. The study findings highlight the potential for further investigation of the application of CCM lifestyle measures to improve health outcomes and the teaching of CCM concepts as a method for enhancing patient self-efficacy and supporting health behaviour change. Recommendations drawn from the study for future similar projects include: further integration of complementary programs with the existing dominant health care system; consideration of cultural alignment relative to the local populace; and the need for secure funding streams when designing community health initiatives.
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