Article: The Experience of Acupuncture for Treatment of Substantial Dependence, by Kunsook Song Bernstein
The study has a clear title and abstract statements. The purpose of the study, the research design and methods used and the findings and conclusions were briefly but adequately explained in the abstract. However, literature synthesis is not provided. Nonetheless, the abstract is able to distinguish the specific purpose identified for the research and how the actual procedures and findings matched the problem.
While the author recognizes the dearth of materials on the subject matter, she comes to this study from a number of conceptual perspectives, most prominent of which are concepts of traditional Chinese medicine and acupuncture treatment of substance abuse. A cursory study of related materials that were available at the time of the research reveals that the author has made an exhaustive presentation of theories and findings of previous researches. The author presents an integrative literature review and gives a critical analysis of the significance, methods, and inadequacies of previous researches on the use of acupuncture as an alternative treatment mode to substance abuse. Discussing concepts of traditional Chinese medicine and the Chinese medical theory of substance abuse helped to broaden the focus. Overall, the literature review is written from an interpretive definitive voice (e.g. they reported, they claimed) as a dimensional analysis.
While the portion on literature review in the introduction is well organized, it does not, however, effectively establish the framework for the way in which the researcher proposes to achieve the purpose of the study. The proposed research method, i.e. phenomenological investigation, and the theoretical foundations of phenomenological tradition as a paradigm in qualitative studies are not explained.
The purpose of the research is to “explore the meaning of substance abuser’s experience while receiving acupuncture as a part of the treatment for substance dependence” (Bernstein, 2000). The study hinges on the importance of studying the facets of substance abuse and of finding ways to improve efforts for prevention and control. She claims that although there were studies already conducted to study the effectiveness of acupuncture as a treatment mode to substance abuse, research has yet to address acupuncture as a treatment for substance abuse through the exploration of a substance abuser’s experiences with acupuncture (Bernstein, 2000). Thus, the author succinctly establishes the significance of her investigation.
While the report does not have any explanation on the philosophical background or assumptions of phenomenological theory as a research method, the author explicitly identified the source of the theoretical framework, enumerated the steps entailed in this method and justified its use as being appropriate to the purpose of the study.
Typical of qualitative studies, the participants of the study were chosen from among a group of individuals who match the criteria and who can contribute to the purposes of the investigation. The researcher claims that redundancy was used as the primary criterion in sample selection which implies that homogeneity was achieved. Twelve patients of a detoxification and rehabilitation unit for substance and gambling addictions were recommended by a volunteer informant. The final sample size was eight subjects who were chosen after having been interviewed by the researcher. Choosing only those patients who have not tried acupuncture as a treatment mode is commendable as it contributed to the reliability of the results. Nonetheless, the small sample size is acceptable for a pioneering study such as this.
Interviewing is a central method in phenomenological studies. This was used by the researcher to explore the experiences of the participants during acupuncture treatment. How the interview was conducted was sufficiently explained by the author but she does not elaborate on the specific questions asked during the interview. The author mentioned she used Giorgi modification method for data analysis and enumerated the steps in accordance to this method but does not explicitly describe the approaches to coding the data and condensing the data in meaningful form. The phenomenological method was very appropriate for the study because this particular qualitative method is often used in situations with a strong emotional element, since it emphasizes experience above thought (Giorgi, 1985). Although the outcome of Giorgi’s method is usually a descriptive statement rather than a list of categories, the researcher was able to come up with a list of themes to give a more substantive presentation of findings.
Overall, the aspects of the research design, data collection and analysis remain true to the rules and assumptions of qualitative research.
At this juncture, it should be pointed out that other design elements could have been incorporated to strengthen the study. For example, a longitudinal perspective could produce more solid evidences on the effectiveness of acupuncture as a treatment to substance abuse, although this was properly acknowledged by the researcher at the end of the report.
Bernstein was successful in integrating theories and findings of previous researches in her discussion of results. She underscores that her findings indicate that acupuncture can be viewed as a complex phenomenon and further studies should be conducted. Although her study was limited in sample size and one-time interview, her preliminary findings are consistent with the related literature and buttress the use of acupuncture as a treatment to substance abuse.
Although validity and reliability are concepts which do not translate well to a qualitative paradigm, the researcher strived to address validity and reliability issues through a number of steps. In sampling, she availed of the expertise of a psychiatrist who determined the diagnosis based on DSM-IV criteria and validated the diagnosis of substance dependence. The researcher sought to ensure credibility of the volunteer informant by choosing someone who has more than 10 years experience in the field of substance abuse and independence. In data collection and analysis, the researcher followed Giorgi’s phenomenological method to ensure reliability of the procedure of identifying and documenting recurrent themes of experiences reported by the participants. She used an external auditors, i.e. other mental health clinicians (but as to how many is not indicated), for critique of the synthesized insights and results.
Basing from the intrinsic limitations of the study, Bernstein lists a number of recommendations to follow up her research among which is the conduct of related studies that either strengthen data collection techniques or broaden the time and setting of the study.
The significance of this study as implied by the researcher in her concluding statements lies in its contribution to knowledge the dimensions of substance abuse and on acupuncture as a treatment modality in order to aid health care providers in incorporating alternative approaches to their practices.
Overall, the research reflects consistency between procedure, data and interpretation. The author was able to make reasonable and founded interpretations from her findings. The researcher adequately applied the principles of qualitative research to come out with a valid and reliable study.
References:
Bersntein, K.S (2000). The experience of acupuncture for treatment of substance dependence. Journal of Nursing Scholarship. Fall 2000 v32 i3 p267.
Giorgi, A. “Sketch of a psychological phenomenological method”. In: Giorgi A (ed). Phenomenology and Psychological Research. Pittsburgh, PA: Duquesne Press, 1985.
