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Research ArticleOriginal Research

Acupuncture for Hot Flashes: Decision Making by Breast Cancer Survivors

Jun J. Mao, Rana Leed, Marjorie A. Bowman, Krupali Desai, Manuel Bramble, Katrina Armstrong and Frances Barg
The Journal of the American Board of Family Medicine May 2012, 25 (3) 323-332; DOI: https://doi.org/10.3122/jabfm.2012.03.110165
Jun J. Mao
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Rana Leed
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Marjorie A. Bowman
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Krupali Desai
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Manuel Bramble
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Katrina Armstrong
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Frances Barg
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Article Figures & Data

Figures

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  • Figure 1.
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    Figure 1.

    Factors Linking Acupuncture with Symptoms of Hot flashes (FLASH Model).

Tables

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    Table 1. Specific Characteristics of Subjects
    SubjectAgeRaceEducation*Reason for MenopauseCurrent General Health StatusDaily Severity of HFCAM UsePrior Acupuncture Use
    A58WhiteGrad/profNaturalFairVery severeYesYes
    B46WhiteCollegePerimenopausalVery goodVery severeYesNo
    C62WhiteCollegeNaturalVery goodSevereYesYes
    D53WhiteGrad/profChemotherapyVery goodModerateNoNo
    E65WhiteCollegeNaturalGoodSevereYesNo
    F62WhiteCollegeNaturalGoodSevereYesYes
    G38WhiteCollegeSurgicalVery goodSevereYesNo
    H79AAHigh schoolSurgicalGoodSevereNoNo
    I62WhiteGrad/profNaturalGoodModerateYesNo
    J53WhiteGrad/profChemotherapyVery goodVery severeYesYes
    K69AACollegeNaturalGoodMildNoNo
    L73AAHigh schoolNaturalGoodMildYesNo
    M42WhiteGrad/profChemotherapyVery goodMildYesNo
    N49WhiteCollegeChemotherapyVery goodMildNoNo
    O73AAHigh schoolSurgicalFairSevereNoNo
    P48AAGrad/profChemotherapyVery goodSevereYesNo
    Q59AAGrad/profSurgicalGoodModerateNoNo
    R51AACollegeNaturalVery goodModerateNoNo
    S56AACollegeNaturalFairVery severeYesNo
    T45WhiteGrad/profChemotherapyGoodModerateYesNo
    U54AACollegeChemotherapyExcellentMildYesNo
    V60AAHigh schoolSurgicalFairMildYesNo
    W57WhiteGrad/profNaturalExcellentModerateNoNo
    X67AACollegeNaturalGoodMildNoNo
    Y48AAGrad/profSurgicalGoodMildNoNo
    • AA, African American; CAM, complementary and alternative medicine; Grad/Prof, graduate/professional; HF, hot flashes.

    • View popup
    Table 2. Constructs from the Theory of Planned Behavior
    AConstruction of effectiveness (perceived benefits)
    • “My friend who had acupuncture for a frozen shoulder is a breast cancer survivor, and so if I was gonna do acupuncture I would talk to her about her experience, which was very positive, you know, for her because physical therapy didn't improve her range of motion but acupuncture did.”

      Subject P, 48 years, African American, graduate/professional education

    • “I remember the movie that I saw where the guy, I can't remember what his name was, who was dying of cancer, went to a Chinese acupuncturist to try to get him to relax and to do some inner thoughts.”

      Subject Q, 59 years, African American, high school education

    • “I know that when I was very depressed one time, when my relationship of many, many years ended and I was really severely depressed I went to a place in New York and I went in an acupuncture program with [a doctor] up there and it helped.”

      Subject B, 46 years, white, college education

    • “Just what my husband tells me and that it helps reconfigurate the flow sometimes of pain or different things. He has a lot of pain so and it helps with his back pain and shoulder pain. And he's had five hip replacements so he uses it for that. And he said it's also relaxing for him…I know it helps, acupuncture helps.”

      Subject E, 65 years, white, college education

    • “My grandmother had crippling rheumatoid arthritis and in the 1970s, late 70s, she used to drag herself into Chinatown in New York City to have acupuncture…And she got tremendous relief from it. And that was my first personal… she was the first person I knew who ever used acupuncture. And for everything I hear and read and see it's very effective for a lot of things.”

      Subject I, 62 years, white, graduate/professional education

    • “I don't know how it would work, but it's been working for the Chinese, I guess it would work for me.”

      Subject S, 56 years, African American, college education

    • “If I guess maybe if there was an ongoing study that was maybe yielding a lot of positive results, you know, and then maybe I would consider it.”

      Subject G, 38 years, white, college education

    BPractical concerns related to using acupuncture (perceived behavior controls)
    • “I would be concerned about the person who was doing the sterility, the cleanliness, their experience doing it.”

      Subject I, 62 years, white, graduate/professional education

    • “I always wondered whether it was going to hurt. I just couldn't believe that needles sticking out of your forehead, but I don't know.”

      Subject Q, 59 years, African American, graduate/professional education

    • “I guess I am just thinking back because I do have issues with lymphedema, so slight because I manage it. I get very, very concerned and paranoid when people come on my left side because it is like I am very guarded. That is the area that you stay away from.”

      Subject U, 54 years, African American, college education

    • “I'm a pretty lazy person. So if I can just be at home and pop a pill in my mouth rather than have to go somewhere and have acupuncture.”

      Subject D, 53 years, white, college education

    • “I think the one issue with acupuncture as far as I understand it is that having to get the treatment, I guess, on a certain schedule, whether it be once a week or twice a week, and having to sort of persist with that.”

      Subject P, 48 years, African American, graduate/professional education

    CDecision support and confirmation (social norm)
    • “I would go to my doctor, but when it came to the decision on me doing the acupuncture, the decision was mine alone.”

      Subject X, 67 years, African American, college education

    • “I may ask my husband or my 3 children, but the final decision is mine.”

      Subject E, 65 years, white, college education

    • “I would ask my primary care physician. I would ask a person who does acupuncture. And I would ask a family member who's a doctor.”

      Subject C, 62 years, white, college education

    • “I would probably go to my sister and she probably would research something and tell me whether to agree with them or not.”

      Subject D, 53 years, white, graduate/professional education

    • “I do rely very heavily on Dr… He's my internist that I've had for over 20 years.”

      Subject E, 65 years, white, college education

    • “My primary care doctor's the one I go through with just about any and everything that I have to have done.”

      Subject O, 73 years, African American, high school education

    • View popup
    Table 3. Viewing Acupuncture as a Natural Alternative to Medicine
    “I'd rather have acupuncture instead of medication because it something that I don't have to put in my body.”
        Subject V, 60 years, African American, high school education
    “I hate taking pills. I have enough of ‘em to take as it is.’”
        Subject K, 69 years, African American, college education
    “Because I think as a cancer person, who has had cancer and has been treated with very invasive means, surgery, chemotherapy, radiation, you don't want another foreign object in your body.”
        Subject T, 45 years, white, graduate/professional education
    “I'm not a person who likes to take meds. So, I would think there would be a little bit more natural for you.”
        Subject S, 56 years, African American, college education
    “…Because I'm taking enough medicine now…I take 6 pills…7, 8, 9, 10 pills a day…you, that's just too many pills.”
        Subject O, 73 years, African American, high school education
    • View popup
    Table 4. Symptom Appraisal in the Context of other Medical Comorbidities
    “If he [the oncologist] told me, “Well [acupuncture] will help with your hot flashes…” I mean my hot flashes aren't gonna kill me. You know what I mean…I'm not gonna subject myself to acupuncture because it will help with my hot flashes. If he told me that it was a guarantee that I would never again have cancer, then sign me up, you know. I would be the first one out the door.”
        Subject G, 38 years, white, college education
    “The only thing that I really have a problem with is I have back problems and that's about the only thing I would wanna, you know, use [acupuncture] for if I was gonna use it for anything.”
        Subject K, 69 years, African American, college education
    “I would like there to be a study on migraines and acupuncture. That is my main problem right now.”
        Subject N, 49 years, white, college education
    “I would still be going for acupuncture for hot flashes except I don't have the time and they're not so intense that I want to take the time off from work to do it.”
        Subject J, 53 years, white, graduate/professional education
    “So if the hot flashes are bad but they don't completely stop my life and they don't completely keep me in bed and all that, I might just wing it and not participate in anything.”
        Subject C, 62 years, white, college education
    “I'm at my life end almost, you know what I'm saying? So I really don't need something like [acupuncture] that would help the younger girls, women that are married and have husbands and things and going through all of these things. If that acupuncture help ‘em, help ‘em. See with me right now, I don't… It's not gonna help me. It may help me but it wouldn't be that I have to keep up with my husband or my children. My children are almost as old as I am and my husband's gone so I mean I don't have anybody to really have to worry about.”
        Subject H, 79 years, African American, high school education
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The Journal of the American Board of Family     Medicine: 25 (3)
The Journal of the American Board of Family Medicine
Vol. 25, Issue 3
May-June 2012
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Acupuncture for Hot Flashes: Decision Making by Breast Cancer Survivors
Jun J. Mao, Rana Leed, Marjorie A. Bowman, Krupali Desai, Manuel Bramble, Katrina Armstrong, Frances Barg
The Journal of the American Board of Family Medicine May 2012, 25 (3) 323-332; DOI: 10.3122/jabfm.2012.03.110165

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Acupuncture for Hot Flashes: Decision Making by Breast Cancer Survivors
Jun J. Mao, Rana Leed, Marjorie A. Bowman, Krupali Desai, Manuel Bramble, Katrina Armstrong, Frances Barg
The Journal of the American Board of Family Medicine May 2012, 25 (3) 323-332; DOI: 10.3122/jabfm.2012.03.110165
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