Virginia Commonwealth University VCU Scholars Compass Theses and Dissertations Graduate School 2014 Perceptions of Acupuncture and Acupressure by Anesthesia Providers Amanda Faircloth Virginia Commonwealth University, [email protected] Follow this and additional works at:http://scholarscompass.vcu.edu/etd Part of theAlternative and Complementary Medicine Commons, and theAnesthesiology Commons © The Author Downloaded from http://scholarscompass.vcu.edu/etd/3586 This Dissertation is brought to you for free and open access by the Graduate School at VCU Scholars Compass. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of VCU Scholars Compass. For more information, please [email protected]. ©Amanda Caroline Faircloth 2014 All Rights Reserved PERCEPTIONS OF ACUPUNCTURE AND ACUPRESSURE BY ANESTHESIA PROVIDERS A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University by Amanda Caroline Faircloth D.N.A.P., Virginia Commonwealth University, 2011 M.S.N., Duke University, 2005 B.S.N., University of Virginia, 2000 Director: Chuck Biddle, PhD Director of Research, Department of Nurse Anesthesia Virginia Commonwealth University Richmond, Virginia September, 2014 ii   Dedication This dissertation is dedicated to my grandparents: Dr. and Mrs. William R. Rice Mr. and Mrs. W. Jackson Faircloth, Sr. iii   Acknowledgements This study would not have been possible without expert guidance from my dissertation committee.    I am deeply indebted to Dr. Chuck Biddle, who served as my chair for two doctoral degrees. I am grateful for his support, his vision in seeing my potential, and his belief in my research ideas. Dr. John Butterworth, IV receives my heartfelt thanks for ensuring that I put forth my best work. He challenged my mind and provided a perspective that broadened my intellectual horizon. Dr. Arkadiy Dubovoy changed my life by providing my first acupuncture experience. He also patiently guided me through the complex milieu of Oriental Medicine. Finally, Dr. Diane Dodd-McCue taught me how to develop, critique, and analyze sound research. The valuable tools and tips I learned from her will remain with me always. My dear friends, Dr. Mary Ford and Virginia Wortham provided edits, honest feedback, meals, and encouragement during this arduous process. I am grateful for many wonderful friends who have provided support, humor, and were understanding of my chaotic schedule, especially Kristen Nettleton, Scotty Bowie, Jr., Luciana Massey, Jan Pasnak, Faresha Sims, Beth Harris, Kate Gormley, Jolanda Knezevich, Jackie Battista, Meriwether Ziegler, and Candace Jaruzel. Finally, I am humbled by my family's love. My parents have generously blessed me with education and the tools to succeed in life. It is my mission to be a good steward of these gifts. To my sister, Emily—you have always been my best friend and your family provides iv   me with more happiness than I can adequately express. I look forward to ski trips and beach vacations where I can be fully present - sans textbooks! Quotes inspire me and I will conclude with the quote posted above my desk: "Accept the challenges so that you can feel the exhilaration of victory.” ~ General George S. Patton These words could not ring more true as I close the door on this academic journey and look forward, with hope, to what is next ... ACF v   Table of Contents List of Tables ..................................................................................................................... xii List of Figures ..................................................................................................................... xiv Abstract ............................................................................................................................... xv Chapter One: The Problem .................................................................................................... 1 Introduction ............................................................................................................... 1 Background of the Problem ....................................................................................... 3 Statement of the Problem .......................................................................................... 3 Purpose of the Study .................................................................................................. 5 Introduction to Theoretical Foundation ..................................................................... 6 Summary of Methods ................................................................................................ 7 Significance of the Study ........................................................................................... 8 Definition of Terms ................................................................................................... 9 Summary ................................................................................................................. 10 Chapter Two: Review of Related Literature ...................................................................... 12 Overview ................................................................................................................ 12 Complementary and Alternative Medicine ............................................................ 12 Oriental Medicine ................................................................................................... 14 History of Acupuncture .......................................................................................... 15 China ........................................................................................................... 15 India ............................................................................................................ 16 vi   Japan ........................................................................................................... 16 France ......................................................................................................... 16 Modern Acupuncture History ................................................................................. 17 International history .................................................................................... 17 U.S. history ................................................................................................. 17 Evidence-Based Support in the Context of Anesthesia Practice ............................ 18 Preoperative Management .......................................................................... 18 International literature ................................................................... 18 U.S. literature ................................................................................. 19 Intraoperative Management ........................................................................ 19 International literature ................................................................... 19 U.S. literature ................................................................................. 21 Postoperative Management ........................................................................ 22 Postoperative nausea and vomiting ................................................ 22 International literature ....................................................... 23 U.S. literature ..................................................................... 23 Postoperative pain management .................................................... 23 International Literature ...................................................... 23 U.S. literature ..................................................................... 25 Acute and Chronic Pain Management ........................................................ 25 International literature ................................................................... 25 U.S. literature ................................................................................. 26 Controversy .................................................................................... 27 vii   Placebo acupuncture ...................................................................... 28 Acupuncture and Acupressure in the Academic Literature ........................ 29 International and Domestic CAM Use by Health-Care Providers ......................... 29 International ................................................................................................ 29 Veterinary medicine ................................................................................... 30 United States ............................................................................................... 30 Government .................................................................................... 30 Nursing ........................................................................................... 30 Physician ........................................................................................ 31 Economic Implications ........................................................................................... 31 Theoretical Framework .......................................................................................... 32 Diffusion of innovations ............................................................................. 32 Summary ..................................................................................................... 37 Chapter Three: Methodology ............................................................................................. 38 Overview ................................................................................................................ 38 Research Design ..................................................................................................... 38 Variables ..................................................................................................... 39 Population and Sample Description ....................................................................... 40 Data sources ................................................................................................ 40 Target population ........................................................................................ 41 Sample ........................................................................................................ 43 Inclusion criteria ............................................................................ 43 Exclusion criteria ........................................................................... 43 viii   Sample size ..................................................................................... 43 Sample Recruitment ................................................................................... 44 Survey ..................................................................................................................... 45 Development ............................................................................................... 45 Administration ............................................................................................ 46 Survey Design ........................................................................................................ 47 Pretesting .................................................................................................... 47 Reliability ................................................................................................... 47 Measurement Validity ................................................................................ 49 Face validity ................................................................................... 48 Content validity .............................................................................. 49 Construct validity ........................................................................... 49 Survey Scoring ........................................................................................... 50 Data Collection ....................................................................................................... 50 Mixed-Mode ............................................................................................... 50 Social exchange principles ......................................................................... 51 Procedure .................................................................................................... 51 Incentive ..................................................................................................... 52 Ethical considerations ................................................................................. 53 Data Analysis ........................................................................................................ 54 Coding and storing ..................................................................................... 54 Statistical analysis ...................................................................................... 54 Summary ................................................................................................................. 56