Theses (Master of Science Acupuncture)

Background: Since ancient times, Acupuncture was used to treat painful conditions in patient. Currently there is limited research evidence as to whether pregnant women are supportive of acupuncture treatment in maternity services for labour pain management in Malaysia. Objective: To evaluate the perception and acceptance of acupuncture as an alternative, non - pharmacological labour pain management (NPLPM) among antenatal women in a district region, Sandakan, state of Sabah in Malaysia. Method: This is a descriptive, cross-sectional study conducted using a convenient and voluntary sampling method. A total of 201 antenatal women were recruited in the antenatal clinic in a private hospital in Sandakan, Sabah, Malaysia. Data collection tool was a validated, self-administered bilingual questionnaire form consisting of Malay and English language version. All antenatal women regardless of their gestational age, who were attending the antenatal clinic, were included during the study period. The collected data were analysed using SPSS software. Results: 201(100%) respondents had completed and returned the questionnaire form. The study population generally have positive perceptions towards acupuncture. 51.7% of the responders are willing to accept acupuncture as an alternative NPLPM method if available. 35.8% of the responders are in the neutral group and 12 .5% of the responders are not willing to accept acupuncture as an option for their labour pain management. There was a statistically significant difference in acceptance of acupuncture as an alternative NPLPM method among those with and without acupuncture knowledge. Conclusion: About half of the study population are willing to accept acupuncture as a NPLPM method. Introduction of acupuncture for labour pain management can be beneficial and considered especially for woman who refused pharmacological treatment, who has contraindication for labour epidural and in rural region with limited resources. Patients' knowledge, awareness and past experience of acupuncture had a significant effect on acceptance of acupuncture for labour pain management. Keywords Perception, attitudes, knowledge, acupuncture, labour pain, Sabah

Background: Knee osteoarthritis is a common problem for which acupuncture provides effective analgesia. Although acupoint selection affects the effectiveness of acupuncture, the basic rules of acupoint selection are little understood. This study aims to investigate the principles of acupoint selection and characteristics of acupoints used for knee osteoarthritis. Objective: To determine the frequency of acupoint and meridian applied in treating knee osteoarthritis by using data mining analysis, and to provide valuable prescription in acupuncture treatment of knee osteoarthritis. Method: PubMed, China National Knowledge Infrastructure, and OVID were searched for clinical trials published in English or Chinese from January 2016 to Dec 2020 evaluating the effect of acupuncture on knee osteoarthritis, with or without methods of randomization and/or control. Results: A total of 99 articles were included, involving 51 acupoints, with a total frequency of 705 times. Among them, the acupoints with higher accumulative application frequency are Du Bi ST35 (93 times), Nei Xi Yan EX-LE04 (86 times), Xue Hai SPI0 (76 times), etc.; the commonly used acupoints are mainly distributed in Stomach meridian of Foot-Yang Ming, Spleen meridian of Foot-Tai Yin, Gall Bladder meridian of Foot-Shao Yang and non - meridian. Du Bi ST35 and Nei Xi Yan EX-LE04 is the most common combination of acupoints, and most of them are the combination of proximal acupoints and far and near acupoints; through the analysis of association rules, 20 groups of acupoint association rules were obtained. Conclusion: It is feasible to use data mining to analyse the selection and compatibility of acupuncture points for knee osteoarthritis, and this study can provide a corresponding reference for clinical treatment.

Acupuncture is the practice of stimulating specific points on the body according to the Chinese medicine meridian theory, usually by inserting very fine needles through the skin. In 2003, the World Health Organization (WHO) published a review of clinical trials where it recognised 28 diseases, symptoms, or conditions that acupuncture has been proven to be an effective form of treatment (10). Hence, there was high rate of acupuncture utilization in countries such as the United States of America, Australia, Japan, and Taiwan (4-7). Studies have shown that acupuncture users were also from high education attainment (14-18). However, the rate of acupuncture utilization in Malaysia is still low. According to the National Health and Morbidity survey 2015, only 2.13% of the Malaysian population are using acupuncture and moxibustion according to the National Health and Morbidity survey 2015 (19). This same phenomenon can be observed at the Chinese Medicine clinic located within International Medical University (IMU) as well, where the utilisation rate of the clinic by IMU staff is only at 1% in 2019, despite the provision of discounts as well as medical expenses covered under staff benefits. Hence, we attempt to study the factors that affect the intention to utilize acupuncture in Malaysia, using questionnaires targeted at IMU staff which mainly comprise of the high educational attainment group, by applying the Theory of Planned Behaviour (TPB). The 3 main constructs of TPB are Attitude, Subjective Norms and Perceived Behaviour Control. This study is a designed to be cross-sectional and questionnaires were distributed through email. A total of 156 samples were collected at the end of the survey for analysis. The findings show that subjective norms and perceived behaviour control had a positive relationship on intention, while attitude appeared to have no effect on intention. Variables of ethnicity, marital status, education level and designation had no significant relationship with intention to utilize acupuncture. Gender and household income have shown to have positive influence on intention. Female respondents with a monthly household income of less than RM5,000 show a higher intention to choose acupuncture as their treatment choice.

Background Traditional and Complementary Medicine (T&CM) services have already started since the year of 2007 in Malaysia. Despite this, the services offered are very limit ed to select ed Ministry of Health (MOH) hospitals and there are no T&CM services provided in Selangor stat e. Therefore, Selayang Hospital (HSEL) has taken the initiative to propose and start the first T&CM service in Selangor state, namely Acupuncture and Traditional Massage. However, prior to starting T&CM service, a survey study is needed to see the knowledge and acceptance of this service among patients (post stroke and chronic pain) treated at HSEL. Objective To determine the level of knowledge and acceptance of Acupuncture and Traditional Massage by post stroke and chronic pain patients who can benefit from Acupuncture and/ or Traditional Massage services in HSEL. Methodology This is a prospective cross sectional study of questionnaires distributed via QR code to access a Google Form. Once the study has been approved by the IMU Joint Committee, MREC and the hospital director, a pilot study was conducted by having 30 participants answer the questionnaires for validation. After the questionnaires have been validated by using content validity and Cronbach's Alpha test, the questionnaires were distributed to a total of 376 numbers of patients. Explanation regarding the study was given to the target population prior to consent. Subsequently, the questions were given to the consented participants to answer. About 20 minutes was required to complete the survey. The data was analyzed using SPSS software. Results There are only 46.5% of the respondents that achieved good general knowledge of T&CM, while 49.2% achieved good specific knowledge on T&CM service in MOH hospitals. 92 % of the respondents have a good attitude towards T&CM service to be set up at HSEL. A total of 81.9% of the respondents are willing to accept T&CM service if it is established at HSEL. Age, employment status, annual income, and treatment modality have a significant difference in general knowledge (p<0.05). There is no significant difference between demographic and specific knowledge (p>0.05). Only age group and treatment modality have significant difference with attitude (p<0.05). Duration of illness and treatment modality with acceptance toward T&CM service have significant difference (p<0.05). Distance from home to HSEL, annual income, duration of illness and treatment modality have significant difference (p<0.05) when compared with experience of respondents to T&CM service. Conclusion Post stroke and chronic pain patients in Selayang Hospital have a fair but limited knowledge on the MOH and modern medicine's standpoint towards T&CM and have limit ed awareness that there are T&CM services offered under MOH hospitals. However, they have good acceptance towards T&CM services being offered by MOH. Efforts to promote knowledge and awareness in this aspect would greatly benefit the establishment and expansion of T&CM services in Selayang Hospital. Keywords Knowledge and acceptance, acupuncture, traditional massage, post stroke, chronic pain

Background: Members seek for traditional & complimentary treatments for a variety of symptoms. No previous studies have reviewed the data available in medical records from Golden Horses Health Sanctuary (GHHS) healthcare. This study aims to identify the characteristics of members who visited (GHHS) Healthcare Traditional Chinese Medicine Center. Objective: I. To identify the socio-demo graphic characteristics and diseases classification of members who seek for Chinese medicine treatments at Golden Horses Health Sanctuary (GHHS) Healthcare Traditional Chinese Medicine Center. 2. To identify the diseases classification of members who undergo multi modal treatments. 3. To determine the types of Chinese medicine treatments that members received. Method: Primary data from April 2022 to May 2022 were collected from members who visited GHHS healthcare traditional Chinese medicine center. Member data, including demo graphics, primary symptom, clinical history, western medicine treatment and Chinese medicine treatment were analysed with descriptive statistics using SPSS version 20.0 Results: From 176 members with their primary symptoms, the mean age of the members was 50.70 and the majority were female (61.4%). The members mostly visited GHHS healthcare are Chinese (78.4%). Majority members were employed and self-employed (69.3%), well educated (69.3%) and monthly income between RM4851 - RMI0970 is (42.0%). Majority members do not have medical conditions and the most primary symptoms were having chronic low back pain. Most of the members did not consult medical doctor regards to their primary symptom (60.8%). Most of the members were seeking for traditional & complimentary medicine (99.4%), the most common integrated modalities were Chinese medicine with physiotherapy and Chinese medicine with chiropractic. Conclusion: This study demonstrated the systematic data collection of sociodemographic characteristics and member self-reported primary symptoms implemented in a private traditional Chinese medicine center. This type of information can be used for service provision, future study planning, and marketing. The following are several of the important lessons learned: 1. Most members at Gf-Il-IS healthcare who seek for T&CM treatments are female, high educated, high income, conscious of general wellbeing. They mostly seek for pain management of chronic musculoskeletal disease. So, practitioners should make sure well prepared to treat those patients manage their symptoms. 2. Future research could explore how confidence and effectiveness in combinations of different CAM modalities such as physiotherapy and chiropractic could affects the disease outcomes, and whether it means further treatments would be welcome and more effective. 3. Future work will have to include a larger, and standardized data collection to look at sociodemographic characteristics and member self-reported primary symptoms.

The objective of this study is to investigate the perception of the patients in Emergency Department (ED), Sultan Ismail Hospital (HSI) towards the acupuncture as a complementary treatment on pain. Methodology The study design was prospective cohort study design. Responses of participants were collected through a validated questionnaire. Results obtained were analyzed using R Studio software. A p-value <0.05 was considered statistically significant. Results Total 191 participants, 52.88% (n=101) of the participants were male, while 47.12% (n=90) were female. All the participants were adult those above 21 years old. 94.76% (n=181) were Malaysians and 5.24% (n=10, China) were foreigners. Majority of the participants’ race were Malay (n=91, 47.64%), follow by Chinese (n=50, 26.18%), Indian (n= 40, 20.94%) and others (n=10, 5.24%). For the occupation, participants who had professional background were 27.75% (n=53), employee were 49.74% (n=95) and businesspeople were 22.51% (n=43). Most of the participants were from the non-communicable diseases (n=163, 85.34%) and the rest were from communicable diseases (n=28, 14.66%). Only a few participants experienced acupuncture before (n=13, 6.81%), most of them only knew about acupuncture treatment (n=155, 81.15%) or never heard about acupuncture treatment before (n=23, 12.04%). The participants never realized that there were having traditional Chinese medicine (TCM) centre in HSI (n=133, 69.63%) and only 30.37% (n=58) noticed that the TCM centre is available in Sultan Ismail Hospital. Overall, the participants (patients) exhibited neutral (n=122, 63.87%) and agree (n=69, 36.13%) with the pain medicine treatment in emergency. Majority of them were also standing neutral (n=155, 81.15%) with the of Western pain medicine being applied in emergency. The patients also agreed the result of acute pain treatment was good (n=118, 61.78%). Overall, a high degree acceptance of complementary treatment in ED in HSI (n= 133, 69.63%) with no contra. The participants agreed they would be exposed to the risk being addicted if only depended on western medicine in pain treatment (n=113, 59.16%). They were agreeing that the acupuncture treatment had been globally proven (n=121, 63.35%), efficacious (n=134, 70.16%) and safe (n=129, 67.54%) as most of the participants only heard and never tried this treatment before (n=121, 63.35%). The participants also strongly agreed or showed high willingness to try acupuncture treatment if the opportunity was being provided (n=146, 76.44%). The patients agreed when answering the question regarding to the advantages of received acupuncture treatment (n=95, 49.74%). The vast majority of the participants strongly agreed that the acupuncture as a complementary treatment would reduce the side effect of the western medicine as well (n=157, 82.20%). Conclusion Through the study conducted, it can be concluded that the patients in ED HSI, Johor Bahru Malaysia were highly accepted the use of acupuncture as complementary treatment to treat pain. Hence, the acupuncture as complementary treatment for pain in emergency department should be widely popularized not only in in ED, HSI. This treatment is also strongly suggested to be listed as an essential complementary pain treatment in ED around Malaysia in order to improve the quality of service. Keywords Patient Perception, Acupuncture, Complementary Treatment, Pain, Emergency department.

Introduction With the growing interest and increasing use of acupuncture in the treatment of various health conditions including pain relief, acupuncture has been integrated within many hospitals around the world. Objective To assess people's perception toward acupuncture as a treatment modality for pain, with the aim of providing meaningful information as an impetus toward future development of acupuncture in pain management. Methodology This research study was carried out via cross-sectional survey using a convenient sampling method. A sample of 373 members of a private healthcare centre was recruited. IBM SPSS Statistics 20 was used to carry out quantitative analysis of the data collected. Descriptive statistics such as percentages and frequencies were used to analyze the data collected. Results The mean knowledge score of the respondents was 3.38 ± 1.52; and the mean attitude score of the respondents was 6.11 ± I .4 I. There was statistically significant difference in the mean knowledge score and mean attitude score between Users and Non-users (p<0.05). Gender, age group, ethnicity, religion, education level and monthly income were found to be statistically insignificant variables in the mean knowledge score and mean attitude score (p>0.05). Close to half the respondents (49.6%) had received acupuncture treatment ("Users"). 60% of the Users were suffered from chronic pain. The most commonly treated pain condition among the Users was back pain (58.9%), followed by joint pain (42.2%) and neck pain (41 .1%). Among the User s, 93.5% of them felt that acupuncture has no side-effect, and 91 .8% of them felt that their pain conditions had been relieved after receiving acupuncture treatment Conclusion A majority of the respondents had an average level of knowledge and demonstrated a positive attitude toward acupuncture. Most of the Users perceived acupuncture as effective in the treatment of pain and without side-effect. Musculoskeletal pain was found to be the most commonly treated pain condition among the Users. Acupuncturists' experience was the top ranked criteria considered by respondents in their decision to use acupuncture. Keywords Pain Management, Acupuncture, Knowledge, Attitude, Survey

Background: Acupuncture is part of the Traditional Chinese Medicine used to treat various disease in ancient time till now. According to the Traditional Chinese Medicine, acupuncture is where filiform needles used to insert at the certain acupoint location at the body to regulate the "Qi" and "Blood" of a person to achieved balance and recover back to healthy state. However, modem science said that the needle insertion able to stimulates the nervous system release chemical in the muscle, spinal cord and brain which further influence releasing of hormones to regulate the body. During this COV10-19 pandemic, many patients suffered post viral olfactory dysfunction with many failed to recover despite conventional medicine treatment. Acupuncture has become an alternate modality to treat post viral olfactory dysfunction and some research had been conducted to test the efficacy of it. In order for acupuncture to be use das alternative or complimentary treatment, research need to be reviewed to look into the methods of conduct and results before systematic review able to be done for testing the efficacy of acupuncture to treat post viral olfactory dysfunction (PVOD). Objective: The purpose of doing this scoping review was to identify the articles about effectiveness of acupuncture used to treat post viral olfactory dysfunction and evaluate the feasibility to do a systematic review in this area of research. Method: A scoping review done to search for the published articles about acupuncture used to treat P OVD from PubMed, ScienceDirect, Cochrane Library and China National Knowledge Infrastructure (CNKI). The key word search used were "acupuncture", "dry needling" or "needling" and "post viral olfactory dysfunction", "post viral olfactory disorder" or "loss of smell" while the Chinese Journal search' with the key words “针灸” and “嗅觉障碍”. Result : According to the search strategy used, a total hit of 54 articles achieved. After scrutinized with the inclusion and exclusion criteria, total of 8 articles were selected for full reading and further discussion. 3 out of the 8 articles were published in Chinese language while the other 5 published in English language. The 8 articles for review consist of 2 randomized controlled trial, J prospective study, J prospective control study, l historical cohort study and 3 case study. From these 8 articles, a table summary of comparison was done for further discussion. Conclusion: There is no unifying standard acupoints in treating PVOD however the study reliability able to be increased by using randomized control trial and larger sample size. It is suggested that control group be used in the study for efficacy of acupuncture in treating PVOD as comparison able to be made to rule out the chances of spontaneous recovery from PVOD. The odour material used for testing the smelling must be suitable for the local to prevent error of answering due to ignorance to the material. Furthermore, the type of diagnostic test also needs to be considered especially the Sniffin' Sticks Test as the components its measured are close to represent the severity and improvement of olfactory dysfunction. It is suggested to use the same practitioner to perform the acupuncture to reduce the variability which may affect the result because different practitioner will have different way of doing the manual manipulation in terms of the frequency of lifting and thrusting or twirling and rotating the needle. In order to run a systematic review, more randomized control trial need to be done to get sufficient data for analysis. Keywords: Acupuncture, Post Viral Olfactory Dysfunction, COVID-19, Anosmia