Patterns of treatment expectation and the physician–patient relationship perceived by women receiving traditional Chinese medicine treatment for menstrual symptoms: a Q‐methodology study

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Recurring menstrual symptoms strongly interfere with the daily lives, social functioning, work and quality of life of women 1. Menstrual symptoms are highly prevalent 2 and may start 3–10 days before the onset of menstrual flow and continue throughout the menstruation period. The prevalence of menstrual pain, the most common menstrual symptom, varied between 16 and 91% in women of reproductive age, with severe pain in 2–29% of the examined participants 3. The prevalence rates of heavy menstrual bleeding, another common menstrual symptom, ranged between 4 and 52% 4. The effects of symptoms on jobs and daily activities increased with symptom severity 5. A higher severity of menstrual symptoms was associated with a greater loss in work productivity, and this may cause a substantial economic burden 1.
Menstrual symptoms occur in clusters. The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) suggests using the symptom cluster of cyclic perimenstrual pain and discomfort (CPPD) to emphasise the relevance of this problem in the reproductive health of women 6. CPPD presents as a cluster of related symptoms, including pericyclic pelvic pain, perimenstrual discomfort and effects on perimenstrual mood 7.
Women may consider seeking professional assistance in the form of traditional Chinese medicine (TCM). Studies have reported that patients perceive TCM as holistic care and view TCM practitioners guiding them to take better care of themselves 8. Adherence is the key factor between process and outcomes in TCM care. It is crucial for women receiving TCM treatment to regularly visit their physicians and adhere to their healthcare regimen 9. However, TCM regimens often interfere with normal life and require integration into daily routines. The most common related limitations are a lack of time to exercise and inability to adhere to dietary instructions. Dunbar‐Jacob et al. 10 indicated that poor adherence to medication regimens resulted in the worsening of diseases and consequently led to a waste of healthcare resources. In addition to patient adherence, a healthy relationship and effective communication between physicians and patients are essential for changing patient behaviours, achieving treatment goals and increasing patient satisfaction 11.
The Q method is a technique for examining individual perceptions of or attitudes about a designed topic by categorising participants according to their opinions 12. Participants are asked to assess the magnitude of descriptions they consider meaningful. This approach aims to detect patterns on the basis of opinions and not to examine the proportional distribution of opinions among participants 13. In a Q study, individual perceptions are obtained by sorting a set of statements associated with a designated topic 14. Patterns of shared opinions are recorded by ranking the statements, and the results of such analyses may reveal new insights that would not have been elicited using traditional Likert scaling techniques. The main objective of using the Q method was to discover the patterns of opinions among people, rather than how many people hold certain viewpoints. Patient perceptions associated with healthcare encounters are an underexplored but crucial topic for understanding how medical practice can be efficiently evolved.
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