Acupuncture outcomes, expectations, patient-provider relationship, and the placebo effect: implications for health promotion.

OBJECTIVES To explore whether treatment outcomes are associated with a patient's degree of general hopefulness, expectations regarding treatment, attributions of health status, beliefs about mind-body dualism, and patient-provider relationship factors, I studied acupuncture patients' goal attainment. METHODS Sixty-two acupuncture patients were interviewed before and after acupuncture regarding goal attainment, mind-body beliefs, hopefulness, and attributions of health status. Demographics, acupuncture treatment, and health care usage information was also collected. Acupuncturists provided 3 months of treatment. RESULTS Patients reported treatment goal attainment from acupuncture. Their perceived outcomes were not associated with previous treatment, patient demographics, or the expected and actual numbers of needle insertion. Successful outcomes were related positively to number of different CAM treatments used in the past year but negatively to patients' expectations and the "Powerful Others" health locus of control dimension. CONCLUSIONS Perceived acupuncture outcomes seem not to be related to placebo effects and patient expectations, but rather to client-practitioner relationship factors.