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A set of outcome questionnaires has been developed to measure the range of treatment effects of traditional acupuncture. In this descriptive outcome study we validated these questionnaires in a busy National Health Service funded acupuncture clinic serving communities of diverse socio-economic circumstances. Some of the questionnaires performed better than others in this setting but EQ-5D and MYMOP-qual both showed statistically and clinically significant improvement in physical and psychological health after six weeks and six months, in all categories of disease and degrees of chronicity. Both the written qualitative data and the Patient Enablement Instrument (PEI) demonstrated considerable patient enablement and, for some patients, the acquisition of new coping and self-care strategies.The questionnaires were feasible to administer, acceptable to patients and clinic staff, and provided robust and detailed quantitative and qualitative outcome data of use for service provision, future planning, and as a basis for further cost-effectiveness studies.

Summary Objective To describe a massage therapy and training programme in a remote Aboriginal community in Australia and to develop the frameworks, procedures and processes necessary for future research. Method Self-report health questionnaires (MYMOP and W-BQ12) and an ethnographic enquiry that included participant observation and 15 interviews with clients and key informants. Results The project was disrupted by typhoons. Baseline questionnaire responses indicate they may be suitable for this context. Qualitative analysis resulted in a conceptual model of the effects of the programme, which is consistent with a system theory approach. People's accounts were rooted in discussions of the community's history, emotional and physical distress, and limited health care resources. Community-level effects included increasing participation; strengthening local health and educational projects; and opening up new opportunities. Individual level effects included improvement in physical and emotional symptoms, improved function and the receipt of preventative care. Conclusion As a result of this early stage research, future studies have a conceptual model to guide them and evidence that a mixed method and a participatory methodology may be the most appropriate design.

Summary Objective To carry out a pilot study, with particular attention to adequacy of outcome measures. Design Observational study and user participation. Setting and participants A local user group selected seven participants with a wide range of illness severity. Intervention A course of eight 1 hr sessions of deep whole body (therapeutic) massage over 8 weeks. Outcome measures The Parkinson's Disease Questionnaire (PDQ-39), the Measure Yourself Medical Outcome Profile (MYMOP), and the Medication Change Questionnaire (MCQ). Semi-structured interviews, before and after the intervention. Results In addition to enjoying the massage, individuals showed improvement in self-confidence, well-being, walking and activities of daily living. There was good agreement between data from the outcome questionnaires, interviews and clinical notes. User involvement highlighted issues that would otherwise have been ignored. Conclusions The study confirms the benefits of involving users in the research process and makes recommendations concerning the design of any future randomised trial.