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Evaluating traditional Chinese medicine interventions on chronic low back pain using goal attainment scaling

journal contribution
posted on 2021-01-06, 01:16 authored by Xinyu Zhang, Jianping Ren, Chaojie LiuChaojie Liu, Mengyan He, Lixian Ren, Zhen Lv
Background. Extensive studies have been conducted to evaluate the pain relief effect of traditional Chinese medicine (TCM) interventions on patients with low back pain, including in China. However, there is a dearth in the literature documenting the diverse goals of TCM interventions, let alone the overall effect of such interventions. In this study, the goal attainment scaling (GAS) method was adopted to evaluate individualised TCM interventions on chronic low back pain. Methods. A pre-post intervention study was conducted on patients with chronic low back pain who received individualised TCM interventions in community health services. The study was undertaken in three community health centres in Hangzhou of China. A total of 165 eligible patients were invited, and 150 participated in the study, including 136 who completed both pre- and postintervention surveys. Each participant was asked to identify three to five intended goals from a pool of 26 outcome indicators and their corresponding expectations of these goals prior to the TCM interventions. Their conditions were rated against the selected indicators on a self-report five-point Likert scale before and after the TCM interventions, respectively. Gaps between the actual conditions and the expected goals were summed up for each participant and converted into a standardised GAS score, with a higher score indicating higher achievements, and 50 indicting patient expectations were met. Linear regression models were established to determine the factors associated with the pre-post GAS changes after adjustment for variations in other variables. Results. On average, an increase of 14.99 (SD = 9.81) in the GAS scores was achieved. This resulted in a mean GAS score of 48.33 (SD = 9.74) after the TCM interventions, falling slightly short (<2) of patient expectations. The multivariate linear regression models revealed that local residents, the retired, and those who perceived lower professional competency of their attending doctors had a smaller increase in the GAS scores after adjustment for variations in other variables. Conclusion. The individualised TCM interventions can help patients with low back pain to achieve their expected goals as measured by the GAS. Further studies are needed to better understand how patients set up their goals and the professional competency requirements to meet patient expectations.


The authors thank the support from the participating community health centres, in particular the directors of the centres Zhen Lv, Jianhua Lu, Huaping Qiu, and Licong Wu. The authors are extremely grateful to the patients and the TCM doctors who were involved in this study. This study was funded by the National Natural Science Foundation of China (grant no. 71874047) and the Zhejiang TCM Science and Technology Plan (2018ZB100 and 2017ZA116).


Publication Date



Evidence-Based Complementary and Alternative Medicine



Article Number

ARTN 8854927


10p. (p. 1-10)


Hindawi Limited



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The Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.

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