Therapeutic credibility in community-based acupuncture care: an ethnographic study in southwest China
Xu Xiao1, Shariffah Suraya Syed Jamaludin1, Yulian Cheng2
1School of Social Sciences, Universiti Sains Malaysia, Minden Heights, Malaysia.
Introduction:
Community-based acupuncture care provides a useful setting for examining how patients judge treatment within plural healthcare systems.
Methods:
Drawing on six months of ethnographic fieldwork in Baise, Guangxi, including more than 300 h of participant observation and 29 in-depth interviews with 17 participants (11 patients, 10 of whom were women, and 6 practitioners), this study examines how patients decide whether acupuncture is plausible, safe, and worth continuing. The study focuses on patient-reported improvement; standardized clinical outcome measures were not collected. Lay therapeutic evidence refers here to the bodily, temporal, practical, social, and relational grounds patients use in making these judgments.
Results:
Patients compared bodily change over time, weighed treatment against work, family responsibilities, cost, and medication burden, consulted interpersonal and digital sources, and assessed practitioner explanation, attentiveness, visible safety practices, and referral decisions. Their judgments remained provisional: relief could coexist with doubt, trust with continued biomedical monitoring, and recommendation with hesitation.
Discussion:
The study conceptualizes therapeutic credibility as an ongoing and revisable judgment assembled from these everyday evaluations. It contributes to medical sociology by showing how patient-reported improvement becomes consequential in plural care through continuing comparison, interpretation, and revision.