Author Identifier
Date of Award
2026
Keywords
primary dysmenorrhea, acupuncture, non-pharmacological intervention, person-centred care, lived experience, expectancy, attitude, mixed methods study
Document Type
Thesis
Publisher
Edith Cowan University
Degree Name
Doctor of Philosophy
School
School of Nursing and Midwifery
First Supervisor
Amanda Towell-Barnard
Second Supervisor
Khui Hung Lee
Abstract
Background: Primary dysmenorrhea (PD) is a common and often debilitating condition, for which acupuncture is frequently used as a complementary or integrative treatment. Existing research has largely focused on treatment efficacy, with comparatively less attention to how women understand, engage with, and evaluate acupuncture within their broader health-seeking processes. In the context of women’s health and integrative care, greater insight into patient perspectives may help to complement outcome-focused approaches.
Aim: This thesis aimed to explore the attitudes, expectations, and experiences of acupuncture among women with self-reported PD, with particular attention to how lived experience, expectations, and contextual influences within the Australian healthcare setting shape engagement with acupuncture.
Methods: This thesis was conducted as a PhD thesis with publication and comprised a programme of mixed methods research. A cross-sectional survey design was employed in the quantitative phase to examine attitudes toward and expectations of acupuncture among women with self reported PD. In the qualitative phase, semi-structured focus group interviews were conducted to explore in depth how women experienced, interpreted, and made sense of acupuncture treatment. Guided by Fetters et al.’s multilevel framework, an integrative approach was adopted to synthesise findings across the quantitative and qualitative components, enabling an integrated examination of women’s engagement with acupuncture.
Results: In the quantitative phase, data from 247 completed questionnaires were analysed. Participants generally reported positive attitudes toward acupuncture, and 81.0% expressed interest in acupuncture as a potential management approach, although overall treatment expectancy remained moderate. Subsequently, 14 participants who expressed interest in acupuncture completed semi-structured focus group interviews in the qualitative phase. Participants represented diverse cultural backgrounds and varying levels of prior acupuncture experience, providing insights into a broad range of perspectives and treatment expectations. Four interrelated themes were identified: (1) menstrual pain as a multidimensional burden, (2) evaluating acupuncture as a treatment option, (3) acupuncture as a relational and supportive care encounter, and (4) barriers shaping engagement with acupuncture. Across the programme of research, women’s engagement with acupuncture emerged as complex, conditional, and context dependent. Decisions about engaging with acupuncture were shaped by the interplay of symptom severity, prior experiences with conventional treatments, personal health values, and evolving expectations of benefit. Expectations were dynamic processes that were formed, revised, and at times disrupted through personal experience, practitioner interaction, and broader cultural narratives surrounding acupuncture and women’s health. Women evaluated acupuncture not only in terms of symptom change, but also through relational and experiential dimensions of care, including feeling heard, supported, and actively involved in treatment.
Conclusion: This thesis examined the attitudes, expectations, and experiences related to acupuncture among women with self-reported PD in Australia. By centring women’s voices and experiences, it contributes to an understanding of how therapeutic value may be interpreted and negotiated in practice and highlights the relevance of attending to experiential, relational, and contextual factors in integrative healthcare. The findings also highlight the value of mixed methods approaches for investigating complex health practices and may inform more patient-informed approaches to research, clinical practice, and policy in women’s health.
Access Note
Access to this thesis is embargoed until 2nd July 2031
Recommended Citation
Liu, W. (2026). The attitudes, expectations and experiences of women with primary dysmenorrhea in Australia regarding acupuncture as a potential treatment modality: A mixed methods study. Edith Cowan University. https://doi.org/10.25958/7av6-dz75