Shiatsu Society

Introduction

In 2001, the European Shiatsu Foundation funded a one-year, two-country, exploratory study to uncover client and practitioner views of the experience and effects of Shiatsu. The plan was that this study would form the first phase of a larger research programme aimed at enhancing the evidence base for Shiatsu. The study, undertaken by the Health Care Practice R&D Unit at the University of Salford, involved field work in the United Kingdom (UK) and Germany. Through a series of interviews with a sample of Shiatsu practitioners and clients, a wide range of common, immediate and longer-term effects was identified. (Mackay and Long 2003; Long and Mackay 2003). These included not only effects on initial symptoms but also areas such as relaxation, sleeping, posture and experiences of the body. Both clients and practitioners drew attention to the importance of their relationship and working together. Although clients described few negative effects a set of transitional effects was also identified, which included both a negative and positive component.

The exploratory research pointed to the need for further research, with larger numbers, both new and continuing Shiatsu users, in more countries, and undertaken through a longitudinal study design. The findings provided the basis for the development of a set of questions on experiences and effects, grounded in client and practitioner views, thus, enabling measurement of the most appropriate outcomes from the client’s and the CAM discipline’s perspective.

Phase Two

With the generation of further research funds, the European Shiatsu Federation is now commissioning the next phase of the research programme. It is planned to begin this autumn. Professor Long of the School of Healthcare at the University of Leeds will lead the study. The study builds on the work already carried out with the aim of assessing the client’s experience of Shiatsu and positive and negative effects, over the short and longer term, and the maintenance of any effects over time. The study will be cross European with fieldwork taking place in three countries: Austria, Spain and the UK. A tight and uniform research protocol will be followed in each country in order to maximise the validity of the findings and the external credibility of the research.

The first stage involves recruitment of a set of practitioners from each country’s national association. A random sample of Shiatsu practitioners will be drawn from the register and invited to take part in the study. Practitioners must have a minimum of two years practice post accreditation and see a minimum of five clients per week. Having given their consent to take part in the study, the practitioners will be supported by the research team in terms of how clients are to be recruited into the study, ways to introduce the study to potential client participants and wider quality assurance procedures. It is anticipated that 600 clients per country will be recruited and about 40 practitioners in each country will be selected at random from those who are eligible. Thus, each participating practitioner will be asked to recruit up to 15 consecutive clients, some of whom will be ‘new’ clients (that is, never having received Shiatsu from the participating practitioner) and some ‘continuing’ clients. A target ratio of 1 new client to 2 continuing clients will be used, based on an estimate of current practice. The sequential sampling technique used will ensure that the sample selection is unbiased.

Each of the clients will be followed up for six months from their initial treatment session. The client will be asked to complete a short questionnaire at four occasions: at initial recruitment, 3-4 days after the first treatment, and 3 and 6 months later. The questionnaires, translated into the relevant language, are those developed during the earlier exploratory study. Topics covered include such areas as: reasons for seeking Shiatsu, initial expectations, experience of the Shiatsu sessions, comments on the client-practitioner interaction and initial and longer-term effects on presenting reasons and general well-being. In the vast majority, each question involves the client indicating their level of agreement with a particular statement or ticking the relevant box (see Box 1).

Once the client has agreed to take part in the study, the practitioner will give the client a consent form, the initial ‘first visit’ questionnaire and the ‘immediate effects’ questionnaire, together with a brief instruction sheet. The client will then return the signed consent form and completed questionnaires to the University of Leeds for processing. The ‘three-month effects’ and ‘six-month effects’ questionnaires will then be sent out from Leeds direct to the client. Thus, once the client is recruited, the practitioner has no further link into the research process; she/he just treats the client as normal.

Concluding Comments

The planned study will extend the evidence base on the experience and effects of shiatsu on general health and well-being and provide a European perspective. Pursuing a tight research protocol and generating data based on a substantial sample of clients within each country will enable wider and confident generalisation of the results. The aim is to provide a high quality foundation for the wider recognition of shiatsu and a basis for future research exploring the relative effectiveness of shiatsu to other CAM modalities, for example, acupuncture or aromatherapy massage, and/or conventional medicine in the promotion of health and well-being.

References

1. Long AF and Mackay H (2003) The effects of shiatsu: findings from a two-country exploratory study. Journal of Alternative and Complementary Medicine 9 (4): 539-548.
2. Mackay H and Long AF (2003) The Experience and Effects of Shiatsu: Findings from a Two Country Exploratory Study. Salford: University of Salford, Health Care Practice R&D Unit. Report No. 9.

Box One: Some Example Questions

Please rate the following statements about how you felt during your most recent shiatsu session. Please circle the relevant number.

1. I enjoyed the session
2. I liked the treatment environment
3. I felt an emotional change during the session
4. The practitioner and I worked together

Thinking about each of these symptoms, how severe a problem is this to you today {at the worst point over the 3 / 6 months}? Please circle the relevant number.

1. Problems with muscles, joints or body structure (e.g. back pain, posture)
2. Problems with body systems (e.g. digestion, breathing, blood pressure, period pain)
3. Low energy or fatigue
4. Tension or stress

Listed below are some comments that other clients have made about shiatsu. Please rate each of these in relation to your experience of shiatsu over the last {3/6} months.

1. My overall health has improved
2. Shiatsu has helped to maintain my health
3. I feel more confident about my health
4. Shiatsu has helped me to feel better in general
5. Shiatsu has been effective in treating my symptoms