[Attitudes, knowledge and use of complementary and alternative medicine among perioperative healthcare professionals]. / Komplementer terápiás gyógymódok megítélése a perioperatív ellátásban dolgozó egészségügyi szakdolgozók között.

INTRODUCTION: Perioperative healthcare professionals' attitudes towards non-conventional treatments have not been explored in Hungary yet. AIM: Our goal was to survey healthcare professionals' attitude and knowledge towards naturopathy in six clinics of the Semmelweis University that provide perioperative care. METHOD: An anonymous, paper-based questionnaire was used. With an 82% response rate, the data was gained from 119 questionnaires and was processed using statistical analysis and chi-squared test. RESULTS: Only 25.2% of those surveyed considered themselves to be well-informed in this field. 68.1% of the participants had an interest in naturopathy and 60.5% would have liked to learn about naturopathy. 70.6% would be willing to use non-conventional treatments in their daily work, predominantly those who have used these methods in the case of their own illness, p = 0.0027. The most popular treatment methods included homeopathy, alternative massage and movement therapy, acupuncture and manual therapy. CONCLUSION: As anticipated based on international literature in this field, those Hungarian healthcare professionals who took part in our survey showed openness and interest towards naturopathy. Orv. Hetil., 2017, 158(10), 368-375.

Complementary and alternative medicine: attitudes, knowledge and use among surgeons and anaesthesiologists in Hungary.

BACKGROUND: Despite their worldwide popularity the question of using non-conventional treatments is a source of controversy among medical professionals. Although these methods may have potential benefits it presents a problem when patients use non-conventional treatments in the perioperative period without informing their attending physician about it and this may cause adverse events and complications. To prevent this, physicians need to have a profound knowledge about non-conventional treatments. METHODS: An anonymous questionnaire was distributed among surgeons and anaesthesiologists working in Hungarian university clinics and in selected city or county hospitals. Questionnaires were distributed by post, online or in person. Altogether 258 questionnaires were received from 22 clinical and hospital departments. RESULTS: Anaesthesiologists and surgeons use reflexology, Traditional Chinese Medicine, herbal medicine and manual therapy most frequently in their clinical practice. Traditional Chinese Medicine was considered to be the most scientifically sound method, while homeopathy was perceived as the least well-grounded method. Neural therapy was the least well-known method among our subjects. Among the subjects of our survey only 3.1 % of perioperative care physicians had some qualifications in non-conventional medicine, 12.4 % considered themselves to be well-informed in this topic and 48.4 % would like to study some complementary method. Women were significantly more interested in alternative treatments than men, p = 0.001427; OR: 2.2765. Anaesthesiologists would be significantly more willing to learn non-conventional methods than surgeons. 86.4 % of the participants thought that non-conventional treatments should be evaluated from the point of view of evidence. Both surgeons and anaesthesiologists accept the application of integrative medicine and they also approve of the idea of teaching these methods at universities. CONCLUSIONS: According to perioperative care physicians, non-conventional methods should be evaluated based on evidence. They also expressed a willingness to learn about those treatments that meet the criteria of evidence and apply these in their clinical practice.

[Complementary and alternative medicine use in surgical patients]. / Nem konvencionális gyógymódok használata sebészeti betegek között.

INTRODUCTION: Due to the rise in use of non-conventional therapies, we may consider the application of those in perioperative setting. AIM: The aims of the authors were to measure the attitude of patients waiting for elective surgery towards naturopathic methods, to determine their use and factors influencing their usage. METHOD: A questionnaire was applied that patients filled in individually and anonymously at the First Department of Surgery of Semmelweis University, between July 1, 2014 and April 30, 2016. RESULTS: 63.6% of the 519 participants (response rate = 21%) were interested in non-conventional therapies, and 26.8% of them applied naturopathy. In this group there were significantly more females (p = 0.022; OR: 1.066-2.3635), patients with university degree (p = 0.000315; OR: 1.3915-3.1132), aged 40-49 (p = 0.012419; OR: 1.1451-3.2405), and patients with hormonal disease (p = 0.039482; OR: 1.0186-5.7242). In terms of lifetime prevalence the most popular methods were traditional Chinese medicine (8.9%), alternative movement and massage therapy (7.5%) and homeopathy (7.3%). Only 12.9% of the patients reported the application of these methods to the physician. CONCLUSION: Surgical patients are interested in naturopathic methods, and one-fourth of them actually use them even in the perioperative period. Orv. Hetil., 2016, 157(37), 1483-1488.

Attitudes Underlying Reliance on Complementary and Alternative Medicine.

Objective: We aimed to map attitudes underlying complementary and alternative medicine (CAM) use, especially those involved in "dysfunctional CAM reliance," that is, forgoing biomedical treatment in a life-threatening situation in favor of alternative treatment. Analyses of modifiable determinants of CAM use were conducted at a sufficiently specific level to inform intervention development. Methods: We collected usable data on CAM-related attitudinal beliefs from 151 participants in Budapest with varying degrees of CAM use, which we analyzed using confidence interval-based estimation of relevance plots. Results: Although there were beliefs that the entire sample shared, there was a marked difference between the biomedical and CAM groups. These differences were beliefs concerning trust in various medical systems, the level of importance assigned to emotions in falling ill, and vitalism or Eastern concepts. Regarding CAM users in general, the most successful intervention targets are beliefs in vitalism on the one hand, and distrust in biomedicine on the other. In addressing dysfunctional CAM use specifically, the most significant beliefs pertain to "natural" cures and reliance on biomedical testing. Conclusions: Albeit much research has been carried out on the motivations behind CAM use, rarely do studies treat CAM users separately in order to scrutinize patterns of nonconventional medicine use and underlying cognition. This is the first study to begin pinpointing specific attitudes involved in dysfunctional CAM use to inform future intervention development. Such interventions would be essential for the prevention of incidents and mortality.

Patient Journeys of Nonintegration in Hungary: A Qualitative Study of Possible Reasons for Considering Medical Modalities as Mutually Exclusive.

INTRODUCTION: Complementary and alternative medicine (CAM) use has been increasing in the past decades in tandem with changes regarding the notions of health and illness. Comparing conventional medicine (CM) and CAM in how they address health problems has been a point of focus for both the health sciences and individuals dealing with health problems. Various social, cultural, political, economic, and personal factors play a role in whether different health approaches are integrated or not when addressing illness experiences. METHODS: The qualitative study comprised semistructured interviews (N = 9) and participant observation involving 105 patients conducted between January 2015 and May 2017 at 4 clinics of Traditional Chinese Medicine in Budapest, Hungary. Code structures were created inductively with Interpretative Phenomenological Analysis. RESULTS: The mutually exclusive view of CM/CAM use occurred due to loss of trust in the doctor-patient relationship causing problems in communication, and also as a result of the patient espousing certain cultural dispositions. Significant dispositions included a preference for the "natural" and psychologization, the latter often manifested in psychosocial etiology, vitalism, and illness symbolism. DISCUSSION: A polarized choice of therapy may occur as a result of a competitive health care market in which medical modalities and their underlying cultural systems compete within a global milieu of information proliferation and a hybridization of individual worldviews. Through a process of "cultural creolization", changing concepts of health and illness create varying patient expectations and meanings regarding illness, which in turn affect therapy choice as well. CONCLUSION: Mirrored in the articulation of an individual's illness trajectory is a tension that is also reflected in the struggles in the health care system to more adequately understand health/illness processes from a pluralistic perspective. The power relations in the health arena (among CAM/CM practitioners and systems) play a role in legitimizing or undermining different health practices, which as consequence affects the possibility of integrating them into the processes of care. Thus, therapy choice is not only linked to changing notions of health and illness, but also to shifting conceptualizations of self, identity, and the practitioner-patient relationship.

Reception of Homeopathy by the Hungarian Churches and Clericals during the 19-20. Centuries. / A prevenció gondolata az 1876. évi közegészségügyi törvényben..

This study gives a special overview of the history of homeopathy in Flungary focusing exclusively on the attitude of the Elungarian churches regarding this new healing method. Authors attempt to prove, that homeopathy actually was a system rooting in Christianity, and according to this fact several priests and eccelesiastical persons took part in the propagation of the method, especially during the 19. century. The essay lists the most important Flunga- rian homeopathic doctors with special regard on their close connections to Catholic priests or bishops and on homeopathic hospitals supported by Christian churches.

[Rheumatic diseases and alternative medicine]. / Reumás betegségek és az alternatív medicina.

Besides the scientific- rational medicine alternative medicine keeps spreading in our days. The authors give a review of the possibilities of the alternative therapy of locomotor diseases. Patients suffering from locomotor diseases ask increasingly often for these therapeutical procedures. Literary review is given on acupuncture, manual therapy, homeopathy and certain physiotherapeutical techniques as well as on other less often applied alternative therapeutical procedures. It is stressed that alternative treatment may also involve potential danger. It is stated finally that as shown by the review of the literature well controllable clinical examinations required indispensably for the estimation of the efficacy of a therapeutical procedure are only in limited number at disposal.

[Acute parotitis in children previously vaccinated against mumps]. / Akut parotitis mumps védöoltásban részesült gyermekekben.

Children who had previously received Morbilli-(Mumps) Rubella (MMR) vaccine developed parotid swelling which was diagnosed as acute parotitis 7 days to 2 years following inoculation. Blood samples from each of the patients were tested for the following virological parameters: Mumps-virus, Parainfluenza-viruses (PIV) type 1., 2., 3., Respiratory Syncytial Virus (RSV), Epstein Barr Virus Capsid Antigen (EBVCA) IgM, IgA, IgG immunofluorescent test (IFT) and EBVCA IgM, IgG ELISA (HUMAN); Epstein Barr Virus Early Antigen (EBV EA) IgG IFT; Adenovirus, Influenza A, B Complement Fixation (CF) test. Some of the sera were examined for CMV IgM, IgG ELISA (Organon Teknika) and Human Parvovirus B19 IgM, IgG recombinant ELISA (Bender) too. Nine cases were interpreted as a clinical reaction of mumps vaccination. Beside the clinical reaction of mumps vaccination. Beside the clinical reaction of mumps vaccination, the etiological role of PIV-1, PIV-2, PIV-3 and PIV-1,2 was confirmed in four, three, one and one patients, respectively. The alonely etiological agent was the PIV-2 in four and PIV-2 and Epstein-Barr virus together were in one patients, respectively. The etiology was unknown in one patient. The results show the importance both of the broad spectrum precise serologic studies and of the skillful interpretation in the exact diagnosis of the acute parotitis to identify parotitis either as a consequence of the mumps vaccine or vaccine failure. The correct diagnosis of acute parotitis can influence the booster mumps vaccination practice too.

Association of adherence to therapy and complementary and alternative medicine use with demographic factors and disease phenotype in patients with inflammatory bowel disease.

BACKGROUND AND AIMS: Previous studies have suggested an increasing use of complementary and alternative medicine (CAM) in patients with inflammatory bowel disease (IBD). Furthermore, a significant number of IBD patients fail to comply with treatment. The aim of our study was to evaluate the prevalence of non-adherence and the use of CAM in Hungarian patients with IBD. METHODS: A total of 655 consecutive IBD patients (CD: 344, age: 38.2 [SD 12.9]years; UC: 311, age: 44.9 [15.3]years) were interviewed during the specialist visit by self-administered questionnaire including demographic and disease-related data as well as items analyzing the extent of non-adherence and CAM use. Patients taking more than 80% of each prescribed medication were classified as adherent. RESULTS: The overall rate of self-reported non-adherence (CD: 20.9%, UC: 20.6%) and CAM (CD: 31.7%, UC: 30.9%) use did not differ between Crohn's disease (CD) and ulcerative colitis (UC). The most common causes of non-adherence were: forgetfulness (47.8%), too many/unnecessary pills (39.7%), being afraid of side effects (27.9%) and too frequent dosing. Most common forms of CAM were herbal tea (47.3%), homeopathy (14.6%), special diet (12.2%), and acupuncture (5.8%). In CD, disease duration, date of last follow-up visit, educational level and previous surgeries were predicting factors for non-adherence. Alternative medicine use was associated in both diseases with younger age, higher educational level, and immunosuppressant use. In addition, CAM use in UC was more common in females and in patients with supportive psychiatric/psychological therapy. CONCLUSIONS: Non-adherence and CAM use is common in patients with IBD. Special attention should be paid to explore the identified predictive factors during follow-up visits to improve adherence to therapy and improving patient-doctor relationship.