Complementary and Alternative Medicine Use in Amyotrophic Lateral Sclerosis Cases in South Korea.

Patients with amyotrophic lateral sclerosis (ALS) sometimes consider complementary and alternative medicine (CAM) because of ineffective treatment. This study investigated the prevalence and utilization pattern of CAM among patients with ALS in South Korea. Participants were recruited through homecare services for mechanical ventilation in South Korea. This study comprised a face-to-face cross-sectional survey with staff members available to address any queries. Fifty-five participants were included; all had used >1 CAM treatment option for ALS symptoms. Dietary treatments were most common, followed by functional food and massages. Most participants had obtained relevant information from family members or friends. The main reason for CAM use was an expectation that symptoms will improve with CAM; most patients were unsure of the effects. CAM use was previously discontinued by the majority of patients because of unsatisfactory effects. The mean expenditure on CAM was 288,385.28 ± 685,265.14 won per month, and the mean duration of CAM use was 11.54 ± 20.09 months. The results indicate that there is a high prevalence of CAM use among ALS patients. Healthcare providers should inquire about CAM use and openly provide accurate CAM information. Further evidence of CAM efficacy is required, as is specific guidance for consulting ALS patients regarding CAM.

Experience of complementary and alternative medicine in patients with amyotrophic lateral sclerosis and their families: A qualitative study.

The purpose of this study was to explore the life experience related to complementary and alternative medicine (CAM) use among patients with amyotrophic lateral sclerosis (ALS). Data were collected though semi-structured interviews of nine patients with ALS and seven family members, who have used CAM. Audio recordings of the interviews were transcribed verbatim and checked for accuracy. The Giorgi's method of phenomenology was used for data analysis. Five constituents forming the units of meaning were: facing the limits of conventional medicine; getting to know CAM; recognizing the ineffectiveness of CAM; using CAM for symptomatic treatment; and seeking new CAM endlessly for complete cure. The study results provide an in-depth understanding of experience with CAM among patients with ALS and their family members. Healthcare providers must give accurate information about the efficacy of CAM as well as its safety and possible adverse effects and should offer patient-centred treatment through active communication throughout the process of diagnosis and treatment.

Discrimination accuracy between real and sham press needles in the hands.

OBJECTIVES: To evaluate the blinding effectiveness of a modified blunt sham press needle on the basis of the ability of subjects to discriminate between real and sham acupuncture needles compared with their discrimination ability based on pure guessing, and to define differences between senses (touch and vision) in the rates of correctly identified needles. METHODS: Sixty-three healthy students and staff members were recruited through convenience sampling. First, real or sham acupuncture was randomly administered to the left LI4 point while subjects could not observe the needle tip. A real or sham needle tip was then shown to the subjects. Finally, a random combination of real or sham acupuncture needles were randomly administered to the left and right LI4 points, this time with the subjects observing the procedure. In all conditions the subjects gave their judgement as Yes or No in response to questions asking them to identify the needle type. The proportion of correct judgements (P(C)) was computed for the last part of the trial in left and right LI4 points, and the rates of correctly identified needles for each trial were obtained. RESULTS: The subjects' accuracy of discrimination between the real and sham acupuncture needles in left and right LI4 points was not significantly different from that based on pure guess (P(C)=0.50 (chance level)), which indicates complete inability to discriminate between needles. The rates of correctly identified needles using touch, vision and a combination of both senses were not significantly different (p=0.807). CONCLUSIONS: The findings from this study show that this sham acupuncture device successfully blinded subjects to real and sham press needles, suggesting that it is effective for subject blinding in studies on acupuncture using press needles, and facilitating evaluation of the effects of acupuncture in placebo-controlled trials using a rigorous scientific research methodology.

Treatment patterns and outcomes in a low-risk nurse-midwifery practice.

Childbirth, which represents more than 20% of all hospitalizations for women, is often accompanied by technical intervention, and identifying best practices is crucial. This study analyzed data entered into the Nurse-Midwifery Clinical Data Set (ACNM, 1990) to ascertain treatment patterns and associated outcomes, using Kane's Model of Treatment and Outcomes (Kane, R. L. [1997]. Understanding health care outcomes research. Gaithersburg, MD: Aspen Publishers, Inc.). Low-risk women (N = 510) received prenatal care from nurse-midwives and delivered at a university facility. Significant relationships were found between patient characteristics (age) and clinical factors (parity, body mass index, number of prenatal visits, comorbidities) and between treatment interventions (activity, intake, invasive monitoring) and outcomes (infant Apgar scores, complications).

Down the rabbit hole: examining outcomes of nurse midwifery care.

Care of the laboring woman and subsequent birth interventions have generally been based on tradition rather than a systematic examination of the cost-effectiveness of the interventions. This retrospective study examined the outcomes of nurse midwifery care at a large metropolitan university clinic setting. Findings suggest that more sensitive cost and quality indicators of nurse midwifery care need to be developed, and the effect of these on outcomes needs to be elucidated.