Complementary and alternative medicine in oncology: knowledge, attitude and practice among Tunisian healthcare workers.

PURPOSE: Over the past years, there has been a considerable increase in complementary and alternative medicine (CAM) use among cancer patients. However, guidance from health care workers (HCWs) is not always provided. We aimed to determine the knowledge, attitude and practice of Tunisian HCWs regarding the use of CAM in cancer patients. METHODS: We conducted a multicenter cross-sectional study over 5 months from February to June 2022 among HCWs caring for cancer patients in the Tunisian center region. Data were collected using a self-administered questionnaire developed by our investigators. RESULTS: The level of knowledge about CAM was declared limited by 78.4% of our population. The best known CAM therapies were herbal medicine and homeopathy while chiropractic and hypnosis where the least. HCWs who had sought information on CAM represented 54.3% of our sample and the main source of information was the Internet (37.1%). A positive attitude towards the use of CAM was found in 56% of HCWs. The integration of CAM into supportive care in oncology was approved by 78% of HCWs. Concerning training on CAM, 78% declared its necessity for HCWs and 73.3% expressed a desire to have it. A personal use of CAM was found in 53% of HCWs while 38.8% had previously used CAM in the treatment of their cancer patients. CONCLUSION: The majority of HCWs had a positive attitude towards the use of CAM in oncology despite their poor knowledge about it. Our study emphasizes the need to train HCWs dealing with cancer patients on CAM.

Assessment of depression, anxiety and fatigue in Tunisian patients in recovery from colon cancer and their impact on quality of life.

PURPOSE: Colon cancer survivors can experience several post-treatment consequences that include fatigue and often report severe psychological illnesses such as depression or anxiety. There is little published quantitative data on the quality of life and psychological well-being associated with the health of Tunisian colon cancer survivors. METHODS: A total of 60 recovering colon cancer patients underwent a structured interview, which included the Hospital Anxiety and Depression (HADS) scale, the Piper fatigue scale and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). RESULTS: Patients were 59.26 years old on average. The median length of remission was 33.3 months. Surgery was performed on all patients, followed by 96.7% adjuvant chemotherapy. 15.1% of study participants were in the severe category for the depression score and 10% were in this category for the anxiety score. Ninety-one percent reported pathological fatigue scores on the Piper scale. However, only 8.33% were experiencing severe fatigue. According to the QLQ-C30 assessment, the overall quality of life was slightly impaired with an overall average score of 79.54 ± 16.98. Anxiety, depression and fatigue negatively affect global health outcomes and all their dimensions. CONCLUSION: Even in the recovery phase, colon cancer patients can see their quality of life deteriorate. It comes out of their psychological experience and their physical life. It is, therefore, crucial to provide greater attention to these patients for holistic and multi-disciplinary care.