Attitudes and barriers towards participation in an acupuncture trial among breast cancer patients: a survey study.

BACKGROUND: As breast cancer patients increasingly use complementary and alternative medicine (CAM), clinical trials are needed to guide appropriate clinical use. We sought to identify socio-demographic, clinical and psychological factors related to willingness to participate (WTP) and to determine barriers to participation in an acupuncture clinical trial among breast cancer patients. METHODS: We conducted a cross-sectional survey study among post-menopausal women with stage I-III breast cancer on aromatase inhibitors at an urban academic cancer center. RESULTS: Of the 300 participants (92% response rate), 148 (49.8%) reported WTP in an acupuncture clinical trial. Higher education (p = 0.001), increased acupuncture expectancy (p < 0.001), and previous radiation therapy (p = 0.004) were significantly associated with WTP. Travel difficulty (p = 0.002), concern with experimentation (p = 0.013), and lack of interest in acupuncture (p < 0.001) were significant barriers to WTP. Barriers differed significantly by socio-demographic factors with white people more likely to endorse travel difficulty (p = 0.018) and non-white people more likely to report concern with experimentation (p = 0.024). Older patients and those with lower education were more likely to report concern with experimentation and lack of interest in acupuncture (p < 0.05). CONCLUSIONS: Although nearly half of the respondents reported WTP, significant barriers to participation exist and differ among subgroups. Research addressing these barriers is needed to ensure effective accrual and improve the representation of individuals from diverse backgrounds.

Maori spiritual beliefs and attitudes towards organ donation.

Organ transplantation is widely agreed to be beneficial to health. Many transplantations involve donation from the deceased. In Aotearoa/New Zealand, Maori both donate and receive proportionally fewer organs than non-Maori. This paper seeks illumination of this fact in unique Maori spiritual beliefs. These spiritual beliefs are not held by all Maori, and their role in an individual's life may vary, nonetheless they constitute a living tradition. Because cadaveric donation involves removal of organs from the dead person as soon after death as possible, considerations arise about customary rules and observances and the movement between the realm of the living and the dead. This may raise concerns for donors, recipients, and their respective whanau (extended family). In some cases, these concerns may form a consideration against donating posthumously.