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1.
Complement Ther Med ; 49: 102320, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32147031

RESUMO

BACKGROUND: Craniosacral therapy (CST) is an established complementary modality for several health complaints. A clinic for psychosomatics in Norway has included CST into a multimodal treatment approach for severely traumatized patients. The aim of this study was to investigate and describe the indications for the use of craniosacral therapy within trauma therapy. Specifically, to explore treatment philosophy, criteria for improvement, treatment aims, and the evaluation of the risk profile of the multimodal treatment approach. METHODS: Semi-structured individual interviews (n = 8) and one focus group interview were conducted with the therapists at the Clinic for Psychosomatics, Hospital of Southern Norway, Kristiansand, Norway. The text data were transcribed verbatim, and the analysis of the material was conducted according to conventional and direct content analysis. RESULTS: The therapists at the clinic applied a holistic treatment approach, based on their understanding of mind and body as one entity. To access emotions and traumata, they used a mixture of different treatment techniques. The therapists experienced patients with severe bodily symptoms as being less cognitively present and attributed this to the symptoms craving most mental resources. The craniosacral therapists' specific aims and task within the multimodal trauma therapy was to ease these physical complaints, so that cognitive and emotional resources could be utilized for therapy. The psychotherapists found that emotions and traumata were more accessible after CST. The general treatment goals were to increase symptom tolerance levels and to enable better self-care. Furthermore, the ability to transform negative behaviors and develop positive alternatives were considered to be signs of improvement. CONCLUSION: The study participants considered that patients with complex traumas, including post-traumatic stress disorder, seemed to benefit from this multimodal treatment approach and appreciated its' holistic treatment philosophy, including craniosacral therapy. With regard to patient safety, the study participants recommended that craniosacral therapy for severely traumatized patients should only be provided in cooperation with psychotherapists, or other highly qualified health personnel working in specialized institutions.

2.
BMC Complement Med Ther ; 20(1): 90, 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32183808

RESUMO

BACKGROUND: Parents often choose Complementary and Alternative Medicine (CAM) as a supportive agent with the aim to reduce cancer treatment-related symptoms in their children. Therefore, it is necessary to understand parents´ information and communication needs regarding CAM. The aim of the present study was to review the research literature as to identify the information and communication needs of parents of children with cancer, and the children themselves, regarding the use of CAM. METHODS: An integrative systematic review design was chosen. Searches were performed in AMED, CAMbase, CINAHL (Ebsco), EMBASE, PubMed and PsycInfo, Theme eJournals and Karger. The search was limited to studies published in English, German, Dutch, and the Scandinavian languages. Using predefined inclusion and exclusion criteria, two reviewers independently screened the title and abstracts of the relevant papers. A data extraction form and critical appraisal checklists were used to extract data for analysis, and a mixed methods synthesis was applied. RESULTS: Out of 24 studies included, 67% were of quantitative and 33% of qualitative study design. Five main themes emerged from the analysis of 21 studies: Information on CAM, sources of CAM information, communication about CAM, informed decision-making on CAM, and Risk/benefit of CAM. The majority of the parents did not disclose the CAM use of their children because they feared negative reactions from the attending oncologist. To make informed treatment decisions for their children, parents wanted unbiased information about CAM and would act accordingly. They demand open communication about these modalities and respect for the family's autonomy when choosing CAM for their children. CONCLUSION: There is an urgent need for parents of children with cancer for high quality information on CAM from reliable and scientific sources. Development of authoritative evidence-based decision tools is thus warranted to enable health care professionals and parents of children with cancer to make well informed, individual decisions concerning CAM.

3.
BMC Complement Altern Med ; 19(1): 305, 2019 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-31711478

RESUMO

BACKGROUND: Patient-centered culturally sensitive health care (PC-CSHC) has emerged as a primary approach to health care. This care focuses on the cultural diversity of the patients rather than the views of the health care professionals. PC-CSHC enables the patient to feel comfortable, respected, and trusted in the health care delivery process. As users of traditional and complementary medicine (T&CM) rarely inform their conventional health care providers of such use, the providers need to identify the users of T&CM themselves to avoid negative interaction with conventional medicine and to be able to provide them with PC-CSHC. Since the patterns of traditional medicine (TM) use are different to those of complementary medicine (CM), the aim of this study was to investigate the prevalence, and the health- and sociodemographic associations for visits to TM- and CM providers in an urban population. METHOD: The data were collected through two self-administrated questionnaires from the seventh survey of the Tromsø Study, a population-based cohort study conducted in 2015-2016. All inhabitants of Tromsø aged 40 or above were invited (n = 32,591) and n = 21,083 accepted the invitation (response rate 65%). Pearson chi-square tests and one-way ANOVA tests were used to describe differences between the groups whereas binary logistic regressions were used for adjusted values. RESULTS: The results revealed that 2.5% of the participants had seen a TM provider, 8.5% had seen a CM provider whereas 1% had visited both a TM and a CM provider during a 12-month period. TM users tended to be older, claim that religion was more important to them, have poorer economy and health, and have lower education compared to CM users. We found that more than 90% of the participants visiting T&CM providers also used conventional medicine. CONCLUSION: A considerable number of the participants in this study employed parallel health care modalities including visits to conventional, traditional, and complementary medicine providers. To offer patient-centered culturally sensitive health care that is tailored to the patients' treatment philosophy and spiritual needs, conventional health care providers need knowledge about, and respect for their patients' use of parallel health care systems.


Assuntos
Terapias Complementares/psicologia , Medicina Tradicional/psicologia , Pacientes/psicologia , Adulto , Idoso , Assistência Ambulatorial/psicologia , Assistência Ambulatorial/estatística & dados numéricos , Estudos de Coortes , Terapias Complementares/estatística & dados numéricos , Demografia , Feminino , Pessoal de Saúde/psicologia , Humanos , Masculino , Medicina Tradicional/estatística & dados numéricos , Pessoa de Meia-Idade , Noruega , Pacientes/estatística & dados numéricos , Prevalência , Religião , Confiança
5.
Explore (NY) ; 15(2): 115-125, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30262161

RESUMO

INTRODUCTION: Healing is reported to be used by 16.8% of the population, however utilization may be considerably higher in selected patient groups. The aim of this study was to map the symptoms the participants reported when visiting a healer for the first time, and to evaluate the subjectively experienced benefits and risks from the healing sessions. METHOD: Data were obtained from the Measure Yourself Medical Outcome Profile (MYMOP) questionnaire. One-hundred adults who, for the first time, referred themselves to a healer in southern Norway between January 2016 and January 2017 were included in the study. Eligible for analyses were 92 participants who fulfilled their treatment plan and returned both the baseline (pre) and post-treatment questionnaire. The occurring symptoms were grouped according to their nature into four symptom groups: pain, psychological problems, fatigue and other. With regard to the observational character of the study, all results were described and interpreted descriptively and exact p-values were given and interpreted as measures of effect. RESULTS: The participants who visited the healers in this study were mainly women (80%) with chronic disease (82%), with pain, fatigue and/or psychological problems as main complaints. They experienced an improvement of symptoms, well-being and improved activity level of approximately 50% regardless of the nature of the complaints. Women reported more improvement than men did. The pre-post changes was found after an average of 4.1 treatments. Forty percent of the participants reported adverse effects, which occurred directly after the healing session, generally lasting for less than one day. CONCLUSION: The study participants reported substantial improvement of, and major reduction of the burden of symptoms, improved well-being and activity level after healing sessions. Due to the observational nature of the study, no interpretations about specificity of the descriptive results or the mechanisms of effect can be made.


Assuntos
Fadiga/terapia , Transtornos Mentais/terapia , Terapias Mente-Corpo/métodos , Manejo da Dor/métodos , Adulto , Idoso , Doença Crônica/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapias Mente-Corpo/efeitos adversos , Estudos Prospectivos , Autorrelato , Inquéritos e Questionários
6.
BMC Health Serv Res ; 18(1): 854, 2018 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-30428878

RESUMO

BACKGROUND: Both conventional health care providers and complementary therapists treat cancer patients. To provide effective treatment, both types of providers should to be familiar with their own as well as alternative types of treatment. Our aim was to compare how conventional health care providers (oncology doctors, oncology nurses, family physicians) and complementary therapists (acupuncturists, reflexologists, massage therapists) seek information about conventional and complementary cancer treatments. METHOD: This analysis was conducted on the basis of feedback from 466 participants. We used self-administered questionnaires in a cross-sectional study. RESULTS: The majority of the medical doctors (96%) searched for evidence-based information regarding conventional cancer treatments. They gathered this information mostly from guidelines, which is considered best practice and is expected from Norwegian health personnel. Eighty-one percent of the nurses gather this information from evidence based resources such as UpToDate. Colleagues were asked for information by 58% of the medical doctors and 64% of the nurses. Moreover, 50% of the medical doctors and 57% of the nurses searched for evidence-based information about complementary cancer modalities. The acupuncturists gathered evidence-based information for both conventional (79%) and complementary (77%) modalities, followed by the reflexologists (54 and 54%, respectively) and massage therapists (54 and 52%, respectively). Nearly half of the acupuncturist (49%) asked a colleague for information. CONCLUSION: To provide safe cancer care, it is important that advice about complementary modalities is based on current and evidence-based evaluations. The majority of the medical doctors and nurses in this study sought information according to evidence-based medicine regarding conventional cancer treatments, and about half of them gathered evidence-based information about complementary cancer modalities. This was also true for the complementary therapists as they gathered information about complementary and conventional treatments from evidence-based evaluations. This demonstrates that since the term evidence-based medicine was first introduced in 1991, the approach has grown extensively and both conventional and complementary providers use this approach to seek information.


Assuntos
Terapias Complementares/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Comportamento de Busca de Informação , Informática Médica/estatística & dados numéricos , Neoplasias/terapia , Terapias Complementares/psicologia , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Humanos , Masculino , Oncologia/estatística & dados numéricos , Pessoa de Meia-Idade , Noruega , Médicos de Família/psicologia , Médicos de Família/estatística & dados numéricos , Inquéritos e Questionários
7.
BMC Complement Altern Med ; 18(1): 260, 2018 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-30257693

RESUMO

BACKGROUND: Due to limitations of conventional medicine for atopic eczema (AE), complementary and alternative medicine (CAM) is widely used as an alternative, maintaining, or simultaneous treatment for AE. We aimed to evaluate the beneficial and harmful effects of CAM for children with AE under 14 years old. METHODS: We searched for randomized trials on CAM in 12 Chinese and English databases from their inception to May 2018. We included children (< 14 years) diagnosed with AE, who received CAM therapy alone or combined with conventional medicine. We extracted data, and used the Cochrane "Risk of bias" tool to assess methodological quality. Effect was presented as relative risk (RR) or mean difference (MD) with 95% confidence interval (CI) using RevMan 5.3. RESULTS: Twenty-four randomized controlled trials involving 2233 children with AE were included. Methodological quality was of unclear or high risk of bias in general. The trials tested 5 different types of CAM therapies, including probiotics, diet, biofilm, borage oil, and swimming. Compared to placebo, probiotics showed improved effect for the SCORAD index (MD 9.01, 95% CI 7.12-10.90; n = 5). For symptoms and signs such as itching, skin lesions, CAM combined with usual care was more effective for symptom relief ≥95% (RR 1.47, 95% CI 1.30-1.68; n = 8), and for ≥50% symptoms improvement (RR 1.34, 1.25-1.45; n = 9) compared to usual care. There was no statistic significant difference between CAM and usual care on ≥95% improvement or ≥ 50% improvement of symptoms. However, swimming, diet and biofilm showed improvement of clinical symptoms compared with usual care. At follow-up of 8 weeks to 3 years, CAM alone or combined with usual care showed lower relapse rate (RR 0.38, 0.28-0.51, n = 2; RR 0.31, 0.24-0.40, n = 7; respectively) compared to usual care. Twelve out of 24 trials reported no occurrence of severe adverse events. CONCLUSIONS: Low evidence demonstrates that some CAM modalities may improve symptoms of childhood AE and reduce relapse rate. Safety remains unclear due to insufficient reporting. Further well-designed randomized trials are needed to confirm the potential beneficial effect and to establish safety use.


Assuntos
Terapias Complementares , Dermatite Atópica/terapia , Adolescente , Viés , Criança , Pré-Escolar , Dermatite Atópica/fisiopatologia , Feminino , Humanos , Lactente , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Risco , Resultado do Tratamento
8.
BMC Complement Altern Med ; 18(1): 239, 2018 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-30103714

RESUMO

BACKGROUND: Alcohol is consumed almost worldwide and is the most widely used recreational drug in the world. Harmful use of alcohol is known to cause a large disease-, social- and economic burden on society. Only a few studies have examined the relationship between CAM use and alcohol consumption. To our knowledge there has been no such research in Norway. The aim of this study is to describe and compare alcohol consumption and injuries related to alcohol across gender and different CAM approaches. METHODS: The data used in this study is based on questionnaire data gathered from the sixth Tromsø Study conducted between 2007 and 2008. Information on CAM use and alcohol consumption was available for 6819 women and 5994 men, 64.8% of the invited individuals. Pearson chi-square tests and independent sample t-tests were used to describe the basic characteristics of the participants and to calculate the differences between men and women regarding these variables. Binary logistic regression analyses were used to investigate the associations between the different CAM approaches and alcohol consumptions and injuries caused by drinking. RESULTS: Women who drank alcohol more than once a month were more likely to have applied herbal or "natural" medicine and self-treatment techniques (meditation, yoga, qi gong or tai-chi), compared to those who never drank, and those who only drank monthly or less. For women, an association was also found between having experienced injuries caused by drinking and use of self-treatment techniques and visit to a CAM practitioner. No association was found between amount of alcohol consumed and use of CAM approaches. For men, an association was found between injuries caused by drinking and use of herbal or "natural" medicine. CONCLUSION: The findings from this cross-sectional study suggests that women who drink frequently are more likely to use "natural" medicine and self-treatment techniques. Both men and women who had experienced injuries because of their drinking were more likely to have used CAM approaches.


Assuntos
Consumo de Bebidas Alcoólicas , Terapias Complementares , Ferimentos e Lesões , Adulto , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Terapias Complementares/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Autocuidado , Fatores Sexuais , Ferimentos e Lesões/induzido quimicamente , Ferimentos e Lesões/epidemiologia
9.
BMC Complement Altern Med ; 18(1): 109, 2018 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-29580283

RESUMO

BACKGROUND: Intentional use of complementary and alternative medicine (CAM) has previously only been researched in small, possibly biased, samples. There seems to be a lack of scientific information regarding healthy individual's attitudes and presumed use of CAM. The aim of this study is to describe prevalence and characteristics of participants who intend to see a CAM provider compared to participants who intend to see a medical doctor (MD) only when suffering from a chronic, non- life-threatening disease and in the need of treatment. Further to describe differences between the groups regarding expected reasons for CAM use and expected skills of CAM providers. METHOD: The survey was conducted in January 2016 as part of the "TNS Gallup Health policy Barometer". In total, 1728 individuals aged 16-92 years participated in the study, constituting an overall response rate of 47%. The survey included questions regarding opinions and attitudes towards health, health services and health politics in Norway. RESULTS: The majority of the participants (90.2%) would see a MD only if they were suffering from a chronic, non- life-threatening disease and were in the need of treatment. Men over the age of 60 with a university education tended to see a MD only. Only 9.8% of all respondents would in addition visit a CAM provider. Being an intentional user of a MD + CAM provider was associated with being a woman under the age of 60. The respondents believed that CAM providers have professional competence based on formal training in CAM. They also believed that individuals seeing a CAM provider have poor health and are driven by the hope of being cured. Further, that they have heard that others have good experience with such treatment. CONCLUSION: Intentional use of CAM is associated with positive attitudes, trustworthiness, and presumed positive experiences in the CAM-patient-setting. Intentional CAM users also have the impression that CAM providers have professional competence based on formal training in alternative therapies.


Assuntos
Doença Crônica/psicologia , Doença Crônica/terapia , Terapias Complementares , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Assistência Ambulatorial/psicologia , Atitude Frente a Saúde , Terapias Complementares/psicologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Prevalência , Adulto Jovem
10.
BMC Complement Altern Med ; 18(1): 44, 2018 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-29386005

RESUMO

BACKGROUND: Many complementary therapies offer benefits for patients with cancer. Others may be risky for patients due to negative interactions with conventional treatment and adverse effects. Therefore, cancer patients need guidance from health care providers to assess complementary modalities appropriately to receive benefits and avoid harm. METHOD: In a self-administered questionnaire-based cross-sectional study, we compared knowledge and attitudes of health care providers with no training in complementary modalities to that of health care providers with training in complementary modalities about the risks for patients who combine complementary modalities with conventional treatment in cancer care. The analysis was based on responses from 466 participants. RESULTS: The attitudes and knowledge about direct risk followed provider specialty. Ninety-four percent of the medical doctors, 93% of the nurses, and 87% of the providers with dual training, but 70% of the complementary therapists, believed that complementary modalities can cause adverse effects (p < 0.001). The majority of the medical doctors and nurses believed that it is risky to combine complementary and conventional cancer treatments (78% and 93%, respectively), compared to 58% of the providers with dual training and 43% of the complementary therapists (p < 0.001). Eighty-nine percent of the medical doctors and nurses believed that complementary modalities should be subjected to more scientific testing before being accepted by conventional health care providers, in contrast to 56% of the dually trained and 57% of the complementary therapists (p < 0.001). The majority of the medical doctors (61%) and nurses (55%) would have neither discouraged nor encouraged the use of complementary modalities if patients asked them for advice. Moreover, less than 1% of the complementary therapists would have discouraged the use of conventional cancer treatments. The study participants believed that the most important factor to recommend a complementary cancer modality to patients is evidence for safety. CONCLUSION: The health care providers in this study believed that complementary modalities are associated with direct risk and can cause adverse effects, and that it is risky to combine conventional and complementary treatments due to potential harmful interactions.


Assuntos
Terapias Complementares , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Medição de Risco , Inquéritos e Questionários
11.
BMC Complement Altern Med ; 17(1): 301, 2017 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-28595577

RESUMO

BACKGROUND: Effective interdisciplinary communication is important to achieve better quality in health care. The aims of this study were to compare conventional and complementary providers' experience of communication about complementary therapies and conventional medicine with their cancer patients, and to investigate how they experience interdisciplinary communication and cooperation. METHOD: This study analyzed data from a self-administrated questionnaire. A total of 606 different health care providers, from four counties in Norway, completed the questionnaire. The survey was developed to describe aspects of the communication pattern among oncology doctors, nurses, family physicians and complementary therapists (acupuncturists, massage therapists and reflexologists/zone-therapists). Between-group differences were analyzed using chi-square, ANOVA and Fisher's exact tests. Significance level was defined as p < 0.05 without adjustment for multiple comparisons. RESULT: Conventional providers and complementary therapists had different patterns of communication with their cancer patients regarding complementary therapies. While complementary therapists advised their patients to apply both complementary and conventional modalities, medical doctors were less supportive of their patients' use of complementary therapies. Of conventional providers, nurses expressed more positive attitudes toward complementary therapies. Opportunities to improve communication between conventional and complementary providers were most strongly supported by complementary providers and nurses; medical doctors were less supportive of such attempts. A number of doctors showed lack of respect for complementary therapists, but asked for more research, guidelines for complementary modalities and training in conventional medicine for complementary therapists. CONCLUSION: For better quality of care, greater communication about complementary therapy use is needed between cancer patients and their conventional and complementary providers. In addition, more communication between conventional and complementary providers is needed. Nurses may have a crucial role in facilitating communication, as they are positive toward complementary therapies and they have more direct communication with patients about their treatment preferences.


Assuntos
Pessoal de Saúde/psicologia , Neoplasias/psicologia , Pacientes/psicologia , Terapia por Acupuntura/psicologia , Adulto , Comunicação , Terapias Complementares , Feminino , Humanos , Relações Interprofissionais , Massagem/psicologia , Pessoa de Meia-Idade , Neoplasias/terapia , Noruega , Recursos Humanos
12.
BMC Complement Altern Med ; 17(1): 324, 2017 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-28629411

RESUMO

BACKGROUND: Engagement in healthy lifestyle behaviors, such as healthy diet and regular physical activity, are known to reduce the risk of developing coronary heart disease (CHD). Complementary and alternative medicine (CAM) is known to be associated with having a healthy lifestyle. The primary aim of this study was to examine the prevalence and predictors of CAM use in CHD patients, and in those without CHD but at risk for developing CHD, using Protection Motivation Theory (PMT) as a guiding conceptual framework. METHOD: Questionnaire data were collected from 12,981 adult participants in the cross-sectional sixth Tromsø Study (2007-8). Eligible for analyses were 11,103 participants who reported whether they had used CAM or not. Of those, 830 participants reported to have or have had CHD (CHD group), 4830 reported to have parents, children or siblings with CHD (no CHD but family risk), while 5443 reported no CHD nor family risk of CHD. We first compared the patterns of CAM use in each group, and then examined the PMT predictors of CAM use. Health vulnerability from the threat appraisal process of PMT was assessed by self-rated health and expectations for future health. Response efficacy from the coping appraisal process of PMT was assessed as preventive health beliefs and health behavior frequency. RESULTS: Use of CAM was most commonly seen in people with no CHD themselves, but family risk of developing CHD (35.8%), compared to people already diagnosed with CHD (30.2%) and people with no CHD nor family risk (32.1%). All four of the PMT factors; self-rated health, expectations for future health, preventive health beliefs, and the health behavior index - were predictors for CAM use in the no CHD but family risk group. CONCLUSION: These findings suggest that people use CAM in response to a perceived risk of developing CHD, and to prevent disease and to maintain health.


Assuntos
Terapias Complementares/estatística & dados numéricos , Doença das Coronárias/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença das Coronárias/psicologia , Estudos Transversais , Feminino , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Noruega , Inquéritos e Questionários
13.
BMC Complement Altern Med ; 16(1): 461, 2016 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-27835971

RESUMO

BACKGROUND: Depression has been identified as one of the most frequent predictors of CAM use. However, limited data exist about the use of CAM providers among people with anxiety/depression in Norway. The aim of this study was to investigate the use of CAM providers, and the use of CAM providers and psychiatric outpatient services in combination, among people with self-reported anxiety and/or depression. METHODS: We used questionnaire data from 12,982 participants (30-87 years) in the cross-sectional sixth Tromsø Study (conducted in 2007-8). Eligible for analyses in our study were 1685 participants who reported suffering from anxiety and/or depression. By descriptive statistical methods, we estimated the use of CAM providers, psychiatric outpatient services, and the combination of these. By logistic regressions we studied the association between the use of these services and gender, age, income, education, and self-reported degree of anxiety/depression. RESULTS: During the previous year, 17.8 % of people with anxiety/depression visited a CAM provider once or more, 11.8 % visited psychiatric outpatient services, and 2.5 % visited both. Men with anxiety/depression were less likely to visit CAM providers compared to women (odds ratio [OR] 0.40, confidence interval [CI] 0.30-0.55), whereas higher educated people were more likely to visit compared to the lowest educated (OR 1.47, CI 1.02-2.13). The use of CAM providers was not associated with the degree of anxiety/depression. For those who used both CAM providers and psychiatric specialist services during the previous year, severe anxiety/depression was strongly associated with use compared to moderate disease (OR 7.53, CI 2.75-20.65). CONCLUSIONS: People with severe anxiety/depression seem to use CAM providers and psychiatric services additionally, whereas those with moderate disease seem to use these services more as alternative pathways. CAM provider treatment might be a substitute for conventional care, particularly in patients with moderate disease.


Assuntos
Ansiedade/terapia , Terapias Complementares/estatística & dados numéricos , Depressão/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Assistência Ambulatorial/estatística & dados numéricos , Ansiedade/psicologia , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Inquéritos e Questionários , Recursos Humanos
14.
BMC Complement Altern Med ; 16: 353, 2016 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-27609097

RESUMO

BACKGROUND: Communication between different health care providers (conventional and complementary) and cancer patients about their use of complementary therapies affects the health and safety of the patients. The aim of this study was to examine the qualitative research literature on the perception of and communication about the risk of complementary therapies between different health care providers and cancer patients. METHODS: Systematic searches in six medical databases covering literature from 2000 to 2015 were performed. The studies were accessed according to the level of evidence and summarized into different risk situations. Qualitative content analysis was used to analyze the text data, and the codes were defined before and during the data analysis. RESULTS: Twenty-nine papers were included in the primary analysis and five main themes were identified and discussed. The main risk situations identified were 1. Differences in treatment concepts and philosophical values among complementary and conventional health care providers. 2. Adverse effects from complementary products and herbs due to their contamination/toxicity and interactions with conventional cancer treatment. 3. Health care physicians and oncologists find it difficult to recommend many complementary modalities due to the lack of scientific evidence for their effect. 4. Lack of knowledge and information about complementary and conventional cancer treatments among different health care providers. CONCLUSION: The risk of consuming herbs and products containing high level of toxins is a considerable threat to patient safety (direct risk). At the same time, the lack of scientific evidence of effect for many complementary therapies and differences in treatment philosophy among complementary and conventional health care providers potentially hinder effective communication about these threats with mutual patients (indirect risk). As such, indirect risk may pose an additional risk to patients who want to combine complementary therapies with conventional treatment in cancer care. Health care providers who care for cancer patients should be aware of these risks.


Assuntos
Comunicação , Terapias Complementares , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Neoplasias/terapia , Segurança do Paciente , Humanos , Relações Médico-Paciente , Pesquisa Qualitativa , Risco
15.
BMC Complement Altern Med ; 16: 75, 2016 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-26911133

RESUMO

BACKGROUND: Research on continued CAM use has been largely atheoretical and has not considered the broader range of psychological and behavioral factors that may be involved. The purpose of this study was to test a new conceptual model of commitment to CAM use that implicates utilitarian (trust in CAM) and symbolic (perceived fit with CAM) in psychological and behavioral dimensions of CAM commitment. METHODS: A student sample of CAM consumers, (N = 159) completed a survey about their CAM use, CAM-related values, intentions for future CAM use, CAM word-of-mouth behavior, and perceptions of being an ongoing CAM consumer. RESULTS: Analysis revealed that the utilitarian, symbolic, and CAM commitment variables were significantly related, with r's ranging from .54 to .73. A series hierarchical regression analyses controlling for relevant demographic variables found that the utilitarian and symbolic values uniquely accounted for significant and substantial proportion of the variance in each of the three CAM commitment indicators (R(2) from .37 to .57). CONCLUSIONS: The findings provide preliminary support for the new model that posits that CAM commitment is a multi-dimensional psychological state with behavioral indicators. Further research with large-scale samples and longitudinal designs is warranted to understand the potential value of the new model.


Assuntos
Terapias Complementares/estatística & dados numéricos , Motivação , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Estudantes/psicologia , Adolescente , Adulto , Atitude Frente a Saúde , Terapias Complementares/psicologia , Feminino , Humanos , Masculino , Modelos Biológicos , Percepção , Inquéritos e Questionários , Confiança , Adulto Jovem
16.
BMC Complement Altern Med ; 16: 22, 2016 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-26801898

RESUMO

BACKGROUND: The dental filling material amalgam is generally well tolerated. However, a small proportion of dental patients experience health complaints which they attribute to amalgam. The symptom pattern is often similar to patients with medically unexplained physical symptoms (MUPS) and the health complaints may persist after amalgam removal. Among patients with MUPS, the use of complementary and alternative medicine (CAM) seems to be high. The aim of this survey was to describe the prevalence and range of CAM use among people with health complaints attributed to dental amalgam fillings in which the health problems persist after the removal of all amalgam fillings. Specific attention was paid to (1) self-reported effects of CAM, (2) differences in CAM use dependent on self-reported health, and (3) gender differences in self-reported CAM use. METHODS: A survey was distributed to all members of The Norwegian dental patient association (NDPA) (n = 999), the response rate was 36.4%. The anonymous questionnaire asked for socio-demographic data, health complaints related to former amalgam fillings, subjectively perceived health status, symptoms, and experience with therapeutic interventions, mostly from the spectrum of CAM. Only participants who had all their fillings removed, which was the vast majority, were analysed. RESULTS: A total of 88.9% of included respondents had used at least one CAM modality, with a higher proportion of men (95.7%) compared to women (86.2%, p = 0.015). The most frequently used therapies were dietary supplements, vitamins and minerals recommended by a therapist (used by 66.7%) followed by self-prescribed dietary supplements, vitamins and minerals (59.0%), homeopathy (54.0%), acupuncture (48.8%) and special diets (47.5%). Use of CAM was similar for participants reporting normal to good health compared to participants reporting poor health. For all but two CAM modalities, the self-reported treatment effect was better in the group reporting normal to good health compared to the group reporting poor health. CONCLUSIONS: CAM was widely used by participants in our study, a finding similar to findings from studies of MUPS patients. To date, health problems associated with the use of dental amalgam is not an accepted diagnosis in the healthcare system. Consequently, people suffering from such complaints experience a lack of adequate treatment and support within conventional health care, which might have contributed to the high number of CAM users in this study.


Assuntos
Terapias Complementares , Amálgama Dentário/efeitos adversos , Doença/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autorrelato , Fatores Sexuais , Inquéritos e Questionários
17.
Complement Ther Med ; 23(4): 535-43, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26275646

RESUMO

UNLABELLED: The registration of adverse events is important to identify treatment that might impose risk to patients. Homeopathic aggravation, a concept unique for homeopathy may impose a particular risk, as it is tolerant towards a worsening of the patients' symptoms. The aim of this study was to explore the classification of patient reported reactions as homeopathic aggravations or adverse drug reactions. DESIGN AND SETTING: In a cross sectional survey, patients were asked to register any reactions they had experienced 14 days after taking homeopathic remedies. Worsening of symptoms was classified as homeopathic aggravation if it was (i) an increase of the patients' existing symptoms (ii) and/or a feeling of well-being that emerged 1-3 days after taking the remedy (iii) and/or headache and/or fatigue accompanying these symptoms. RESULTS: A total of 26% of the participants reported worsening of symptoms. One third was classified as adverse events. Half of these were graded as minor and the other half as moderate according to the Common Terminology Criteria for Adverse Events. Two thirds were classified as homeopathic aggravations. Of these, 73% were classified as minor and 27% as moderate, giving a tendency towards milder severity for those classified as homeopathic aggravations (p=0.065). CONCLUSION: Patients reported a substantial part of the short-term reactions after taking homeopathic remedy as a worsening of symptoms. These reactions were classified as mild and moderate. Hence, the risk connected to homeopathic treatment is minor. More studies are needed to confirm the existence of homeopathic aggravation and how to classify the concept in a clinically meaningful way.


Assuntos
Homeopatia/efeitos adversos , Homeopatia/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Medição de Risco , Inquéritos e Questionários , Adulto Jovem
18.
BMC Complement Altern Med ; 14: 463, 2014 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-25465676

RESUMO

BACKGROUND: Self-reported use of Complementary and Alternative Medicine (CAM) varies widely from 10% to 75% in the general populations worldwide. When limited to use of a CAM provider 2% to 49% reported use is found. CAM use is believed to be closely associated with socio demographic variables such as gender, age, education, income and health complaints. However, studies have only occasionally differentiated CAM use according to gender. Therefore, the aim of the study presented here is to describe the prevalence of CAM use on the background of gender and to describe the specific characteristics of male and female users in the total Tromsø 6 population. METHODS: A total of 12,982 men and women aged 30-87 in the municipality of Tromsø, Norway went through a health screening program and completed two self-administered questionnaires in 2007/2008. The questionnaires were developed specifically for the Tromsø study and included questions about life style and health issues in addition to socio demographic variables. RESULTS: A total of 33% of the participants reported use of any CAM within the last 12 months, women more often than men (42% and 24%, respectively). When limited to visits to a CAM provider, we found 17% use among women and 8% among men. The relationship between the demographic variables and being a CAM user differed significantly between men and women with regard to age, household income, and marital status. We did not find significant differences between men and women concerning education and self-reported health. CONCLUSIONS: Findings from this study suggest that the prevalence and associations for use of CAM differ between men and women concerning several socio demographic variables (age, education and household income). Neglect of women's health care needs in public health care may contribute to the fact that women to a higher degree than men turn to CAM and CAM products.


Assuntos
Terapias Complementares/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde , Saúde da Mulher , Adulto , Fatores Etários , Feminino , Disparidades em Assistência à Saúde , Humanos , Renda , Estilo de Vida , Masculino , Estado Civil , Pessoa de Meia-Idade , Noruega , Prevalência , Autorrelato , Fatores Sexuais , Inquéritos e Questionários , Adulto Jovem
19.
BMC Health Serv Res ; 14: 629, 2014 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-25491638

RESUMO

BACKGROUND: Continuity of general practitioner (GP) care is associated with reduced use of emergency departments, hospitalisation, and outpatient specialist services. Evidence about the relationship between continuity and use of complementary and alternative medical (CAM) providers has so far been lacking. The aim of this study was to test the association between continuity of GP care and the use of CAM providers. METHODS: We used questionnaire data from the sixth Tromsø Study, conducted in 2007-8. Using descriptive statistical methods, we estimated the proportion using a CAM provider among adults (30-87 years) who had visited a GP during the last 12 months. By means of logistic regressions, we studied the association between the duration of the GP-patient relationship and the use of CAM providers. Analyses were adjusted for the frequency of GP visits, gender, age, marital status, income, education, and self-rated health and other proxies for health care needs. RESULTS: Of 9,743 eligible GP users, 85.1% had seen the same GP for more than two years, 83.7% among women and 86.9% among men. The probability of visiting a CAM provider was lower among those with a GP relationship of more than 2 years compared to those with a shorter GP relationship (odds ratio [OR] 0.81, 95% confidence interval [CI] 0.68-0.96). Other factors associated with CAM use were female gender, poor health, low age and high income. There was no association with education. CONCLUSIONS: Continuity of GP care as measured by the duration of the GP-patient relationship was associated with lower use of CAM providers. Together with previous studies this suggests that continuity of GP care may contribute to health care delivery from fewer providers.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Terapias Complementares/estatística & dados numéricos , Continuidade da Assistência ao Paciente/estatística & dados numéricos , Assistência à Saúde/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Medicina Geral/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Noruega , Razão de Chances , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
20.
Artigo em Inglês | MEDLINE | ID: mdl-23606877

RESUMO

The associations for CAM use are only occasionally differentiated by gender in populations where both male and female cancer survivors occur. The aim of this study is to describe the prevalence of CAM use in individuals with a previous cancer diagnosis and to investigate gender differences regard to factors associated with use. A total of 12982 men and women filled in a questionnaire with questions about life style and health issues. Eight hundred of those had a previous cancer diagnosis of whom 630 answered three questions concerning CAM use in the last 12 months. A total of 33.8% of all cancer survivors reported CAM use, 39.4% of the women and 27.9% of the men (P < 0.01). The relationship between the demographic variables and being a CAM user differed significantly between men and women with regard to age (P = 0.03), education (P = 0.04), and income (P < 0.01). Female CAM users were more likely to have a university degree than the nonusers, while male CAM users were more likely to have a lower income than the nonusers. According to this study, prevalence and factors associated with CAM use differ significantly between male and female survivors of cancer.

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