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1.
Complement Med Res ; : 1-7, 2019 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-31722354

RESUMO

BACKGROUND: The German Cancer Aid set up a priority research programme with the intention to generate high-quality information based on evidence and to make this information easily accessible for health-care professionals and advisors, researchers, patients, and the general public. SUMMARY: The Kompetenznetz Komplementärmedizin in der Onkologie (KOKON) received 2 funding periods within this programme. During the first funding period, KOKON assessed patients' and health-care professionals' informational needs, developed a consulting manual for physicians, developed an education programme for self-help groups, set up a knowledge database, and developed a pilot information website for patients. Funding period 2 continues with work that allows cancer patients and health-care professionals to make informed decisions about complementary and alternative medicine (CAM). For this aim, KOKON evaluates training programmes for physicians (oncology physicians, paediatric oncologists, and general practitioners) and for self-help groups. All training programmes integrate results from an analysis of the ethical, psychological, and medical challenges of CAM in the medical encounter, and the knowledge database is being extended with issues related to CAM for supportive and palliative care. Key Message: A Germany-wide collaborative research project to identify needs, provide information, foster communication, and support decision-making about CAM in oncology is being set up.

2.
J Pediatr Hematol Oncol ; 41(7): 551-556, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31403489

RESUMO

More than one third of all German pediatric patients with cancer use complementary and integrative medicine (CIM). Parents want to discuss the topic of CIM with their pediatric oncologists (POs); however, POs mostly do not feel confident discussing these topics. POs report openness to receiving further information and training, but CIM training opportunities in medical education seem rare. We investigated POs' information and training needs and preference patterns regarding CIM training content with a paper-based or online survey. A total of 101 POs from Germany completed the survey. Only 11.4% agreed to being sufficiently informed of CIM. The participants stated needing further CIM information very often (8.6%), often (38.7%), or occasionally (44.1%). They considered an overview of CIM therapies and information about relaxation methods, herbal remedies, and acupuncture for cancer-related symptoms such as lack of appetite, nausea, or vomiting as most important in CIM training material, and also the topics of adverse effects and summary of evidence. Finally, POs reported on clinical situations in which a need for further information on CIM emerged. The results of our study indicate that there is a need for a structured training that offers knowledge and skills on the subject of patient counseling on CIM in pediatric oncology.

3.
Z Kinder Jugendpsychiatr Psychother ; 47(1): 27-33, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30560714

RESUMO

Scientific data are sparse on hospital design in child and adolescent psychiatry. The present article aims to give an overview of various concepts of hospital design and to develop concepts how architecture can consider the special needs of children and adolescents in their recovery from psychiatric diseases. Literature research is provided from PubMed and collected from architectural and anthroposophic bibliography. Access to daylight and nature, reduced level of noise and an atmosphere of privacy are general principles to support convalescence in patients. Especially in psychiatry, spatial structures and colour can strengthen appropriate social interrelations on both the patient and staff level. Authors suggest that children and adolescents benefit from architectural concepts which consider the issues: Welcome, Path, Territory, Area of Freedom, Outdoor Space, Access to Light, Motion in the Structure and Orientation of Space.


Assuntos
Psiquiatria do Adolescente , Psiquiatria Infantil , Arquitetura Hospitalar , Transtornos Mentais/terapia , Criança , Humanos
5.
Complement Ther Med ; 41: 247-251, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30477848

RESUMO

PURPOSE: Purpose of this paper is to describe the project design for the development of a context-specific and patient-focused integrative care programme for an intensive care unit for paediatric oncology to ease the strain of the treatments for patients and their families. Integrative care interventions based on anthroposophical medicine such as wraps, compresses and rhythmic body oiling can be used to ease typical side effects such as nausea, pain and agitation. METHODS: Conduct of a literature research on existing integrative care programmes in medical hospitals and biomedical settings and the identification of appropriate methods to achieve the research aim. RESULTS: A project design was developed which can be used as a basis for developing, introducing and evaluating an integrative care programme for a paediatric oncological intensive care unit in a German university hospital. A qualitative study design was chosen to develop this programme. This included participant observations and interviews with all stakeholders at the respective oncology ward as well as in existing oncology wards that work with an integrative care programme. The primary emphasis was on the criteria appropriateness for the specific setting, sustainability and financial viability as well as on the development of an appropriate evaluation model. CONCLUSIONS: When developing an integrative care programme for use in the specific setting of a paediatric oncology ward and selecting the appropriate interventions for inclusion in the programme, particular attention should be paid to the needs of the patients as well as to the practicability for the nursing staff, particularly with regard to resources such as time and personnel. Both the nursing team and nursing management should be actively involved in the project design from the outset. In the evaluation particular importance is attached to feasibility. The challenge for the economic evaluation is to create a robust database for negotiation of financing possibilities.

6.
Complement Ther Med ; 40: 185-190, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30219446

RESUMO

BACKGROUND: In Europe only few integrative pediatric wards exists and there are two German hospitals focusing on anthroposophic medicine as part of complementary and alternative medicine (CAM). Whilst the most common pediatric diseases are treated here, pseudocroup patients make up a large group in these hospitals, receiving conventional as well as anthroposophic therapies. However, effectiveness of these therapy concepts mostly based on physicians' experiences but clinical studies are hitherto missing. METHODS: A systematic literature search identifying therapy approaches for pseudocroup in children was conducted in general electronic databases (Cochrane Library, PubMed, OVID) and in CAM-specific databases (CAMbase, CAM-QUEST®, Anthromedics). Search results were screened for anthroposophic therapy options. In addition, anthroposophic guidebooks were handsearched for relevant information. RESULTS: Among 157 articles fulfilling search criteria one retrospective study, and five experience reports describing anthroposophic treatments were identified. Several medications for the treatment of pseudocroup were mentioned such as Aconitum, Apis, Bryonia, Hepar sulfuris, Lavender, Pyrit, Sambucus and Spongia. During appropriate use no adverse effects were reported. CONCLUSION: Anthroposophic medicine harbors a broad spectrum of remedies for the treatment of pseudocroup in children. In particular, Aconitum, Bryonia and Spongia are frequently recommended; however, clinical trials investigating the effectiveness are sparse. Therefore, development and validation of therapy strategies are required.

7.
Complement Ther Med ; 40: 198-202, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30219449

RESUMO

BACKGROUND: Long-term survival of children with cancer has reached rates of up to 80%. Nevertheless, continued research devoted to further improvement of survival rates especially for patients with high-risk illnesses is necessary. Recent studies have shown direct positive effects on tumor reduction through Viscum album (mistletoe) extracts in adults, mainly as a result of higher dosage treatment and intravenous or intratumoral application. PATIENTS AND METHOD: A retrospective analysis of data was carried out of all oncological, pediatric patients treated with intravenous high-dose mistletoe therapy for a period of two years (11/2013-11/2015). RESULTS: A total of ten non-coherent cases were examined, all suffering from advanced and/or relapsed forms of cancer (leukemia, neuroblastoma, nephroblastoma, osteosarcoma, lymphoma, anaplastic astrocytoma, atypical teratoid rhabdoid tumor and soft tissue sarcoma). Patients were treated for an average period of 48 days with a mean survival rate of 130 days after beginning the mistletoe therapy. Partial remission was observed in four and a slowed disease progression was monitored in two patients. However, unrestricted progression of disease was documented in two other patients. Patients showed side effects including fever as well as fatigue and in some cases systemic inflammatory reactions with transient organ impairment occurred. CONCLUSION: Our study underpinned the safety and feasibility of high-dose mistletoe infusion in children with advanced stages of cancer and showed noteworthy antineoplastic effects, which should be verified in a prospective clinical phase II/III-study. Because of possible side effects, the treatment should be implemented only in an in-patient setting in experienced pediatric oncology centers.

8.
Complement Med Res ; 25(5): 321-330, 2018.
Artigo em Alemão | MEDLINE | ID: mdl-30041164

RESUMO

BACKGROUND: Acute gastroenteritis in children accounts for about 10% of hospital admissions and is still one of the major causes of death worldwide. As many children are treated with complementary and alternative medicine (CAM) and anthroposophic medicine, respectively, especially in Europe, the aim of this review was to descriptively present published anthroposophic therapies applied for the treatment of acute gastroenteritis in childhood. METHODS: A complex search strategy recording a broad spectrum of CAM therapies was developed to identify anthroposophic therapy options for the treatment of gastroenteritis in children. The search was conducted in 4 general scientific as well as 3 CAM-specific databases. RESULTS: In total, 3,086 articles were identified and screened for anthroposophic related content. The majority of hits deal with nutritional/dietary therapies. Articles considering anthroposophic approaches constitute only 3.1% (7/227) of all CAM-related articles. Among these articles 2 observational studies, 3 experience reports and 2 reviews were identified. In the experience reports, a variety of anthroposophic remedies was recommended but mostly unsupported by scientific evidence. However, observational studies for the anthroposophic medications, Bolus alba comp. and Gentiana comp., were detected. Additionally, studies investigating the efficacy and safety of Chamomilla, Ipecacuanha, Podophyllum or Tormentilla preparations in homeopathy and phytomedicine, respectively, were presented. CONCLUSIONS: Most CAM-associated therapies for gastroenteritis in childhood comprise dietary recommendations. Studies concerning anthroposophic approaches and medications, respectively, are deficient. The results of this study underline that effort is needed to evaluate anthroposophic therapies in a clinical setting.

9.
Med Teach ; 40(9): 944-952, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29347873

RESUMO

BACKGROUND: There have been calls to enhance clinical education by strengthening supported active participation (SAP) of medical students in patient care. This study examines perceived quality of care when final-year medical students are integrated in hospital ward teams with an autonomous relationship toward their patients. METHODS: We established three clinical education wards (CEWs) where final-year medical students were acting as "physician under supervision". A questionnaire-based mixed-method study of discharged patients was completed in 2009-15 using the Picker Inpatient Questionnaire complemented by specific questions on the impact of SAP. Results were compared with matched pairs of the same clinical specialty from the same hospital (CG1) and from nationwide hospitals (CG2). Patients free-text feedback about their hospital stay was qualitatively evaluated. RESULTS: Of 1136 patients surveyed, 528 (46.2%) returned the questionnaire. The CEWs were highly recommended, with good overall quality of care and patient-physician/student-interaction, all being significantly (p < 0.001) higher for the CEW group while experienced medical treatment success was similar. Patient-centeredness of students was appreciated by patients as a support to a deeper understanding of their condition and treatment. CONCLUSION: Our study indicates that SAP of final-year medical students is appreciated by patients with high overall quality of care and patient-centeredness.

10.
Women Birth ; 31(2): e89-e98, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28844865

RESUMO

BACKGROUND: Spirituality is part of the basic needs of all humans, yet often undervalued by health professionals. Less is known about the spiritual needs of mothers of preterm or sick new born children. AIM: Identify unmet psychosocial and spiritual needs of these mothers, and to relate these needs to their perceived stress and impairments of life concerns. METHODS: Anonymous cross-sectional survey with standardized instruments (e.g., Spiritual Needs Questionnaire) among 125 mothers of two paediatric departments in Germany. FINDINGS: Mothers felt supported by their partner and hospital staff, and hospital staff assured 82% of them that they must not worry about their child's prognosis. They nevertheless did have specific unmet spiritual needs. Religious Needs and Existentialistic Needs scored lowest, while Giving/Generativity Needs were of moderate and Inner Peace Needs of strongest relevance. With respect to the expected diagnosis and prognosis of their child, there were no significant differences for their secular spiritual needs scores, but significant differences for Religious Needs which scored highest in mothers with children having an unclear prognosis (F=8.6; p=.004). Particularly Inner Peace Needs correlated with their stress perception (r=.34), impairments of life concerns (r=.25) and grief (r=.23). DISCUSSION: Mothers of sick born/premature children felt supported by the hospital team and their partner, but nevertheless experienced stress and daily life impairments, and particularly have unmet Inner Peace Needs. CONCLUSIONS: Addressing mothers' specific needs may help support them in their struggle with their difficult situation avoiding fears and insecurity and thus facilitating positive bonding to their child.


Assuntos
Ansiedade/psicologia , Recém-Nascido Prematuro , Mães/psicologia , Espiritualidade , Adulto , Ansiedade/epidemiologia , Criança , Estudos Transversais , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Inquéritos e Questionários
12.
Pediatr Blood Cancer ; 63(10): 1800-5, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27348500

RESUMO

BACKGROUND: In Germany, about 1,800 new cases of pediatric cancer under 15 years of age are diagnosed each year and survival rates approach 80%. Although treatment is covered by health insurance and is thus available for all patients at no cost, treatment refusal and treatment discontinuation have been observed. However, no data providing numbers and outcomes for developed countries have been published thus far. PROCEDURE: A questionnaire-based survey was performed among German pediatric oncology centers to ascertain the number of treatment refusals among pediatric patients who were diagnosed between January 2008 and December 2009 in Germany. RESULTS: Questionnaires from 70 of 73 centers were available, and of these 13 centers reported a total of 15 cases of treatment refusal or discontinuation within this 2-year period. Five of the 15 patients died, 7 of 15 were still alive, and the current status of 3 of 15 patients was unknown. Diseases were heterogeneous. Six of the 15 parents refused treatment for their children initially, 8 of 15 discontinued during the course of treatment. Five patients were treated after parental custody had been withdrawn due to the lack of compliance. All these five patients survived. Parents' reasons given for refusal or discontinuation of treatment were related to personal health beliefs and coping strategies. CONCLUSIONS: Although treatment refusal or discontinuation is rare, it is accompanied by a high mortality rate. Parents' personal health beliefs play a primary role in treatment refusal or discontinuation in Germany. This emphasizes the importance of sustaining a functioning and mutually communicative physician-parent-patient relationship.


Assuntos
Neoplasias/terapia , Recusa do Paciente ao Tratamento , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Neoplasias/mortalidade , Pais , Relações Médico-Paciente , Estudos Retrospectivos , Inquéritos e Questionários
13.
Support Care Cancer ; 24(7): 2869-75, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-26838025

RESUMO

PURPOSE: Although the popularity of complementary and alternative medicine (CAM) has risen in the last decade, information about its use by pediatric patients in palliative care is still scarce. The purpose of the study was to assess the frequency and types of CAM administered by parents with children suffering from cancer during the palliative phase. METHODS: All parents who lost their child due to cancer in the federal state North Rhine Westfalia/Germany were eligible for the study. The first group of eligible parents was contacted in 1999-2000 and a second group of parents in 2005-2006. Upon agreement, parents were asked to complete a semi-structured questionnaire about the frequency of CAM use and the specific treatments that had been used. The types of CAM were categorized according to the National Center for Complementary and Alternative Medicine (NCCAM). RESULTS: A total of 96 parents participated in the study (48 in each cohort). Forty-three percent of all parents in both groups reported CAM use. The results show an increase of CAM use from 38 % in the first group to 49 % in the second cohort of pediatric patients during palliative care. The most common types of CAM used in both groups were homeopathy and treatment with mistletoe preparations. CONCLUSIONS: The study provides information about usage of CAM in children suffering from cancer during the palliative phase of the disease. Further research is required to investigate benefits, potential adverse effects, and the potential efficacy of CAM in this population.


Assuntos
Terapias Complementares/métodos , Neoplasias/terapia , Cuidados Paliativos/métodos , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino
14.
Br J Haematol ; 170(4): 539-49, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25940575

RESUMO

Haemophagocytic lymphohistiocytosis (HLH) in the context of malignancy is mainly considered a challenge of adult haematology. While this association is also observed in children, little is known regarding inciting factors, appropriate treatment and prognosis. We retrospectively analysed 29 paediatric and adolescent patients for presenting features, type of neoplasm or preceding chemotherapy, treatment and outcome. Haemophagocytic lymphohistiocytosis was considered triggered by the malignancy (M-HLH) in 21 patients, most of whom had T- (n = 12) or B-cell neoplasms (n = 7), with Epstein-Barr virus as a co-trigger in five patients. In eight patients, HLH occurred during chemotherapy (Ch-HLH) for malignancy, mainly acute leukaemias (n = 7); an infectious trigger was found in seven. In M- and Ch-HLH, median overall survival was 1·2 and 0·9 years, and the 6 month survival rates were 67% and 63%, respectively. Seven of 11 deceased M-HLH patients exhibited active malignancy and HLH at the time of death, while only two out of five deceased Ch-HLH patients had evidence of active HLH. To overcome HLH, malignancy- and HLH-directed treatments were administered in the M-HLH cohort; however, it was not possible to determine superiority of one approach over the other. For Ch-HLH, treatment ranged from postponement of chemotherapy to the use of etoposide-containing regimens.


Assuntos
Infecções por Vírus Epstein-Barr , Leucemia , Linfo-Histiocitose Hemofagocítica , Doença Aguda , Adolescente , Adulto , Criança , Pré-Escolar , Intervalo Livre de Doença , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/tratamento farmacológico , Infecções por Vírus Epstein-Barr/mortalidade , Feminino , Humanos , Lactente , Recém-Nascido , Leucemia/tratamento farmacológico , Leucemia/mortalidade , Linfo-Histiocitose Hemofagocítica/etiologia , Linfo-Histiocitose Hemofagocítica/mortalidade , Linfo-Histiocitose Hemofagocítica/terapia , Masculino , Estudos Retrospectivos , Taxa de Sobrevida
15.
World J Pediatr ; 10(4): 299-305, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25515802

RESUMO

BACKGROUND: Complementary and alternative medicine (CAM) is applied both to children and adults widely throughout the world. A previous pan-European survey showed a surprisingly high CAM-use in Turkish children. This review aimed to survey information on the use of CAM in pediatrics in Turkey. DATA SOURCES: A narrative, non-systematic review was conducted by melding expert opinions with a thorough and balanced review of available evidence. An unrestricted literature search using the key words, "alternative", "complementary", "integrative", "prevalence" and "pediatric" or "children" and "Turkey" was performed by internet search in March, 2012 using PubMed and Google Scholar. RESULTS: CAM use was examined in general pediatrics, pediatric oncology, patients with asthma, and patients with diabetes. A frequency of CAM use was 87% in Turkish pediatric patients, with a mean of 60%. The primary sources of information about CAM are family and friends. Communication with patients/parents and health care professionals showed that most parents do not speak about CAM use with their physicians or nurses. CONCLUSIONS: CAM is extensively used in Turkish pediatric patients. This might be due to Turkey's status as a developing country in which a traditional medical system still dominates in comparison to developed countries. Thus, larger studies are required to prove an extensive use of CAM in Turkey, as this review article does not have the capacity for in-depth analysis. Knowledge about CAM and its related topics is essential for physicians and nurses in order to meet the patients' wish for a competent consultation concerning all aspects of a possible therapy.


Assuntos
Terapias Complementares , Criança , Humanos , Turquia
16.
Pediatr Blood Cancer ; 61(3): 488-92, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24038864

RESUMO

BACKGROUND: Use of complementary and alternative medicine (CAM) in children with cancer is common and probably increasing. However, data concerning differences between children and adolescents focusing on prevalence, reasons for use/non-use, costs, adverse effects, and socio-demographic factors are lacking. PROCEDURE: A population-based survey over a 1 year period with 497 participants was conducted. RESULTS: Of the 457 respondents (92%) 322 were children and 135 adolescents (>16 years of age) with malignancies. 31% reported CAM use from the time when being diagnosed, compared to an overall lifetime prevalence rate of 41% before cancer diagnosis. Among CAM users the most prevalent therapies were homeopathy, massage, anthroposophic medicine, acupuncture, and Bach flowers. The main reasons for use were to reduce therapy-related side effects, to strengthen the immune system, to achieve physical stabilization and to increase healing chances. Socio-demographic factors associated with CAM use were higher parental education and higher family income. A majority of CAM users (97%) would recommend CAM use. Most users (78%) informed a physician about CAM use. Side effects were rarely reported (5%), minor and self-limiting. CONCLUSIONS: The high prevalence rates seem to represent the parental or patients needs for additional treatment perceived as successful and devoid of side-effects. Clinical care and the physician-patient relation would profit from an enhanced understanding of CAM and a greater candidness towards the parental needs. Safety and efficacy - especially of CAM with high prevalence rates - should be studied in rigorous basic and clinical research.


Assuntos
Terapias Complementares , Neoplasias/terapia , Adolescente , Adulto , Criança , Pré-Escolar , Terapias Complementares/efeitos adversos , Terapias Complementares/economia , Gastos em Saúde , Humanos , Lactente
17.
Complement Ther Med ; 21 Suppl 1: S10-9, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23578912

RESUMO

The last decades have seen increasing patient use of complementary and alternative treatment methods (CAM) in paediatric oncology, too. However, there have been few scientific studies of paediatric oncologists' views and attitudes on CAM to date. We report the results of a cross-sectional questionnaire survey amongst paediatric oncologists in Germany. In addition to descriptive statistics, dichotomous subgroups were formed and univariate and multivariate analyses performed. There were 175 evaluable questionnaires (response rate 26.5%). Almost half of the responders (48%) had not been taught anything about CAM at medical school. Knowledge about CAM was found significantly more often in younger doctors (<43 years), in doctors who brought up the subject of CAM with the parents and in doctors working in non-university hospitals with fewer than 50 new admissions per year. A little over half of the responders (56%) had never used CAM when they had been ill themselves. Most of the doctors (78.9%) agreed fully or somewhat with the statement "CAM should be used after completion of the conventional treatment". Older doctors agreed significantly more often that CAM should be used after failure of the conventional treatment. Paediatric oncologists were worried about CAM use by their patients because of possible interactions (76%) or side-effects (65.7%), additional costs (75.4%), possible prevention or delay of conventional treatment (68%) and their own lack of competence to provide advice. The topic of CAM was raised at the first consultation by 41.1% of the responders. A wish for more continuing medical education on CAM was expressed by 85.2%. In summary, the data presented here indicate that the majority of the responding German paediatric oncologists is open towards continuing medical education on CAM, not least in the interest of becoming more competent to advise their patients. This is in contrast to the fact that German paediatric oncologists currently tend not to actively bring up the topic of CAM in their consultations with parents. Younger doctors with shorter professional experience in paediatric oncology currently have a fundamentally more positive attitude towards CAM issues.


Assuntos
Atitude do Pessoal de Saúde , Terapias Complementares , Cultura , Neoplasias/terapia , Pediatria , Médicos , Competência Profissional , Adulto , Fatores Etários , Estudos Transversais , Interações de Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Educação Médica Continuada , Feminino , Alemanha , Custos de Cuidados de Saúde , Gastos em Saúde , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Relações Médico-Paciente , Faculdades de Medicina , Inquéritos e Questionários
18.
Complement Ther Med ; 21 Suppl 1: S26-33, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23578914

RESUMO

INTRODUCTION: Complementary and alternative medicine (CAM) is used by both adults and children in Europe. Diverse cultural, ethnic and historical preconditions in European countries result in broad differences between the types of CAM practiced, prevalence of CAM use and integration in the health system. To date, no survey of CAM availability to paediatric patients in Europe exists. METHODS: We present an overview of CAM integration within the different levels of the European paediatric health systems as a narrative review. Paediatric CAM specialists in 20 European countries provided information about CAM integration in their countries in semi-structured interviews. RESULTS: Data from 20 European countries were available, representing 68% of the European population. CAM is offered in private practices in all 20 (100%) countries, and 80% described some form of CAM training for health professionals. While CAM is offered in outpatient clinics treating adults in 80% of these countries, only 35% offer CAM in paediatric outpatient clinics. Dedicated CAM inpatient wards exist in 65% of the countries for adults, but only in Germany and the Netherlands for children. Groups conducting some CAM research or CAM research focussed on paediatrics exist in 65% and 50% of the 20 countries, respectively. Homeopathy, acupuncture and anthroposophic medicine were most often named. CONCLUSION: Every child in Europe has access to CAM treatment, mainly in private practices, whereas CAM outpatient clinics and inpatient services for children are rare. This is in contrast to adult treatment facilities, many of which offer CAM services, and the high percentage of European children using CAM.


Assuntos
Instituições de Assistência Ambulatorial , Terapias Complementares/estatística & dados numéricos , Hospitais , Medicina Integrativa , Pediatria , Padrões de Prática Médica , Terapias Complementares/educação , Europa (Continente) , Pesquisas sobre Serviços de Saúde , Pesquisa sobre Serviços de Saúde , Hospitalização , Humanos , Pacientes Internados , Entrevistas como Assunto , Pacientes Ambulatoriais , Prática Privada
19.
Complement Ther Med ; 21 Suppl 1: S3-9, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23578915

RESUMO

BACKGROUND: Pediatric posterior fossa brain tumour survivors are burdened with extensive neurologic, emotional, behavioral and mental impairments. Even long-term common remediation therapies such as conventional physical therapy and occupational therapy do not warrant full recovery. Innovative complementary therapy strategies offer a new option that needs evaluation. EYT is a movement therapy that belongs to the field of mind-body therapies (MBTs). This holistic approach aims to promote self-regulation and self-healing powers e.g. in cancer patients. This pilot study is a first attempt to assess the feasibility, treatment adherence and impact of eurythmy therapy (EYT) in pediatric neurooncology. METHODS: Seven posterior fossa tumour survivors who each participated in 25 EYT interventions over 6 months were followed for an additional 6 months. The outcome parameters cognitive functioning, neuromotor functioning and visuomotor integration were assessed at baseline as well as six and 12 months afterwards. RESULTS: We found good adherence and improvements in cognitive and neuromotor functioning in all children and better visuomotor integration in 5/7 children after 6 months. After 12 months, neuromotor functioning and visuomotor integration diminished again to some extent. CONCLUSION: EYT in pediatric cerebellar tumour survivors is feasible and patients may profit from this new approach.


Assuntos
Transtornos Cognitivos/terapia , Neoplasias Infratentoriais/terapia , Terapias Mente-Corpo , Movimento , Doenças do Sistema Nervoso/terapia , Sobreviventes , Adolescente , Assistência ao Convalescente , Neoplasias Cerebelares/complicações , Neoplasias Cerebelares/terapia , Criança , Cognição , Transtornos Cognitivos/etiologia , Feminino , Seguimentos , Humanos , Neoplasias Infratentoriais/complicações , Neoplasias Infratentoriais/psicologia , Masculino , Doenças do Sistema Nervoso/etiologia , Cooperação do Paciente , Pediatria , Resultado do Tratamento
20.
Complement Ther Med ; 21 Suppl 1: S34-47, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23578916

RESUMO

INTRODUCTION: Few data document the use of complementary and alternative medicine (CAM) in Europe, with even fewer investigating use by children. METHODS: A narrative, non-systematic review of CAM use in Europe was performed by combining data from published surveys with expert perspectives. Limitations created by a lack of representative studies, varying definitions of CAM use, and what qualifies as CAM in different countries was partially overcome by integrating local experts to summarise information available only in the national language and provide their perspectives about CAM availability, quality, use and popularity in their countries using a semi-structured questionnaire. Local and international published surveys were summarised, and the prevalence of CAM use was extrapolated. RESULTS: Data from 20 European countries were available, representing 69% of the European population. Some data about CAM use by the general population were available for 90% of the examined countries, whereas peer-reviewed published surveys were available for only 60%. We extrapolated that 56% (range: 10-90%, adjusted for population size) of the European population in general had used CAM at least once in the past year. Surveys in CAM use by children were available for 55% of the investigated countries. The extrapolated prevalence of CAM use by children in Europe was 52% (range: 5-90%, adjusted for population size). Paediatric CAM experts reported an increasing awareness for and use of CAM in healthcare institutions. CONCLUSION: This precursor for further surveys indicates that CAM appears to be popular not only among adults in Europe, but also for children. Development of a pan-European definition of CAM use and CAM therapies are required to achieve surveys comparable between European countries. Additionally, more research investigating the efficacy and potential adverse effects of CAM therapies is needed because of increasing CAM use by children in Europe.


Assuntos
Terapias Complementares/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde , Fatores Etários , Conscientização , Criança , Europa (Continente) , Pesquisas sobre Serviços de Saúde , Humanos , Pediatria
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