Perceptions about traditional Chinese medicine use among Chinese breast cancer survivors: A qualitative study.

INTRODUCTION: An increasing number of breast cancer survivors (BCS) use traditional Chinese medicine (TCM) throughout their cancer journey. There is emerging evidence that TCM is effective in the reducing side effects of chemotherapy. However, qualitative patient-centric and culturally relevant research into TCM use is scant. This qualitative study aimed to explore the use and perceptions of Chinese Hong Kong BCS using TCM. METHODS: Participants were recruited from a university hospital and three breast cancer patient groups in Hong Kong. Questionnaires regarding the use of TCM were given to all participants, followed by individual semi-structured interviews on selected BCS to comprehensively understand TCM's use and perceptions. A greater emphasis was placed on the qualitative data. RESULTS: About half of the participants (n = 67, 48.9%) used TCM during their cancer treatment journey, among which almost all (n = 64, 95.5%) had improved symptoms. Sleeping disturbances (n = 58, 86.6%) and fatigue (n = 53, 79.1%) were the two most common symptoms that improved after TCM. Interview data revealed that participants used TCM to satisfy unmet needs that mainstream conventional Western medicine could not fulfil. They wished for a sense of control and better well-being. They expressed improvements in physical and psychological well-being after the use of TCM. Despite existing barriers, including high cost, long duration of treatment, and disapproval from oncologists, most would still recommend TCM to fellow survivors. CONCLUSIONS: Chinese Hong Kong BCS who used TCM reported positive experiences. Understanding how BCS perceive and use TCM is important to integrating TCM into survivorship care in this population.

Complementary and alternative medicine therapies and COVID-19: a systematic review.

OBJECTIVES: Despite the high prevalence of coronavirus and various treatment approaches, including complementary and alternative medicine (CAM), there is still no definitive treatment for coronavirus. The present study aimed to evaluate the effect of CAM interventions on COVID-19 patients. CONTENT: Four databases (Web of Science, PubMed, Scopus, and EMBASE) were searched from the inception of databases until July 16, 2020. Keywords included complementary and alternative medicine therapies and Coronavirus. SUMMARY AND OUTLOOK: Of the 1,137 studies searched, 14 studies performed on 972 COVID-19 patients entered the systematic review final stage. The results showed that different CAM interventions (acupuncture, Traditional Chinese medicine [TCM], relaxation, Qigong) significantly improved various psychological symptoms (depression, anxiety, stress, sleep quality, negative emotions, quality of life) and physical symptoms (inflammatory factors, physical activity, chest pain, and respiratory function) in COVID-19 patients. The results showed that various CAM interventions have a positive effect on improving the various dimensions of coronavirus disease but since there are few studies in this regard, further studies using different CAM approaches are recommended.

New Frontiers in the Prevention, Diagnosis, and Treatment of Alzheimer's Disease.

One of the major puzzles in medical research and public health systems worldwide is Alzheimer's disease (AD), reaching nowadays a prevalence near 50 million people. This is a multifactorial brain disorder characterized by progressive cognitive impairment, apathy, and mood and neuropsychiatric disorders. The main risk of AD is aging; a normal biological process associated with a continuum dynamic involving a gradual loss of people's physical capacities, but with a sound experienced view of life. Studies suggest that AD is a break from normal aging with changes in the powerful functional capacities of neurons as well as in the mechanisms of neuronal protection. In this context, an important path has been opened toward AD prevention considering that there are elements of nutrition, daily exercise, avoidance of toxic substances and drugs, an active social life, meditation, and control of stress, to achieve healthy aging. Here, we analyze the involvement of such factors and how to control environmental risk factors for a better quality of life. Prevention as well as innovative screening programs for early detection of the disease using reliable biomarkers are becoming critical to control the disease. In addition, the failure of traditional pharmacological treatments and search for new drugs has stimulated the emergence of nutraceutical compounds in the context of a "multitarget" therapy, as well as mindfulness approaches shown to be effective in the aging, and applied to the control of AD. An integrated approach involving all these preventive factors combined with novel pharmacological approaches should pave the way for the future control of the disease.

Therapeutic effect of Chinese herbal medicines for post-stroke depression: A meta-analysis of randomized controlled trials.

BACKGROUND: Whether the addition of Chinese herbal medicine (CHM) in routine western medicines for post-stroke depression yields additional therapeutic effects still remains to be controversial. This study aimed to assess the efficacy and safety of combination of CHM with routine western medicines versus routine western medicines alone in patients with post-stroke depression (PSD). METHODS: Electronic databases such as PubMed, EmBase, Cochrane library, and China National Knowledge Infrastructure were systematically searched from inception till October 2019. Studies designed as randomized controlled trials (RCTs) and that investigated the therapeutic effects of CHM plus routine western medicines (CHM group) versus routine western medicines alone (control group) in PSD patients were eligible. The relative risk (RR) and weighted mean difference (WMD) with 95% confidence interval (CI) were used to assess the categories and continuous data using random-effects model. Software STATA was applied to perform statistical analysis (Version 10.0; StataCorp, TX,). RESULTS: A total of 18 RCTs involving a total of 1,367 PSD patients were selected for final analysis. The effective rate in CHM group was significantly higher than that in control group (RR: 1.18; 95%CI: 1.12-1.24; P < .001). Moreover, patients in CHM group showed association with lower Hamilton Depression Rating Scale (WMD: -3.17; 95%CI: -4.12 to -2.22; P < .001) and Scandinavian Stroke Scale (WMD: -3.84; 95%CI: -5.73 to -1.96; P < .001) than those in control group. Furthermore, patients in CHM were associated with high level of Barthel Index than those in control group (WMD: 11.06; 95%CI: 4.01 to 18.10; P = .002). Finally, patients in CHM group had lower risk of gastrointestinal (RR: 0.49; 95%CI: 0.31-0.77; P = .002) and neurological (RR: 0.50; 95%CI: 0.33-0.75; P = .001) adverse events than those in control group. CONCLUSIONS: The study findings revealed that addition of CHM to routine therapies could improve the therapeutic effects and reduce gastrointestinal or neurological adverse events.

Influence of Traditional Chinese Medicine on Medical Adherence and Outcome in Estrogen Receptor (+) Breast Cancer Patients in Taiwan: A Real-World Population-Based Cohort Study.

BACKGROUND: Medical adherence is often higher in clinical trials than in real world practice. The aim of this study was to investigate the effects of traditional Chinese medicine (TCM) on medical adherence to hormonal therapy (HT) and survival outcome in ER (+) breast cancer patients in Taiwan. SUBJECTS AND METHODS: Using a nationwide longitudinal population-based database, we enrolled patients with newly diagnosed ER-positive breast cancer who had received HT, and followed for up to 5 years (N = 872). Medication adherence in terms of medication possession ratios (MPR) and patient outcome were evaluated with or without TCM exposure. We applied logistic regression and Cox proportional hazards (PH) analysis to identify factors, including TCM exposure, associated with adherence to HT and mortality. RESULTS: MPR to HT in general decreased over the 5-year period post breast cancer diagnosis. Both TCM and MPR to HT ≥ 80% were significantly associated with reduced risk of breast cancer-associated mortality. Subgroup analysis revealed that TCM annual visits ≥ 3 times with CHP prescription 1~90 days per year affected mortality reduction most significantly (HR: 0.26; 95% CI = 0.08-0.83; p < 0.05) compared to other TCM use. In contrast, using TCM (either short-term or long-term) was not associated with MPR in HT. CONCLUSIONS: Our results supported the potential advantage of TCM on breast cancer-associated mortality, whereas TCM use does not compromise medical adherence to HT. This study offers important insights in integrative therapy for HT in patients with estrogen receptor (+) breast cancer.

The Importance of Patient's Experience and Its Impact on Health Care System for People Receiving Traditional Chinese Medicine.

Objectives: Health system responsiveness is a complicated issue that guides researchers in determining an efficient methodology to enhance the understanding of health care systems' perspectives. This study examined the relationship between patients' experience profiles and their satisfaction with medical outcomes. Design: The authors used 11 items from the Taiwanese Annual National Health Insurance survey and used latent class analysis (LCA) to develop experience profiles for 2012 Traditional Chinese Medicine (TCM) patients. A logistic regression model was developed to explore differences in patients' satisfaction with their treatment outcome across four groups identified using the LCA, with adjustment for demographic factors. Subjects: Patients' experiences with medical services in TCM in 2015. Outcome measures: Patients' satisfaction with their treatment outcome. Results: Participants (N = 2012) were divided into four groups. Regardless of gender and age, Group 2 (nall) held the lowest satisfaction with treatment outcome relative to those reported by the other three groups (odds ratios with p-value: Group 1 [pall]: 7.40, Group 3 [nComm]: 1.37, Group 4 [Skip]: 2.20, p < 0.001). Respondents with a more favorable patient experience reported higher satisfaction with treatment outcome. Conclusions: An increased favorable treatment experience in TCM (such as positive accessibility and better interpersonal relationships with providers) is associated with higher satisfaction with treatment outcome. The World Health Organization emphasizes that traditional medicine integrated with Western medicine can play an important role in achieving the goal of "Health for All." Health authorities should develop strategies aimed at enhancing patients' experiences in TCM to contribute to a positive care process.

Application of electroencephalographic (EEG) biofeedback therapy in the rehabilitation of patients with chronic diseases.

Schizophrenia is one of the chronic mental disorders characterized by disturbances in thought, emotion, language, perception, and behavior. There is no cure for this disease, and most of the current treatments are palliative. In this study, we aimed to analyze the application of electroencephalographic (EEG) biofeedback therapy, an adjunctive treatment used for many psychiatric disorders, in the rehabilitation of schizophrenic patients. Schizophrenic patients were selected as the experimental subjects, and the initial diagnosis criteria were set accordingly. A primary and a secondary efficacy index was then developed for the evaluation of EEG biofeedback therapy rather than traditional drug treatment. Lastly, the effects of the two methods were compared. The findings indicate that traditional drugs could be used in the treatment of mild schizophrenia, but showed poor results for severe and moderate schizophrenia. EEG biofeedback therapy was effective for the treatment of various degrees of schizophrenia and improved patients' sleep quality and anxiety. These findings have significant practical implications for the rehabilitation of schizophrenic patients and patients with chronic diseases in general.

The Neglected Role of Buddhism in the Development of Medicine in Late Imperial China Viewed through the Life and Work of Yu Chang (1585-1664).

Despite significant revisions over recent decades, the field of medicine in late imperial China continues to be defined by a number of problematic boundaries such as that between medicine and religion. In this article I challenge the validity of this boundary through a detailed examination of the life and work of the hugely influential seventeenth-century physician Yu Chang (1585-1664), whose openly Buddhist critique of literati medicine has hitherto largely escaped the attention of medical historians. I argue that Yu Chang's case, read against the more widespread revival of Buddhism at the time, the important historical role of literati-Buddhist networks, and evidence of many other late imperial physicians' interest in Buddhism, was not exceptional. A wider reevaluation of Buddhism's role in the development of medicine in late imperial China as well as its historical neglect is therefore called for.

Smallpox Vaccine and Resident Responses in Modern Shanghai: Focusing on Regional and Cultural Comparison.

In modern Shanghai, smallpox was one of the most threatening diseases with its mortality rate going up to 30 percent. In response to the disease, Dr. William Lockhart, a medical missionary of the London Missionary Society, introduced vaccination to the Chinese people in Shanghai. He built the first western style hospital in Shanghai, Renji Hospital, in 1843. At this time, native doctors also played a very important role. For example, Huang Chun-pu was in charge of the dispensary in the Chinese City in Shanghai, and he was the one who introduced vaccination under Dr. Lockhart's direction. In 1868, the Health Office of Shanghai Municipal Council began to implement a vaccination program. Around the turn of the 20th century, the Health Office of Shanghai Municipal Council managed several sub-district offices, hospitals, dispensaries, gaol, and even the traditional place like simiao for the free vaccinations. Urban residents benefited from a sanitary system, such as wide and free vaccination, compared to people who lived in rural areas. Moreover, Shanghai possessed the advantage of having the vaccine as a staple product of the Municipal Laboratory. The number of units of the vaccine issued from the Laboratory in sequence of years from 1898 to 1920 has been 115,351 on average. Unlike the International Settlement, where systematic inoculation was conducted under the leadership of the Municipal Council, the Chinese City was still reliant on charity organizations in the early 1900s. The foreign residence in the International Settlement had a strong influence from the foreign governments, and foreign doctors were well-aware of the need for the vaccination. However, the Chinese City was a Chinese enclave that was still under the traditional rule of the Qing Dynasty. In addition, the people of Shanghai had different perceptions of the smallpox vaccination, and this became an obstacle to the establishment of urban sanitation systems. Some Chinese people still relied on the traditional Chinese variolation and Chinese custom. For example, Chinese people still applied for inoculation in the spring and avoided summer and fall following traditional Chinese variolation, even though the best time to get vaccinated was in early winter before the spread of smallpox. In addition, foreigners were often more problematic than Chinese because they often overlooked the importance of vaccines and relied on drugs instead. The municipal authority, therefore, provided a wide range of free vaccinations for the poor and needy people regardless of their nationalities, and with such measures, sought to establish a stable urban sanitation system. This had been the key to the success of hygiene policies.

Issues in internet-based support for chinese-american breast cancer survivors.

Objective: The incidence of breast cancer in Chinese-Americans is increasing. This article aims to present and discuss the challenges encountered in implementing an Internet-based coaching/support program for Chinese-American breast cancer survivors and to provide direction for future Internet-based interventions targeting this specific population.Methods: The data were collected from (a) interventionists' diaries written during individual coaching/support sessions with survivors, (b) minutes taken during research meetings, and (c) written records of issues discussed during the interventions. The data were analyzed using content analysis.Results: The issues were categorized into eight themes. The following six themes were identified among the survivors: (1) low computer literacy, (2) ambivalent attitudes towards study participation (e.g., joining the project to maintain a harmonious relationship with the gatekeepers versus lack of trust in the project), (3) reticence to share opinions and experiences, (4) struggles with family affairs (e.g., intergenerational cultural dissonance), (5) overvaluing Traditional Chinese Medicine, and (6) specific participants' preferences (e.g., language, font size, timing). Among the interventionists, the following two themes were identified: (1) recruitment and retention of interventionists and (2) language barriers.Conclusions: Culture-specific challenges need to be considered when designing and implementing an Internet-based coaching/support program for Chinese-American breast cancer survivors.

Treatment satisfaction in Chinese medicine outpatient care: a comparison of patients' and doctors' views.

BACKGROUND: Both doctors' and patients' opinions are important in the process of treatment and healthcare of Chinese medicine. This study is to compare patients' and doctors' treatment satisfaction over the course of two visits in a Chinese medicine outpatient setting, and to explain their respective views. METHODS: Patients' chief complaints were collected prior to the outpatient encounter. The doctor was then asked (through a questionnaire) to state what complaints he or she was prioritizing during the process of diagnosing disease and making a prescription for herbal medicine or acupuncture treatment. On the next visit, both the patient and the doctor completed a questionnaire assessing satisfaction with the treatment of Chinese medicine prescribed in the first visit and administered by the patient at home. A 5-point Likert scales was used to assess the patients' and doctors' satisfaction with treatment. The timing of the follow-up appointment was determined by the doctor. One chief specialist, one associate chief specialist and one attending practitioner in Chinese medicine, and 60 patients having a follow-up appointment with one of the doctors, participated in the study. RESULTS: For 11 patients, their most urgent complaint was different from what the doctor's choose to focus on in his or her treatment. And only one patient refused to comply due to his or her dissatisfaction with the treatment focus of the doctor. Overall, 59 patients completed the satisfaction assessment, and 53 patients visited their doctors for a follow-up appointment. Patients' total satisfaction was higher than their doctors' (mean 3.55 vs. 3.45), and correlation of patients' and doctors' treatment satisfaction was moderate (r = 0.63, P < 0.01). Both of the patients' and doctors' satisfaction ratings were correlated with treatment adherence (P < 0.001). The predictors of their treatment satisfaction were different. Doctors' satisfaction with treatment was a significant factor in the process of making further clinical decisions. CONCLUSION: Patients and doctors form their opinion about the treatment effects in different ways. When evaluating treatment satisfaction, doctor's opinions are also an important indicator of positive or negative clinical effects and affect the subsequent decisions-making.

Saiga horn user characteristics, motivations, and purchasing behaviour in Singapore.

Unsustainable wildlife trade is a pervasive issue affecting wildlife globally. To address this issue, a plethora of demand reduction efforts have been carried out. These necessitate consumer research which provides crucial knowledge for designing and evaluating targeted interventions. We implemented a rigorous consumer survey on saiga (Saiga tatarica) horn use in Singapore, where usage is legal and widely sold. Saiga are Critically Endangered antelopes from Central Asia with horns (often marketed as ling yang) used in traditional Chinese medicine (TCM). Few past studies have assessed saiga horn consumers. This work is the most extensive consumer research to date specifically characterising saiga horn consumers and usage. We conducted 2294 in-person surveys on saiga horn use with Chinese Singaporeans, employing neutral questioning approaches. We found 19% of individuals reported saiga horn as a product they choose most often for themselves and/or others when treating fever and/or heatiness (a TCM state of illness), indicating a minimum estimate of high-frequency usage, not including possible low-frequency users. Overall saiga users were most characterised as middle-aged Buddhists and Taoists. However, saiga users were found in a range of demographic groups. Women preferred saiga shavings (the more traditional form), while men preferred saiga cooling water (the more modern form). About 53% of individuals who used saiga horn themselves also bought it for someone else. Buyers for others were most likely to be female middle-aged Buddhists or Taoists. Key motivating reasons for usage were "it works" and "someone recommended it to me." The top two reported recommenders were family and TCM shopkeepers. Saiga users were more likely than non-saiga users to perceive saiga as a common species in the wild. This research holds significance for interventions targeting saiga horn consumption within Singapore and throughout Asia, by identifying potential target audiences, product types, non-desirable alternatives, and motivations for use.

Science communication activism: Protesting Traditional Chinese Medicine in China.

This article investigates how activists use science communication to protest the regulation and use of Traditional Chinese Medicine in China. The article reports on a participant observation study of the motivations of the activists as well as the form and content of their activities. The article hereby questions the apparently close links between the systems of state and science in China. It also points to different configurations of the relationship between scientists, activists, science communication and publics than what has been common in analyses of science communication and activism in Western countries.

Delivery of patient-centered care in complementary medicine: Insights and evidence from the Chinese medical practitioners and patients in primary care consultations in Hong Kong.

INTRODUCTION: Traditional Chinese Medicine (TCM) has become increasingly popular around the world, and has been accepted by people not only in China and Southeast Asia, but also in Western countries. Despite its historic role in the Chinese society, there has been limited research on exploring the nature of TCM practitioner-patient interactions in the Chinese context. As indicated by a major study regarding the Hong Kong context1, there is a need to investigate the role of TCM practitioner and promote interdisciplinary research to ensure safety and synergy of TCM and Western medicine in primary care. This study aims to address this gap by investigating the nature of TCM consultations and their communication patterns in Hong Kong. METHODS: Based on 10 h of conversations (in Cantonese) between TCM practitioners and their patients in the diagnostic interviews, the study explored how the doctor-patient relationship was negotiated in the course of the consultation, while both the TCM practitioners and the patients were constantly trying to manage and maintain common ground. Particular attention had been paid to the identification of specific linguistic and discourse strategies that TCM practitioners had employed to establish doctor-patient rapport, so that a better understanding of patient-centred care in the TCM context could be obtained. The participants were recruited from a local university operated clinic which shared the characteristic of TCM practitioners in Hong Kong. RESULTS: A range of linguistic strategies that TCM practitioners used to deliver patient-centred care have been identified. These strategies are also helpful in shaping a joint decision-making process that will lead to better patient understanding and compliance with the doctors' treatments. CONCLUSIONS: This study demonstrates empirically how TCM practitioners utilize a range of linguistic resources and communication strategies to shape the ongoing discourse so that their patients can have a better understanding of their illnesses. For an example, it is found that TCM practitioners and their patients were constantly trying to manage and maintain common ground by using a range of grammatical markers, including sentence-final particles (SFPs) and discourse markers (DMs), to negotiate the epistemic commitment so that the patient would have good compliance with the practitioner's suggested treatment. It is also observed that various types of interrogatives have been used by the TCM practitioners to elicit information from the patients as well as to encourage them to talk and make a response. Furthermore, it is found that TCM practitioners would deliberately enquire about the patients' everyday experiences because what they eat, do, and encounter all have an important impact on their body conditions. By exploring into the patients' daily routines in the social talk, the practitioner can help maintain and promote the overall balance of the patient's body, and help them monitor and enhance their health conditions by modifying their daily habits and behaviours. With the adoption of these linguistic and communication strategies, the TCM practitioners are shown to have placed the patients' needs as their top priority. Previous studies in the field have already proved that co-construction of the treatment plan between the doctor and the patient is extremely important, and that a patient-centred approach can largely reduce adverse events leading to avoidable patient harm. The specific strategies identified in the current study can enhance the TCM practitioners' communication with patients, creating an environment that will surely optimise safety for both patients and clinicians.

Are we all the same? The critical role of translational brain, behavior, and immunity research in East Asia.

Traditional Chinese medicine (TCM) is founded on the idea that the "Mind and Body" are all interconnected. When you have a difficult time or disturbing lifestyle and experience a series of somatic and psychological symptoms mimicking inflammation-induced sickness behaviors, the TCM practitioners would be very likely to give you a diagnosis of "On Fire" and prescribe specific food intervention and herbal medicine, which might be considered anti-inflammatory to "cool you down." Psychoneuroimmunology has been long stemmed in ancient medicine.

Is Traditional Chinese Medicine Use Associated with Worse Patient-reported Outcomes among Chinese American Rheumatology Patients?

OBJECTIVE: Chinese Americans are a fast-growing immigrant group with more severe rheumatic disease manifestations than whites and often a strong cultural preference for traditional Chinese medicine (TCM). We aimed to examine TCM use patterns and association with patient-reported outcomes (PRO) among Chinese American rheumatology patients. METHODS: Chinese Americans actively treated for systemic rheumatic diseases were recruited from urban Chinatown rheumatology clinics. Data on sociodemographics, acculturation, clinical factors, and TCM use (11 modalities) were gathered. Self-reported health status was assessed using Patient Reported Outcomes Measurement Information System (PROMIS) short forms. TCM users and nonusers were compared. Factors independently associated with TCM use were identified using multivariable logistic regression. RESULTS: Among 230 participants, median age was 57 years (range 20-97), 65% were women, 71% had ≤ high school education, 70% were on Medicaid insurance, 47% lived in the United States for ≥ 20 years, and 22% spoke English fluently. Half used TCM in the past year; these participants had worse self-reported anxiety, depression, fatigue, and ability to participate in social roles and activities compared with nonusers. In multivariable analysis, TCM use was associated with belief in TCM, female sex, ≥ 20 years of US residency, reporting Western medicine as ineffective, and shorter rheumatic disease duration. CONCLUSION: Among these Chinese American rheumatology patients, TCM users had worse PRO in many physical and mental health domains. TCM use may be a proxy for unmet therapeutic needs. Asking about TCM use could help providers identify patients with suboptimal health-related quality of life who may benefit from targeted interventions.

Perceptions of traditional Chinese medicine for chronic disease care and prevention: a cross-sectional study of Chinese hospital-based health care professionals.

BACKGROUND: In China, demands for disease prevention and health care and the prevalence of chronic non-communicable diseases have increased. TCM and general hospitals are increasingly utilizing TCM strategies for chronic non-communicable disease care and prevention. This study aimed to investigate health care professionals' (HCPs') perceptions of TCM for prevention, their TCM knowledge, and their abilities to provide such services in TCM and general hospitals. METHODS: This cross-sectional study investigated Chinese medicine hospitals and Chinese medicine departments in general hospitals in five Chinese cities. A self-designed questionnaire used to study 400 HCPs focused on basic demographic data, the demand for and effects of TCM for prevention and treatment, and their perceptions of such service implementation. The data analysis included chi-squared tests and descriptive and multi-factor analyses. RESULTS: The 335 HCP respondents comprised 230 (68.7%) females and 105 (31.3%) males, 75.5% of whom overall had knowledge of TCM preventive and health care services. Respondents older than 40 years (28.6%) had greater knowledge of and satisfaction with TCM for preventive and health care services than younger respondents. Moreover, 97.7% of the older respondents were clearly willing to provide TCM preventive services for chronic diseases, 67.8% of whom indicated that their hospitals already provided TCM for prevention and treatment. According to the chi-squared test results, the TCM service characteristics in hospitals, hospital outlooks regarding TCM and TCM development in hospitals were the primary factors affecting the respondents' perceptions of TCM for chronic disease care and prevention. The multivariate analysis showed high satisfaction as significantly associated with older providers and those with lengthier work experience, particularly among those who worked in hospitals that provided typical TCM services and had positive attitudes towards TCM. CONCLUSION: The study HCPs had relatively satisfactory knowledge of and positive attitudes towards TCM for chronic disease care and prevention and would use it in practice. Their perceptions and satisfaction levels correlated closely with the successful application of TCM for preventive care and treatment in hospitals. While the use of TCM for prevention and treatment was well developed in some hospitals, further improvements are warranted.

Evaluating Cancer Patients' Expectations and Barriers Toward Traditional Chinese Medicine Utilization in China: A Patient-Support Group-Based Cross-Sectional Survey.

BACKGROUND: Traditional Chinese medicine (TCM) is widely used among Chinese cancer patients. However, little is known about Chinese patients' expectations and barriers toward using TCM for cancer. METHODS: We conducted a cross-sectional survey within a patient-support group, the Beijing Anti-Cancer Association. We measured the outcome, Chinese cancer survivors' expectations and barriers toward TCM utilization, using a modified version of ABCAM (Attitudes and Beliefs towards Complementary and Alternative Medicine), the ABTCM (Attitudes and Beliefs towards Traditional Chinese Medicine). We used multivariate models to evaluate the impact of socioeconomic status and clinical factors on their expectations and barriers (including treatment concerns and logistical challenges domain) toward TCM. RESULTS: Among 590 participants, most patients expected TCM to boost their immune system (96%), improve their physical health (96%), and reduce symptoms (94%). Many had logistical challenges (difficulty decocting herbs (58%) and finding a good TCM physician (55%)). A few were concerned that TCM might interfere with conventional treatments (7.6%), and that many TCM treatments are not based on scientific research (9.1%). In the multivariable regression model, age ≤60 years was independently associated with higher expectation score ( P = .031). Age ≤60 years (coefficient 5.0, P = .003) and localized disease (coefficient 9.5, P = .001) were both associated with higher treatment concerns. Active employment status (coefficient 9.0, P = .008) and localized disease (coefficient 7.5, P = .030) were related to more logistical challenges. CONCLUSION: Age and cancer stage were related to Chinese cancer patients' perceived expectations and barriers toward TCM use. Understanding these attitudes is important for reshaping the role that TCM plays in China's patient-centered comprehensive cancer care model.

Treating people with arthritis with traditional Chinese medicine (TCM): an examination of the perception of TCM practitioners.

INTRODUCTION: Emerging evidence has shown that traditional Chinese medicine (TCM) has a positive effect on arthritis. This research provides the first critical, systematic examination of TCM practitioners' perceptions of TCM use for people with arthritis. METHODS: An online survey was distributed to all TCM professionals including acupuncturists and Chinese herbal medicine practitioners registered with the Practitioner Research and Collaborate Initiative (PRACI) practitioner database. The survey questions focus on practitioner characteristics, practice characteristics and clinical management approaches regarding arthritis care. RESULTS: The survey attracted a response rate of 53% (n=52). The average age of the respondents was 49.9 years, more than half were female, and the majority held a bachelor degree or higher qualification. More than two thirds of TCM practitioners in our study worked with other health professionals, while they had a high level of referral relationships with a wide range of conventional, allied health and complementary and alternative medicine (CAM) providers. Most of the TCM practitioners reported that their patients with arthritis used other treatments alongside TCM and a large number of the TCM practitioners who participated believed that TCM was effective for treating arthritis. CONCLUSIONS: The TCM profession represents a substantial component of the healthcare field in Australia, and treating patients with arthritis appears to be an important area of TCM practice, among others. Further detailed research is needed to help ensure effective, safe patient care for those with arthritis who may be utilising TCM alongside a broader range of conventional medicine, allied health, and other CAM treatments.

Experiences of Chinese immigrant women following "Zuo Yue Zi" in British Columbia.

AIMS AND OBJECTIVES: To describe Chinese women's experiences with "zuo yue zi" in British Columbia, Canada. BACKGROUND: Women born in China and Taiwan are increasingly immigrating to westernised countries. Many women choose to follow traditional Chinese postpartum practices, also called "zuo yue zi." Few studies have examined women's use of traditional practices in western countries. DESIGN: The study used a qualitative descriptive design. METHODS: We recruited 13 mothers who were: aged 19 or older, immigrants from mainland China, Hong Kong or Taiwan in the last 5 years, and caring for infants born in the previous 6 weeks. Semistructured interviews were conducted in Mandarin, translated into English, transcribed and analysed using inductive content analysis. RESULTS: The core theme was Chinese women's novel encounters with "zuo yue zi." The women's expectations of "zuo yue zi" were acquired through birth experiences or interactions with family and friends. The participants struggled with implementing traditional practices because social support and formal institutional structures were lacking. They modified their expectations about "zuo yue zi." Factors affecting their practices were catalysts and deterrents. Catalysts included help from Chinese family members, friends and informed healthcare providers. Deterrents included unregulated paid helpers, uninformed care providers, financial constraints and structural limitations in their new environments. CONCLUSIONS: Chinese immigrant women struggled to modify and implement traditional practices in their adopted country when they encountered financial constraints, unregulated paid helpers and varying support from health care providers. RELEVANCE TO CLINICAL PRACTICE: Some postpartum women following "zuo yue zi" believed that the practice would prevent chronic illness and strengthen their intrafamily relationships. Immigrant mothers require nursing support to follow traditional postpartum practices. Nurses can advocate on patients' behalf to increase care providers' knowledge about "zuo yue zi" and public awareness for necessary regulated institutional structures.