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1.
BMC Complement Altern Med ; 19(1): 332, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31752830

RESUMO

BACKGROUND: Weight gain is common after breast cancer (BC) treatment and may increase the risk of disease recurrence. Complementary medicine (CM) use is high amongst BC patients. This paper describes the use of CM from a cross-sectional self-administered survey on prevalence and management of weight after BC. METHODS: Use of CM was assessed using a question modified from the I-CAM Questionnaire. Participants were asked to rate perceived effectiveness, advantages and disadvantages, and which CM they were willing to use for weight management if there was evidence for effectiveness. The survey was emailed to members of the Breast Cancer Network Australia Survey and Review Group, the largest consumer advocacy group in Australia for people with breast cancer. RESULTS: There were a total of 309 responses. Three quarters had used CM in the past 12 months. One third had tried CM for weight loss. Yoga, meditation and pilates were perceived to be effective for weight loss. Perceived advantages of CMs for weight loss were the ability to improve general wellbeing, relaxation, and being non-pharmacological while disadvantages were financial cost, finding a reliable practitioner, and lack of research for effectiveness. Three quarters would be willing to try CM for weight loss if there was evidence for effectiveness, with the most popular CMs being acupuncture, relaxation, yoga, supplements, and meditation. CONCLUSIONS: The high use of CM in this group is consistent with previous research. Our research suggests that BC survivors would use acupuncture, meditation, supplements and yoga for weight loss if supported by scientifically-credible evidence. Research into the effectiveness of these treatments on weight loss after BC is warranted.


Assuntos
Neoplasias da Mama , Terapias Complementares , Conhecimentos, Atitudes e Prática em Saúde , Sobrepeso , Ganho de Peso , Adulto , Idoso , Austrália , Peso Corporal/fisiologia , Neoplasias da Mama/complicações , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Terapias Complementares/psicologia , Terapias Complementares/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Sobrepeso/epidemiologia , Sobrepeso/etiologia , Sobrepeso/psicologia , Sobrepeso/terapia , Prevalência
2.
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
3.
BMC Complement Altern Med ; 19(1): 301, 2019 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-31694617

RESUMO

BACKGROUND: Complementary and alternative medicine (CAM) use among infertile women is popular in many countries, including Korea. Previous research has repeatedly found more than half of infertile women surveyed use CAM therapies for fertility enhancement and overall well-being. However, there is currently little evidence to support this practice, and this raises the question of infertile women's experiences in the uptake of those modalities and sociodemographic and psychological factors associated with CAM use. Thus, this study aims to explore the perceptions and experiences of infertile women with regard to their use of CAM in Korea. METHODS: A cross-sectional study was conducted using data from 263 infertile women attending infertility specialty clinics in Seoul, Korea, in June 2012. The survey instrument included 47 questions on the use of CAM, demographic characteristics, health status, and infertility related factors such as duration and type of infertility, experience and satisfaction of conventional treatment, and self-perceived severity of infertility condition. Chi-square test and logistic regression were used for data analysis. RESULTS: Among 286 respondents (response rate, 95.3%), a total of 263 women were included in the final analysis. 63.5% of respondents used one or more types of CAM modalities during infertility treatment. The utilization of CAM was associated with employment status, duration of infertility treatment, and self-perceived severity of the disease. The most commonly used CAM modalities were multivitamin and herbal medicine, and differences in types of CAM modalities used were found between the group with a higher rating of self-perceived disease severity and the lower perceived severity group. CONCLUSIONS: High prevalence of CAM use among infertile women was observed in Korea. Our findings support that infertile women's own understanding of their illness and physical condition influences self-care behavior such as CAM use. This calls for an urgent need for further in-depth study of the clinical effects of popular CAM modalities among infertile women when used in conjunction with conventional treatment.


Assuntos
Terapias Complementares/psicologia , Infertilidade Feminina/terapia , Adulto , Estudos Transversais , Feminino , Humanos , Infertilidade Feminina/psicologia , Pacientes/psicologia , Percepção , República da Coreia , Índice de Gravidade de Doença
4.
BMC Complement Altern Med ; 19(1): 259, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533782

RESUMO

BACKGROUND: Traditional and complementary medicines (T&CM) are any form of medicine, practice, treatment, product, technology, knowledge system or ceremony outside of conventional medical practice that aims to prevent and/or treat illness and/or promote well-being. Alongside conventional cancer treatments, T&CM usage is increasing; with 19% of indigenous Australians with cancer reporting using T&CM. There is limited evidence surrounding T&CM use and disclosure by indigenous patients. Our aim was to explore healthcare providers' views about usage, disclosure/non-disclosure of T&CM by Indigenous cancer patients. METHODS: Semi-structured, in-depth interviews with 18 healthcare providers, including three indigenous providers, at a large urban hospital providing care to Indigenous cancer patients were conducted to explore providers' experiences and attitudes towards T&CM use by Indigenous cancer patients. An interpretive phenomenological approach was used to thematically analyse the data. RESULTS: Analysis revealed six themes: concern about risk; no 'real' benefits; perception of T&CM and conventional medicine as antithetical; barriers to disclosure; 'patients' choice' a double-edged sword; and providers' lack of knowledge about T&CM. Healthcare providers perceived discord between T&CM and conventional medicine. Most lacked knowledge of T&CM, and had concerns around negative-interactions with conventional treatments. They considered T&CM outside their role, citing this as reasoning for their lack of knowledge. Indigenous healthcare providers had greater understanding and openness towards T&CM. CONCLUSIONS: Given the potential usage of T&CM by Indigenous cancer patients, providers need a more comprehensive understanding of T&CM in order to inform discussion and facilitate effective disclosure on this topic. If indigenous Australians with cancer feel that cancer care providers are unreceptive to discussing T&CM, patient care risks being compromised; particularly given the potential for negative interactions between T&CM and conventional cancer treatments. Fostering health care interactions where indigenous patients feel comfortable to discuss T&CM usage should be a priority for all cancer care services.


Assuntos
Terapias Complementares/psicologia , Pessoal de Saúde/psicologia , Medicina Tradicional/psicologia , Neoplasias/terapia , Adulto , Atitude do Pessoal de Saúde , Austrália , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/psicologia
5.
BMC Complement Altern Med ; 19(1): 251, 2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31500604

RESUMO

BACKGROUND: While traditional, complementary and alternative medicine (TCAM) is gaining increased interest worldwide, the structural factors associated with the usage of TCAM at the social level have not been sufficiently explored. We aim to understand the social structure of uncertainty in society that affects the TCAM usage for men and women. METHODS: We studied 32 countries using data from the International Social Survey Programme and the World Bank. In this study, we defined TCAM usage as visits to an alternative/traditional/folk health care practitioner during the past 12 months. We performed a correlation analysis and used a generalized linear model . RESULTS: The prevalence of TCAM usage in terms of visits to practitioners was 26.1% globally, while usage varied across the 32 countries. Generalized linear models showed that unemployment rate was associated with the prevalence of TCAM usage in terms of visits to practitioners. CONCLUSIONS: At the social-structural level TCAM usage involving visits to practitioners was related to job insecurity. Job insecurity led to a decrease in TCAM usage regarding visits to practitioners. These findings suggest that it is necessary to consider the social-structural factors of uncertainty in society when designing health policies related to TCAM.


Assuntos
Terapias Complementares/psicologia , Medicina Tradicional/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Assistência Ambulatorial/psicologia , Assistência Ambulatorial/estatística & dados numéricos , Terapias Complementares/estatística & dados numéricos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Medicina Tradicional/estatística & dados numéricos , Pessoa de Meia-Idade , Inquéritos e Questionários , Incerteza , Adulto Jovem
6.
BMC Complement Altern Med ; 19(1): 250, 2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31500611

RESUMO

BACKGROUND: Parents' use of complementary health approaches (CHA) for children with autism spectrum disorder (ASD) are common despite the uncertain evidence of its benefit. Parents often adopt CHA due to dissatisfaction with conventional treatment. This study aimed to examine parents' satisfaction with ASD treatment and their perception of progress in their child's development. Parents' use of CHA among children with ASD and the factors related were also evaluated. METHODS: Self-administered questionnaires were completed by 48 parents of children with ASD at a single tertiary referral hospital in Malaysia. Correlation analysis was used to explore associations between parental satisfaction scores, perception of progress scores and use of CHA. RESULTS: Use of CHA was reported by parents for 35.4% of children with ASD in the sample. Parents who were less satisfied with conventional treatment and parents who perceived poorer progress in their child's development were more likely to use CHA. Strong positive relationship was found between parent satisfaction with ASD treatment scores and parent perception of progress scores, which indicates that parents who were satisfied with treatment were more likely to perceive greater progress in their child's development. Improvement in child's progress was most appreciated by parents in their child's behavior (85.5%), social skills (83.3%) and motor skills (77.1%). CONCLUSION: The use of CHA was common among children with ASD. Parents were more likely to practice CHA when they were less satisfied with conventional treatment and perceived poorer progress. A larger multicenter study is required to further explore the practice of CHA among children with ASD throughout Malaysia.


Assuntos
Transtorno do Espectro Autista/terapia , Terapias Complementares/psicologia , Satisfação Pessoal , Adolescente , Adulto , Transtorno do Espectro Autista/psicologia , Criança , Comportamento Infantil , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Malásia , Masculino , Pessoa de Meia-Idade , Pais/psicologia , Habilidades Sociais , Inquéritos e Questionários , Resultado do Tratamento
8.
J Med Radiat Sci ; 66(3): 191-199, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31393077

RESUMO

INTRODUCTION: Complementary and alternative therapies (CATs) are widely used by cancer patients but are infrequently disclosed and documented. This study aimed to improve radiation therapy staff knowledge, confidence, views and documentation of radiation oncology patients' use of CATs. METHOD: Participants completed a baseline questionnaire regarding their knowledge, confidence, views and documentation relating to patients' CAT use. An intervention was undertaken whereby participants attended an educational session and a CAT screening tool was implemented simultaneously. Participants immediately completed a post-intervention questionnaire and later a 6-month follow-up questionnaire. A patient record audit was conducted to measure the documentation of CAT use pre- and post-intervention. RESULTS: From baseline to post-intervention, there was a statistically significant shift in staff knowledge and confidence (P = 0.001-0.01). The observed shift was sustained over a 6-month period, (P = 0.453-1.00). Participants' perceived views of CATs did not change as a result of the intervention (P = 0.261-1.000). The post-intervention audit compared to the baseline audit yielded a statistically significant increase in documentation. There was an increase in CAT use mentioned in patient records from 14% (15/108) to 40% (35/88) (P < 0.001). CONCLUSIONS: The implementation of a screening tool and staff education increased radiation therapy staff knowledge of CATs and increased staff confidence when discussing CAT use with patients. Documentation of CATs in the patient record increased post-intervention. These changes positively affected radiation therapy staff understanding the use of CATs by cancer patients.


Assuntos
Terapias Complementares/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Neoplasias/terapia , Enfermeiras e Enfermeiros/psicologia , Radio-Oncologistas/psicologia , Serviço Hospitalar de Radiologia/estatística & dados numéricos , Humanos , Registros Médicos , Neoplasias/radioterapia , Inquéritos e Questionários
9.
Medicina (Kaunas) ; 55(7)2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31323758

RESUMO

Background and objectives: In addition to conventional healthcare, Ebola survivors are known to seek traditional and complementary healthcare (T&CM) options to meet their healthcare needs. However, little is known about the general beliefs of Ebola survivors regarding T&CM and the impact of these beliefs in influencing their decisions around T&CM use. This study examines Ebola survivors' attitudes towards T&CM use in Sierra Leone. Materials and Methods: We conducted a nationwide quantitative cross-sectional study of 358 Ebola survivors in Sierra Leone between January and August 2018. We used descriptive analysis, chi-square tests and backward stepwise binary logistic regression for data analysis. Results: Close to half of the survivors (n = 163, 45.5%) had used T&CM since their discharge from an Ebola treatment centre. Survivors who viewed T&CM as boosting their immune system/resistance were 3.89 times (95%CI: 1.57-9.63, p = 0.003) more likely to use T&CM than those who did not view T&CM as boosting their immune system/resistance. Additionally, survivors who viewed T&CM as having fewer side effects than conventional medicine were more likely to use T&CM [OR = 5.03 (95%CI: 1.92-13.19, p = 0.001)]. Ebola survivors were more influenced to use T&CM based on their personal experience of the effectiveness of T&CM than by clinical evidence [OR = 13.72 (95%CI: 6.10-30.84, P < 0.001)]. Ebola survivors who perceived T&CM as providing them with more control than conventional medicine over their health/body were more likely to use T&CM [OR = 4.15 (95%CI: 1.74-9.89, p = 0.001)] as opposed to those who did not perceive T&CM in this way. Conclusions: Considering the widespread use of T&CM, an understanding of Ebola survivors' attitudes/beliefs towards T&CM is useful to healthcare providers and policymakers with regard to public education and practitioner-survivors communication, T&CM regulation and research in Sierra Leone. Ebola survivors appear to turn to T&CM not only for treatment, but also to fill gaps in conventional health care services.


Assuntos
Terapias Complementares/psicologia , Doença pelo Vírus Ebola/psicologia , Sobreviventes/psicologia , Adolescente , Adulto , Terapias Complementares/normas , Estudos Transversais , Ebolavirus/patogenicidade , Feminino , Doença pelo Vírus Ebola/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Serra Leoa , Inquéritos e Questionários , Sobreviventes/estatística & dados numéricos
10.
Complement Ther Med ; 45: 198-204, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31331561

RESUMO

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.


Assuntos
Terapias Complementares/psicologia , Pessoal de Saúde/psicologia , Medicina Tradicional Chinesa/psicologia , Cooperação do Paciente/psicologia , Adulto , China , Comunicação , Tomada de Decisões , Feminino , Hong Kong , Humanos , Masculino , Pessoa de Meia-Idade , Assistência Centrada no Paciente/métodos , Relações Médico-Paciente , Atenção Primária à Saúde/métodos , Encaminhamento e Consulta , Adulto Jovem
11.
Complement Ther Med ; 45: 25-32, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31331570

RESUMO

BACKGROUND: Most healing research has focussed on the views of healers, complementary and alternative medical (CAM) practitioners or medical professionals, and little is known about how the general public conceives of healing. Because healing is a complex and often abstract concept, we addressed this gap in the knowledge using creative qualitative approaches with members of the public. We aimed to elucidate the views of members of the public about their healing, to help offer a better understanding to healthcare professionals. METHODS: Our qualitative arts-based drawing method invited people to respond using crayons and paper to the question 'What does the word healing mean to you?' These drawings were followed by a short recorded interview in which people explained their image. We used convenience sampling to approach members of the public visiting a large wellbeing show and a museum. We analysed images and interviews in tandem using a focus on metaphor. RESULTS: We interviewed 59 people, including three children. Almost two thirds of participants were female. Participants' images and interviews documented three main models of the healing process: i) Healing comes from a great external force, exemplified by the sun; ii) Healing comes from other people, whether medical professionals, CAM practitioners or healers; and iii) Healing comes from within, and the individual has the ability to self-heal. People described practices and inner states that could help achieve healing. Some people depicted more than one model, demonstrating the interlinkages between the models, and some described the outcome of healing (wholeness) rather than the process. CONCLUSIONS: The drawing-based approach encouraged an intuitive way of thinking, capturing concepts that cannot easily be verbalised. Members of the public have nuanced, complex understandings of the concept of healing, and these echo historical and modern concepts of healing and healthcare. The models our participants described often interlink, suggesting an overarching framework for the way people conceive of healing. The findings may be useful both as a guide to further research and as insight that may facilitate healthcare processes.


Assuntos
Terapias Complementares/psicologia , Cicatrização/fisiologia , Adolescente , Adulto , Idoso , Feminino , Pessoal de Saúde/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
12.
J Cancer Res Clin Oncol ; 145(8): 2141-2148, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31278473

RESUMO

PURPOSE: Many cancer patients (PTS) suffer from somatic or non-somatic symptoms. Studies have shown positive effects of music intervention (MI) on aspects of quality of life or symptom management. METHODS: Since there are poor data available about patient's needs regarding the use of MI as an adjunct to cancer treatment, n = 548 tumor PTS were polled anonymously at the outpatient department of the University Hospital Mannheim Tumor Center using a self-designed questionnaire. Univariate and multivariate analyses were performed. RESULTS: 486 data sets were eligible for analysis. 240 of the PTS were male and median age was 63 years. 38% had metastatic disease. 81% (n = 386) were currently receiving anti-tumor treatment. The majority of the PTS stated to have somatic symptoms. However, some of the PTS reported non-somatic symptoms like anxiety, loneliness, and depression. N = 187 (40%) of the PTS reported interest in complementary MI. In the univariate and multivariate analyses, especially PTS with non-somatic complaints and PTS, actively playing or making music showed significantly more interest in complementary MI, hoping for a relaxing therapeutic effect. PTS who play instruments would prefer more active forms of MI. CONCLUSION: 40% of PTS reported interest in additional MI during cancer treatment. PTS with non-somatic symptoms as well as patients affine to music might benefit from the use of MI potentially reducing their symptom burden. The inconsistent and heterogeneous data from randomized trials underline the importance of systematic research approaches with more relevant and standardized endpoints.


Assuntos
Terapias Complementares/métodos , Musicoterapia , Música , Neoplasias/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/complicações , Ansiedade/epidemiologia , Ansiedade/psicologia , Ansiedade/terapia , Terapias Complementares/psicologia , Terapias Complementares/estatística & dados numéricos , Depressão/complicações , Depressão/epidemiologia , Depressão/psicologia , Depressão/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Música/psicologia , Neoplasias/epidemiologia , Neoplasias/patologia , Neoplasias/psicologia , Qualidade de Vida , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Estresse Psicológico/terapia , Inquéritos e Questionários , Adulto Jovem
13.
BMC Gastroenterol ; 19(1): 115, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266461

RESUMO

BACKGROUND: Patients with Inflammatory Bowel Disease (IBD) also suffer from a wide range of additional disorders, which may be caused by the disease, the side effect of the medication, or a lack of physical activity (PA). This results in reduced physical and psychological wellbeing. However, as known from other chronic diseases exercise could be utilized as supportive therapy for IBD patients. Main goals of this article are (a) collecting data of the effects structured physical activity interventions have on validated clinical parameters of IBD and health related symptoms, (b) developing activity recommendations for this clientele. METHODS: A scoping review was conducted, searching for relevant articles published until May 2018, which investigated the effects of structured exercise interventions in IBD patients. The heterogeneity of the outcomes and the interventions did not support a quantitative synthesis thus, a qualitative discussion of the studies is provided. RESULTS: After reviewing 353 records, 13 eligible articles were identified. Five studies investigated aerobic exercise, three studies resistance exercise, three studies mind-body therapies and two studies yoga. The quality of the studies is mixed, and the duration is rather short for exercise interventions. Only few studies assessed validated IBD activity markers or inflammatory biomarkers. Nevertheless, the patients showed an increase in fitness, bone mineral density (BMD), quality of life and a decrease of IBD induced stress and anxiety. No severe adversial events were reported. CONCLUSION: Even though the evidence is limited the application of exercise interventions in IBD patients can be assumed to be safe and beneficial for the patients' overall-health, and IBD specific physical and psychosocial symptoms. But there is still a high demand for more thoroughly conducted studies, focussing on important clinical outcome parameters.


Assuntos
Terapias Complementares/métodos , Terapia por Exercício/métodos , Doenças Inflamatórias Intestinais/terapia , Adulto , Terapias Complementares/psicologia , Exercício , Terapia por Exercício/psicologia , Feminino , Humanos , Doenças Inflamatórias Intestinais/psicologia , Masculino , Pessoa de Meia-Idade , Terapias Mente-Corpo/métodos , Treinamento de Resistência/métodos , Resultado do Tratamento , Ioga
14.
Cancer Res Treat ; 51(3): 851-860, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31208165

RESUMO

PURPOSE: A cross-sectional survey was conducted to explore the current awareness and use of complementary and alternative medicine (CAM), as well as attitudes toward CAM, in patients with cancer and their family members in South Korea. MATERIALS AND METHODS: Between September 21 and October 31, 2017, a 25-item questionnaire regarding CAM experiences among cancer patients and their family members was conducted in 10 oncology clinics in South Korea after institutional review board approval at each institution. RESULTS: In total, 283/310 patients were analyzed. The median age was 60 years, and 60% were male. Most of the patients were actively receiving anticancer treatment at the time of the survey. A total of 106 patients (37%) had experienced a median of two types (interquartile range, 1 to 3) of CAM. Belief in CAM (odds ratio [OR], 3.015; 95% confidence interval [CI], 1.611 to 5.640) and duration of disease (OR, 1.012; 95% CI, 1.004 to 1.020) were independent factors for using CAM in multivariable analysis. Belief in CAM was significantly associated with current use of CAM (OR, 3.633; 95% CI, 1.567 to 8.424). Lay referral was the most common reason for deciding to use CAM, and only 25% of patients (72/283) discussed CAM with their physicians. CONCLUSION: Patient attitudes toward and confidence in CAM modalities were strongly associated with their CAM experiences, and only a small number of patients had an open discussion about CAM with their physicians. A patient education program for CAM is needed.


Assuntos
Cuidadores/psicologia , Terapias Complementares/psicologia , Neoplasias/terapia , Pacientes/psicologia , Idoso , Terapias Complementares/educação , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , República da Coreia , Inquéritos e Questionários
15.
BMC Complement Altern Med ; 19(1): 93, 2019 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-31039772

RESUMO

BACKGROUND: Complementary and alternative medicine (CAM) is a rather novel issue within public healthcare and health policy-making. CAM use in Europe is widespread, patient-initiated, and patient-evaluated, and the regulation across countries has been evaluated as disharmonized. CAM users are left in an uncertain position, and patient safety may be threatened. How "risk" is understood by individuals in health policy-making and clinical encounters involving the use of CAM has not yet been much debated. The aim of this article is to explore and discuss the existence and possible consequences of differing risk understandings among stakeholders maneuvering in the complex landscape of CAM practice and CAM regulation contextualized by European public healthcare systems. METHODS: Qualitative data were derived from two studies on CAM in European healthcare contexts. Findings from the EU project CAMbrella on legislation and regulation of CAM were mixed with data from an interview study exploring risk understandings, communication, and decision-making among Scandinavian CAM users and their doctors. In a secondary content analysis, we constructed the case Sara as a typology to demonstrate important findings with regard to risk understandings and patient safety involving European citizens' use of CAM in differing contexts. RESULTS: By combining and comparing individual and structural perspectives on risk and CAM use, we revealed underexplored gaps in risk understandings among individuals involved in European CAM regulation and legislation, and between CAM users and their medical doctors. This may cause health risks and uncertainties associated with CAM use and regulation. It may also negatively influence doctor-CAM user communication and CAM users' trust in and use of public healthcare. CONCLUSION: Acknowledging implications of stakeholders' differing risk understandings related to CAM use and regulation may positively influence patient safety in European healthcare. Definitions of the concept of risk should include the factors uncertainty and subjectivity to grasp the full picture of possible risks associated with the use of CAM. To transform the findings of this study into practical settings, we introduce sets of questions relevant to operationalize the important question "What is risk?" in health policy-making, clinical encounters and risk research involving European patients' use of CAM.


Assuntos
Terapias Complementares , Conhecimentos, Atitudes e Prática em Saúde , Política de Saúde , Qualidade da Assistência à Saúde , Terapias Complementares/legislação & jurisprudência , Terapias Complementares/psicologia , Terapias Complementares/normas , Europa (Continente) , Humanos , Formulação de Políticas , Risco
16.
BMC Complement Altern Med ; 19(1): 95, 2019 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-31053114

RESUMO

BACKGROUND: Traditional medicine has always been Pakistan's cultural heritage, providing health care to a large part of its population. Thus, we aimed to assess and compare the knowledge, attitude, and perception about complementary and alternative medicine (CAM) between pharmacy and non-pharmacy students, the results of which may be helpful in devising national health-education policy. METHODS: A cross-sectional study was conducted by enrolling 937 students, pharmacy (437) and non-pharmacy (500), of Punjab University, Lahore. A self-administered questionnaire was used for data collection. Data were analyzed using SPSS. (IBM v22). RESULTS: Data suggested that majority of students knew about the use of traditional herbs and considered massage (P: 84.4%, NP: 82%, p = 0.099), homeopathy, herbs (P: 86.5%, NP: 81%, p = 0.064], yoga [P: 357 (81.7%), NP: 84%), p = 0.42] and spiritual healing (P: 85.6%, NP: 86.2%, p = 0.55) as effective and least harmful CAM modalities. The pharmacy students had better knowledge about CAM modalities compared to non-pharmacy students. Despite utilizing non-reliable sources of CAM information and their belief that CAM is practiced by quacks, the majority of students had positive attitudes and perceptions about CAM usage. Students also believed that CAM had a positive impact on health outcomes [P: 3.19 ± 1.04, NP: 3.02 ± 1.09, p = 0.008] and acceded to include CAM in the pharmacy curriculum. However, non-pharmacy students scored higher in their beliefs that CAM usage should be discouraged due to the non-scientific basis of CAM (P: 3.04 ± 0.97, NP: 3.17 ± 1.02, p = 0.028) and a possible threat to public health (P: 3.81 ± 1.74, NP: 4.06 ± 1.56, p = 0.02). On the other hand, pharmacy students believed that patients might get benefits from CAM modalities (P: 4.31 ± 1.48, NP: 4.12 ± 1.45, p = 0.02). Majority of students perceived that spiritual healing is the most useful and safer CAM modality, while acupuncture (P: 25.4%, NP: 21.8%, p = 0.0005), hypnosis (P: 26.8%, NP: 19.6%, p = 0.001) and chiropractic (P: 18.8%, NP: 11.6%, p = 0.0005) were among the harmful ones. CONCLUSION: In conclusion, despite poor knowledge about CAM, students demonstrated positive attitudes and beliefs regarding CAM. They exhibited better awareness about yoga, spiritual healing/prayer, herbs, and massage. Students also showed willingness to advance their knowledge about CAM and favored its inclusion in the curriculum.


Assuntos
Atitude do Pessoal de Saúde , Terapias Complementares/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Estudantes de Farmácia/psicologia , Estudantes de Farmácia/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Masculino , Adulto Jovem
17.
Oncology ; 97(1): 18-25, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31132779

RESUMO

PURPOSE: It is usual for cancer patients to use complementary and alternative medicines (CAMs) and yet the literature evaluating their efficacy in cancer patients is very limited. The objective of the present study was to report on the nature, frequency of use, and patient-reported outcome of CAMs in a single-center study. METHODS: All the consecutive patients treated between November 2017 and June 2018 at the Lucien Neuwirth Cancer Institute (France) were screened. Their reasons for using CAMs and their usage habits were collected. Patients evaluated their benefit. RESULTS: Of the 209 patients screened, 200 patients were included. CAMs ranged from osteopathy, homeopathy, acupuncture, healing touch, magnetism, naturopathy, suction cups, Chinese medicine, reflexology, to hypnosis. CAMs were widely used (n = 166, 83%), the first being osteopathy (n = 99, 49.5%), the second homeopathy (n = 78, 39.0%), and finally acupuncture (n = 76, 38.0%). Whatever the CAM, high satisfaction rates were reported (median satisfaction: 61-81%). CAMs were mainly used to prevent/treat side effects of anticancer treatments (81.2% for healing touch), increase well-being (55.4% for naturopathy), improve the immune system (16.9% for homeopathy), and treat cancer (n = 3, 5.1% for homeopathy). Patients could easily consider using CAMs, as up to 50.8% would have accepted a consultation. CONCLUSIONS: The reasons for using CAMs differed among patients. They praised CAMs and kept asking for more information although there is limited evidence about their efficacy in the literature. Thus, prospective randomized controlled trials exploring the safety and efficacy of CAMs in cancer patients are needed.


Assuntos
Terapia por Acupuntura/métodos , Terapias Complementares/métodos , Medicina Tradicional Chinesa/métodos , Neoplasias/terapia , Terapias Complementares/psicologia , Feminino , França/epidemiologia , Homeopatia/métodos , Humanos , Hipnose/métodos , Masculino , Massagem/métodos , Naturopatia/métodos , Neoplasias/epidemiologia , Neoplasias/patologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Satisfação do Paciente , Resultado do Tratamento
18.
BMC Complement Altern Med ; 19(1): 78, 2019 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-30940118

RESUMO

BACKGROUND: Teaching Complementary and alternative medicine (CAM) in medical schools is becoming prevalent worldwide. Few studies have been conducted to evaluate medical students' knowledge and attitude toward CAM. Therefore, this study was designed to assess CAM knowledge, attitudes, and beliefs among Palestinian medical students. METHODS: This study was developed in a cross-sectional design. It targeted medical students at An-Najah National University, between January and April of 2018. We gathered the data from students using a questionnaire printed as a hard copy. Medical students of both sexes in their 4th, 5th, or 6th year of studies were included in the survey. The questionnaire consisted of 3 sections: demographic characteristics and detailed practices of the participants, their attitude and held beliefs towards CAM, and their knowledge on CAM. Mann-Whitney U Test and Kruskal-Wallis Test were used to test if there were differences between knowledge about CAM and the characteristics of the participants. RESULTS: Of the 300 medical students who were offered the questionnaire, 251 students (43.8% male and 56.2% female) were included in the final analysis. Out of a maximum of 8 points, the mean knowledge score of the participants was 2.0 ± 1.6. The Kruskal-Wallis test showed a statistically significant difference in overall knowledge score among students of different year groups, with students at lower levels obtaining higher scores (P < 0.001). Additionally, the highest knowledge scores were found in students with low income, and students who came from the Palestinian refugee camps (P < 0.001). Students frequently recommended CAM modalities, with herbal medicine being the most recognized and used CAM modality and Ayurvedic medicine being the least recognized and recommended one. Social media was the most popular source of information about CAM, cited by 72.9% of the participants. Participants generally had a good attitude towards CAM but held varying beliefs about it. CONCLUSIONS: In the current study, a knowledge gap regarding CAM was found among medical students in our sample, despite their good attitude towards the subject. Also, there was a general acceptance to include materials on CAM within the curriculum of medical students.


Assuntos
Atitude do Pessoal de Saúde , Terapias Complementares , Conhecimentos, Atitudes e Prática em Saúde , Estudantes de Medicina , Adulto , Terapias Complementares/psicologia , Terapias Complementares/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Oriente Médio/epidemiologia , Estudantes de Medicina/psicologia , Estudantes de Medicina/estatística & dados numéricos , Adulto Jovem
19.
Complement Ther Clin Pract ; 35: 272-277, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31003669

RESUMO

PURPOSE: To estimate the overall prevalence of complementary and alternative medicine and specific modalities used among children with asthma, identify predictors of use, and perceived positive or negative effects of therapies. RESULTS: Of the 161 children enrolled in the study, 76.4% had ever used complementary and alternative medicine. Humidifiers, air purifiers, and multivitamins were the most common modalities used. Complementary and alternative medicine use in children was associated with family use, younger child age, and disease severity, indicated by recent asthma exacerbation. The majority of participants perceived benefit from their complementary and alternative medicine use, with very few reporting negative side effects. Only 36.7% of participants reported discussing their complementary and alternative medicine use with the asthma clinic healthcare team. CONCLUSIONS: The prevalence of complementary and alternative medicine use in children with asthma is high, with the majority of families perceiving benefit from its use. This study offers clinicians a reference to inform families regarding the subjective helpfulness of various types of complementary and alternative medicine modalities that can facilitate the dialogue between health care professionals and families interested in complementary and alternative medicine use.


Assuntos
Asma/terapia , Atitude do Pessoal de Saúde , Terapias Complementares/métodos , Terapias Complementares/psicologia , Pessoal de Saúde/psicologia , Pais/psicologia , Adolescente , Instituições de Assistência Ambulatorial , Criança , Pré-Escolar , Terapias Complementares/estatística & dados numéricos , Feminino , Humanos , Masculino , Ontário
20.
BMC Complement Altern Med ; 19(1): 83, 2019 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-30961586

RESUMO

BACKGROUND: Integrative and complementary health approaches (ICHA) are often pursued by patients facing chronic illnesses. Most of the studies that investigated the factors associated with ICHA consumption have considered that the propensity to use ICHA is a stable or fixed characteristic of an individual. However, people may prefer using ICHA in some situations and not in others, depending on the characteristics of the illness to face. Moreover, the attitude toward ICHA may differ within a single individual and between individuals so that ICHA can be used either in addition to (i.e., complementary attitude) or in place of (i.e., alternative attitude). The present study aimed at examining distinct patterns of attitudes toward ICHA in people hypothetically facing chronic illnesses that differed according to severity and clinical expression. METHODS: We conducted a web-based study including 1807 participants who were asked to imagine that they had a particular chronic illness based on clinical vignettes (mental illnesses: depression, schizophrenia; somatic illnesses: rheumatoid arthritis, multiple sclerosis). Participants were invited to rate their perceived distress and social stigma associated with each illness as well as its perceived treatability. They also rated their belief in treatment effectiveness, and their treatment preference. Four patterns of treatment choice were determined: strictly conventional, weak or strong complementary, and alternative. Bayesian methods were used for statistical analyses. RESULTS: ICHA were selected as complementary treatment option by more than 95% of people who hypothetically faced chronic illness. The complementary attitude towards ICHA (in addition to conventional treatment) was more frequent than the alternative one (in place of conventional treatment). Factors driving this preference included employment status, severity of illness, age and perceived distress, social stigma and treatability of the illness. When the label of illnesses was included in the vignettes, patterns of treatment preference were altered. CONCLUSIONS: This study provides evidence that "medical pluralism" (i.e., the integration of ICHA with conventional treatment) is likely the norm for people facing both mental or somatic illness. However, our result must be interpreted with caution due to the virtual nature of this study. We suggest that taking attitudes toward ICHA into account is crucial for a better understanding of patients' motivation to use ICHA.


Assuntos
Terapias Complementares , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Idoso , Doença Crônica/terapia , Terapias Complementares/psicologia , Terapias Complementares/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
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