Abstract
Communication about Traditional Complementary and Alternative Medicine (TCAM) use is important in both Western and Eastern countries to prevent interference with conventional cancer treatment. This study compares communication about TCAM of health-care providers (HCP) involved in childhood cancer care in Netherlands and Indonesia.Cross-sectional study at Dutch and Indonesian academic hospital using semi-structured questionnaires.Overall 342 HCP participated: 119 Dutch and 223 Indonesian HCP (response rate 80% and 87%). HCP have negative perspectives about TCAM according to more Dutch (80%) than Indonesian (42%) HCP (p < 0.001). More Dutch (97%) HCP think cancer patients use TCAM than Indonesian (75%) HCP (p = 0.001). Less Dutch (36%) than Indonesian (65%) HCP ask parents, during routine history taking, if they use TCAM in their child (p < 0.001). In both settings, most HCP (98%, 90% respectively) consider it important that parents inform them if their child uses TCAM (p = 0.004). Parents do not disclose their TCAM use to doctors according to 75% of Dutch and 84% of Indonesian HCP (p = ns). Parents are afraid of receiving less care from doctors if they disclose their interest in or use of TCAM according to more Indonesian (74%) than Dutch (42%) HCP (p < 0.001). Parents actually receive less care from doctors if they disclose their interest in or use of TCAM according to more Indonesian (40%) than Dutch (2%) HCP (p < 0.001). More Dutch (46%) than Indonesian (30%) HCP never openly discuss TCAM with parents (p = 0.002).Dutch HCP have more negative perspectives and communicate less openly about TCAM with parents than Indonesian HCP. In both settings HCP realize that their patients use TCAM and do not disclose this. Doctors need to initiate and facilitate open discussions about TCAM with parents, without retributing families after TCAM disclosure.
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