CAM Use Research Articles

Complementary and alternative medicine use amongst Malaysian orthopaedic oncology patients.

BackgroundAlthough studies have shown that a large proportion of cancer patients use CAM, no study on CAM use amongst orthopaedic oncology patients has been published. Therefore, this study aims to determine the prevalence, characteristics and factors associated with CAM use amongst orthopaedic oncology patients.MethodsAll consecutive consenting patients/parents who presented at the Orthopaedic Oncology Clinic, University Malaya Medical Centre (1st January to 31st December 2013) were interviewed using a structured questionnaire.ResultsOverall, one hundred sixty-eight of the 274 patients recruited (61.3%) had used CAM at some time during their current illness. The prevalence of CAM used was 68% (123/181) for patients with malignant tumours and 48.4% (45/93) for patients with benign tumours. The most popular CAMs were biological-based therapies (90.5%), followed by mind-body techniques (40.5%). The most frequently used biological therapies were mega/multivitamins (31%), snakehead (Chana striatus) (28%) and sea cucumber (Stichopus horrens) (18%); whereas prayers (31%) and holy water (13%) dominated the mind-body category. Common reasons for CAM use were to improve physical well-being (60.1%), try out everything that would help (59.5%) and to enhance wound-healing (39.3%). Independent predictors for CAM use in multivariate analysis were paediatric patients [OR 2.46; 95% CI 0.99–6.06; p = 0.05], malignant tumours [OR 1.90; 95% CI 1.12–3.25; p = 0.018] and patients who underwent surgery [OR 2.06; 95% CI 1.15–3.69; p = 0.015]. Majority patients started taking CAMs following suggestions from family members (53%) and friends (49%). Sixty-six percent of patients felt they actually benefitted from CAM and 83.3% were satisfied/very satisfied. Only 5 patients reported side-effects. Majority of CAM users planned to continue CAM use or recommend it to others. However, only 31.5% of patients disclosed their CAM usage to their doctors.ConclusionsThis survey revealed a high prevalence of CAM usage amongst orthopaedic oncology patients, with majority patients expressing satisfaction towards CAM. Oncologists should proactively ask patients about CAM to prevent potential adverse effects, as most patients do not share this information with them.

154. Breast cancer and pregnancy

Methods: We explored factors predicting CAM use among a nationally representative sample of breast cancer patients. In total 267 breast cancer patient were administered questionnaires about their CAM use and factors that might predict CAM use including socioedemographics, clinical and quality of life factors (EQ5D), time since diagnosis, trust in conventional treatment, trust in national health insurance policy, satisfaction and informational needs (CNAT). Data were analyzed using Pearsons test and mulvariant logistic regression analysis. Result: Overall 75,5% reported that they had used or were using CAM. Lower income, presence of late stage, poor national health care insurance system, lower average satisfaction to conventional treatment and high degree of informational need were significantly associated with CAM use. Conclusion: The use of CAM in breast cancer patient can be interpreted as an attempt to explore all possible options, expression of an active coping style or expression of unmet needs in the breast cancer care. The oncologist need to openly discuss the use of CAM with the patients and identify whether they have other unmet supportive needs. No conflict of interest.

Vitamin and Supplement Use among Old Order Amish: Sex-Specific Prevalence and Associations with Use

BackgroundComplementary and alternative medicine (CAM) in the form of vitamin and supplement use is increasingly prevalent in the United States. The interplay between CAM use and use of conventional medications is not well studied. We examined this issue in Old Order Amish (OOA), a population lacking several factors known to influence supplement use, whose culture and barriers to conventional medications may result in high rates of supplement use. ObjectiveWe characterized the patterns of supplement use in OOA, including the extent to which CAM use aggregates in families, and assessed whether higher use of supplements is associated with lower medication use. DesignWe conducted a cross-sectional study of conventional medications and supplements in 2,372 adult Amish from the Lancaster County, PA, area. Data were collected through face-to-face interviews. Supplements were subcategorized as herbal vs vitamin/mineral supplements. ResultsSeventy-seven percent of all Amish adults reported current supplement use, whereas 22% reported medication use. Women used supplements more often and used more supplements than men, and familial aggregation of supplement use was stronger in family pairs involving women. Supplement use was associated with less medication use after controlling for age, sex, body mass index, and self-reported histories of hypertension, diabetes, and hyperlipidemia (adjusted odds ratio [OR] 0.96, 95% CI 0.92 to 1.00; P=0.047). This association was driven primarily by use of herbal supplements (adjusted OR 0.94, 95% CI 0.89 to 0.99; P=0.025) as vitamin/mineral supplements were not associated with different use of medication (adjusted OR 0.99, 95% CI 0.90 to 1.09; P=0.8). In analyses limited to cardiovascular medications and cardiovascular supplements in participants with hyperlipidemia, hypertension, or diabetes, supplement use was not associated with conventional medication use. ConclusionsOAA, particularly women, take dietary supplements much more frequently than they use conventional medications. Use of herbal supplements is associated with less use of conventional medications, whereas vitamin/mineral supplement use is not.

Psychosocial factors that predict why people use complementary and alternative medicine and continue with its use: A population based study

Studies have explored the predictors of CAM use but fewer data explain the psychosocial factors associated with this and why people continue with CAM. AimsTo examine the psychosocial factors that predict CAM use; to explore the predictors of continuing with CAM. DesignA cross sectional survey. Methods1256 adults were interviewed as part of 2012 Queensland Social Survey. We included questions about CAM, perceived control, cognitive style, spirituality and openness. Relationships were explored using bivariate and multiple logistic regression. Results79% of people had used CAM in the last 12 months. Socio-demographics, health behaviours, spirituality, openness and prescribing sources were the strongest predictors of CAM use. General health, chronic illness and prescribing sources predicted continued CAM use. ConclusionThere was high CAM use in Queensland, Australia. Personal characteristics and psychosocial factors need to be considered as part of the individual's holistic assessment and on-going care.

Abstract 4127: A prospective study of breast cancer prognosis in Kaiser Permanente Northern California: Cohort description and initial findings from the Pathways Study

Abstract Background: With over 2.8 million breast cancer survivors in the U.S. today, there is increasing interest and need to identify factors associated with recurrence and survival. The Pathways Study was designed to examine the effects of lifestyle (e.g., diet, physical activity, complementary and alternative medicine [CAM]), psychosocial (e.g., quality of life), molecular and genetic, medical care, and contextual (e.g., social and built environment characteristics) factors on breast cancer prognosis. Methods: Women newly-diagnosed with invasive breast cancer were identified daily from Kaiser Permanente Northern California (KPNC) electronic pathology records from January 2006 to April 2013; KPNC is a large, integrated health care organization. Eligibility included age at diagnosis of at least 21 y, no previous history of invasive cancer, and English, Spanish or Chinese-speaking. Women were enrolled during an in-person baseline interview that took place on average two months post-diagnosis, with collection of blood and saliva specimens. Active follow-up to update lifestyle and other factors and ascertain outcomes occurs periodically. Outcomes are also identified using KPNC electronic databases and confirmed via medical record review. Results: The final study cohort consists of 4,505 women, with blood and saliva collected from 90% and 95% of participants, respectively. The cohort has substantial racial/ethnic diversity: 64.2% White, 12.4% Hispanic, 12.8% Asian, 7.9% African American, 2.7% other. The mean age at diagnosis was 59.6 y (range: 23.6-94.8 y). Educational attainment is high, with 84.1% of the cohort having at least some college education. Most women were diagnosed with AJCC Stage I (54.0%) or II (34.6%) cancers, and receptor status was positive for estrogen in 83% of women, progesterone in 63.4%, and Her2 in 12.3%. As of December 1, 2013, 307 recurrences and 327 deaths have been confirmed, with 490 experiencing either. Initial age-adjusted results with proportional hazards regression demonstrate poorer disease-free survival (DFS) among African Americans (hazard ratio [HR]=1.84, 95% confidence interval [CI],1.39-2.45) and better DFS among Asians (HR=0.70, 95% CI, 0.49, 1.00) compared to Whites. Greater stage at diagnosis, increasing age, and negative ER status are also associated with poorer DFS. Discussion: The Pathways Study is a rich, unique resource collecting data on multiple factors that may influence breast cancer prognosis, including lifestyle, molecular, medical, and contextual factors. To date, 14 papers have been published on topics ranging from CAM use, quality of life, and physical activity during treatment, to tumor DNA methylation profiles and correlates of breast cancer molecular subtypes. With continued follow-up, it promises to provide findings on factors influencing prognosis to help guide breast cancer care. Citation Format: Lawrence H. Kushi, Marilyn L. Kwan, Isaac J. Ergas, Cecile A. Laurent, Julie R. Munneke, Janise M. Roh, Heather Greenlee, Chi-Chen Hong, Theresa H. Keegan, Dawn L. Hershman, Susan E. Kutner, Marion M. Lee, Jeanne Mandelblatt, Alfred I. Neugut, Peggy Reynolds, Salma Shariff-Marco, Li Tang, Song Yao, Janice Barlow, Scarlett Lin Gomez, John K. Wiencke, Christine B. Ambrosone. A prospective study of breast cancer prognosis in Kaiser Permanente Northern California: Cohort description and initial findings from the Pathways Study. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4127. doi:10.1158/1538-7445.AM2014-4127

Prevalence of Use and Level of Awareness of CAM in Older People - Results from the KORA-Age Study

Background: Despite the growing proportion of older adults in Europe there is only limited knowledge of CAM use among the elderly. This analysis aims to provide estimates for the prevalence of CAM use in persons with an age of ≥65, and to investigate correlations of CAM use with demographic characteristics. Methods: Based on participants of the MONICA/KORA studies S1-S4 who were born before 1944, a random sample of 1,079 was selected for comprehensive medical examinations. Questions were presented in structured face-to-face interviews conducted from February to November 2009. Results: Data on CAM use were available for 1,026 subjects with a mean age of 76 years, ranging from 65 to 93 years. 14% of the participants were unaware of CAM. The overall prevalence of CAM use was estimated 37% with minor differences between age groups, but clear differences between male (29%) and female (44%) participants. 1-year prevalence of CAM use was 22% (16% males, 28% females). 1-year of CAM use was associated with a higher level of education in both men and women; with higher income in men; and with more actual diseases in women. Conclusion: Findings indicate that awareness of CAM is high even among people ≥65 years. Estimates for the prevalence of CAM use confirm the relevance of this treatment sector in the healthcare system for the elderly.

Complementary therapies in inflammatory bowel diseases.

Complementary and alternative therapies (CAM) are defined as therapies that are presently not considered part of conventional medical practice. They are termed "complementary" when used in addition to conventional therapies and termed "alternative" when used instead of conventional therapies. CAM includes many different practices, for example Ayurveda, acupuncture or traditional Chinese medicine (TCM), phytotherapy, homeopathy, probiotics and dietary supplements. While some evidence of benefit exists regarding some therapies, for most of these therapeutic approaches, the therapeutic efficacy and safety have not been proven in well-designed scientific studies. However, the use of complementary and alternative medicine among IBD patients is common, and physicians are frequently confronted with questions about their use. As most of the reported studies contain methodological problems, it is often difficult for physicians to inform their patients adequately. Nevertheless, the widespread use of CAM needs to be recognized. Some of these agents exert plausible biological effects in IBD patients and warrant further investigation. Controlled trials in IBD are warranted to show therapeutic benefits and safety of CAM. This review aims to give a brief overview on the current use of various complementary and alternative treatment options in IBD patients.

Internal health locus of control in users of complementary and alternative medicine: a cross-sectional survey.

BackgroundComplementary and alternative medicine (CAM) is widely used in Germany, with some treatments eligible for health insurance reimbursements. CAM encourages patients to play an active role in their healing process. The belief that a person’s own behavior influences health is assessed as the internal health locus of control (IHLOC). Studies on the association between IHLOC and CAM use yield inconsistent results. Using various indicators of CAM use, we evaluated whether there were differences in IHLOC between different groups of CAM users.MethodsA cross-sectional online survey was conducted. IHLOC was compared between participants with high and low appraisal of CAM, between participants who used different types of medications (none, CAM, conventional, both), and who consulted with different health care professionals (none, CAM, conventional, both). Independent samples t-tests and ANOVAs were conducted for the total group and for subgroups of chronically ill and healthy participants. Post-hoc, we conducted a multivariate linear regression evaluating which indicators of CAM use or other characteristics showed the strongest association with IHLOC.ResultsA total of 1,054 undergraduate students completed the survey. Participants with high CAM appraisal showed higher IHLOC than those with low CAM appraisal, regardless of whether they were chronically ill (p < .001). Participants without chronic conditions showed higher IHLOC when only using CAM medications than when using either conventional medications alone or both conventional and CAM medications (p < .05). All participants showed higher IHLOC when visiting only CAM practitioners than when visiting either only conventional or both conventional and CAM practitioners (p < .05). CAM appraisal was associated the strongest with IHLOC in the linear regression model.ConclusionsGenerally, participants using CAM more or exclusively, and participants with higher appraisal of CAM showed higher IHLOC than those with less CAM use or lower CAM appraisal. Because of the cross-sectional design, it is not possible to determine whether differences in IHLOC are reasons for or consequences of CAM use. Research using a longitudinal design is needed. The sample, though more representative than most student samples, might not represent the general population. Studies evaluating clinical populations might add to the findings.

Geometric variable designs of cam/post mechanisms influence the kinematics of knee implants.

Reproducing the femoral rollback through specially designed mechanism in knee implants is required to achieve full knee function in total knee arthroplasty. Most contemporary implants use cam/post mechanism to replace the function of Posterior Cruciate Ligament. This study was aimed to determine the most appropriate cam and post designs to produce normal femoral rollback of the knee. Three different cams (triangle, ellipse, and circle) and three different posts (straight, convex, concave) geometries were considered in this study and were analysed using kinematic analyses. Femoral rollback did not occur until reaching 50° of knee flexion. Beyond this angle, two of the nine combinations demonstrate poor knee flexion and were eliminated from the study. The combination of circle cam with concave post, straight post and convex post showed 15.6, 15.9 and 16.1mm posterior translation of the femur, respectively. The use of ellipse cam with convex post and straight post demonstrated a 15.3 and 14.9mm femoral rollback, whilst the combination of triangle cam with convex post and straight post showed 16.1 and 15.8mm femoral rollback, respectively. The present study demonstrates that the use of circle cam and convex post created the best femoral rollback effect which in turn produces the highest amount of knee flexion. The findings of the study suggest that if the design is applied for knee implants, superior knee flexion may be possible for future patients. IV.

Interface, interaction and integration: how people with chronic disease in Australia manage CAM and conventional medical services.

To understand the extent to which conventional and complementary health care are integrated for CAM users with chronic conditions. In-depth interviews and a self-administered questionnaire were used to collect data on care-seeking, self-management and CAM use among people with type 2 diabetes and/or cardiovascular disease living in Victoria, Australia. Many participants reported regular, frequent and long-term use of CAM therapies to maintain their health or assist in the management of their chronic condition. They generally managed the interface between convention and complementary health care on their own, as the perceived or expressed negative attitudes of some doctors, or the belief that the doctor did not need to know, were barriers to the disclosure of CAM use. For a smaller group, there was interaction between conventional and CAM providers, which limited the extent of uncertainty and conflicting information being (mis)interpreted by consumers. Greater interaction between CAM and medical providers would be beneficial to consumers. Structural barriers, related to financing and service organization, need to be addressed. Attitudinal shifts of some health-care practitioners also need to be addressed, in the context of workforce development.

Complementary and Alternative Medicine in Midwifery

The World Health Organization defines “complementary and alternative medicine” (CAM) as a “broad set of health care practices that are not part of that country’s own tradition and are not integrated into the dominant health care system” (1). Complementary therapy is usually used in combination with current treatments, and alternative treatments are used instead of current treatments. Commonly utilized types of CAM include acupuncture, aromatherapy, herbal and homeopathic medicines, meditation, movement therapies, chiropractic and osteopathic manipulation and so on (2). An overview of the recent research around the world showed that in developing country 5-74.8% of people use these therapeutic methods especially for chronic diseases (3). In Iran, some of these methods such as herbal medicine have been used for thousands of years and are rapidly expanding. There is no clear estimation of CAM users in Iran but studies showed that 62.5% of people in Isfahan city and 66.3% in Tehran city use CAM therapy (4, 5). Women use CAM more than men. Many women prefer to use CAM during pregnancy because of fewer side effects compared to chemical drugs. Studies have shown that 73% of pregnant mothers in Australia (6) and 83.7% in Mashhad city used CAM during pregnancy (7). Today, around the worldwide, midwives use complementary therapies in their profession more than the other medical practitioners. A literature review estimated that between 65% - 100% of midwives have used one or more complementary therapies. Common types of CAM that are recommended by midwives were: massage therapy, herbal medicines, relaxation techniques, nutritional supplements, aromatherapy, homeopathy and acupuncture (8). However, one survey in Iran found that CAM methods are prescribed by 37.3% of obstetricians with the most common methods being acupressure, massage and herbal therapy (9). Another study also showed that 44% of midwifery students had recommended CAM therapies to others (10). These methods can be used for treatment of nausea and vomiting, back pain, anxiety, postpartum depression, anemia, striae gravidarum, insomnia, hemorrhoid, vaginal infection, mal-presentation, augmentation and induction of labor, perineal care, retained placenta and lactation problems (8, 11, 12). Since midwives are care providers to women during puberty and reproductive periods, especially at pregnancy and also during menopause and post-menopausal periods, therefore use of complementary and alternative therapies gives an opportunity to midwives for providing holistic care and enables them to respond to the community and women’s needs. Hence, all midwives who are interested in/or are practicing CAM for their clients should be empowered in this field through participating in educational programs to acquire the necessary skills. In midwifery training programs, evidence based CAM therapy should be included. Midwives not only need to know the strengths and limitations of CAM methods, but also they should be able to talk to women about the effectiveness and possible risks of these procedures. Given the widespread use of CAM in the midwifery field, it is necessary for medical organizations to prepare relevant guidelines for using these medicines in midwifery practice, especially for maternity care. It seems that further research to evaluate the prevalence, safety, efficacy and economic benefits of these methods are required.

Serious adverse events associated with pediatric complementary and alternative medicine

IntroductionComplementary and alternative medicine (CAM) use among children is extremely popular. Users consider CAM to be more ‘natural’, more aligned with personal health values, and associated with fewer side effects. However, few pediatric studies have investigated adverse events (AEs) associated with CAM therapies. The objective of this review was to identify serious AEs associated with use of pediatric CAM in partnership with the Canadian Pediatric Surveillance Program. MethodsActive surveillance of a national representative sample of Canadian pediatricians. Participants were asked to report if they had seen any suspected serious AEs associated with CAM in the past month. Harms could be direct (associated with the CAM therapy itself) or indirect (delay in diagnosis or treatment of a serious medical condition). Details of reported AEs were adjudicated by two independent experts to assess causality. ResultsDuring the study period (January 01, 2009 to December 31, 2010), Canadian pediatricians reported 12 unique cases of suspected serious adverse events associated with CAM. Of these, detailed reports were provided in nine cases, of which eight were adjudicated as serious. Six of the eight cases were considered ‘probably’ and two ‘possibly’ caused by CAM interventions. Serious pediatric AEs identified included anaphylaxis, hallucinations, muscle weakness with elevated creatine kinase, hypervitaminosis D with possible chronic nephrocalcinosis as a consequence, and short term paralysis. ConclusionFew serious AEs were identified in this study, despite widespread use of pediatric CAM. Active surveillance is challenged by under-reporting and can be enhanced by improved communication at each patient encounter.This article belongs to the Special Issue: Ensuring and Improving Patients’ Safety in Integrative Health Care.

The Fuzzy Edge of CAM Use: Challenges in What Constitutes CAM Use in Self-Administered Questionnaires

The Journal of Alternative and Complementary MedicineVol. 20, No. 5 Research MethodologyThe Fuzzy Edge of CAM Use: Challenges in What Constitutes CAM Use in Self-Administered QuestionnairesAaron Leppin, Katherine James, Kathleen Yost, and Jon TilburtAaron LeppinSearch for more papers by this author, Katherine JamesSearch for more papers by this author, Kathleen YostSearch for more papers by this author, and Jon TilburtSearch for more papers by this authorPublished Online:7 May 2014https://doi.org/10.1089/acm.2014.5348.abstractAboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"The Fuzzy Edge of CAM Use: Challenges in What Constitutes CAM Use in Self-Administered Questionnaires." The Journal of Alternative and Complementary Medicine, 20(5), p. A130FiguresReferencesRelatedDetails Volume 20Issue 5May 2014 InformationCopyright 2014, Mary Ann Liebert, Inc.To cite this article:Aaron Leppin, Katherine James, Kathleen Yost, and Jon Tilburt.The Fuzzy Edge of CAM Use: Challenges in What Constitutes CAM Use in Self-Administered Questionnaires.The Journal of Alternative and Complementary Medicine.May 2014.A130-A130.http://doi.org/10.1089/acm.2014.5348.abstractPublished in Volume: 20 Issue 5: May 7, 2014PDF download

Impact of Sociodemographic Factors on Attitudes and Beliefs Towards CAM Use Among Cancer Patients

The Journal of Alternative and Complementary MedicineVol. 20, No. 5 Clinical ResearchImpact of Sociodemographic Factors on Attitudes and Beliefs Towards CAM Use Among Cancer PatientsSagar K. Chokshi, Susan Q. Li, Christina Seluzicki, Krupali Desai, and Jun J. MaoSagar K. ChokshiSearch for more papers by this author, Susan Q. LiSearch for more papers by this author, Christina SeluzickiSearch for more papers by this author, Krupali DesaiSearch for more papers by this author, and Jun J. MaoSearch for more papers by this authorPublished Online:7 May 2014https://doi.org/10.1089/acm.2014.5185.abstractAboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Impact of Sociodemographic Factors on Attitudes and Beliefs Towards CAM Use Among Cancer Patients." The Journal of Alternative and Complementary Medicine, 20(5), p. A71FiguresReferencesRelatedDetails Volume 20Issue 5May 2014 InformationCopyright 2014, Mary Ann Liebert, Inc.To cite this article:Sagar K. Chokshi, Susan Q. Li, Christina Seluzicki, Krupali Desai, and Jun J. Mao.Impact of Sociodemographic Factors on Attitudes and Beliefs Towards CAM Use Among Cancer Patients.The Journal of Alternative and Complementary Medicine.May 2014.A71-A71.http://doi.org/10.1089/acm.2014.5185.abstractPublished in Volume: 20 Issue 5: May 7, 2014PDF download

Avoiding Unrealistic Results When Analyzing Influencing Factors Associated with CAM Use: Introducing the Idea of Multilevel Modeling

The Journal of Alternative and Complementary MedicineVol. 20, No. 5 Research MethodologyAvoiding Unrealistic Results When Analyzing Influencing Factors Associated with CAM Use: Introducing the Idea of Multilevel ModelingYing Zhang, Yutong Fei, and Jianping LiuYing ZhangSearch for more papers by this author, Yutong FeiSearch for more papers by this author, and Jianping LiuSearch for more papers by this authorPublished Online:7 May 2014https://doi.org/10.1089/acm.2014.5350.abstractAboutSectionsView articleView Full TextPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Avoiding Unrealistic Results When Analyzing Influencing Factors Associated with CAM Use: Introducing the Idea of Multilevel Modeling." The Journal of Alternative and Complementary Medicine, 20(5), pp. A130–A131FiguresReferencesRelatedDetails Volume 20Issue 5May 2014 InformationCopyright 2014, Mary Ann Liebert, Inc.To cite this article:Ying Zhang, Yutong Fei, and Jianping Liu.Avoiding Unrealistic Results When Analyzing Influencing Factors Associated with CAM Use: Introducing the Idea of Multilevel Modeling.The Journal of Alternative and Complementary Medicine.May 2014.A130-A131.http://doi.org/10.1089/acm.2014.5350.abstractPublished in Volume: 20 Issue 5: May 7, 2014PDF download

The Association Between Women's Choice of Birth Setting and Their Use of CAM During Labor and Birth

The Association Between Women's Choice of Birth Setting and Their Use of CAM During Labor and Birth

Experiences of patients identifying with chronic Lyme disease in the healthcare system: a qualitative study.

BackgroundChronic Lyme disease is a term that describes a constellation of persistent symptoms in patients with or without evidence of previous Borrelia burgdorferi infection. Patients labeled as having chronic Lyme disease have a substantial clinical burden. Little is known about chronic Lyme disease patient experiences in the healthcare system and their relationships with healthcare providers. The purpose of this study was to gather insights about the experiences of patients who carry a diagnosis of chronic Lyme disease in the United States healthcare system.MethodsQualitative, phenomenological study in 12 adult participants who identified themselves as having chronic Lyme disease. Semi-structured face-to-face in-depth interviews were conducted, 60–90 minutes in length, focusing on perceptions of disease burden and of their healthcare providers, using the dimensions of the Health Belief Model. Transcribed interviews were analyzed for emergent topics and themes in the categories of beliefs/understanding, personal history/narrative, consequences/limitations, management, and influences on care.ResultsEnrollment continued until theoretical saturation was obtained. Four major themes emerged from participants’ descriptions of their experiences and perceptions: 1) changes in health status and the social impact of chronic Lyme disease, 2) doubts about recovery and the future, 3) contrasting doctor-patient relationships, 4) and the use of unconventional therapies to treat chronic Lyme disease.ConclusionsParticipants reported a significant decline in health status associated with chronic Lyme disease and were often unsatisfied with care in conventional settings. Negative experiences were associated with reports of dismissive, patronizing, and condescending attitudes. Positive experiences were associated with providers who were reported to be attentive, optimistic, and supportive. Consultations with CAM practitioners and use of CAM therapies were common. Actively engaged and sympathetic clinical encounters may foster greater satisfaction in healthcare settings.

Complementary Alternative Medicine Use Among Female Oncology Patient: Literature Review

The importance to know about uses of complementary and alternative medicine has been increased, especially among oncology patients because of the growing community interest in natural or holistic therapies. Although there is no clear information about improved survival among the use of CAM. From the 18 articles analyzed, it could be concluded that goals of CAM use in women with cancer are therapeutic and psychological: i.e. to reduce symptoms, to show greater control over their life and express hopefulness over there disease and life. Furthermore, its use plays an important role in the identity construction of cancer patients, helping them to make decisions related to conventional treatment. Among the many findings of the review, biologically based practices were noted as the types of CAM most used by women with cancer, followed by mind-body medicine, whole medical systems, and energy medicine. Sources of information about CAM use for women with cancer vary widely, including family, friends, media, healthcare providers, CAM providers, and self-help groups. Sociodemographic factors that appear to be related to CAM use were younger age, higher education, higher income, married status, involvement in a support group, and health insurance. Oncology nurses should learn more about CAM use among women with cancer. Open communication about CAM use helps ensure that safe and holistic care is provided. Additional research in this particular area is needed.

A systematic review investigating the effectiveness of Complementary and Alternative Medicine (CAM) for the management of low back and/or pelvic pain (LBPP) in pregnancy

To evaluate and summarize the current evidence on the effectiveness of complementary and alternative medicine for the management of low back pain and/or pelvic pain in pregnancy. International research demonstrates that 25-30% of women use complementary and alternative medicine to manage low back and pelvic pain in pregnancy without robust evidence demonstrating its effectiveness. A systematic review of randomized controlled trials to determine the effectiveness of complementary and alternative medicine for low back and/or pelvic pain in pregnancy. Cochrane library (1898-2013), PubMed (1996-2013), MEDLINE (1946-2013), AMED (1985-2013), Embase (1974-2013), Cinahl (1937-2013), Index to Thesis (1716-2013) and Ethos (1914-2013). Selected studies were written in English, randomized controlled trials, a group 1 or 2 therapy and reported pain reduction as an outcome measure. Study quality was reviewed using Risk of Bias and evidence strength the Cochrane Grading of Recommendations and Development Evaluation Tool. Eight studies were selected for full review. Two acupuncture studies with low risk of bias showed both clinically important changes and statistically significant results. There was evidence of effectiveness for osteopathy and chiropractic. However, osteopathy and chiropractic studies scored high for risk of bias. Strength of the evidence across studies was very low. There is limited evidence supporting the use of general CAM for managing pregnancy-related low back and/or pelvic pain. However, the restricted availability of high-quality studies, combined with the very low evidence strength, makes it impossible to make evidence-based recommendations for practice.

Complementary/Alternative Medicine Experience in Cancer Patients: A Questionnaire-Based Survey.

A study was designed to evaluate the frequency of complementary/alternative therapy (CAM) knowledge and usage in cancer patients. A 23-item survey questionnaire was administered to 494 patients who received chemotherapy in the medical oncology department of three hospitals between June 2011 and December 2011. After giving written informed consent, patients completed a selfadministered questionnaire. Differences among participants were assessed by using the SPSS 17.0 software. Of the 494 patients, 48% had heard of CAM, and 23.5% had used at least one CAM model. Herbs and vitamins were the most frequently used approach (82.2%). The most commonly used herb was the stinging nettle (55.5%). Marital status (p= 0.003), educational status (p< 0.001), monthly income (p< 0.001), knowledge about disease (p< 0.001), family history of comorbidity (p<0.012), and place of residence (0.004) were statistically significant for knowledge about CAM. However, marital status (p< 0.001), comorbidity (p= 0.004), educational status (p=0.006), family history of comorbidity (p= 0.008), and family history of cancer (p= 0.03) were statistically significant for CAM use. Logistic regression analysis showed that educational status (p=0.015), high monthly income (p=0.03), knowledge about disease (p= 0.005), and a family history of comorbidity (p= 0.005) were statistically significant for knowledge about CAM. Otherwise, only marital status (p< 0.001) and comorbidity (p= 0.04) were determined as independent factors for CAM use. Health professionals should routinely ask their patients about CAM use and discuss the reasons and outcomes of use. Randomized clinical trials are needed to determine possible risks and benefits associated with CAM use.