Complementary And Alternative Medicine Content Research Articles

The suggestive nature of words. Media coverage of homeopathy, acupuncture, reiki and Bach flower remedies in Spanish press 2011-2016.

The maxim of proponents of pseudoscience is to spread ignorance through false perceptions of its scientific status. One of its most attractive - and simultaneously harmful - manifestations is complementary and alternative medicine (CAM). Despite the scientific evidence against them, CAM has taken hold in today's society as a therapeutic model for a growing segment of the population. We analysed 379 articles on homeopathy, acupuncture, reiki and Bach flower remedies published in mainstream Spanish newspapers (El País, El Mundo, La Vanguardia, El Periódico and ABC) for the period 2011-2016, finding that disinformation is participated in actively by the Spanish press. CAM content was detected in these newspapers, together with a lack of an editorial perspective. In most of the cases, the uncritical articles were found in the interpretive genre and the society section. We also characterized the pseudoscientific discourse aimed at the public, finding that it is irrational and fraudulent in sowing fear and distrust regarding science. On the basis of theories invalidated by the scientific method and on appeals to the emotions, pseudoscience not only threatens scientific knowledge, but directly undermines public health by encouraging the abandonment of conventional medicine. In order to remedy this situation, better scientific training, informative screening and editorial commitment is urgently needed in the Spanish press.

State of complementary and alternative medicine education in psychiatry residency programs

The incorporation of integrative medicine as a holistic approach increased in medical education. However, complementary and alternative medicine (CAM) formal teaching in psychiatry residency programs is limited. To assess the incorporation of CAM education in different Chilean psychiatry programs and to determine the knowledge and attitudes toward this issue. An online survey was sent to 80 academic staff from five psychiatry programs. Forty-nine participants answered the survey (61%). Some of the questionnaire topics were the inclusion of CAM content in the program, types of CAM included, and motivation and strategies for the CAM content incorporation in their training curriculum. Most respondents answered that there is no formal CAM content in their program's curriculum. The main topics to incorporate CAM in a psychiatry residency are sleep hygiene, stress management, and motivational interviewing. The lack of knowledge, time constraints, and the limited resources are major barriers to include CAM in their curriculums. Our results suggest that many academic staff of Chilean psychiatry training programs are aware of the importance of having CAM content in their curriculum. However, some barriers hinder their incorporation and implementation.

Dental students’ knowledge of and attitudes towards complementary and alternative medicine in Australia – An exploratory study

ObjectivesWhile complementary and alternative medicine (CAM) is used by more than half of Australians, its role in dentistry is rarely covered in the curricula of Australian dental schools. This study aimed to investigate dental students’ knowledge of and attitudes towards CAM. DesignAustralian dental students in the final two years of their study were invited to undertake a survey. These questions consisted of five clinically relevant case vignettes, for which there was only one correct answer amongst four possible options and seven self-reported perspective-based questions. Results were analysed using descriptive statistics. ResultsOf the 185 students that participated, the mean correct response rate for the five clinical scenarios was 3.46 ± 0.95 (range: 0–5 out of 5). Of 185 students, 157 (85 %) answered more than half of the questions correctly. All five questions were answered correctly by 19 (10 %) students. Most (74 %) students self-reported to have little to no knowledge. More than two-thirds of dental students reported an interest in and belief in the effectiveness of CAM. A similar proportion expressed a desire for the integration of CAM content into their undergraduate curriculum. ConclusionsDespite approximately three out of four of dental students in this study having little to no knowledge on CAM, attitudes towards CAM therapies, and the need to integrate them into the dental curriculum, were generally positive. Future research into identifying specific knowledge gaps could help to redesign improved dental curricula.

Complementary and Alternative Medicine Provider Knowledge Discourse on Holistic Health

Complementary and alternative medicine (CAM) promises a wide array of therapies employed increasingly by consumers for disease prevention and health promotion. Despite this increasing use, however, CAM and biomedical paradigms are often not combined effectively in the US. The lack of coordination negatively impacts several aspects of patient care including CAM and biomedical provider-patient relationships and the practice of integrative medicine. The goal of this study is to understand how CAM providers position their knowledge and practice of holistic health within the healthcare landscape in the US. In-depth interviews with CAM providers (N=17) sampled from practices in the mid-Atlantic region of the US were analyzed for provider descriptions of holistic health. Discourse analysis of CAM provider interviews identifies the three themes employed by CAM providers to describe holistic health as comprising the: (a) epistemologies of legitimization and identity, (b) epistemologies of sense and intuition, and (c) epistemologies of environment and community. The three epistemologies define holistic health by organizing diverse knowledge foundations through reconciling and integrating differences, including diverse modes of evidence such as non-empirical forms of whole body experiences, and privileging the relational praxis through integrating the individual’s biological and sociocultural environment. The epistemologies illuminate how CAM knowledge and practice is positioned as alternative within the sociocultural context of the participants and reflect CAM providers’ challenges in carving out a distinct knowledge space reflecting their professional identity. CAM providers’ discourse encompasses the ontological and experiential-relational praxis to foreground health as a mutually constitutive, ongoing process of granting legitimacy to diverse sense-making ontologies of medicine within a continuum of provider-patient meaning-making. Theoretically, CAM knowledge of holistic health integrates the experiential praxis of the patient’s spiritual and physiological self and the relational praxis of the patient’s biological-sociocultural-epigenetic relationships in the conceptualization and delivery of health outcomes. The study findings recommend including CAM knowledge discourses to inform the epistemological foundations of basic medicine. Pragmatically, the study recommends support for efforts to include credentialing of CAM practitioner teaching within allopathic healthcare institutions, faculty development within existing allopathic health professional schools, and incorporation of CAM content in allopathic medical education and practice.

Medical student attitudes towards complementary and alternative medicine (CAM) in medical education: a critical review.

Background This paper aims to remedy a gap in the knowledge by presenting the first critical review of the literature on major themes relating to medical students perceptions and attitudes towards the exponentially growing field of complementary and alternative medicine (CAM). MethodsAfter a comprehensive database search of the literature, 21 papers were chosen as suitable for the review. The results from these papers were tabled and discussed. ResultsThe results indicated that medical students lacked knowledge of CAM and are generally positive towards CAM education (especially in the preclinical years, if it provided evidence of efficacy and post-placement). Medical students thought that CAM should generally be incorporated into the medical curriculum mainly so they can confidently undertake referral to CAM practitioners. Being able to communicate with future patients about their CAM use was a major motivation for medical students to learn about CAM and a factor for medical student support of further incorporation of CAM content in the medical curricula. Educational exposure to CAM in many forms and in many papers was shown to significantly affect medical student attitudes to CAM. This may be reflective of the fact that, outside direct CAM training, there may be limited accessible opportunities for medical students and if integration is to occur, educational exposure is most important. ConclusionsThe rise of CAM as a social and clinical phenomenon necessitates consideration of further inclusion of these topics in the medical curriculum, if future physicians are to be able to fully discharge their role as care providers in an increasingly medically pluralistic world. However, the inclusion of CAM needs to be done in an objective and critical manner, which is relevant to the learner.

The need for evidence-based complementary and alternative medicine (CAM) information in Malaysian pharmacy curricula based on pharmacy students’ attitudes and perceptions towards CAM

ObjectivesPharmacists are often sought as complementary and alternative medicine (CAM) information providers, and therefore they should have sufficient familiarity to provide evidence-based advice to CAM users. Attitudes and perceptions towards CAM by future pharmacists could reflect the current CAM content in pharmacy curricula. The purpose of the present study is to investigate the attitudes and perceptions towards CAM among undergraduate pharmacy students enrolled at a Malaysian university. MethodsA survey instrument to obtain data on the self-use of CAM, self-perceived knowledge on CAM, likelihood to suggest CAM, attitudes towards CAM, barriers to using CAM and preferred CAM information sources was administered to the third- and fourth-year pharmacy students. ResultsA total of 226 third- and fourth-year pharmacy students participated in the study. The students’ attitudes towards CAM were positive (CHBQ score of 48.58 ± 4.66). Knowledge related to praying, vitamins, and massage was perceived the highest, and they were comfortable in using and recommending these modalities. A lack of evidence was perceived as the main barrier to using CAM. The most preferred sources of CAM information by the respondents were CAM websites and the internet. ConclusionDespite exhibiting positive attitudes towards CAM, Malaysian pharmacy students were uncomfortable with modalities that are not tested in scientific methods, perceived lack of evidence as a barrier to using CAM, and regarded formal education as less effectual in providing CAM information. More CAM education should be incorporated in current pharmacy curricula to guide Malaysian pharmacy students in future practice.

Knowledge, Attitudes, and Practices of Nursing Faculty and Students Related to Complementary and Alternative Medicine

A comprehensive assessment of the knowledge, attitudes, and practices of nursing faculty and students related to complementary and alternative medicine (CAM) of one state in the Mid-Atlantic region of the United States was conducted and information was obtained from faculty about CAM content in their individual courses. Using a descriptive study design, a 32- and a 23-question online surveys were sent through e-mail to faculty and students, respectively. The response rate was: faculty 76% (N=117) versus students 41% (N=578). Positive support was found with regard to the addition of CAM into the nursing curriculum (81% students vs 92% faculty). Faculty provided some CAM didactic content to students on an inconsistent basis. It is unknown what CAM competencies students are expected to achieve. Integrating in the curriculum, experiential learning, a broad view of CAM therapies and holistic concepts, and evidence regarding CAM therapies is necessary. The results informed a plan for a professional development program for faculty.

Integration of complementary and alternative medicine information and advice in chronic disease management guidelines

The growing evidence on the benefits and risks of complementary and alternative medicine (CAM) and its high rate of use (69% of Australians) - particularly for chronic or recurrent conditions - means increasing attention on CAM. However, few people disclose CAM use to their GP, and health professionals tend to inadequately discuss CAM-related issues with their patients, partly due to insufficient knowledge. As clinical and non-clinical chronic condition management guidelines are a means to educate primary health care practitioners, we undertook a content analysis of guidelines relevant to two common chronic conditions - cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) - to assess their provision of CAM-related information. Ten current Australian guidelines were reviewed, revealing scant CAM content. When available, the CAM-relevant information was brief, in some cases unclear, inconclusive and lacking in direction to the GP or health care provider. Although we focus on CVD and T2DM, we argue the value of all chronic condition management guidelines integrating relevant evidence-informed information and advice on CAM risks, benefits and referrals, to increase GP awareness and knowledge of appropriate CAM therapies, and potentially to facilitate doctor-client discussion about CAM.

Complementary and Alternative Medicine (CAM) Attitudes and Competencies of Nursing Students and Faculty: Results of Integrating CAM Into the Nursing Curriculum

As part of the National Center for Complementary and Alternative Medicine (CAM) R25 Education Grant Program, a faculty development program for integrating CAM into the nursing curriculum was instituted in 2003-2006. The Integrating CAM program was composed of a number of elements; the primary strategy included a series of 4-week didactic and experiential summer CAM "Camps," attended by 27 faculty members. Camps were designed to influence faculty integration of CAM material into course offerings. The Integrating CAM program was evaluated via a series of faculty and student surveys regarding CAM competencies, attitudes, and perceptions. For more than half of the faculty (out of the 43 who responded), the program yielded a moderate-to-strong influence on incorporation of CAM material into course content and moderate-to-great increases in both enthusiasm for CAM and perceived CAM knowledge gains. Students at all levels (undergraduate, master's, and doctoral; n = 184) reported that their courses contained CAM content; for 70% of students, their CAM knowledge increased; for 50% of students, level of CAM interest increased. Self-reported student CAM competencies were significantly greater in 2006-2007 (n = 191) than those in 2003-2004 (n = 143). Results support the strategy of broadly infusing the nursing curriculum with CAM content via faculty development.

A Cost-Benefit Analysis of the Legalization of an Informal Health Sector

Problem statement: The Philippines--a developing Southeast Asian country--exemplifies the co-existence of Western-oriented, medical science and indigenous, non-allopathic practices collectively known as Complementary and Alternative Medicine (CAM). The purpose of this study is to determine why and how the economics and politics of CAM’s integration with biomedical science could impede the achievement of health care redistribution in developing countries like the Philippines. Approach: Representative case studies of CAM methods and content analysis of related legislation and policy initiatives were undertaken. Results: The study shed light on the problems, challenges and opportunities in addressing the misdistribution of primary and secondary health care in the Philippines. It found that subjective considerations underlie CAM’s legitimacy. These become critical when scientific validity is at issue, information exchanged is asymmetric and political consensus is not readily available. How these considerations were valued from a cost-benefit perspective shaped actual policy outcomes. Conclusion: The study suggested that proper timing, phasing and collaborative strategies are critical to CAM's institutionalization in light of confining economic conditions and political conflicts over health policy. Both objective and subjective costs and benefits of CAM methods and products should be considered in integrating the formal (biomedical) and informal (CAM) health sectors, particularly in developing countries where health care is largely dependent on individual or household resource-based access and competitive prowess.

Inclusion of Complementary and Alternative Medicine in US State Comprehensive Cancer Control Plans: Baseline Data

The use of complementary and alternative medicine (CAM) among cancer patients has increased substantially during the last decade. The purpose of this investigation is to summarize CAM content of comprehensive cancer control (CCC) plans in the United States, territories, and tribes. Sixty-six CCC plans, including all the states, most of the territories, and nearly all the Native American tribes were analyzed for content of CAM, and predominant thematic areas were summarized. Thirty-nine plans (59.1%) included CAM content. The predominant themes identified included increased education of CAM practices (46.2%), followed by utilization of existing CAM providers (28.2%), increasing CAM research efforts (18%), encouraging patient and provider communication about CAM use (18%), establishment of CAM baseline data (10.3%), and CAM as a barrier to treatment (10.3%). CAM is an emerging area in cancer care. The increasing inclusion of various themes of CAM into CCC plans indicate that many US cancer coalitions are taking steps to include the education and promotion of safe and efficacious CAM therapies for cancer patients.

Complementary and alternative medicine inclusion in physical therapist education in the United States

The purpose of this study was to determine the current prevalence, and at what level, complementary and alternative medicine (CAM) content is included in physical therapist (PT) education in the United States. This survey study provides self-report data regarding reasons why faculty members choose to include or not include CAM into programme content. This study investigates the current prevalence of CAM content, and what level of inclusion (minimal, moderate, advanced) in PT curricula will assist programmes as they modify existing curricula and develop new programmes. All 196 US-accredited programmes were included in our survey. An IRB-approved (Investigational Review Board), pilot-tested, two-page survey was emailed to all programme chairpersons of accredited PT programmes. A hard copy survey was mailed to non-responding programmes. Returned surveys were analyzed descriptively to characterize the data shape, tendency and variability. Data were summarized in a frequency distribution and graphically depicted in a histogram for each category. In addition, qualitative analysis was completed for the explanatory data. Forty-seven per cent (92) of all accredited PT programmes (196) responded. Most commonly included CAM areas were: manipulative and body-based methods, alternative medical systems and biologically based therapies. Most frequent responses to limitations to including CAM in PT curriculum were: limited curriculum time, lack of evidence supporting CAM practices and trouble locating qualified CAM presenters. This survey suggests the following: CAM techniques are included in entry-level PT education in the United States; the majority of these techniques are offered at the minimum or exposure level; manipulative and body-based methods, alternative medical systems and biologically based therapies are the most frequently included CAM techniques.

Assessing cancer treatment related information online: unintended retrieval of complementary and alternative medicine web sites

The aims of this study were to determine the number of Complementary and Alternative Medicine (CAM) web sites retrieved form Korean search engines, and to evaluate the quality of online CAM content. We evaluated results retrieved by the use of the key word 'anticancer treatment' on six common search engines in Korea. Among a total of 651 web sites, 226 web sites (35%) related to CAM were identified. The quality and risk of these sites were assessed for 97 web sites after removing duplicate and dysfunctional web sites. We evaluated the quality of the sites using Sandvik score. Scores in this study varied between 5 and 12 points, with a maximum of 14 points. We categorized the risk score for each web site based on the following criteria: (1) the site discourages the use of conventional medicine (23%: 22/97); (2) the site discourages adherence to the advice of a clinician (15%:15/97); (3) the site either provides opinions and experiences, or factual details (26%: 25/97); and (4) the site provides commercial details (46%: 45/97). The most popular web sites in Korea that relate to CAM for cancer offer information of extremely variable quality. Clinicians should be aware of the risks of inaccurate online information and attempt to protect their patients from those.

CAM Competencies for the Health Professions

As consumer demand for complementary therapies has increased, so too has the public's expectation that health care professionals be knowledgeable about complementary and alternative medicine (CAM) and prepared to advise patients. In 2000, the National Institutes of Health National Center for Complementary and Alternative Medicine (NCCAM) began awarding competitive, 5-year educational grants to academic institutions committed to teaching CAM content to health professional students. Fifteen awards were made under this program. Five somewhat overlapping domains of competency have emerged: awareness of CAM therapies and practices, evidence base underlying CAM therapies, CAM skill development, self-awareness and self-care, and CAM models and systems. The NCCAM R-25 projects have demonstrated the value of defining competencies in a variety of ways that can usefully guide the allopathic learner toward the broader goals of informed integrative, patient-centered practice and enhanced self-care.

Evaluating CAM Education in Health Professions Programs

As medical, nursing, and allied health programs integrate complementary and alternative medicine (CAM) content into existing curricula, they face many of the same challenges to assessment and evaluation as do more traditional aspects of health professions education, namely, (1) specifying measurable objectives, (2) identifying valid indicators, and (3) evaluating the attainment of desired outcomes. Based on the experiences of 14 National Center for Complementary and Alternative Medicine (NCCAM) education grant recipients funded between 2000 and 2003, the authors cite selected examples to illustrate strengths and deficits to "mainstreaming" CAM content into established health professions curricula, including subjecting it to rigorous, systematic evaluation. In addition to offering recommendations for more strenuously evaluating key CAM-related educational outcomes, the authors discuss related attitudes, knowledge, and skills and how these, like other aspects of health professions training, may result in enhanced patient care through modifications in clinical (provider) behaviors.

What Should Students Learn about Complementary and Alternative Medicine?

With thousands of complementary and alternative medicine (CAM) treatments currently being used in the United States today, it is challenging to design a concise body of CAM content which will fit into already overly full curricula for health care students. The purpose of this article is to outline key principles which 15 National Center for Complementary and Alternative Medicine-funded education programs found useful when developing CAM course-work and selecting CAM content. Three key guiding principles are discussed: teach foundational CAM competencies to give students a framework for learning about CAM; choose specific content on the basis of evidence, demographics and condition (what conditions are most appropriate for CAM therapies?); and finally, provide students with skills for future learning, including where to find reliable information about CAM and how to search the scientific literature and assess the results of CAM research. Most of the programs developed evidence-based guides to help students find reliable CAM resources. The cumulative experiences of the 15 programs have been compiled, and an annotated table outlining the most highly recommended resources about CAM is presented.

Barriers, Strategies, and Lessons Learned from Complementary and Alternative Medicine Curricular Initiatives

Fifteen U.S. academic programs were the recipients of a National Center for Complementary and Alternative Medicine R25 Education Grant Program to introduce curricular changes in complementary and alternative medicine (CAM) in their institutions. The authors describe the lessons learned during the implementation of these CAM education initiatives. Principal investigators identified these lessons along with discovered barriers and strategies, both those traditionally related to medical and nursing education and those unique to CAM education. Many lessons, barriers, and strategies were common across multiple institutions. Most significant among the barriers were issues such as the resistance by faculty; the curriculum being perceived as too full; presenting CAM content in an evidence-based and even-handed way; providing useful, reliable resources; and developing teaching and assessment tools. Strategies included integration into existing curriculum; creating increased visibility of the curriculum; placing efforts into faculty development; cultivating and nurturing leadership at all levels in the organization, including among students, faculty, and administration; providing access to CAM-related databases through libraries; and fostering efforts to maintain sustainability of newly established CAM curricular elements through institutionalization and embedment into overall educational activities. These lessons, along with some detail on barriers and strategies, are reported and summarized here with the goal that they will be of practical use to other institutions embarking on new CAM education initiatives.

Collaborations between Allopathic and Complementary and Alternative Medicine Health Professionals: Four Initiatives

An effort to increase the understanding of complementary and alternative medicine (CAM) by health care professionals requires an interdisciplinary and collaborative approach. Between 2000 and 2002, National Institutes of Health National Center for Complementary and Alternative Medicine funded 15 educational institutions to develop curricular models for educating allopathic medical and nursing learners in CAM literacy. Four of these 15 programs, Tufts University School of Medicine, University of California at San Francisco School of Medicine, Oregon Health & Sciences University School of Medicine, and University of Washington School of Nursing, formed collaborative partnerships with nearby academic institutions that train CAM practitioners. This article focuses on these four examples of institutional collaboration, summarizing the challenges faced and the positive outcomes achieved for learners, faculty, and institutions. As collaborations between such institutions increase, future potential directions for consideration include credentialing of CAM practitioners teaching within allopathic health professional institutions, faculty development within existing allopathic health professional schools on incorporating evidence-based CAM content into their standard allopathic education, and viewing CAM as an aspect of cultural sensitivity.

Rationales for CAM Education in Health Professions Training Programs

The authors review the use of complementary and alternative medicine (CAM) in the United States. They then present and discuss the rationales used by the 15 National Center for Complementary and Alternative Medicine CAM educational grantees in their original proposals for incorporating CAM content into conventional health professions training programs. Fourteen of the grantees were from major U.S. medical and nursing schools, and one was from a medical student foundation. Awards were for five-year periods (with the exception of one three-year grant) from 2000 to 2008. Rationales for developing educational programs about CAM for conventional health professionals included (1) the prevalence and growth of CAM in the United States, (2) response to governmental, legislative, and other mandates, (3) need for enhanced communication between conventional providers and patients using CAM, (4) need to enhance safety of CAM use and interactions with conventional care, (5) CAM education's positive impact on broadening core competencies for conventional health care professionals, (6) positive impact on enhancing cultural competency, (7) need for better communication between conventional and CAM providers, (8) potential for improving health care coordination, (9) potential impact on increasing CAM research quality and capacity, and (10) potential for enhancing quality of care through informed CAM use. Integration of CAM with conventional health care requires educational venues that prepare conventionally trained caregivers with a sufficient knowledge base for assessing beneficial and detrimental interactions between CAM and conventional care approaches; development of criteria for making informed referrals to CAM practitioners; and enhanced research capacity.

Lessons learned from complementary and integrative medicine curriculum change in a medical school

This paper describes a pilot study that examined lessons learned from the introduction of complementary and alternative medicine (CAM) elements into a medical school curriculum. A qualitative approach was selected as a first step in evaluating the phenomenological experience of introducing the CAM Educational Project in 2000-05. In 2005, semi-structured interviews were conducted with faculty staff and graduating students who had participated in all 4 years of the CAM Project. Qualitative content was analysed focusing on linguistic data and contextual meaning. The overall response to the integration of CAM curricular elements into the medical school curriculum was positive among all faculty and graduating medical students. Participant experiences were often dependent on the perceived rigour of alternative approaches to a presenting patient problem, along with the importance attributed to openness to patient perspectives as part of evidence-based practices. There was an appreciation of the importance of developing increased awareness and utilisation of CAM in medical practice, as well as a recognition of resistance by some medical school faculty to CAM approaches. This evaluation of a specific CAM educational project suggests potentially transferable findings to other medical schools. Integrating CAM into the medical school curriculum requires a dedicated team if it is to result in a significant change. This change requires that CAM practices are visible to both students and faculty, that there is a co-operative climate, accessible resources, and institutional support, and that CAM content is embedded into the existing curriculum. All these factors combined can lead to sustainable integration of CAM content issues into the medical school curriculum.