Integration Of Complementary And Alternative Medicine Research Articles

Prevalence and Factors Associated With Using Complementary Medicine Among Adults With Type 2 Diabetes in Primary Healthcare Centers of Al-Ahsa, Eastern Saudi Arabia.

Background and aim Type 2 diabetes mellitus (T2DM) is a major health problem in Saudi Arabia. The use of complementary and alternative medicine (CAM) for the management of T2DM is increasing, but there is limited research on its safety and efficacy. This study aimed to investigate the prevalence and factors associated with CAM use among patients with T2DM attending primary healthcare centers in Al-Ahsa, Saudi Arabia. Methods A cross-sectional study was conducted between January and March 2024 to assess CAM use among T2DM patients in Al-Ahsa. Data were collected through telephone interviews using a validated questionnaire covering demographics, diabetes information, and CAM use. A total of 499 participants completed the questionnaire. Results CAM use was reported by 106 (21.2%) participants, with fenugreek (51, 48.1%), cinnamon (48, 45.3%), and blackseed (29, 27.4%) being the most common. Key factors associated with CAM use included residence in the Eastern or Northern Region, older age, having diabetic complications, and lower frequency of doctor visits. Only 24 (22.6%) participants consulted their doctor about CAM, and 83 (78.3%) believed that CAM could prevent diabetes progression. Conclusion This study provides insights into the use of CAM among T2DM patients in Al-Ahsa, Saudi Arabia. The findings highlight the need for larger-scale longitudinal research to better understand the patterns and potential benefits and/or harms of CAM use. Developing targeted interventions and promoting evidence-based integration of CAM into the healthcare system could optimize patient care and encourage patient-provider communication regarding these therapies.

The Role of Alternative Medicine in Managing Type 2 Diabetes: A Comprehensive Review.

Diabetes, a chronic metabolic disorder marked by elevated blood glucose levels, is increasingly prevalent globally, significantly impacting health-related quality of life. Type 2 diabetes (T2DM), characterized by insulin resistance and inadequate insulin production, presents a substantial public health challenge, necessitating comprehensive management strategies. Conventional treatments, including lifestyle modifications and pharmacotherapy, are essential for glycemic control and preventing complications. However, adherence to these treatments is often limited, highlighting the need for alternative strategies. Complementary and alternative medicine (CAM) offers potential cost-effective and accessible approaches for managing T2DM.Key herbal remedies like cinnamon, fenugreek, and bitter melon, along with dietary supplements like chromium, magnesium, and vanadium, have shown promise in glycemic control. Mind-body therapies, including yoga, tai chi, and meditation, contribute to improved hemoglobin A1c and fasting blood glucose levels. Research supports the integration of CAM with conventional therapies, demonstrating enhanced clinical efficacy and reduced economic burden. However, challenges such as standardization, quality control, and potential risks of herbal medicines need careful consideration. Regulatory frameworks and ethical considerations are essential to ensure patient safety and informed decision-making.Patient education and effective communication between healthcare providers and patients are crucial for integrating CAM into diabetes management. Empowerment-based interventions and collaborative approaches can enhance self-management skills and clinical outcomes. Overall, integrating CAM with conventional treatments offers a holistic approach to managing T2DM, potentially improving patient outcomes and reducing healthcare costs.

The Ethical Implications of Integrating Complementary and Alternative Medicine (CAM) in Chinese Psychological Practice

This paper meticulously delves into the intricate ethical implications that arise from the integration of Complementary and Alternative Medicine (CAM) into the realm of Chinese psychological practice. The surge in interest in holistic well-being has spurred the incorporation of CAM modalities within psychology. This convergence lays bare a tapestry of intricate ethical quandaries. With a meticulous and rigorous examination, this study navigates the core ethical principles, including the imperative commitments to public welfare, shielding against potential harm, and upholding individual autonomy. The exploration unearths multifaceted challenges spanning transparency, the intricacies of accountability, the nuances of informed consent, and the shadows of potential exploitation. In response to these complexities, the paper advocates for strategic measures such as fostering interprofessional collaboration, catalyzing governmental initiatives, and embracing qualitative methodologies. Inescapably, the study underscores the pressing need for a responsible and reasonable integration that ensures the delivery of comprehensive and patient-centered care while aligning with China's constantly evolving mental health landscape. By engaging rigorously with these ethical dimensions, the integration of CAM emerges as a pivotal contributor to an inclusive and all-encompassing mental health framework.

Perception, attitudes, knowledge of using complementary and alternative medicine for cancer patients among healthcare professionals: A mixed-methods systematic review.

With the rapid increase in the prevalence of cancer worldwide, the utilization of complementary and alternative medicine (CAM) has increased among cancer patients. This review aimed to understand the perception, attitudes, and knowledge of healthcare professionals toward using CAM for cancer patients. A mixed-methods systematic review was undertaken in four databases. Inclusion criteria were primary studies reporting perception, attitudes, and knowledge of healthcare professionals for using CAM for cancer patients were eligible. A mixed-methods convergent synthesis was carried out, and the findings were subjected to a GRADE-CERQual assessment of confidence. Forty-two studies were chosen. The majority of the studies were quantitative and had less than 100 participants. Most publications were from European countries, and oncology was the highest among the specialties. The review found the following themes: feasibility of having negative adverse effects, low expectations of using CAM among HCPs, potential positive effects of using CAM, specific CAM training may be helpful, no concrete regulations to promote CAM practice, and poor physician-patient communication. Nurses had more positive views than other professions; oncologists were concerned regarding herb-drug interactions; integration of CAM into the healthcare system was favorable; HCPs felt the need to participate in specific CAM training; and HCPs agreed that CAM education should be provided more regularly. Future studies should explore the studies views of cancer patients and details of in-depth evidence of CAM in oncology settings.

The effectiveness of teaching complementary and alternative medicine based on the components of theory of planned behavior on nutrition students: multicenter research study

ObjectiveSafe and beneficial use of complementary and alternative medicine (CAM) modalities results from integrating CAM education into curricula and increasing CAM knowledge. We sought how much teaching CAM procedures in a virtual environment can influence the components of the theory of planned behavior (TPB), including knowledge, attitude, behavioral intention, and behavior of nutrition students.MethodsThis cross-sectional descriptive-analytic study was conducted on 162 undergraduate nutrition students were selected through convenience sampling based on inclusion criteria in 2021–2022. Data were collected through a validated researcher-made CAM questionnaire that was designed based on TPB questionnaire that consisted of four constructs (knowledge, attitude, behavioral intention, and behavior). The content validity index and content validity ratio of the questionnaire were evaluated.ResultsOur results revealed that students who significantly scored the highest scores in attitude, behavioral intention, and behavior constructs were the students who claimed that “teaching two credits of CAM for nutrition students is not enough” (p. value = < 0.001, < 0.001, and 0.005, respectively). In addition, these students used treatment methods of CAM for themselves, suggested treatment methods of CAM to others, and followed the recommendations of the CAM specialists (for three pairwise comparisons: p. value = < 0.001, < 0.001, and < 0.001, respectively). The attitude could predict 70% of behavioral intention. However, attitude and behavioral intention could predict 90% of behavior.ConclusionAttitude was the most critical determinant influencing behavioral intention and behavior. CAM teaching using evidence-based CAM-ITM principles with a succinct, concerted, and collaborative curriculum, integration of CAM into continuing education, and integration of educational CAM programs continuously for several years into the academic curriculum in the actual setting influence the success of the educational CAM program.

Perception of integrating complementary and alternative medicine practice in patient's treatment among the healthcare practitioners: a systematic review

There is a growing trend in complementary and alternative medicine (CAM) usage among the population with medical conditions. However, there is hesitancy for medical practitioners to integrate its application with the current treatment modality, despite governance by the authority. Hence, our objective is to systematically evaluate the healthcare perception towards integrating CAM in their practices. We systematically searched three large and renowned databases i.e., Scopus, Web of Science and PubMed, regarding "Perception on Integrating CAM Usage in Patient's Treatment among Healthcare Practitioners" from 2016 until 2020. At least two independent reviewers comprehensively screened and extracted the data from the accepted articles. A total of 15 studies were included in the final qualitative synthesis following a strict and rigorous assessment checked using MMAT 2018 checklist. The studies included providing the richness of information due to the qualitative nature of the study design. There were three main domains extracted i.e. knowledge, attitude, and perspective of the healthcare practitioner towards CAM integration. Limited knowledge of CAM among healthcare providers may be the possible main reason for non-supportive attitude and negative perspective on CAM. However, those who showed an inclination towards CAM were found to be more open and ready to learn about CAM if it provides benefits to the patients. There is a heterogeneity of perception towards CAM integration from healthcare providers' point of view. A proactive and systematic CAM literacy awareness program may help to improve their understanding and possibly gain more trust in its application.

Complementary and alternative medicine use in infertility: A review of infertile women's needs

The use of complementary and alternative medicine (CAM) is common in infertile women in different countries. The purpose of the current study was to review the infertile women's needs in relation to CAM use. This narrative review was conducted through searching English databases including Scopus, PubMed, Embase, Web of Science, Cochrane library as well as Persian databases consisted of SID, and Magiran. The used keywords included “CAM/therapy, needs, and Infertility.” All studies published in English peer-reviewed journals from conception to October 2020, which examined the infertile women's needs in the field of CAM use were included in the review. In the process of data extraction, two researchers screened the title, abstract, and full text of the articles. Out of the 2166 articles reviewed, 29 articles including six qualitative and mixed methods studies, four review, and 19 quantitative studies met the inclusion criteria. The results showed that infertile women have different needs in six domains consisted of educational and informational needs, the need for psychological counseling, supportive needs, the need for CAM use counseling, the need to treatment consistent with women's culture and demands, and the need to the integration of CAM with conventional medicine. Awareness of infertile women's needs toward CAM use can help health policymakers and planners in designing and implementing counseling services in accordance with the demands and culture of infertile couples. It also helps to develop a coherent program to integrate the use of CAM in the classical infertility treatment.

Infertile women's healing experiences of using complementary and alternative medicine: A phenomenological inquiry

IntroductionInfertile women frequently use complementary and alternative medicine (CAM), in addition to conventional therapy. This study explored infertile women's use of CAM and their lived experience of healing. MethodThis qualitative study was conducted using Van Mannen's approach to phenomenology. Individual semi-structured face to face or telephone interviews were conducted with 22 infertile women with experience of CAM use, who were selected purposefully from February 2019 to July 2020 from referral infertility centers of Iran. All interviews transcribed and analyzed using six-step Van Manen's descriptive-interpretive approach, in which the process of analysis occurred while interviews were ongoing to explore the essence of the experience, so that sampling was terminated when saturation was achieved. The MAXQDA 10 software program was used for qualitative data organization. Lincoln and Guba's (1985) criteria were used to ensure trustworthiness. ResultsThe essence of the experience of CAM use, which emerged as the main theme from analysis of the data was “healing the body and mind”. Eleven sub-themes emerged within this major theme included body salve, harmonious with nature, increasing love in relationships, worth enduring the trouble, fostering wellbeing, reassuring, providing mental pleasure, inspiring calm, promising and motivating, having a supportive role and creating satisfaction. ConclusionInfertile women understood CAM treatments as a remedy for “healing the body and mind”. Integration of CAM into conventional medical therapies of infertility should be considered. Fertility centers need to offer counseling programs for infertility treatment based on culturally embedded factors relating to CAM use.

"Miracle" or "Medicine": A Turning-Point Analysis of Patients' and Physicians' Shifting Views on Acupuncture.

Objective: Acupuncture is one of the most widely used treatments of complementary and alternative medicine (CAM) within the military's health system. The success of CAM integration is partially dependent on both providers' and patients' perceptions that acupuncture is health-promoting. The aim of this research was to identify turning points, or changes, across treatments that enhanced or inhibited physicians' and patients' perception of acupuncture as health-promoting. Materials and Methods: Using a retrospective-interview approach, interviews were conducted with 15 family medicine physicians practicing medical acupuncture in a family medicine setting and with 17 patients (N = 32). Turning points were separated into 2 groups (health-promoting or health-inhibiting). Similarities and differences between perspectives were noted. Results: Patients and physicians identified two changes that enhanced their perspective of acupuncture as health-promoting: (1) observed health changes and (2) pain-medicine/narcotic reduction/elimination. Patients identified their ability to fulfill personal or professional roles, whereas physicians identified (1) training experiences and (2) enhanced relationships with patients. Health-inhibiting changes in perspective were identified as logistical constraints/barriers by both parties, although their perspectives differed to some degree. Turning points that were viewed as health-inhibiting treatment were identified as clinical challenges by physicians and as a lack of consistency in care by patients. Conclusions: The insight from these findings can help identify areas where medical acupuncture can be improved to promote successful integration in conventional medicine settings, as well as how providers can tailor communication with patients about acupuncture.

Complementary and alternative medicine use among patients with type 2 diabetes living in the United Arab Emirates

BackgroundThe use of Complementary and Alternative Medicine (CAM) among Type 2 Diabetes Mellitus (T2DM) patients is increasing to manage the complexities of their condition, enhance their health, and ease complications. The burden of T2DM in the United Arab Emirates (UAE) coupled with the high prevalence of CAM use and its associated risks among patients with T2DM necessitated the investigation of the use of CAM by this patients’ population. The aim of this study is to examine the prevalence, types, and correlates of CAM use among T2DM patients in the UAE.MethodsPatients with T2DM attending the outpatient clinics in the two governmental hospitals in Dubai and Sharjah, UAE were invited to participate in a cross-sectional survey. Face-to-face interviews were conducted with participants to complete a multi-component questionnaire. The questionnaire comprised of three main sections: demographic data, diabetes-related information, and CAM use details. Data analysis employed descriptive statistics, univariate and multivariate logistic regression to assess the prevalence and correlates of CAM use.ResultsTwo hundred forty-four T2DM patients completed the questionnaire (response rate: 80%). A total of 39.3% of participants were CAM users since diagnosis. After adjustment; the logistic regression results showed that CAM use was significantly associated with age, sex, education, employment, and having health insurance. The most commonly used type of CAM by participants were folk foods and herbs followed by spiritual and natural healing and vitamins and minerals supplements. The majority of CAM users were referred or encouraged to use CAM by family (42.7%), friends (25%) or social media (17.7%). Only 13.5% of participants used CAM because it was suggested by health care practitioners. Only 1 in four of CAM users disclosed CAM use to their treating physician.ConclusionCAM use among T2DM patients in the UAE is considerably high. Health policy and decision-makers are encouraged to dedicate particular attention to facilitating proper regulation and integration of CAM within conventional medicine to protect the health and wellbeing of patients. A concerted effort by medical schools and public health authorities should be committed to educating health care providers and patients on the safe and effective use of CAM therapies.

Prevalence and Predictors for Nonuse of Complementary Medicine among Breast and Gynecological Cancer Patients

Background: Complementary and alternative medicine (CAM) use is common among cancer patients. Data indicated that CAM use correlates with younger age, higher education levels, higher income, and less physician consultations. However, non-CAM use and predictors for non-CAM use are less clear among breast and gynecological cancer patients. Objectives: The purpose of this study was to determine the prevalence of non-CAM use and to investigate factors that might influence non-CAM use. Methods: The survey was conducted in breast cancer patients from January to May 2013 and in gynecological cancer patients from January to May 2014 with 2 pseudoanonymous questionnaires: one for CAM users (109 questions) and one for non-CAM users (85 questions). The survey was conducted via a telephone interview with 333 patients. Eligible participants were women with breast cancer (n = 285) and gynecological cancer (n = 291) who had undergone surgery at the Department of Gynecology and Obstetrics at the Technical University Munich, Germany, in the years 2012 (breast cancer) and 2011–2013 (gynecological cancer). Descriptive statistics were generated to determine patterns of non-CAM use. Univariable analysis was used to detect patient characteristics associated with noninterest in the different CAM therapies. Results: A total of 333 of 576 patients participated in the survey (58%). Fifty-eight percent (n = 192/333) were diagnosed with breast cancer and 42% (n = 141/333) with gynecological cancer. The overall prevalence of non-CAM use was 42% (n = 139/333). Eighty-one percent (n = 112/139) of the non-CAM users stated to have received no recommendation for CAM use, although 53% (n = 73/139) would have liked to receive information from their physician. As reasons for the nonuse of CAM therapies, 76% (n = 106/139) nonusers declared that they did not believe CAM use was necessary since the conventional therapy was considered sufficient, 44% (n = 61/139) reported a lack of information, 31% (n = 43/139) a fear of fraud, and 22% (n = 31/139) a fear of interactions and side effects of CAM. Sixty-eight percent (n = 95/139) of the patients stated that they would resort to CAM if the disease progressed while only 27% (n = 37/139) would still not use any CAM with progression of disease. Five percent (7/139) did not give any information regarding possible future CAM use with disease progression. Seventy-three percent (n = 102/139) would both welcome more physicians with qualifications in complementary medicine and supported an integration of CAM into our health care system. Furthermore, statistically significant correlations between patients’ sociodemographic characteristics and their nonuse of complementary therapies were identified. Conclusions: Our data demonstrate a high overall interest in CAM even in non-CAM users. Health care professionals should be aware of this in order to be able to better address patients’ needs. It is necessary to explore the use of CAM with cancer patients, educate them about potentially beneficial therapies even in the light of the limited available evidence, and work towards an integrated model of health care. Therefore, we implemented a counseling service as an outpatient program (ZIGG) for integrative medicine concepts and evidence-based complementary treatments to discuss integrative health approaches proactively with cancer patients in our cancer center in 2013.

Managing dermatology patients who prefer “all natural” treatments

Dermatology patients are expressing a growing interest in complementary and alternative medicine (CAM) and natural treatment options for management of dermatologic conditions. Counseling on the optimal integration of CAM with conventional therapeutic approaches can be daunting for practitioners who do not feel well-versed in these modalities. A productive conversation between the clinician and patient seeking natural treatments should address the appropriate role and scope of CAM in a therapeutic plan, which is best suited for use as maintenance therapy or to augment traditional pharmaceutical or procedural interventions. Understanding the patient’s goals, discussing evidence-based conventional and complementary treatment options, and employing shared decision making can enhance the clinical encounter and strengthen the physician-patient relationship.

Development of complementary and alternative medicine (CAM) education for clinical psychologists: An example from Indonesia

The inclusion of education about complementary and alternative medicine (CAM) into health education has occurred among the conventional health professions, but not for clinical psychologists. Clinical psychologists, as health professionals, need to have CAM knowledge in order to provide psychoeducation about CAM to their clients based on the latest scientific research. This novel cross-sectional research aimed to explore CAM-related educational needs among Indonesian clinical psychologists based on their knowledge of CAM and attitude towards knowledge of CAM. The participants were 318 clinical psychologists (Mage = 33.94 years, SD = 8.21; 87.7% females) who completed an online survey. In general, participants self-reported a lack of CAM knowledge. CAM education, especially in regards to the risks of CAM use, was strongly needed in psychology curricula and its continuing education. Findings of this study show that professional psychology associations may need to regulate CAM integration in psychological services; and educational institutions teaching psychology may consider delivering CAM education using experiential learning methods. Asian nations could consider the recommendations in this study due to their similarity with Indonesian culture and history of education within the field of psychology.

Counseling students’ attitudes toward complementary and alternative medicine integration in counseling practice

AbstractThis study explored counseling students’ attitudes toward beliefs and personal experience with complementary and alternative medicine (CAM) integration in counseling practices. A total of 113 clinical mental health counseling students completed a demographic questionnaire, the CAM use, and the Complementary and Alternative Medicine Beliefs Inventory. Data were analyzed using descriptive statistics, nonparametric Chi-Square testing, Mann–Whitney U test, and logistic regression analysis to determine the prevalence of CAM use, CAM beliefs, and predictive factors of CAM integration. The results indicated differences in ethnicity, gender, and age for CAM use, CAM beliefs, and predictors of attitudes toward CAM integration. Recommendations for counseling practice and education regarding CAM use and community-based health promotion were discussed.

Experiences and Perceptions Toward Integrative, Complementary, and Alternative Medicine Among Conventional Medicine Practitioners of Mangalore, India

ObjectivesThe purpose of this study was to identify experiences and perception of conventional (Western, allopathic) medical practitioners toward integrative, complementary, and alternative medicine (ICAM). MethodsThere are approximately 1200 conventional medical doctors in Mangalore, India. In February 2017, semistructured self-administered questionnaires were distributed to 200 medical practitioners. The association between categorical variables was analyzed using a χ2 test and those involving continuous variables using unpaired t test, analysis of variance, and Karl Pearson’s coefficient of correlation. A P value ≤ .05 was considered statistically significant. ResultsOf the surveys, 163 were returned and 129 were satisfactorily completed, giving a response rate of 64.5%. Mean age was 39.9 ± 11.9 years, and most 94 (72.9%) were male. A majority, 96 (74.4%), recommended ICAM to their patients. Nine had some training in ICAM modalities, and 76 (58.9%) participants reported personal usage of ICAM. Regarding perception toward effectiveness of ICAM, 33 (25.6%) felt that it was effective or somewhat effective. However, 82 (63.6%) participants felt that lack of sufficient scientific evidence was a major drawback of ICAM. However, 39 (30.2%) participants felt that ICAM should be part of Bachelor of Medicine and Bachelor of Surgery curricula. Favorable perception toward ICAM (P < .001) and personal usage of ICAM (P < .001) was associated with participants recommending any ICAM for their patients. Elderly practitioners (aged above 65 years) (P = .003) and practitioners with favorable perception regarding effectiveness of ICAM (P = .033) recommended a higher number of types of ICAM to their patients. Favorable perception toward effectiveness of ICAM was associated with favorable perception toward inclusion of ICAM in medical curriculum among participants (P = .002). ConclusionMost participants recommended ICAM to their patients and also reported personal usage of the same.

A comparison of attitudes towards complementary and alternative medicine between psychologists in Australia and Indonesia: a short report

BackgroundThe growth of complementary and alternative medicine (CAM) has been increasing, including amongst psychological clients. Therefore, it is important to investigate psychologists’ attitudes towards CAM. Negative attitudes towards CAM among psychologists could be a barrier to CAM integration into psychological services and may prevent clients to trust psychologists. This study aims to compare Indonesian and Australian psychologists’ attitudes towards CAM using the previously published study on Psychologists’ Attitudes Towards Complementary and Alternative Therapies (PATCAT) scale validation. MethodsThe PATCAT scale was adapted from an Australian study to an Indonesian version using backward-and-forward translation. This scale was used to investigate attitudes towards: (1) CAM knowledge; (2) CAM integration; and (3) the risks associated with CAM. An online survey was sent to all Indonesian psychologists and completed by 247 participants. Afterward, the data were compared with the published data from 115 Australian psychologists. ResultsIn general, psychologists in Indonesia and Australia showed relatively similar ambivalent attitudes towards CAM. This uncertainty may stem from the same Western psychology education, which is a basis for the medical models in both nations. They also considered it somewhat important to have an understanding of CAM. Participants in both nations displayed positive attitude towards CAM integration into psychological services. However, they felt that CAM usage for mental health holds some risks. ConclusionAustralian and Indonesian psychologists reported ambivalent attitudes towards CAM that might be reduced with clear regulation of CAM integration into psychological services from the government and professional organizations.

Georgia’s healthcare system and integration of complementary medicine

BackgroundAn increasing number of people in the Republic of Georgia use complementary and alternative medicine (CAM). CAM has long been practiced in the country, but is not currently part of the formal medical system. The aim of this study was to explore patients’ CAM use and their perspectives of CAM complementation of existing services in Georgia’s health care system. MethodologyWe conducted a qualitative study exploring patient needs and wants by performing in-depth, contextual interviews with patients using CAM. We recruited participants at CAM clinics and collected data until we reached saturation. A thematic analysis involving line by line coding explored perspectives and allowed us to formulate recommendations of CAM integration in Georgia. ResultsStudy participants voiced that they pursued cure beyond symptom relief; their disappointment in that regard with conventional medicine in Georgia directed them towards CAM as a safe and effective care setting. Most sought natural approaches as a sustained approach to their health and perceived CAM as empathetic therapeutic and preventive space. Participants were in favor of integration of CAM with conventional health services through government support and regulation. They saw coverage of payments for CAM visits and treatments as important aspect for an effective and sustainable integration. ConclusionPatients favor an integration of CAM into Georgia’s current healthcare systems to ensure CAM’s broad availability as well as effective regulation and financing, including coverage by health insurance.

Differences in demographics and complementary and alternative medicine use between patients attending integrative kampo versus biomedical clinics in Japan

ObjectivesGrowing interest in integrative medicine motivates examination of who seeks integrative care, and why. By examining differences in demographics and complementary and alternative medicine (CAM) use between patients recruited from Japanese Kampo (traditional herbal medicine) versus biomedical clinics, this study aimed to identify whether integrative medicine options might attract different patients. Design and settingIn this cross-sectional, observational study we administered the International Complementary and Alternative Medicine-Questionnaire (I-CAM-Q) to 209 patients recruited from four hospital clinics. Demographics, use of different types of CAM (self-help CAM, CAM practitioners, CAM products), and motivations were compared between Kampo and Non-Kampo patients and by gender. Factors influencing attendance at the Kampo clinic and CAM use were identified using logistic regression. ResultsWhile some demographic characteristics, CAM provider and total CAM use differed between Kampo and non-Kampo patients, self-help CAM use did not. Motivations (for acute, long-term, health maintenance, or other reasons) differed between Kampo and non-Kampo clinic patients for going to non-Kampo physicians (P = 0.02) and Kampo physicians (P = 0.1). Logistic regression results for ‘any CAM’ use showed odds ratio of 0.32 (95%CI 0.15-0.67) for self-rated health, and 1.60 (95%CI 1.10–2.32) for Macarthur subjective social status scale. Attendance at the Kampo clinic showed odds ratios of 1.50 (95%CI 1.11–2.02) for education and 0.56 (95%CI 0.39-0.80) for employment status. ConclusionsBetter understanding of factors such as motivation, self-rated health, and socioeconomic conditions that influence patients’ CAM use and integrative clinic attendance may enable more effective targeting of populations and integration of CAM into biomedical settings.

Integrative medicine in Dutch curative and long-term healthcare centres: Mapping the field

IntroductionLittle is known about integration of Complementary and Alternative Medicine (CAM) in the Dutch healthcare system. The aim of the present study was to investigate how Integrative Medicine (IM) is practiced and how CAM is integrated with conventional medicine in curative and long-term healthcare centres in the Netherlands. MethodsA mixed methodology was applied, including a systematic internet search, an online survey and focus groups among healthcare professionals. ResultsMost hospitals (92%) offered some form of CAM to treat anxiety (72%), restlessness (68%), pain (65%), sleeping problems (50%), stress (48%) and fatigue (36%). Mostly offered modalities were relaxation exercises (88%), art therapy (44%) and mindfulness (42%). Similar percentages of CAM use were found in other healthcare centres. Most CAM modalities were implemented without organizational vision, guidelines or protocols. Only 5% of implemented CAM was labelled as IM. Focus groups with health care professionals revealed the need to increase knowledge and to develop a vision for integration of CAM with conventional medicine, as well as to support effectiveness research in this area. ConclusionsThis study is the first in the Netherlands to quantitatively map the extent of CAM integration in conventional health care. The number of CAM interventions offered at conventional health care settings was surprisingly high. However, integration was fragmented. Guidelines, education and research programs are needed to further integration of CAM, preferably organised in a Dutch Consortium for IM.

Beliefs, attitudes towards, and experiences of using complementary and alternative medicine: A qualitative study of clinical psychologists in Indonesia

IntroductionLittle is known about psychologists’ beliefs, attitudes toward, and experiences of using complementary and alternative medicine (CAM). Exploring how psychologists’ beliefs and attitudes toward CAM are developed may identify potential barriers toward integrating CAM in psychological education and services. Therefore, this study aims to explore clinical psychologists’ beliefs, attitudes toward, and experiences of using CAM in Indonesia to reduce the understanding gap. MethodsTotal population sampling was used to recruit 43 clinical psychologists in public health centres. They were interviewed using a semi-structured interview schedule. Then, the recordings were transcribed and analysed using deductive thematic analysis. ResultsSix themes developed for beliefs and attitudes toward CAM and stretched along a continuum scale from negative to positive. Also, four themes arose for experiences of using CAM among the responses by participants: personal use, giving a recommendation, making a referral, and combining CAM into conventional psychotherapy. Participants often used CAM for themselves and family members but rarely integrated some CAM treatments into their clinical practice, especially when making a referral. Factors that affected beliefs, attitudes toward, and experiences of using CAM among participants were identified and discussed. ConclusionsBased on the qualitative findings, it is recommended that education about CAM should be included into clinical psychology education curricula to increase the likelihood of psychologists discussing CAM openly and scientifically with their clients. In addition, the government and psychology associations should standardise the practice of CAM integration into psychological services in order to provide more holistic psychological services.