Personal Use Of Complementary And Alternative Medicine Research Articles

The Influence of Spirituality and Religiosity on US Oncologists' Personal Use of and Clinical Practices Regarding Complementary and Alternative Medicine.

Background:Cancer patients frequently use complementary and alternative medicine (CAM), and spirituality has been associated with CAM use among patients. We evaluated how oncologists’ spirituality and religiosity are associated with personal use and patient recommendations for CAM.Methods:A survey was mailed to 1000 medical oncologists in the United States. The questionnaire asked about oncologists’ approaches to CAM use by patients, focusing on the use of herbs and supplement (HS), and about religiosity and spirituality.Results:Of 937 deliverable questionnaires, 392 were returned (response rate 42%). Respondents were mostly men (71%) and Caucasian (76%), with a median age of 48. Approximately 16% reported no religion, 19% Jewish, 24% Catholic, 28% Christian, and 13% other religions. Eighteen percent reported attending religious services at least once a week, including 15% who attend several times per week. Twenty-eight percent reported high theological pluralism (skepticism regarding whether one religion is comprehensively and uniquely true); 58% described themselves as moderately or very spiritual. Self-reported spirituality and religious service attendance were associated with using CAM personally and recommending HS to patients. In multivariate analyses, moderate-high spirituality and attending religious services less than monthly was positively associated with personal use of CAM: odds ratio (OR) = 3.10 (confidence interval [CI] = 1.5-6.5) and OR = 3.04 (CI = 1.5-6.6), respectively. Physicians with moderate to high spirituality were more likely to report recommending CAM in general (OR = 3.07, CI = 1.3-7.1), but less likely to report recommending HS (OR = 0.33, CI = 0.14-0.75).Conclusion:Self-reported spirituality is a significant factor among US oncologists’ decision to use CAM and recommend CAM to patients.

Perceptions and personal use of Complementary and Alternative Medicine (CAM) by Iranian health care providers

PurposeAim of this study was to determine the perceptions about and personal use of CAM by health care providers. MethodsA cross-sectional survey was carried out on 320 health care providers, who were selected by census method. Results86.6% of the subjects reported that they had used at least one or more CAM. The most commonly used CAM was prayer (65.6%). There was a significant relationship between sex and all the five factors of attitude. The highest mean score of attitude was related to Factor 1 (attitude toward the desirability of CAIM therapies). Based on the results of univariate logistic regression, there was a significant association between the use of complementary medicine and education level. ConclusionBased on the results it seems that this group can play an effective role in providing the appropriate information for the community and prevent the unnecessary use of CAM.

Complementary and integrative medicine attitudes and perceived knowledge in a large pediatric residency program

ObjectiveThere is limited formal complementary and alternative medicine (CAM)/integrative medicine (IM) training in most US pediatric residency programs. Not surprisingly, the AAP Fellows survey #49 demonstrated that pediatricians in residency training and those younger than 42 years old reported less knowledge of CAM than their counterparts. The purpose of this study was to assess pediatric residents’ attitudes toward CAM and IM, personal use of CAM, perceived knowledge gaps, and preferred methods of delivery for IM education in a large pediatric residency program. MethodsA 20-question anonymous, voluntary electronic survey was sent to all categorical and combined program pediatric residents at a pediatric residency program in Texas. ResultsEighty of 177 pediatric residents completed the survey. Eighty-three percent of respondents reported that patients have asked them about complementary and integrative medicine, and 88% reported that they would like to expand their knowledge on CAM/IM. Lack of knowledge was the top barrier to residents’ incorporation of complementary and integrative medicine into their practice. Preferred methods of education delivery were reported as exposure to complementary and integrative medicine providers and noon conference lectures. ConclusionsResidents in this large pediatric residency program recognize their knowledge gaps and wish to improve their understanding of complementary and integrative medicine. A formal IM curriculum could bridge knowledge gaps and help residents feel more comfortable discussing IM with patients and their families.

Nurses' knowledge, clinical practice and attitude towards unconventional medicine: Implications for intercultural healthcare

ObjectiveThe aim of this hospital-based, cross-sectional study was to examine nurses' knowledge, personal and professional practices and attitude towards complementary and alternative medical therapies in urban Ghana. MethodUsing convenience sampling technique, cross-sectional data were collected from 210 registered and practicing nurses with self-administered questionnaire based on the Complementary and Alternative Medicine (CAM) Health Belief Questionnaire (CHBQ). Descriptive statistics and the associations between variables were calculated using Pearson's Chi-square test and/or Fisher's exact test with p < 0.05. ResultsThe mean score of nurses' knowledge on CAM therapies was low (mean ± SD, 38.39 ± 10.11; possible range, 18–72) which was built on nurses' personal experiences. Nurses, therefore, lacked the confidence to recommend CAM therapies to patients. Despite the isolated cases of non-herbal supplements, relaxation techniques, massage and prayer healing, the study found an overall low personal use of CAM (mean ± SD, 32.97 ± 10.78; possible range, 18–72) among nurses over the last 12 months. Yet, nurses exhibited a positive attitude towards CAM (mean ± SD, 72.7 ± 12.5, possible range, 67–110). We observed significant associations among nurses' CAM knowledge and education [χ2 (2) = 6.69, p = 0.035] and religion [χ2 (2) = 7.96, p = 0.019]; nurses' personal use of CAM and income [χ2 (2) = 16.07, p < 0.001] and religion [χ2 (2) = 18.65, p < 0.001]; and nurses' clinical CAM use and income [χ2 (2) = 7.01, p = 0.030]. ConclusionDespite the overall positive attitude towards CAM therapies, Ghanaian nurses do not perceive themselves to have sufficient knowledge of CAM. Integrating CAM education into the nurses' training curriculum can improve CAM knowledge and professional practice among nurses, and in turn, enhance evidence-based patient care within the framework of intercultural healthcare system in Ghana.

Midwives' personal use of complementary and alternative medicine (CAM) influences their recommendations to women experiencing a post-date pregnancy.

A survey of a national midwifery association midwifery members (n=3,552) was undertaken at a midwifery conference (October 2015) and via e-bulletins (November 2015-March 2016). The self-administered survey included questions on what self-help and CAM strategies midwives discuss and recommend to women with a post-date pregnancy, midwives' confidence levels on discussing or recommending CAM, midwives' own personal use of CAM. A total of 571 registered midwives completed the survey (16%). Demographics (age, years as a midwife, state of residence) reflected Australian midwives and the midwifery association membership. Most respondents discuss (91.2%) and recommend (88.6%) self-help/CAM strategies to women with a post-date pregnancy. The top five CAM recommended were Acupuncture (65.7%), Acupressure (58.1%), Raspberry Leaf (52.5%), Massage (38.9%) and Hypnosis/Calmbirthing/Hypnobirthing (35.7%). Midwives were more likely to discuss strategies if they personally used CAM (p<.001), were younger (p<.001) or had worked less years as midwives (p=.004). Midwives were more likely to recommend strategies if they used CAM in their own pregnancies (p=.001). Midwives' personal use of CAM influenced their discussions and recommendations of CAM/self-help strategies to women experiencing a post-date pregnancy. This study has implications for inclusion of CAM in midwifery education curricula.

Complementary and alternative medicine (CAM) among Australian hospital-based nurses: knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users

ObjectiveThis study was intended to examine CAM among Australian hospital-based nurses, identifying their knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users. Methods and materialsNurses holding a qualification in nursing and working in surgical wards were included using a convenience sampling technique. A self-complete questionnaire was developed to achieve the aims of the study. Descriptive and non-parametric statistics were calculated to describe and analyse data. ResultsOverall, 95.7% and 49.7% of nurses reported personal and professional use of CAM, respectively. The most popular CAM/CAM domain personally and professionally used by nurses was massage therapy and mind-body therapies. The primary reason for personal use of CAM was “[it] fits into my way of life/philosophy”. Furthermore, massage therapists were the most commonly recommended CAM practitioners to patients. Only 15.8% of nurses would always ask patients about use of herbal medicines as part of nursing history taking. Over one-fifth (22.4%) of nurses rated their attitude as having a very positive, and 60.3% rated themselves as having very little or no knowledge of CAM. A positive correlation was also found between knowledge and attitude about CAM. Positive attitude and higher knowledge about CAM were positively correlated to CAM referrals. Several socio-demographic factors predicted personal and professional use of CAM. ConclusionThis study revealed that nurses generally believe not to have sufficient knowledge of CAM but are open to use CAM with patients. Nurses' positive attitude toward and personal use of CAM could be an indication that they are poised for further integration of evidence-based CAM into nursing practice to treat whole person.

Attitudes and Uses of Alternative Medicine by Physicians at a Pediatric Hospital in Mexico

Background: Several studies have described the physician’s attitudes, perceptions, knowledge and experience about the complementary and alternative medicine (CAM), reporting among their results that these therapies are usually perceived as useful, which has favor the increase in its use and recommendation, both personally and in the medical practices. Despite the relevance that CAM has regained in the last years, in Mexico there are no studies developed about this topic nor in this population. Methodology: A descriptive and transversal study was developed. The participants answer a survey designed and validated for Mexican population (α = 0.72). The survey was applied to the doctors in a pediatric tertiary care hospital, the survey included demographic data, history of personal use of CAM, recommendation to patients and attitudes towards CAM. Averages, standard deviations and association statistics (χi2) were calculated. Results: A total of 249 physicians were included: 51% turned to CAM, primarily to treat acute conditions in a complementary manner to conventional treatment. A third of the participants recommended CAM to their patients. The use of CAM by the physician was the only factor related to their recommendation of these treatments. The most commonly used and recommended therapies by doctors were homeopathy and herbal medicine. 72% consider it useful to have knowledge in CAM and 67% want more information about these therapies. 51% agree that the CAM should be included in the medical career. Conclusions: Half of the respondents use CAM, and one-third recommend. The most used therapies were homeopathy and herbal medicine. Most doctors consider the knowledge about CAM useful and want to have more information, but only half of them agreed on its inclusion in the career of medicine.

Primary Care Providers’ Attitudes and Beliefs About Patients’ Complementary and Alternative Medicine Use for Asthma Self-Management

Background: Asthma is a major cause of health resource utilization, poor quality of life and disability. However, adherence to asthma treatments remains relatively poor, partially because patients often prefer to use complementary and alternative medicine (CAM) instead of conventional therapies. Moreover, individuals with asthma are reluctant to disclose CAM use with their providers. It was suggested that providers’ negative attitude towards CAM is one barrier to creating an open dialogue. Purpose: The aim of this exploratory study was to identify primary care providers’ attitudes and beliefs about their asthma patients’ CAM use. Methods: Providers who referred patients into a research study about asthma self-management, including CAM, completed three surveys: the revised Integrative Medicine Attitude Questionnaire (r-IMAQ) ; the 10-item CAM Health Belief Questionnaire (CHBQ); and the 30-item Morehouse College Survey of CAM Practices (MCSCAMP). Results: Of the 21 referring providers, 14 physicians and 2 nurse practitioners were enrolled. Seven were male (44%); 13 White (81%), 2 Asian (13%), 1 Black (6%); mean age was 45.7. All providers endorsed the majority of r-IMAQ items and an additional CHBQ item. The MCSCAMP found fitness and nutritional approaches to be the most common health practice (94%), followed by counseling (56%), and prayer/spiritual healing (50%). Conclusions: The results of this exploratory study suggest that providers have positive opinions about CAM, uniformly endorsing items related to spirituality, the importance of patient-provider partnerships and patients’ beliefs. However, there was relatively low personal use of CAM by providers.

Attitudes, Patterns of Recommendation, and Communication of Pediatric Providers About Complementary and Alternative Medicine in a Large Metropolitan Children’s Hospital

The authors conducted an e-mail survey of their medical staff to explore the attitudes, patterns of recommendation, and communication of pediatric providers about complementary and alternative medicine (CAM) in a large metropolitan children's hospital. Two thirds of the respondents reported awareness about their patients' CAM therapy use (65%) and recommended CAM therapy to their patients (67%). Providers who reported personal use of CAM (71%) were more likely to recommend CAM to their patients compared with those who do not (76% vs 45%; P < .05). One half of pediatric providers reported occasional consultation with their patient's CAM provider, but bidirectional communication was rare (4%). Specific changes in care based on a CAM provider's recommendations were also unusual (4%). Despite the positive attitudes about and willingness to recommend CAM by pediatric providers, communication between these clinicians and CAM providers may be less than ideal.

Religion, Clinicians, and the Integration of Complementary and Alternative Medicines

The aim of this study was to compare religious characteristics of general internists, rheumatologists, naturopaths, and acupuncturists, as well as to examine associations between physicians' religious characteristics and their openness to integrating complementary and alternative medicine (CAM). The design involved a national mail survey. The subjects were internists, rheumatologists, naturopaths, and acupuncturists. Physician outcome measures were use of and attitudes toward six classes of CAM. Predictors were religious affiliation, intrinsic religiosity, spirituality, and religious traditionalism. There was a 65% response. Naturopaths and acupuncturists were three times as likely as internists and rheumatologists to report no religious affiliation (35% versus 12%, p < 0.001), but were more likely to describe themselves as very spiritual (51% versus 20%, p < 0.001) and to agree they try to carry religious beliefs into life's dealings (51% versus 44%, p < 0.01). Among physicians, increased spirituality and religiosity coincided with more personal use of CAM and willingness to integrate CAM into a treatment program. Current and future integrative medicine will be shaped in part by religious and spiritual characteristics of providers.

Exploring the Role of Complementary and Alternative Medicine in Public Health Practice and Training

Consumer use of complementary and alternative medicine (CAM) in the United States continues to expand. Although conventional medicine has responded actively, the response from public health has been far less pronounced. To examine the potential for integrating CAM into public health contexts, an exploratory survey was conducted. A 19-item, self-administered survey instrument was used to collect participant data. Participants were surveyed at the 2003 American Public Health Association (APHA) annual meeting while attending CAM-related talks sponsored by the Alternative and Complementary Health Practices Special Interest Group (ACHP SPIG). A convenience sample of 153 individuals was surveyed, which was predominantly female (81%) and Caucasian (68%), with an average age of 42 years. The survey instrument included items about participant and client demographics, participant use of CAM (personal and professional), perceived client interest in CAM, and several attitude measures. The majority of participants (64%) were currently employed as public health professionals working in a wide variety of settings with highly diverse populations. Personal use of CAM was high (66% using four or more modalities). The majority also reported integrating CAM into work settings. There was a significant relationship between personal and professional use of CAM. Participants overwhelmingly agreed that more professional training in this area was needed. This exploratory study provides insight into the potential role of CAM as an important resource in public health settings. Additional funding and research in this area is urgently needed.

An approach to educating family practice residents and family physicians about complementary and alternative medicine

Complementary and alternative medicine (CAM) in the context of medical education is a controversial topic among the medical community. With the increased popularity of complementary and alternative medicine, medical educators are faced with the need of educating physicians so they would become competent to communicate with patients about CAM. As academic medicine shows more interest in CAM, it is critical to develop initiatives to overcome physicians' attitudinal barriers toward CAM and develop an instruction strategy that can address these needs. An approach to educate family practice residents and family physicians about CAM is described in this article. This patient-centered teaching approach hinges on the belief that CAM and family medicine are closely related. It espouses utilizing critical thinking and basing decisions on evidence-based material. The course covered four main topics in CAM: herbal medicine, traditional Chinese medicine (TCM), homeopathy and complementary nutrition. The course had limited objectives of exposing physicians to the common methods in CAM and providing sufficient information, so physicians could provide their patients with an informed, safe and balanced advice. The instructions emphasized the importance of improving physician-patient relationship and enriching the participant both professionally and personally. Results of our study revealed that after the course physicians' referral to CAM became more selective, at the same time, their personal use of CAM also increased. This reflects the increased value of CAM in the physicians' own healthcare, as well as their improved knowledge of appropriate referral patterns. Most importantly, the course increased the physicians' awareness of the psychosocial aspect of clinical problems encountered in family practice and, through the close observation of CAM in practice, gave them an additional viewpoint to better understand the patient-doctor relationship.