Patterns of using complementary and alternative medicine by stroke patients at two university hospitals in Korea

This study measured the prevalence of complementary and alternative medicine (CAM) use among Korean stroke patients. Questionnaire-based 20-min interviews were conducted at the hospitals by a trained nurse after an outpatient visit. It included questions on demographic information, clinical information and the utilization of CAM. Of 304 stroke-patient respondents, 164 (54%) had used CAM, of which 66% had started taking CAM products following suggestions from family members and other relatives. Of the 57% of users who felt that CAM was effective, 84% considered that it improved the symptoms of stroke and 16% felt it was effective in achieving psychological relaxation. Of the eight CAM categories used by respondents, 92% used traditional Oriental medical treatments, 36% used plant- and animal-derived over-the-counter health care products, 24% used minerals and vitamins, and 11% used manual therapies. The majority of stroke patients (68%) were trying a new type of CAM, and half of the respondents (45%) relied on the knowledge of their general practitioner about CAMs when deciding whether to use them. Most of the stroke patients in this study used CAM, and a half of them reported beneficial effects. Despite the presence of adverse side effects, they tended to be used without discussion with chief physicians, and hence physicians should be actively involved in the usage of CAM.     

Use of complementary and alternative medicine among US adults with and without functional limitations

Purpose. This study characterizes the use of complementary and alternative medicine (CAM) among adults with and without functional limitations. We also examine the reasons for using CAM and for disclosing its use to conventional medical professionals. Methods. Data were obtained from the 2007 adult CAM supplement and components of the National Health Interview Survey (n?=?20,710). Results. Adults with functional limitations used CAM more frequently than those without (48.7% vs. 35.4%; p?<?0.001). Adults with functional limitations used mind–body therapies the most (27.4%) and alternative medical systems the least (4.8%). Relaxation techniques were the most common therapy used by adults with functional limitations, and they used it more often than those without limitations (24.6% vs. 13.7%; P?<?0.001). More than half of the adults with functional limitations (51.3%) discussed CAM use with conventional medical professionals, compared with 37.9% of adults without limitations (p?<?0.001). The main reason for CAM use was general wellness/disease prevention among adults with and without functional limitations (59.8% vs. 63.1%; P?=?0.051). Conclusions. CAM use among adults with functional limitations is high. Health practitioners should screen for and discuss the safety and efficacy of CAM when providing health care.

Implications for Rehabilitation

• Complementary and alternative medicine (CAM) is often used for overall health, disease prevention, and to supplement conventional medical treatment.

• While most adults used CAM on the recommendation of friends and family, one-third of adults with functional limitations (FLs) reported CAM use recommended by a health care provider.

• This study found that ~50% of adults with FLs discussed their CAM use with a health care provider.

• Open discussion of CAM use and its safety and efficacy is vital.

     

Use of complementary and alternative medicine by patients with chronic tension-type headache: results of a headache clinic survey

OBJECTIVES: This study was undertaken to evaluate the rates, pattern, and presence of predictors of complementary and alternative medicine use in a clinical population of patients with chronic tension-type headache. BACKGROUND: The use of complementary and alternative medicine in the treatment of headaches is a growing phenomenon about which little is known. METHODS: A total of 110 chronic tension-type headache patients attending a headache clinic participated in a physician-administered structured interview designed to gather information on complementary and alternative medicine use. RESULTS: Past use of complementary and alternative therapies was reported by 40% of the patients surveyed (22.7% in the previous year). Chronic tension-type headache patients prefer complementary and alternative practitioner-administered physical treatments to self-treatments, the most frequently used being chiropractic (21.9%), acupuncture (17.8%), and massage (17.8%). Only 41.1% of the patients perceived complementary and alternative therapies to be beneficial. The most common source of recommendation of complementary and alternative medicine was a friend or relative (41.1%). Most of the chronic tension-type headache patients used complementary and alternative treatment as a specific intervention for their headache (77.3%). Almost 60% of complementary and alternative medicine users had not informed their medical doctors of their use of complementary and alternative medicine. The most common reasons given for choosing to use a complementary or alternative therapy was the "potential improvement of headache" it offered (45.4%). The patients who had used more complementary and alternative treatments were found to be those recording a higher lifetime number of visits to conventional medical doctors, those with a comorbid psychiatric disorder, those enjoying a higher (household) income, and those who had never tried a preventive pharmacological treatment. CONCLUSIONS: Our findings suggest that headache-clinic chronic tension-type headache patients, in their need of and quest for care, seek and explore both conventional and complementary and alternative therapies, even if only 41.1% of them perceived complementary treatments as effective. Physicians should be made aware of this patient-driven change in the medical climate in order to prevent misuse of health care resources and to be better equipped to meet patients' care requirements.     

Evidence-based research in complementary and alternative medicine I: history

Contemporary Western medicine has witnessed a fragmentation of our conceptualization of the medical endeavor into 'traditional medicine' and 'non-traditional medicine'. The former is meant to refer to the Western medical tradition, the latter encompasses both 'complementary' and 'alternative' medical practices. Complementary medicine complements conventional medical treatments, and alternative modes of medical interventions are meant to replace traditional Western medicine. Evidence-based research must be directed at establishing the best available evidence in complementary and alternative medicine. This paper is the first of a set of four 'lectures' that reviews the process of evidence-based research, and discusses its implications and applications for the early decades of the 21st century. The purpose of this paper is to introduce the series by examining some of the historical and philosophical foundations of this research endeavor.     

Knowledge levels and attitudes of staff nurses in Israel towards complementary and alternative medicine

AIMS: The purpose of this study was to determine the knowledge level and attitudes of Israeli nurses towards complementary and alternative medicine and what factors are related to these variables. BACKGROUND: Over recent years there has been increased interest among the lay public and health care professionals in complementary and alternative medicine (CAM). Previous studies have shown that several variables such as education, income, age, perceived health status and satisfaction with medical therapy are associated with use of CAM. Conflicting reports were found with respect to the relationship between health locus of control and the use of CAM. Israel is a small country comprised mostly of immigrants from vastly differing cultures with differing beliefs about health and health care. Nurses whose origins are similar to the general population are also caregivers who are used to integrating diverse therapies into the plan of care devised with the client. No study was found which investigated these issues among Israeli nurses. DESIGN/METHODS: A systematic random sample of 369 staff nurses working at a major academic medical centre in Jerusalem, Israel were invited to participate in the study. Informed consent was obtained. Four self-administered, pencil and paper, questionnaires were distributed to the study participants: a questionnaire designed by the authors to determine the level of knowledge and attitudes towards complementary and alternative medicine; a questionnaire which measured satisfaction with the patient-physician relationship; a questionnaire which measured health locus of control; and a demographic questionnaire. Participants received a packet containing the questionnaire and a note explaining the study. The anonymous questionnaires were collected by the ward secretaries and sent in bulk to the researchers. RESULTS: Results demonstrated that nurses in this sample perceived that they had little knowledge of complementary and alternative medicine but were very interested in learning more. Few used complementary and alternative medicine in their nursing practice but levels of personal use were similar to that of the general population. Nurses who used complementary and alternative medicine were satisfied with their care. CONCLUSIONS: In general, nurses tended to be wary of the use of complementary and alternative medicine. Nurses were also not satisfied with their relationships with their physicians. Those of middle age were more likely to use complementary and alternative medicine but no other demographic characteristics were associated with knowledge or attitudes towards complementary and alternative medicine. Nurses had higher levels of internal health locus of control which was associated with more positive attitudes and knowledge levels of complementary and alternative medicine.     

Use of complementary and alternative medicine among people living with diabetes: literature review

AIM: This paper is a report of a literature review to explore the prevalence of complementary and alternative medicine use amongst people with diabetes to inform nursing practice, education and research. BACKGROUND: Diabetes mellitus affects the entirety of a person's being and increasingly people use complementary and alternative medicine in conjunction with other medical treatments and lifestyle modifications to manage their condition and improve well-being. METHODS: The CINAHL, Medline, ProQuest nursing journals and Psych INFO databases were searched for the period 1990-2006 using identified keywords. RESULTS: A total of 18 studies from nine countries were found. The results suggest that the prevalence of complementary and alternative medicine use among people with diabetes ranges from 17% to 72.8%. The most widely used therapies among diabetic populations are nutritional supplements, herbal medicines, nutritional advice, spiritual healing and relaxation techniques. The characteristics which influence complementary and alternative medicine use are age, duration of diabetes, degree of complications and self-monitoring of blood glucose. CONCLUSION: Although inconsistency in the definition of complementary and alternative medicine and varying research designs make estimation of usage prevalence difficult, evidence suggests that a high proportion of people with diabetes use these therapies concurrently with conventional healthcare services. Healthcare professionals need to be aware of this issue and may need to incorporate complementary and alternative medicine information into patient assessment and intervention.     

Performance care practices in complementary and alternative medicine by Thai breast cancer survivors: An ethnonursing study

The purpose of this study was to explore how Thai breast cancer survivors perform care practices in complementary and alternative medicine to promote their health and well-being. Research was conducted using an ethnonursing method. Data were collected through semi-structured interviews with 17 Thai breast cancer survivors in Thailand. The transcribed interviews were analyzed using the ethnonursing analysis method. The findings showed Thai breast cancer survivors started their care practices in complementary and alternative medicine immediately following a diagnosis of breast cancer. They sought out and gathered alternative medicine information from several sources, such as the people around them, media resources, books, magazines, or newspapers. After gathering information, Thai breast cancer survivors would try out various types of complementary medicines rather than use only one type because of information from other people and their own evaluation. The findings of this study indicate the need for a conversation about complementary medicine use between healthcare providers and Thai breast cancer survivors as an on-going process throughout the cancer trajectory to ensure that safe and holistic care is provided.     

Use of complementary and alternative medicine among Dominican emergency department patients

This small, pilot study examined presenting complaint, brief health history, use of complementary and alternative medicine (CAM), and sociodemographic characteristics, among patients attending the emergency department (ED) of a large urban hospital. The sample (n = 50) was primarily Dominican and of low socioeconomic status. Almost half had used CAM for their presenting complaint or another health problem during the past year, most commonly in the form of medicinal plants made into herbal teas. CAM users were more likely to be female, longer-term residents of the United States, and to have also used religious practices for health problems. Subjects who had used CAM for any problem other than the presenting complaint during the past year rated its effectiveness higher than subjects who had used CAM for their presenting complaint. In conclusion, it is likely that a significant proportion of Dominican ED patients use CAM, suggesting that they should be asked about their CAM use during triage.     

A descriptive study on complementary and alternative medicine use in 0 to 1‐year‐old infants and nurses' awareness and recommendation for complementary and alternative medicine

This study aimed to determine complementary and alternative medicine (CAM) recommended by midwives and nurses and used by mothers on their 0 to 1‐year‐old infants. A cross‐sectional survey design was used. The sample of the study consisted of 65 midwives and mothers of 349 infants registered at these health‐care centres. The frequency of CAM use on a regular basis by mothers participating in the study on their infants was 24.6%, whereas the frequency of CAM use for a while was 41.3%. Of the mothers using CAM, 81.5–98.5% stated that the method they were employing was useful. The mothers used CAM on their infants, and the midwives and nurses recommended CAM use. However, the midwives and nurses themselves should be first trained to be able to inform individuals/mothers about CAM. Evidence‐based studies on CAM are needed.