Quality of life and complementary and alternative medicine use among cancer patients in Turkey

AimThe purpose of this study was to assess the relationships between quality of life and use of complementary and alternative medicine (CAM) among Turkish cancer patients.MethodsThis cross-sectional study was conducted in Istanbul University Institute of Oncology, Turkey. Two-hundred patients were invited and informed consent was obtained, however 179 cancer patients completed the study. The Patient Characteristics form, The Nightingale Symptom Assessment Scale and The Functional Assessment of Cancer Therapy Scale were used in the evaluation of the patients’ characteristics and quality of life.ResultsSome form of CAM had been used by 71.5% of the sample. Frequently used CAM methods appeared to be religious practices (68.2%) and only 37.4% of the patients used herbs. However, female patients, single patients, and individuals with metastatic disease and worse quality of life showed a tendency to use CAM more often. More than one-third of our patients began to use CAM immediately after being diagnosed with cancer and factors associated with CAM use varied according to the type of CAM. Although CAM use did not affect the patients’ quality of life, logistic regression analysis revealed that gender, type of cancer diagnosis and education level were important factors to be considered in different CAM therapies.ConclusionCAM use is common in cancer patients in Turkey. More discussion about CAM use should take place between patients and health professionals to inform the patients’ decisions.     

Complementary and alternative medicine in cancer — A qualitative study on the Internet offer in Spanish-speaking South America

BackgroundThe number of people with cancer using complementary and alternative medicine (CAM) is increasing. However, CAM may have interactions with conventional cancer therapies. In addition, alternative medicine procedures may result in significant health risks. Because of the Internet, regional CAM methods easily spread globally. This study aims at evaluating CAM procedures offered on Spanish-speaking South American websites and assessing the quality of these websites.MethodsAn Internet search was carried out in nine Spanish-speaking countries in South America. Websites were analysed using a standardized tool.ResultsIn total, 85 websites, with a wide range of 158 different CAM procedures were evaluated. The vast majority of websites had poor content and formal quality. Overall, no website was rated as very good and only two websites could be rated as good. Among the most commonly mentioned South American methods were an Aloe- mixture called “Fray Romano”, graviola, uncaria tomentosa (Cat’s claw), the "Método HANSI" and components of the lapacho tree.ConclusionsThere is an urgent need for quality-assured, easy-to-find sites with high quality for Spanish speaking persons in South America. Several of the methods have already spread to Europe as graviola or uncaria.     

Use of complementary and alternative medicine and quality of life of cancer patients who received chemotherapy in Turkey

ObjectivesThis study aims to evaluate the frequency of use of CAM therapies among cancer patients, the types of CAM therapies they used, the demographic and clinical factors affecting their tendency to use CAM therapies, and the difference between quality of life of CAM user and non-user patients.DesignThis cross-sectional study was carried out between March and June 2016 in an education and research hospital located in Mugla, Turkey. A CAM use questionnaire, the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire (EORTC QLQ-C30 version 3.0) and the Nightingale Symptom Assessment Scale (N-SAS) were administered to 211 patients.ResultsAmong all the participating patients, 46.4% were CAM users. The most commonly used CAM therapy was herbal products. The rate of CAM use was higher among the patients with a low education level (P = 0.004). No statistically significant difference was found between the quality-of-life scores of the CAM user and non-user patients.ConclusionAlmost half of the cancer patients used CAM therapy, with the most commonly used CAM therapy being herbal products. Doctors/nurses should assess patients in terms of the CAM therapies they use to determine their possible side effects and drug interactions. Further research should be performed to determine the relationship between CAM therapy and quality of life.     

Effect of complementary and alternative medicine interventions on cancer related pain among breast cancer patients: A systematic review

ObjectiveThis systematic review aimed to evaluate the efficacy of CAM interventions for cancer-related pain in breast cancer patients.MethodsDatabases (PubMed, Scopus, Web of Science, and EMBASE) were searched from January 1, 2000, up to April 31, 2019, using the keywords: Complementary and alternative medicine therapies and cancer related pain. Standard tools were used to evaluate the quality of the studies included.ResultsOf the 3742 articles found, 46 articles comprising 3685 participants entered the final phase. Our results indicate that interventions including acupuncture/acupressure, tai chi/qi gong, hypnosis, meditation, music therapy, yoga, massage, reflexology, and Reiki improve cancer-related pain in breast cancer patients. However, aromatherapy had no effect on the same.ConclusionsDespite the positive effect of various CAM interventions in reducing cancer-related pain, necessary precautions should be adopted to use them alongside other treatments to control cancer pain in the clinical setting.     

Massage therapy as a complementary treatment for Parkinson’s disease: A Systematic Literature Review

ObjectiveThere is no definite cure for Parkinson’s disease (PD); therefore, the goals for symptomatic treatment are to improve quality of life and manage the motor and non-motor symptoms of the disease. Although massage is the one of the commonest used forms of complementary and alternative medicine (CAM), there is no systematically-oriented review focusing specifically on the efficacy of the different massage techniques on PD.Aim of this review was to evaluate the quality of evidence referring to massage therapy for PD.DesignA systematic search was conductedin the MEDLINE database to identify the efficacy of massage on PD between 01/01/1970 and 06/12/2019.ResultsA total of 12 studies were analyzed in this systematic review. Massage therapy seems to induce relaxation in most cases, which is accompanied by biological measures involving urine stress hormones. Quality of life has been shown to be improved upon various therapeutic massage styles, involving classical whole-body therapeutic massage and reflexology. Non-motor symptoms, such as sleep disturbances, pain, fatigue, anxiety and depressive symptoms have been demonstrated to be improved upon different massage techniques, including classical deep therapeutic massage, Traditional Japanese (Anma) massage, Thai massage, neuromuscular therapy and Yin Tui Na massage. Regarding motor symptoms, classical therapeutic massage, Traditional Japanese (Anma) massage, Thai massage, and neuromuscular therapy seemed to improve motor symptoms, whereas Yin Tui Na technique combined with acupuncture was associated with worse motor scores.ConclusionsDespite the methodological concerns regarding the existing evidence, there is a wide range of safe massage techniques with beneficial effects on both motor and non-motor symptoms of PD. Longitudinal studies are needed to justify the introduction of massage therapy into clinical practice.     

Expected and perceived efficacy of complementary and alternative medicine: A comparison views of patients with cancer and oncologists

Background & aimsThis study sought to identify discrepancies between the expectations of patients with cancer and oncologists regarding the efficacy of complementary and alternative medicines (CAMs), and to determine how patients evaluate CAM efficacy after its use.MethodsData from the Cancer Patient Experience Study, a nationwide survey, were used. Seven subdivided efficacy domains were included in the survey. An oncologist-patient matching analysis was done to assess the concordance of CAM efficacies between oncologists and patients with cancer. In addition, the patients’ expectations of CAM efficacies were compared before and after use.ResultsOut of 719 participants, 201 patients with cancer (28.0%) reported using CAMs. The patients with cancer generally tended to be more positive about CAM efficacies than the oncologists. The largest discrepancy in efficacy perception was found in the efficacy domain of survival benefit, which included complete disease remission and prolonged survival. Many patients reported that they did not experience the positive efficacy they had anticipated before use. However, a substantial proportion of patients indicated that CAMs were as effective as they had expected, even though there is little evidence supporting the CAM efficacies.ConclusionsThere was a marked discrepancy and a lack of concordance in expectations of CAM efficacy between patients with cancer and oncologists. Better communication between the patients and oncologists regarding CAM efficacy would be needed to make the patients to have shared expectations, and to reduce unnecessary CAM use.     

Is a biopsychosocial–spiritual approach relevant to cancer treatment? A study of patients and oncology staff members on issues of complementary medicine and spirituality

Background Complementary and alternative medicine (CAM) is increasingly being used by patients with cancer.Objectives Our aim is to compare the attitudes of cancer patients who use CAM to those of nonusers, on issues of CAM, biopsychosocial considerations, and spiritual needs.Methods Questionnaires were administered to patients and medical care providers in a tertiary teaching hospital with a comprehensive cancer center.Results Forty-nine percent of the study patients reported integrating CAM into their conventional care. Health care providers considered psychological and spiritual needs as major reasons for CAM use, while patients considered the familial–social aspect to be more important.Conclusions Cancer patients do not correlate CAM use with spiritual concerns but expect their physicians to attend to spiritual themes. Health care providers involved in oncology cancer care should emphasize spiritual as well as CAM themes. The integration of these themes into a biopsychosocial–spiritual approach may enrich the dialogue between patients and health providers.     

The impact of acculturation on the use of traditional Chinese medicine in newly diagnosed Chinese cancer patients

Goals of work This study assessed the impact of acculturation on the prevalence of traditional Chinese medicine and other complementary and alternative medicine (TCM/CAM) use in newly diagnosed Chinese cancer patients. The individual determinants of TCM/CAM use among patients were also investigated. Materials and methods A consecutive sample of Chinese cancer patients treated at the British Columbia Cancer Agency was surveyed at admission using a 15-item questionnaire. Items included TCM/CAM use, sociodemographics, as well as medical and cultural factors. Data were analyzed using bivariate methods including Pearson’s X ² test and Student’s t test. As well, multiple logistic regression was used to obtain the final causal model. Main results Of the 230 respondents, 57% completed the survey in Chinese and 94% were immigrants. The average age was 59. Participants had a mean disease duration of approximately 2 months and 79% had already received at least one conventional treatment. Overall, TCM/CAM was used by 47% of respondents. Herbal remedies, vitamins/minerals, and prayer were the most commonly used therapies. Multivariable analysis showed that prior TCM/CAM use (p < 0.001), having received conventional treatment(s) (p = 0.029), and being less acculturated (p = 0.028) were associated with TCM/CAM use. Conclusions Prevalence and type of use were found to vary as a function of the degree of acculturation. Health care practitioners would be well advised to discuss TCM/CAM use with their patients, especially those who are less acculturated to Western society, since they are the most likely users of TCM/CAM.     

A cross-sectional analysis of patient characteristics,health conditions and patient experience at a Portuguese medical acupuncture teaching appointment

BackgroundAcupuncture is one of the most popular and most frequently used complementary medicines worldwide, with benefits for several health conditions when integrated into Western medical practice.ObjectiveTo perform a retrospective analysis of patient characteristics, health conditions and patient experience in a teaching medical acupuncture appointment at the Faculty of Medicine, University of Coimbra/Coimbra Hospital and University Centre.Methods500 medical records between January 2010 and December 2015 were accessed and 324 were included. The characteristics examined include gender, age, health conditions treated, number of acupuncture needles used in each treatment, professional who referred the patient, type of stimulation, number of treatment sessions and patient experience regarding the degree of improvement at the end of treatment.ResultsPatients range from 13 to 92 years old, with most between 40 and 59 yo (40.7%). In total, 71.3% were female and 28.7% male. The most commonly treated health conditions were musculoskeletal symptoms (60.4%), nervous and headaches (18.2%) and orofacial (11.3%). The median number of appointments was 6 and the median needles used per treatment was 12. In 52.2% of consultations, electrostimulation was performed. The majority of patients were referred by physical and rehabilitative medicine and dentists. 85.3% of patients reported improvement at the end of the treatment, with those who performed more sessions presenting a higher improvement.ConclusionsThis pioneering study in Portugal presents similar results to other countries regarding patient characterization. The high success rate (85.3%) regarding patient improvement recommends the use of acupuncture as an effective complementary therapy.     

睡眠干预对内科患者睡眠质量及生活质量的影响

目的 探讨睡眠干预在内科住院患者中的应用效果.方法 选取100例内科患者为研究对象,并对他们的睡眠情况进行分析.100名患者随机分为观察组和对照组,对照组采用常规护理,观察组在对照组的基础上采用睡眠干预,比较两组的护理效果.结果 身体不适、病房噪音和心理因素是影响内科患者睡眠的主要因素.观察组干预1 w后、出院前的睡眠质量指数均显著高于对照组（P＜0.05）.观察组出院前在生理功能、躯体疼痛、情感职能等生活质量方面的评分均显著高于对照组（P＜0.05）.结论 内科住院患者存在一定的睡眠障碍,睡眠干预有利于提高患者的睡眠质量和生活质量.     

The use of complementary and alternative medicine in children with atopic eczema at a tertiary care centre in Malaysia

ObjectiveGlobally, the use of complementary and alternative medicines (CAMs) for children with atopic eczema (AE) is gaining popularity. At present, information on the pattern of CAM use in Malaysia among children with AE is limited. This study aimed to investigate the pattern of CAM use in children with AE and factors associated with its use.MethodsThis was a cross-sectional survey conducted at a tertiary care centre in Kuala Lumpur, Malaysia among parents of children with AE aged ≤ 12 years using validated questionnaires including Beliefs about Medicines Questionnaire (BMQ-General) and Patient-Oriented Eczema Measure (POEM) scale.ResultsIn total, 173 parents were recruited. The prevalence of CAM use over the last 12-month period was 46.8 %. The most commonly used CAM was Ruqyah (Islamic prayer), followed by Malay herbs, virgin coconut oil, nutritional therapy and homeopathy. AE severity from parental perspective was the major predictor of CAM use based on multiple logistic regression analysis. Parents of children with ‘clear or almost clear’ (adjusted OR 0.06; 95 % CI 0.01-0.54; p = 0.012) and ‘mild’ (adjusted OR 0.15; 95 % CI 0.03-0.85; p = 0.032) eczema were less likely to use CAM than those with ‘very severe eczema’. Conclusion: CAM use was prevalent among children with AE. Its use was significantly associated with AE severity from a parental perspective. Healthcare providers may need to enquire parents about CAM use for their child during routine clinic appointment.     

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.     

KAP护理干预模式对肠癌患者术后睡眠质量、生活质量及胃肠功能的影响

目的探讨知、信、行(KAP)护理干预模式对肠癌患者术后胃肠功能及其睡眠质量、生活质量的影响。方法选取江阴市人民医院收治的130例肠癌患者作为研究对象,其中2017年5月至2018年1月65例作为对照组,施行常规护理;2018年5月至2019年4月65例作为研究组,施行常规护理+KAP护理干预模式。对比两组患者的睡眠质量、生活质量和胃肠功能恢复情况。结果护理前,两组患者的睡眠质量无明显差异(P>0.05);干预后,与对照组比较,研究组患者的睡眠质量明显改善,生活质量明显提高,术后胃肠功能恢复时间提前,差异均有统计学意义(P<0.05)。结论KAP护理干预模式有助于改善肠癌患者术后的睡眠质量,提高生活质量,促进胃肠功能恢复。