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.     

Biologically based complementary and alternative medicine use among breast cancer survivors: relationship to dietary fat consumption and exercise

Previous literature has shown that more than half of all female cancer survivors use some form of complementary and alternative medicine (CAM). Although the prevalence of CAM use in this population is becoming apparent, few researchers have examined the relationship between CAM use and lifestyle factors that could influence patients’ well-being. The present study examined whether breast cancer survivors who use biologically based CAM are more likely than CAM nonusers to follow a low-fat diet and maintain moderate or vigorous exercise. Sixty-five female breast cancer survivors who were within 3 months of completing primary treatment were recruited. CAM use was measured by self-reported use of one or more of a list of 15 supplements. Dietary fat was measured by a 23-item self-report measure estimating fat consumption in the past month. Dietary fat stage of change and moderate and vigorous exercise stage of change were assessed using measures based on the Transtheoretical Model of Behavior Change. Results showed that biologically based CAM users maintained a lower percentage of calories from fat in their diet (t=2.12, p<0.05), and there was a trend for CAM users to be more likely than CAM nonusers to be in the action or maintenance stage for dietary fat consumption (p<0.09). However, this study did not find that CAM users were more likely to be in the action or maintenance stage of change for moderate or vigorous exercise. These findings suggest that biologically based CAM use among breast cancer survivors is associated with some, but not all, healthy lifestyle behaviors.     

Depression and the use of complementary medicine among breast cancer patients

This was a cross-sectional study to examine the association between anxiety, depression and quality of life and the use of complementary and alternative medicine. Anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS), and quality of life was measured using the global quality of life subscale selected from the European Organization for Treatment and Research of Cancer (EORTC) quality of life core questionnaire (QLQ-C30). In all, 177 breast cancer patients were studied, and 32% (n=57) reported that they used or were using complementary medicine. Users and nonusers did not differ significantly in almost all variables studied, with the exception of duration of their diagnosis. The most commonly used complementary medicine was prayer and spiritual healing (n=45, 73.8% of responses). Performing the logistic regression analysis controlling for age, marital status, educational level, knowledge of diagnosis, time since diagnosis, global quality of life, depression, and anxiety scores, the results indicated that the use of complementary medicine among breast cancer patients was associated with sever depression (odds ratio 2.49, 95% CI 1.06–5.89, P 0.04). The other variables studied did not show any significant results. The study findings confirm that the use of complementary medicine is more common among depressed breast cancer patients and might be a marker of greater psychological distress in this group of patients.The preliminary results of this study was presented at the 4th European Breast Cancer Conference, Hamburg, Germany, 16–20 March 2004     

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.     

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.     

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.

     

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.     

Use of complementary and alternative medicine by patients with breast cancer: observations from a health-care survey

Goals of the work The aim of this study was to assess the period prevalence and identify predictors of the use of complementary and alternative medicine (CAM) among women with breast cancer.Patients and methods In a cross-sectional study, 263 women participating in a quality of life survey reported on CAM use. Differences between CAM users and nonusers were evaluated using logistic regression.Results About 3 years after diagnosis the period prevalence of CAM use among women with breast cancer was 36%. Younger women reported usage of CAM more often than older women. Associations between remote disease, pain and psychosocial variables were found. Involvement in self-help groups and active participation in leisure activities were associated with CAM use; this may indicate differences in the patients ability to cope with the disease. Most patients were informed of CAM by a physician.Conclusions Involvement in self-help groups and leisure activities were associated with CAM use, indicating differences in the patients ability to cope. Further research is necessary to evaluate the safety of CAM and to determine the value of CAM in health care.     

Survey on the use of complementary and alternative medicine among patients with headache syndromes

The objective was to determine headache patients' knowledge, prevalence of use and perceived effectiveness of complementary and alternative medicine. Seventy-three patients with headache syndromes attending a head and neck pain clinic were interviewed using a standardized questionnaire. Alternative medical therapies were used by 85% of surveyed patients for the relief of their head pain. In 60%, the therapies were perceived to have a benefit. Almost 100% of the patients were familiar with one or more of the presented alternative treatments. Eighty-eight per cent perceived at least one of the complementary treatments to be an effective remedy for headache pain. Exposure to and interest in alternative treatments are common among patients with headache syndromes, despite the lack of scientific evidence of benefit and assessments of risks for many of the treatments. Neurologists and general physicians should be aware of the increasing role of alternative medicine in the healthcare system. There is still an urgent need for objective, integrative and critical research with regard to complementary and alternative medicine.     

Nurses' responses to people with cancer who use complementary and alternative medicine

There is a growing demand for complementary and alternative medicines (CAMs) among people with cancer. This study aims to describe how nurses' respond to people with cancer who use CAMs, and the factors which might contribute to these different responses. A grounded theory approach was used. Six semistructured interviews were conducted with nurses who were working in cancer settings. The core category which emerged from this study was 'nurses' responses towards patients who use CAMs'. Nurses respond in a variety of ways to patients who use CAMs. They include: open, sceptical and ambivalent responses. A range of factors which influence the way nurses respond were also identified. These include the ambiguous definitions of CAM, nurses' personal philosophies, life experiences, evidence of the therapy's effectiveness, impact on patients, the motives of patients who use CAM and organizational culture. Several implications for nursing education and practice are identified from these findings.     

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.     

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.     

The knowledge and usage of complementary and alternative medicine by emergency department patients and physicians

Objectives: To evaluate Emergency Department (ED) patients' desire to discuss complementary and alternative medicine (CAM) with their emergency physicians, their willingness to try CAM for their presenting complaint, and emergency physicians' attitudes, beliefs, and usage of CAM. Methods: A written questionnaire asking about CAM knowledge, usage, and interest was administered to a convenience sample of ED patients and put in work mailboxes of emergency physicians at an academic tertiary care referral center with an emergency medicine residency program. Results: Of the 75 patients surveyed, 54.7% stated that they were currently using or had used some form of CAM in the past. Only 24% of patients stated that they would discuss their usage of CAM with their emergency physician. Eighty-one percent of patients thought it was important for their physicians to be educated about CAM, and 85% would be willing to incorporate CAM into the treatment of their presenting complaint. Out of 34 emergency physicians, 28 (82%) completed their surveys. Forty percent of physicians stated that they are currently using or had used some form of CAM in the past. Ninety-six percent of physicians surveyed thought it was important for physicians to be educated about CAM and were willing to discuss CAM with their patients. Conclusion: The use and public acceptance of CAM in our study population, for both patients and physicians, was high. Although patients and physicians need more education about CAM, both made it clear that they desire and are willing to discuss CAM with each other.