Eisenberg D M, Kessler R C, Van Rompay M I, Kaptchuk T J, Wilkey S A, Appel S, Davis R B
Center for Alternative Medicine Research and Education, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
Ann Intern Med. 2001 Sep 4;135(5):344-51. doi: 10.7326/0003-4819-135-5-200109040-00011.
Little is known about perceptions of complementary and alternative medical (CAM) therapy relative to conventional therapy among patients who use both.
To document perceptions about CAM therapies among persons who use CAM and conventional therapies.
Nationally representative, random-household telephone survey.
The 48 contiguous U.S. states.
831 adults who saw a medical doctor and used CAM therapies in 1997.
Perceptions about helpfulness and patterns of CAM therapy use relative to conventional therapy use and reasons for nondisclosure of CAM therapies.
Of 831 respondents who saw a medical doctor and used CAM therapies in the previous 12 months, 79% perceived the combination to be superior to either one alone. Of 411 respondents who reported seeing both a medical doctor and a CAM provider, 70% typically saw a medical doctor before or concurrent with their visits to a CAM provider; 15% typically saw a CAM provider before seeing a medical doctor. Perceived confidence in CAM providers was not substantially different from confidence in medical doctors. Among the 831 respondents who in the past year had used a CAM therapy and seen a medical doctor, 63% to 72% did not disclose at least one type of CAM therapy to the medical doctor. Among 507 respondents who reported their reasons for nondisclosure of use of 726 alternative therapies, common reasons for nondisclosure were "It wasn't important for the doctor to know" (61%), "The doctor never asked" (60%), "It was none of the doctor's business" (31%), and "The doctor would not understand" (20%). Fewer respondents (14%) thought their doctor would disapprove of or discourage CAM use, and 2% thought their doctor might not continue as their provider. Respondents judged CAM therapies to be more helpful than conventional care for the treatment of headache and neck and back conditions but considered conventional care to be more helpful than CAM therapy for treatment of hypertension.
National survey data do not support the view that use of CAM therapy in the United States primarily reflects dissatisfaction with conventional care. Adults who use both appear to value both and tend to be less concerned about their medical doctor's disapproval than about their doctor's inability to understand or incorporate CAM therapy use within the context of their medical management.
对于同时使用补充替代医学(CAM)疗法和传统疗法的患者而言,人们对这两种疗法的认知了解甚少。
记录使用CAM疗法和传统疗法的人群对CAM疗法的认知情况。
具有全国代表性的随机家庭电话调查。
美国48个毗连州。
1997年看过医生并使用过CAM疗法的831名成年人。
对CAM疗法相对于传统疗法的有效性认知、使用模式以及不透露CAM疗法使用情况的原因。
在过去12个月看过医生并使用过CAM疗法的831名受访者中,79%的人认为两种疗法结合使用比单独使用任何一种更好。在报告同时看过医生和CAM从业者的411名受访者中,70%的人通常在看CAM从业者之前或同时看医生;15%的人通常在看医生之前先看CAM从业者。对CAM从业者的信任度与对医生的信任度没有实质性差异。在过去一年中使用过CAM疗法并看过医生的831名受访者中,63%至72% 的人至少未向医生透露一种CAM疗法。在报告未透露使用726种替代疗法原因的507名受访者中,未透露的常见原因有 “医生知道与否并不重要”(61%)、“医生从未问过”(60%)、“这与医生无关”(31%)以及 “医生不会理解”(20%)。较少受访者(14%)认为他们的医生会不赞成或不鼓励使用CAM疗法,2%的人认为他们的医生可能不会继续为其提供医疗服务。受访者认为CAM疗法在治疗头痛、颈部和背部疾病方面比传统护理更有帮助,但认为传统护理在治疗高血压方面比CAM疗法更有帮助。
全国性调查数据并不支持以下观点,即在美国使用CAM疗法主要反映了对传统护理的不满。同时使用这两种疗法的成年人似乎对二者都很重视,并且相比于医生不理解或在医疗管理中无法纳入CAM疗法的使用,他们不太担心医生的不赞成态度。