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整体论、赋权、可及性和合法性等主题界定了补充医学、替代医学和整合医学相对于传统生物医学的范畴。

Themes of holism, empowerment, access, and legitimacy define complementary, alternative, and integrative medicine in relation to conventional biomedicine.

作者信息

Barrett Bruce, Marchand Lucille, Scheder Jo, Plane Mary Beth, Maberry Rob, Appelbaum Diane, Rakel David, Rabago David

机构信息

Department of Family Medicine, University of Wisconsin Medical School, 777 South Mills, Madison, WI 53715, USA.

出版信息

J Altern Complement Med. 2003 Dec;9(6):937-47. doi: 10.1089/107555303771952271.

Abstract

Complementary and alternative medicine (CAM) has been defined largely in relation to conventional biomedicine. CAM therapies that are used instead of conventional medicine are termed "alternative." CAM therapies used alongside conventional medicine are said to be "complementary." "Integrative medicine" results from the thoughtful incorporation of concepts, values, and practices from alternative, complementary, and conventional medicines. The evolving process of integration between CAM and conventional medicine evokes new conceptual frameworks, as well as new terminology. Interview-based qualitative research at the University of Wisconsin-Madison seeks to probe and develop this theoretical structure. Interviews with users and practitioners of CAM therapies have revealed four primary themes: holism, empowerment, access, and legitimacy (HEAL). These themes characterize CAM and contrast it with conventional medicine. CAM is said to be more holistic and empowering yet less legitimate than conventional medicine. CAM is more intuitive; conventional is more deductive. While CAM is perhaps more psychologically accessible to many patients in that it better reflects commonly held values, it is often less financially and institutionally accessible, at least for those with conventional health insurance and limited income. Substantive barriers--including economic, organizational and scientific differences, as well as an apparent widespread lack of understanding--continue to thwart attempts at integration. More and better evidence is needed if CAM therapies are to be accepted by mainstream medicine. State-of-the-art research methods developed by conventional science will be needed to test CAM therapies. Conventional medicine, however, has much to learn from CAM. By incorporating a more holistic, empowering and accessible therapeutic approach, conventional medicine could build on its present legitimacy, and thereby enhance its power to "HEAL."

摘要

补充与替代医学(CAM)很大程度上是相对于传统生物医学来定义的。替代传统医学使用的CAM疗法被称为“替代疗法”。与传统医学同时使用的CAM疗法则被称为“补充疗法”。“整合医学”是将替代医学、补充医学和传统医学的概念、价值观及实践进行深思熟虑的融合而产生的。CAM与传统医学之间不断发展的整合过程催生了新的概念框架以及新的术语。威斯康星大学麦迪逊分校基于访谈的定性研究旨在探究并发展这一理论结构。对CAM疗法使用者和从业者的访谈揭示了四个主要主题:整体观、赋权、可及性和合法性(HEAL)。这些主题刻画了CAM的特点,并将其与传统医学进行了对比。据说CAM比传统医学更具整体观且能赋予人力量,但合法性较低。CAM更具直觉性;传统医学则更具演绎性。虽然CAM可能在心理上对许多患者来说更容易接受,因为它更好地反映了普遍持有的价值观,但至少对于那些有传统医疗保险且收入有限的人来说,在经济和机构层面往往更难获得。实质性障碍——包括经济、组织和科学方面的差异,以及明显普遍存在的缺乏理解——继续阻碍整合的尝试。如果CAM疗法要被主流医学所接受,就需要更多更好的证据。将需要传统科学开发的先进研究方法来测试CAM疗法。然而,传统医学也有许多可从CAM中学到的东西。通过纳入更具整体观、能赋予人力量且易于获得的治疗方法,传统医学可以在其现有的合法性基础上更进一步,从而增强其“治愈”的能力。

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