Cincotta D R, Crawford N W, Lim A, Cranswick N E, Skull S, South M, Powell C V E
University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK.
Arch Dis Child. 2006 Feb;91(2):153-8. doi: 10.1136/adc.2005.074872. Epub 2005 Sep 15.
To compare prevalence, reasons, motivations, initiation, perceived helpfulness, and communication of complementary and alternative medicine (CAM) use between two tertiary children's hospitals.
A study, using a face-to-face questionnaire, of 500 children attending the University Hospital of Wales, Cardiff, UK was compared to an identical study of 503 children attending the Royal Children's Hospital, Melbourne, Australia.
One year CAM use in Cardiff was lower than Melbourne (41% v 51%; OR = 0.67, 95% CI 0.52-0.85), reflected in non-medicinal use (OR = 0.41, 95% CI 0.29-0.58) and general paediatric outpatients (OR = 0.38, 95% CI 0.21-0.67). Compared to Melbourne, factors associated with lower CAM use in Cardiff included families born locally (father: OR = 0.58, 95% CI 0.44-0.77) or non-tertiary educated parents (mother: OR = 0.54, 95% CI 0.38-0.77). Cardiff participants used less vitamin C (OR = 0.31, 95% CI 0.18-0.51) and herbs (OR = 0.49, 95% CI 0.34-0.71), attended less chiropractors (OR = 0.25, 95% CI 0.06-0.37) and naturopaths (OR = 0.08, 95% CI 0.02-0.33), but saw more reflexologists (OR = 3.33, 95% CI 1.08-10.29). In Cardiff, CAM was more popular for relaxation (OR = 1.92, 95% CI 1.03-3.57) but less for colds/coughs (OR = 0.4, 95% CI 0.27-0.73). Most CAM was self-initiated (by parent) in Cardiff and Melbourne (74% v 70%), but Cardiff CAM users perceived it less helpful (OR = 0.46, 95% CI 0.31-0.68). Non-disclosure of CAM use was high in Cardiff and Melbourne (66% v 63%); likewise few doctors/nurses documented recent medicinal CAM use in inpatient notes (0/21 v 2/22).
The differences in CAM use may reflect variation in sociocultural factors influencing reasons, motivations, attitudes, and availability. The regional variation in use and poor communication highlights the importance of local policy development.
比较两家三级儿童医院中补充和替代医学（CAM）的使用患病率、原因、动机、起始情况、感知的帮助程度以及沟通情况。
采用面对面问卷调查的方法，对英国加的夫威尔士大学医院的500名儿童进行研究，并与澳大利亚墨尔本皇家儿童医院的503名儿童进行相同的研究。
加的夫一年中CAM的使用率低于墨尔本（41%对51%；比值比=0.67，95%可信区间0.52 - 0.85），这体现在非药物使用（比值比=0.41，95%可信区间0.29 - 0.58）和普通儿科门诊患者中（比值比=0.38，95%可信区间0.21 - 0.67）。与墨尔本相比，加的夫CAM使用率较低的相关因素包括在当地出生的家庭（父亲：比值比=0.58，95%可信区间0.44 - 0.77）或父母未接受高等教育（母亲：比值比=0.54，95%可信区间0.38 - 0.77）。加的夫的参与者较少使用维生素C（比值比=0.31，95%可信区间0.18 - 0.51）和草药（比值比=0.49，95%可信区间0.34 - 0.71），看脊椎按摩师（比值比=0.25，95%可信区间0.06 - 0.37）和自然疗法医生的次数较少（比值比=0.08，95%可信区间0.02 - 0.33），但看反射疗法师的次数较多（比值比=3.33，95%可信区间1.08 - 10.29）。在加的夫，CAM在用于放松方面更受欢迎（比值比=1.92，95%可信区间1.03 - 3.57），但在用于感冒/咳嗽方面则不太受欢迎（比值比=0.4，95%可信区间0.27 - 0.73）。在加的夫和墨尔本，大多数CAM是由家长自行起始使用的（74%对70%），但加的夫的CAM使用者认为其帮助较小（比值比=0.46，95%可信区间0.31 - 0.68）。在加的夫和墨尔本，不透露CAM使用情况的比例都很高（66%对63%）；同样，很少有医生/护士在住院病历中记录近期使用药用CAM的情况（0/21对2/22）。
CAM使用情况的差异可能反映了影响原因、动机、态度和可获得性的社会文化因素的差异。使用情况的地区差异和沟通不畅凸显了制定地方政策的重要性。
