Roberts Cleora S, Baker Frank, Hann Danette, Runfola Joan, Witt Cathy, McDonald Jamie, Livingston Mary L, Ruiterman Jane, Ampela Rosemarie, Kaw Okrae C K, Blanchard Chris
School of Social Work, University of South Florida, Tampa, FL 33620, USA.
J Psychosoc Oncol. 2005;23(4):35-60. doi: 10.1300/j077v23n04_03.
It is estimated that as many as 80% of adult cancer patients use at least one form of Complementary and Alternative Medicine (CAM) during or after conventional treatment. Studies of physician-patient communication about the use of CAM have concluded that patients frequently do not tell their oncologists about their use of CAM and physicians consistently underestimate the numbers of their patients using CAM. The purpose of this multi-site study was to assess newly diagnosed cancer patients' and oncologists' communication practices with regard to complementary therapies. Patients (106 breast and 82 prostate) indicated which of 45 complementary therapies they were using while physicians at their institutions indicated which they supported. It is noted that, although we use the popular acronym "CAM" all patients surveyed were receiving conventional medical treatment. Thus, the survey addressed complementary therapies only. A large majority (84%) indicated they were using at least one therapy with the most popular being exercise, vitamins, prayer, and nutritional supplements. Surprisingly, the oncologists surveyed were generally enthusiastic and supportive of patients' use of complementary therapies. In addition to those therapies popular with patients, at least half the physicians supported massage, journal writing, support groups, acupuncture, biofeedback, and art therapy. However, discussions of CAM are relatively rare and most likely to be initiated by patients. When the topic is discussed, both patients and doctors say it usually enhances their relationship. Implications for CAM program development and oncology professionals' roles in patient education regarding complementary therapies are presented.
据估计,多达80%的成年癌症患者在传统治疗期间或之后会使用至少一种形式的补充和替代医学(CAM)。关于医患之间就使用CAM进行沟通的研究得出结论,患者常常不向肿瘤医生透露他们使用CAM的情况,而医生一直低估使用CAM的患者数量。这项多中心研究的目的是评估新诊断癌症患者和肿瘤医生在补充疗法方面的沟通情况。患者(106名乳腺癌患者和82名前列腺癌患者)指出他们正在使用45种补充疗法中的哪几种,而他们所在机构的医生则指出他们支持哪些疗法。需要注意的是,尽管我们使用了广为人知的首字母缩写词“CAM”,但所有接受调查的患者都在接受传统医学治疗。因此,该调查仅涉及补充疗法。绝大多数(84%)患者表示他们正在使用至少一种疗法,其中最受欢迎的是锻炼、维生素、祈祷和营养补充剂。令人惊讶的是,接受调查的肿瘤医生总体上对患者使用补充疗法持热情和支持态度。除了那些患者常用的疗法外,至少一半的医生支持按摩、写日记、支持小组、针灸、生物反馈和艺术疗法。然而,关于CAM的讨论相对较少,而且很可能由患者发起。当讨论这个话题时,患者和医生都说这通常会增进他们之间的关系。文中还阐述了对CAM项目开发以及肿瘤学专业人员在患者补充疗法教育方面角色的启示。