Shaw Alison, Thompson Elizabeth A, Sharp Debbie
Academic Unit of Primary Health Care, Department of Community Based Medicine, University of Bristol, Cotham House, Cotham Hill, Bristol, England, UK.
BMC Health Serv Res. 2006 Jun 15;6:76. doi: 10.1186/1472-6963-6-76.
Patients are increasingly using complementary therapies, often for chronic conditions. Asthma is the most common chronic condition in the UK. Previous research indicates that some asthma patients experience gaps in their NHS care. However, little attention has been given to how and why patients and parents of children with asthma use complementary therapies and the implications for NHS care.
Qualitative study, comprising 50 semi-structured interviews with a purposeful sample of 22 adults and 28 children with asthma (plus a parent), recruited from a range of NHS and non-NHS settings in Bristol, England. Data analysis was thematic, drawing on the principles of constant comparison.
A range of complementary therapies were being used for asthma, most commonly Buteyko breathing and homeopathy. Most use took place outside of the NHS, comprising either self-treatment or consultation with private complementary therapists. Complementary therapies were usually used alongside not instead of conventional asthma treatment. A spectrum of complementary therapy users emerged, including "committed", "pragmatic" and "last resort" users. Motivating factors for complementary therapy use included concerns about conventional NHS care ("push factors") and attractive aspects of complementary therapies ("pull factors"). While participants were often uncertain whether therapies had directly helped their asthma, breathing techniques such as the Buteyko Method were most notably reported to enhance symptom control and enable reduction in medication. Across the range of therapies, the process of seeking and using complementary therapies seemed to help patients in two broad ways: it empowered them to take greater personal control over their condition rather than feel dependant on medication, and enabled exploration of a broader range of possible causes of their asthma than commonly discussed within NHS settings.
Complementary therapy use reflects patients' and parents' underlying desire for greater self-care and need of opportunities to address some of their concerns regarding NHS asthma care. Self-management of chronic conditions is increasingly promoted within the NHS but with little attention to complementary therapy use as one strategy being used by patients and parents. With their desire for self-help, complementary therapy users are in many ways adopting the healthcare personas that current policies aim to encourage.
患者越来越多地使用补充疗法，通常用于治疗慢性病。哮喘是英国最常见的慢性病。先前的研究表明，一些哮喘患者在国民保健服务（NHS）护理方面存在差距。然而，对于哮喘患者及其父母如何以及为何使用补充疗法以及对NHS护理的影响，关注甚少。
定性研究，对来自英国布里斯托尔一系列NHS和非NHS机构的22名成年哮喘患者、28名儿童哮喘患者（加一名家长）进行了有目的抽样，进行了50次半结构化访谈。数据分析采用主题分析法，运用持续比较原则。
一系列补充疗法被用于治疗哮喘，最常见的是布泰科呼吸法和顺势疗法。大多数使用是在NHS之外进行的，包括自我治疗或咨询私人补充疗法治疗师。补充疗法通常与传统哮喘治疗同时使用，而非替代传统治疗。出现了一系列补充疗法使用者，包括“坚定”、“务实”和“最后手段”使用者。使用补充疗法的动机因素包括对传统NHS护理的担忧（“推动因素”）和补充疗法的吸引人之处（“拉动因素”）。虽然参与者往往不确定这些疗法是否直接有助于治疗他们的哮喘，但布泰科方法等呼吸技术最显著地被报告可增强症状控制并减少药物使用。在所有疗法中，寻求和使用补充疗法的过程似乎在两个广泛方面帮助了患者：它使患者能够对自己的病情有更大的个人掌控力，而不是依赖药物，并且能够探索比NHS环境中通常讨论的更广泛的哮喘可能病因。
补充疗法的使用反映了患者及其父母对更大自我护理的潜在渴望，以及解决他们对NHS哮喘护理的一些担忧的机会需求。NHS越来越多地推广慢性病的自我管理，但很少关注补充疗法的使用是患者及其父母所采用的一种策略。出于自助的愿望，补充疗法使用者在许多方面采用了当前政策旨在鼓励的医疗保健角色。
