Koithan Mary, Bell Iris R, Caspi Opher, Ferro Lynn, Brown Victoria
Department of Medicine (Program in Integrative Medicine) at The University of Arizona Health Sciences Center, Tucson, AZ 85724-5153, USA.
Integr Cancer Ther. 2007 Jun;6(2):174-84. doi: 10.1177/1534735407301992.
A common theme in integrative medicine (IM) is patient-centered partnering in care between patients and providers. Despite the stated ideals, few studies have assessed patients' perspectives on their actual experience in the context of a specific care model. The purpose of the present study was to retrospectively explore and compare experiences of cancer and noncancer patients under care in a consultative IM outpatient teaching clinic in the south-western United States.
Qualitative study using inductive content analysis of focus group interview transcripts (2 groups of adult patients with cancers of various types and 1 group of chronically ill noncancer patients with mixed diagnoses).
Participants were recruited by random selection from a pool of eligible patients. Groups were conducted with patients who had completed their initial conventional cancer treatment and were at least 6 months postconsultation with an IM clinic physician. Transcripts of the audiotaped focus groups were analyzed.
Cancer patients (n = 15) and noncancer patients (n = 6) (mean age, 60 years; 77% women) expressed overall satisfaction with IM, emphasizing (1) expansion of treatment options with lower perceived toxicity than conventional therapies, (2) positive experiences of the IM physician as caring and taking time to listen, and (3) improved self-care skills and sense of empowerment. Cancer patients noted positive relationships with their conventional MDs more than did noncancer patients, although both groups appreciated the IM physicians' communication styles.
Patients experience a consultative integrative clinic model overall as favorable. The impact on outcomes, costs, and long-term quality of life requires additional study.
整合医学（IM）的一个共同主题是患者与医疗服务提供者之间以患者为中心的合作式医疗。尽管有既定的理想模式，但很少有研究评估患者对其在特定医疗模式下实际体验的看法。本研究的目的是回顾性地探索和比较美国西南部一家咨询性整合医学门诊教学诊所中癌症患者和非癌症患者的就医体验。
采用归纳性内容分析法对焦点小组访谈记录进行定性研究（2组患有各种类型癌症的成年患者和1组患有多种慢性病诊断的非癌症慢性病患者）。
从符合条件的患者群体中随机选择参与者。小组访谈对象为已完成初始常规癌症治疗且至少在咨询整合医学诊所医生6个月后的患者。对焦点小组的录音记录进行分析。
癌症患者（n = 15）和非癌症患者（n = 6）（平均年龄60岁；77%为女性）对整合医学总体表示满意，强调（1）治疗选择的扩展，其毒性低于传统疗法；（2）整合医学医生富有关怀且愿意花时间倾听的积极体验；（3）自我护理技能和自主感的提升。癌症患者比非癌症患者更强调与他们的常规医生之间的积极关系，尽管两组都赞赏整合医学医生的沟通方式。
患者总体上体验到咨询性整合诊所模式是有益的。对治疗结果、成本和长期生活质量的影响需要进一步研究。
