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三类慢性病群体中基于医疗服务提供者的补充和替代医学使用情况:与社会心理因素的关联以及与传统医疗服务的同时使用情况

Provider-based complementary and alternative medicine use among three chronic illness groups: associations with psychosocial factors and concurrent use of conventional health-care services.

作者信息

Sirois Fuschia M

机构信息

Department of Psychology, University of Windsor, 401 Sunset Ave., Windsor, Ontario, Canada N9B 3P4.

出版信息

Complement Ther Med. 2008 Apr;16(2):73-80. doi: 10.1016/j.ctim.2007.03.006. Epub 2007 Jun 6.

Abstract

OBJECTIVE

The focus of this study was to examine the patterns of provider-based complementary and alternative medicine (CAM) use across three chronic illness groups, and to identify the socio-demographic, health-related, and psychosocial factors associated with CAM use.

DESIGN

Cross-sectional international survey administered on the Internet to individuals with arthritis, inflammatory bowel disease (IBD), and mixed chronic conditions.

MAIN OUTCOME MEASURES

Self-reported consultations to CAM providers and to a variety of conventional health-care services made in the previous 6 months.

RESULTS

365 surveys were received from people with arthritis (N=140), IBD (N=110), and other chronic conditions (N=115). Overall 38.1% of respondents had used CAM, with rates ranging from 31.8 to 46.1% across the three illness groups. Backward step-wise logistic regression revealed that being female, having more than high school education, a greater number of comorbid conditions, higher perceived control over health and reward motivations, lower stress and less belief that health is governed by chance, were the best predictors of CAM consultations. CAM clients also used a greater variety of conventional health-care services and made more consultations relative to non-CAM clients.

CONCLUSIONS

In this study the socio-demographic and health status factors associated with CAM consultations in three different chronic illness groups were similar to those found in the general population. CAM use in the study population was also related to higher use and a greater variety of use of conventional health-care services, and with stronger beliefs in the controllability of health and an enduring motivation to seek out rewards.

摘要

目的

本研究的重点是调查三类慢性病患者使用基于医疗服务提供者的补充和替代医学(CAM)的模式,并确定与使用CAM相关的社会人口学、健康相关及心理社会因素。

设计

通过互联网对患有关节炎、炎症性肠病(IBD)和混合慢性病的个体进行横断面国际调查。

主要观察指标

自我报告的在过去6个月内与CAM提供者及各种传统医疗服务机构的咨询情况。

结果

共收到来自患有关节炎(N = 140)、IBD(N = 110)和其他慢性病(N = 115)患者的365份调查问卷。总体而言,38.1%的受访者使用过CAM,在这三类疾病群体中的使用率在31.8%至46.1%之间。向后逐步逻辑回归分析显示,女性、受过高中以上教育、合并症数量较多、对健康的感知控制和奖励动机较高、压力较低以及较少相信健康受机遇支配,是CAM咨询的最佳预测因素。与未使用CAM的患者相比,使用CAM的患者还使用了更多种类的传统医疗服务,并且咨询次数更多。

结论

在本研究中,三类不同慢性病群体中与CAM咨询相关的社会人口学和健康状况因素与普通人群中发现的因素相似。研究人群中CAM的使用还与更多地使用和更广泛地使用传统医疗服务有关,并且与对健康可控性的更强信念以及寻求奖励的持久动机有关。

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