Institute of Health Services Research, Peninsula College of Medicine and Dentistry, Universities of Exeter and Plymouth, Exeter, UK.
J Health Serv Res Policy. 2010 Apr;15 Suppl 2:54-61. doi: 10.1258/jhsrp.2009.009104. Epub 2010 Mar 1.
The use of complementary therapies by people with cancer is commonplace. In a recent synthesis of 26 qualitative studies of patients' experiences of complementary therapy use after a diagnosis of cancer, the emergent theme of 'polarization' was the most notable barrier to a positive experience of complementary therapies. In this paper, we explore the two synthesis concepts of 'polarization' and 'integration', and their relationship to health service policies and guidelines on integrated services.
A systematic literature search and a meta-ethnography to synthesize key concepts.
The majority of patients who used complementary therapies after a diagnosis of cancer wanted to be certain that the therapies were not interfering with their conventional cancer treatment. They valued the therapies in wider terms including: taking 'a niche of control', relieving symptoms, improving wellbeing, and promoting reconnection and social interaction. The emergent theme of 'polarization' suggested that conventional physicians who are perceived to be poorly informed or negative about complementary approaches induce patient anxiety, safety concerns, and difficulties in access. They may compromise their therapeutic relationship and, rarely, they may trigger patients to abandon conventional medicine altogether. In contrast, integrated advice and/or services were highly valued by patients, although some patients preferred their complementary health care to be provided in a non-medicalized environment.
Our findings suggest that the current polarized situation is unhelpful to patients, detrimental to therapeutic relationships and may occasionally be dangerous. They indicate that complementary therapies, in a supportive role, should be integrated into mainstream cancer care.
癌症患者使用补充疗法是很常见的。在最近对 26 项关于癌症诊断后患者补充疗法使用体验的定性研究的综合分析中,最显著的障碍是“两极分化”这一新兴主题,它对补充疗法的积极体验产生了影响。在本文中,我们探讨了“两极分化”和“整合”这两个综合概念,以及它们与综合服务的卫生服务政策和指南的关系。
系统文献检索和元民族志综合关键概念。
大多数在癌症诊断后使用补充疗法的患者希望确定这些疗法不会干扰他们的常规癌症治疗。他们从更广泛的角度重视这些疗法,包括:获得“一定的控制”、缓解症状、改善健康状况以及促进重新联系和社会互动。“两极分化”这一新兴主题表明,被认为对补充方法了解不足或持否定态度的常规医生会引起患者的焦虑、安全担忧和获取困难。他们可能会损害他们的治疗关系,在极少数情况下,他们可能会促使患者完全放弃常规医学。相比之下,患者非常重视综合咨询和/或服务,尽管一些患者更喜欢在非医疗环境中提供补充性的医疗保健。
我们的研究结果表明,目前的两极分化局面对患者无益,对治疗关系不利,有时甚至可能很危险。它们表明,补充疗法应作为一种辅助手段,纳入主流癌症治疗。