School of Nursing, McGill University, 3506 University Street, Montreal, Quebec H3A 2A7, Canada.
Eur J Oncol Nurs. 2012 Dec;16(5):520-7. doi: 10.1016/j.ejon.2012.01.004. Epub 2012 Feb 12.
Cancer patients are increasingly turning to complementary and alternative medicine (CAM) because they believe that conventional treatments are not optimizing their overall wellness. However, the relationship between CAM use, wellness, and patient beliefs has received little attention in the nursing literature. This study aimed to understand lung cancer patients' beliefs about CAM use in promoting their own wellness.
An interpretive qualitative design guided the study. Semi-structured interviews were conducted with 12 adult lung cancer outpatients who used CAM. An inductive approach to analysis was taken; this included immersion in the data, open coding, categorization of similar codes, and identification of emerging patterns and themes.
The patients' beliefs about CAM use in promoting their own wellness were the result of an ongoing adaptive process of belief modification and reformation/transformation that began with their cancer diagnosis. This evolution of patient beliefs comprised four main themes: processing the initial upheaval of beliefs into a life change; developing beliefs that motivated CAM use; validating their new beliefs; and synthesizing these experiences and belief changes into a personal philosophy/meaning of "wellness with cancer."
CAM, as a strategy to promote wellness, played an integral role in the experience of wellness with cancer. Patients' experiences with CAM were governed by their underlying beliefs; thus, clinicians should consider their patient's beliefs when discussing CAM strategies. Given the importance of recommendations health professionals should also offer guidance and open discussion of CAM with patients and tailor CAM to their needs.
由于癌症患者认为常规治疗无法最大限度地提高其整体健康水平，因此他们越来越多地转向补充和替代医学（CAM）。然而，CAM 使用、健康和患者信念之间的关系在护理文献中很少受到关注。本研究旨在了解肺癌患者对使用 CAM 促进自身健康的信念。
一项解释性定性设计指导了这项研究。对 12 名使用 CAM 的成年肺癌门诊患者进行了半结构式访谈。采用归纳方法进行分析，包括沉浸在数据中、开放编码、对相似代码进行分类以及识别新出现的模式和主题。
患者对使用 CAM 促进自身健康的信念源于他们癌症诊断后开始的信念修正和重塑/转变的持续适应过程。患者信念的演变包括四个主要主题：将最初的信念混乱转化为生活的改变；形成促使使用 CAM 的信念；验证他们的新信念；将这些经验和信念的改变综合成一种“癌症与健康共存”的个人哲学/意义。
CAM 作为促进健康的策略，在癌症与健康共存的体验中发挥了重要作用。患者对 CAM 的体验受其潜在信念的影响；因此，临床医生在讨论 CAM 策略时应考虑患者的信念。鉴于健康专业人员的推荐很重要，他们还应提供对 CAM 的指导和开放讨论，并根据患者的需求定制 CAM。
