Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands.
Patient Educ Couns. 2012 Dec;89(3):529-36. doi: 10.1016/j.pec.2012.02.019. Epub 2012 Mar 29.
Examine stability of use of complementary and alternative medicine (CAM) of breast cancer patients, reasons for CAM use, and sociodemographic, clinical, and psychological predictors of CAM use.
CAM use was assessed after adjuvant therapy and six months later. Following the CAM Healthcare Model, CAM use was divided into use of provider-directed (guided) and self-directed (self-help) CAM. Stability and reasons for CAM use were examined with McNemar's tests and descriptive statistics. Cross-sectional and longitudinal associations between predictors and CAM use were examined with univariate and multivariate logistical analyses.
Use of provider-directed and self-directed CAM was stable over time (N=176). Self-directed CAM was more often used to influence the course of cancer than provider-directed CAM. Both were used to influence well-being. Openness to experience predicted use of provider-directed CAM, while clinical distress predicted use of self-directed CAM, after adjusting for other predictors. Perceived control did not predict CAM use.
CAM use is stable over time. It is meaningful to distinguish provider-directed from self-directed CAM.
Providers are advised to plan a 'CAM-talk' before adjuvant therapy, and discuss patients' expectations about influence of CAM on the course of cancer. Distressed patients most likely need information about self-directed CAM.
探讨乳腺癌患者在辅助治疗后及 6 个月后使用补充和替代医学（CAM）的稳定性、CAM 使用的原因，以及预测 CAM 使用的社会人口学、临床和心理因素。
在辅助治疗后和 6 个月后评估 CAM 使用情况。根据 CAM 医疗保健模型，CAM 使用分为提供者指导（引导）和自我指导（自助）CAM。使用 McNemar 检验和描述性统计来检查 CAM 使用的稳定性和原因。使用单变量和多变量逻辑分析来检查预测因素与 CAM 使用之间的横断面和纵向关联。
在时间上，提供者指导和自我指导的 CAM 使用是稳定的（N=176）。自我指导的 CAM 比提供者指导的 CAM 更常用于影响癌症的进程，而两者都用于影响幸福感。在调整其他预测因素后，开放性经验预测了提供者指导的 CAM 使用，而临床困扰预测了自我指导的 CAM 使用。感知控制并不能预测 CAM 使用。
CAM 使用在时间上是稳定的。区分提供者指导和自我指导的 CAM 是有意义的。
建议在辅助治疗前为患者提供“CAM 会谈”，并讨论患者对 CAM 对癌症进程影响的期望。有困扰的患者最有可能需要关于自我指导的 CAM 的信息。
