Integrative Oncology Program, Oncology Service, Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District.
Ann Oncol. 2014 Feb;25(2):476-80. doi: 10.1093/annonc/mdt554. Epub 2014 Jan 7.
Limited research is available on the perspectives of patients with cancer regarding integration of complementary medicine (CM) in conventional supportive cancer care. The purpose of this study was to explore patients' perspectives concerning CM integration within conventional oncology settings.
A 27-item questionnaire was constructed and administered to a convenient sample of Arab patients receiving cancer care in three oncology centers in northern Israel.
Of the 324 respondents (94.7% response rate), 124 of 313 (39.6%) reported the use of CM for cancer-related outcomes. A logistic regression model indicated that CM was used with active chemo- or radiotherapy treatment [EXP [B], 2.926, 95% confidence interval (CI) 1.276-6.708; P=0.011] and a higher degree of spiritual quest (EXP [B], 3.425, 95% CI 1.042-11.253; P=0.043). Herbal medicine was the leading CM modality (87.9% of CM users), which included the use of 28 plants and traditional remedies, of which 17 were used to improve QOL, with 5 of the herbs having potential interactions with chemotherapy. 83.1% of respondents stated that they would consult with a CM provider if CM were to be integrated into the oncology department. Patients' expectation of CM consultation was clearly associated with expectations of QOL improvement, coping with cancer, and alleviating chemotherapy's side-effects when compared with expectations of cancer cure (P<0.0001). The three leading concerns which patients expected to be improved by integrative CM treatment were gastrointestinal symptoms (63.2%), fatigue (51.9%), and pain (40.5%).
Integrative CM consultations should focus on the improvement of QOL concomitant with safety concerns regarding potential drug-herb interactions. The need to integrate a nonjudgmental yet evidence-based CM consultation service may also be applicable to oncology institutions challenged with culturally diverse populations with a high prevalence of traditional medicine use.
关于癌症患者对将补充医学（CM）整合到常规支持性癌症护理中的看法，相关研究十分有限。本研究旨在探讨患者对在常规肿瘤学环境中整合 CM 的看法。
构建了一个包含 27 个条目的问卷，并对在以色列北部三个肿瘤中心接受癌症治疗的阿拉伯患者进行了便利抽样调查。
在 324 名应答者中（应答率为 94.7%），313 名中有 124 名（39.6%）报告使用 CM 治疗癌症相关结果。逻辑回归模型表明，CM 与积极的化疗或放疗治疗一起使用（EXP [B]，2.926，95%置信区间 [CI] 1.276-6.708；P=0.011），以及更高程度的精神探索（EXP [B]，3.425，95%CI 1.042-11.253；P=0.043）。草药是主要的 CM 模式（87.9%的 CM 用户），其中包括使用 28 种植物和传统疗法，其中 17 种用于提高生活质量，其中 5 种草药与化疗有潜在的相互作用。83.1%的受访者表示，如果 CM 被整合到肿瘤科，他们将咨询 CM 提供者。与对癌症治愈的期望相比，患者对 CM 咨询的期望显然与对生活质量改善、应对癌症和减轻化疗副作用的期望有关（P<0.0001）。患者期望通过综合 CM 治疗改善的三个主要问题是胃肠道症状（63.2%）、疲劳（51.9%）和疼痛（40.5%）。
综合 CM 咨询应侧重于提高生活质量，同时关注潜在药物与草药相互作用的安全性问题。对于面临传统医学使用率高的文化多元化人群的肿瘤学机构来说，还需要整合一种非评判性但基于证据的 CM 咨询服务。
