Salamonsen Anita
The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway.
Forsch Komplementmed. 2015;22(1):24-9. doi: 10.1159/000376555. Epub 2015 Feb 19.
Studies on the widespread use of complementary and alternative medicine (CAM) demonstrate that CAM users base their treatment decisions on both subjective, experience-based knowledge and medical knowledge. The aim of this study was to explore lay and medical risk perceptions associated with CAM and conventional medicine.
In this explorative qualitative study, we conducted in-depth interviews with 25 Norwegian CAM users with cancer or multiple sclerosis and 12 doctors.
The interviews revealed fundamental differences in risk perceptions influencing treatment decisions and risk communication in a clinical setting. While CAM users considered conventional medicine as potentially risky and related this to experiences of severe adverse effects, CAM was perceived as natural and safe. Doctors' risk perceptions were quite the contrary, mainly because of lack of scientific evidence for CAM as a safe and beneficial treatment option.
For the safety of CAM users, such divergent risk perceptions may have far-reaching consequences. CAM users should be taken seriously with their self-perception as decision-makers considering their approaches to experiences, knowledge, and science. An awareness of differing lay and medical risk perceptions associated with CAM and conventional medicine in research, doctor-patient communication, and education of patients and doctors is thus important to optimize patient safety in complex health care systems.
关于补充和替代医学(CAM)广泛使用的研究表明,CAM使用者在做出治疗决策时既基于主观的、基于经验的知识,也基于医学知识。本研究的目的是探讨与CAM和传统医学相关的外行和医学风险认知。
在这项探索性定性研究中,我们对25名患有癌症或多发性硬化症的挪威CAM使用者以及12名医生进行了深入访谈。
访谈揭示了在临床环境中影响治疗决策和风险沟通的风险认知存在根本差异。CAM使用者认为传统医学有潜在风险,并将其与严重不良反应的经历联系起来,而CAM被认为是天然且安全的。医生的风险认知则恰恰相反,主要是因为缺乏CAM作为安全有益治疗选择的科学证据。
对于CAM使用者的安全而言,这种不同的风险认知可能会产生深远影响。应认真对待CAM使用者作为决策者的自我认知,考虑他们对待经验、知识和科学的方式。因此,在研究、医患沟通以及患者和医生教育中,认识到与CAM和传统医学相关的外行和医学风险认知差异,对于在复杂的医疗保健系统中优化患者安全非常重要。