Mountifield Réme, Andrews Jane M, Mikocka-Walus Antonina, Bampton Peter
Réme Mountifield, Peter Bampton, Department of Gastroenterology and Hepatology, Flinders Medical Centre, South Australia 5042, Australia.
World J Gastroenterol. 2015 Mar 28;21(12):3663-70. doi: 10.3748/wjg.v21.i12.3663.
To examine the frequency of regular complementary and alternative therapy (CAM) use in three Australian cohorts of contrasting care setting and geography, and identify independent attitudinal and psychological predictors of CAM use across all cohorts.
A cross sectional questionnaire was administered to inflammatory bowel disease (IBD) patients in 3 separate cohorts which differed by geographical region and care setting. Demographics and frequency of regular CAM use were assessed, along with attitudes towards IBD medication and psychological parameters such as anxiety, depression, personality traits and quality of life (QOL), and compared across cohorts. Independent attitudinal and psychological predictors of CAM use were determined using binary logistic regression analysis.
In 473 respondents (mean age 50.3 years, 60.2% female) regular CAM use was reported by 45.4%, and did not vary between cohorts. Only 54.1% of users disclosed CAM use to their doctor. Independent predictors of CAM use which confirm those reported previously were: covert conventional medication dose reduction (P < 0.001), seeking psychological treatment (P < 0.001), adverse effects of conventional medication (P = 0.043), and higher QOL (P < 0.001). Newly identified predictors were CAM use by family or friends (P < 0.001), dissatisfaction with patient-doctor communication (P < 0.001), and lower depression scores (P < 0.001).
In addition to previously identified predictors of CAM use, these data show that physician attention to communication and the patient-doctor relationship is important as these factors influence CAM use. Patient reluctance to discuss CAM with physicians may promote greater reliance on social contacts to influence CAM decisions.
研究澳大利亚三个不同护理环境和地理位置的队列中常规补充和替代疗法（CAM）的使用频率，并确定所有队列中CAM使用的独立态度和心理预测因素。
对三个不同地理区域和护理环境的炎症性肠病（IBD）患者进行横断面问卷调查。评估人口统计学和常规CAM使用频率，以及对IBD药物的态度和焦虑、抑郁、人格特质和生活质量（QOL）等心理参数，并在各队列间进行比较。使用二元逻辑回归分析确定CAM使用的独立态度和心理预测因素。
在473名受访者（平均年龄50.3岁，60.2%为女性）中，45.4%的人报告经常使用CAM，各队列之间无差异。只有54.1%的使用者向医生透露了使用CAM的情况。与之前报告一致的CAM使用独立预测因素为：秘密减少常规药物剂量（P < 0.001）、寻求心理治疗（P < 0.001）、常规药物的不良反应（P = 0.043）和较高的生活质量（P < 0.001）。新发现的预测因素为家人或朋友使用CAM（P < 0.001）、对医患沟通不满意（P < 0.001）和较低的抑郁评分（P < 0.001）。
除了之前确定的CAM使用预测因素外，这些数据表明医生对沟通和医患关系的关注很重要，因为这些因素会影响CAM的使用。患者不愿与医生讨论CAM可能会促使他们更多地依赖社会关系来影响CAM决策。
