Bahall Mandreker, Edwards Mark
Arthur Lok Jack Graduate School of Business, Max Richards Drive, Champ Fleurs, Mount Hope, Trinidad.
Faculty of Medicine, University of the West Indies, St. Augustine, Trinidad and Tobago.
BMC Complement Altern Med. 2015 Mar 31;15:99. doi: 10.1186/s12906-015-0577-8.
Complementary and alternative medicine (CAM) has been practiced for centuries owing to the absence or limited availability of conventional medicine. CAM has persisted globally with over USD34 billion spent annually, despite modernization, globalization, technological advancement, and limited supportive evidence. The present qualitative study explores the perception of CAM among cardiac patients with respect to rationale, perceived outcomes, influences, and public health concerns.
This study used a qualitative, interpretative approach. Twelve cardiac disease patients were recruited from private clinics in South Trinidad and interviewed. The study obtained ethical approval, and all participants provided written consent. The semi-structured interviews were digitally recorded, transcribed, and thematically analyzed. Participants with poor cognitive function, difficulty speaking, and those not understandable owing to language barriers were excluded.
CAM use was based largely on patient perception regardless of the clinical reality. The perceived mode of action and its natural character was responsible for the therapeutic outcomes and uses. Participants reported that CAM provided holistic care, improved the quality of life, overcame the limitations of conventional medicine, satisfied their increased expectation for comprehensive care, and prevented or counteracted adverse effects caused by conventional medicine. Participants reported a lack of scientific information on CAM and stated that policy makers should assist patients through increased research, public health education, and improved integration of CAM and conventional medicine.
The participants' use of CAM was largely based on perception. CAM was thought to improve therapeutic outcomes, provide holistic care, decrease or prevent complications from conventional medicine, and improve quality of life. Participants acknowledged that they may be ill-informed about the basic concepts or actions of CAM. They urged policymakers to create an environment that assists the public and health care providers in promoting safe and effective CAM practice.
由于传统医学的缺失或可及性有限,补充和替代医学(CAM)已被应用了几个世纪。尽管经历了现代化、全球化、技术进步且支持证据有限,但CAM在全球仍持续存在,每年的花费超过340亿美元。本定性研究探讨了心脏病患者对CAM在基本原理、感知结果、影响及公共卫生问题方面的看法。
本研究采用定性的解释性方法。从特立尼达岛南部的私人诊所招募了12名心脏病患者并进行访谈。该研究获得了伦理批准,所有参与者均提供了书面同意书。半结构化访谈进行了数字录音、转录并进行了主题分析。排除了认知功能差、言语困难以及因语言障碍而无法理解的参与者。
CAM的使用很大程度上基于患者的认知,而不顾临床实际情况。其感知的作用方式及其天然特性决定了治疗效果和用途。参与者报告称,CAM提供了整体护理,改善了生活质量,克服了传统医学的局限性,满足了他们对综合护理日益增长的期望,并预防或抵消了传统医学引起的不良反应。参与者报告称缺乏关于CAM的科学信息,并表示政策制定者应通过加强研究、开展公共卫生教育以及改善CAM与传统医学的整合来帮助患者。
参与者对CAM的使用很大程度上基于认知。CAM被认为能改善治疗效果,提供整体护理,减少或预防传统医学的并发症,并提高生活质量。参与者承认他们可能对CAM的基本概念或作用了解不足。他们敦促政策制定者营造一个有助于公众和医疗服务提供者推广安全有效的CAM实践的环境。