在第六次特罗姆瑟研究中冠心病患者或有冠心病风险人群中补充和替代医学使用情况及其预测因素：基于保护动机理论的比较分析
Prevalence and predictors of complementary and alternative medicine use among people with coronary heart disease or at risk for this in the sixth Tromsø study: a comparative analysis using protection motivation theory.
作者信息
Kristoffersen Agnete E, Sirois Fuschia M, Stub Trine, Hansen Anne Helen
机构信息
The National Research Center in Complementary and Alternative Medicine (NAFKAM), Faculty of Health Sciences, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
Department of Psychology, University of Sheffield, Sheffield, UK.
出版信息
BMC Complement Altern Med. 2017 Jun 19;17(1):324. doi: 10.1186/s12906-017-1817-x.
BACKGROUND
Engagement in healthy lifestyle behaviors, such as healthy diet and regular physical activity, are known to reduce the risk of developing coronary heart disease (CHD). Complementary and alternative medicine (CAM) is known to be associated with having a healthy lifestyle. The primary aim of this study was to examine the prevalence and predictors of CAM use in CHD patients, and in those without CHD but at risk for developing CHD, using Protection Motivation Theory (PMT) as a guiding conceptual framework.
METHOD
Questionnaire data were collected from 12,981 adult participants in the cross-sectional sixth Tromsø Study (2007-8). Eligible for analyses were 11,103 participants who reported whether they had used CAM or not. Of those, 830 participants reported to have or have had CHD (CHD group), 4830 reported to have parents, children or siblings with CHD (no CHD but family risk), while 5443 reported no CHD nor family risk of CHD. We first compared the patterns of CAM use in each group, and then examined the PMT predictors of CAM use. Health vulnerability from the threat appraisal process of PMT was assessed by self-rated health and expectations for future health. Response efficacy from the coping appraisal process of PMT was assessed as preventive health beliefs and health behavior frequency.
RESULTS
Use of CAM was most commonly seen in people with no CHD themselves, but family risk of developing CHD (35.8%), compared to people already diagnosed with CHD (30.2%) and people with no CHD nor family risk (32.1%). All four of the PMT factors; self-rated health, expectations for future health, preventive health beliefs, and the health behavior index - were predictors for CAM use in the no CHD but family risk group.
CONCLUSION
These findings suggest that people use CAM in response to a perceived risk of developing CHD, and to prevent disease and to maintain health.
背景
众所周知，养成健康的生活方式，如健康饮食和定期体育锻炼，可降低患冠心病（CHD）的风险。补充和替代医学（CAM）与健康的生活方式相关。本研究的主要目的是以保护动机理论（PMT）作为指导概念框架，研究冠心病患者以及无冠心病但有患冠心病风险人群中补充和替代医学的使用情况及预测因素。
方法
从横断面的第六次特罗姆瑟研究（2007 - 2008年）的12981名成年参与者中收集问卷数据。符合分析条件的是11103名报告是否使用过补充和替代医学的参与者。其中，830名参与者报告患有或曾患有冠心病（冠心病组），4830名报告其父母、子女或兄弟姐妹患有冠心病（无冠心病但有家族风险），而5443名报告既无冠心病也无冠心病家族风险。我们首先比较了每组中补充和替代医学的使用模式，然后研究了补充和替代医学使用的保护动机理论预测因素。通过自我评估健康状况和对未来健康的期望来评估保护动机理论威胁评估过程中的健康易损性。通过预防性健康信念和健康行为频率来评估保护动机理论应对评估过程中的反应效能。
结果
补充和替代医学的使用在自身无冠心病但有患冠心病家族风险的人群中最为常见（35.8%），相比之下，已被诊断患有冠心病的人群为（30.2%），既无冠心病也无冠心病家族风险的人群为（32.1%）。保护动机理论的所有四个因素，即自我评估健康状况、对未来健康的期望、预防性健康信念和健康行为指数，都是无冠心病但有家族风险组中补充和替代医学使用的预测因素。
结论
这些发现表明，人们使用补充和替代医学是为了应对感知到的患冠心病风险，预防疾病并保持健康。
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