Wardle J, Steel A, Lauche R, Adams J
a Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health , University of Technology Sydney , Ultimo , NSW , Australia.
b Office of Research , Endeavour College of Natural Health , Fortitude Valley , QLD , Australia.
J Interprof Care. 2017 Nov;31(6):734-743. doi: 10.1080/13561820.2017.1351424. Epub 2017 Sep 6.
Complementary and alternative medicine (CAM) is an increasingly prevalent part of contemporary health care. Whilst there have been some attempts to understand the dynamics of CAM integration in the health care system from the perspective of conventional care providers and patients, little research has examined the view of CAM practitioners. This study aims to identify the experiences of integration within a conventional healthcare system as perceived by naturopaths. Qualitative semi-structured interviews were conducted using a purposeful sample of 20 practising naturopaths in South East Queensland, Australia to discuss their experiences and perceptions of integrating with conventional medical providers. Analysis of the interviews revealed five broad challenges for the integration of CAM according to naturopaths: competing paradigms between CAM and conventional medicine; co-option of CAM by conventional medical practitioners; the preservation of separate CAM and conventional medical worlds by patients and providers due to lack of formalised relations; negative feedback and biases created through selective or limited experience or information with CAM; and indifferent, reactive and one-sided interaction between CAM and conventional medical providers. Naturopaths support the integration of health services and attempt to provide safe and appropriate care to their patients through collaborative approaches to practice. The challenges identified by naturopaths associated with integration of CAM with conventional providers may impact the quality of care of patients who choose to integrate CAM and conventional approaches to health. Given the significant role of naturopaths in contemporary health-care systems, these challenges require further research and policy attention.
补充与替代医学(CAM)在当代医疗保健中所占比重日益增大。虽然已经有人尝试从传统医疗服务提供者和患者的角度去理解补充与替代医学融入医疗保健系统的动态过程,但很少有研究考察过补充与替代医学从业者的观点。本研究旨在确定自然疗法从业者所感知到的在传统医疗系统中的融入经历。研究采用有目的抽样的方法,对澳大利亚昆士兰州东南部20名执业自然疗法从业者进行了定性半结构化访谈,以探讨他们与传统医疗服务提供者融合的经历和看法。访谈分析揭示了自然疗法从业者认为的补充与替代医学融入过程中的五大挑战:补充与替代医学和传统医学之间相互竞争的范式;传统医学从业者对补充与替代医学的吸纳;由于缺乏正式关系,患者和医疗服务提供者将补充与替代医学和传统医学领域分隔开来;因对补充与替代医学的经验或信息有限或片面而产生的负面反馈和偏见;以及补充与替代医学和传统医疗服务提供者之间冷漠、被动和片面的互动。自然疗法从业者支持医疗服务的整合,并试图通过协作性的实践方法为患者提供安全、恰当的护理。自然疗法从业者所确定的与补充与替代医学和传统医疗服务提供者融合相关的挑战,可能会影响选择将补充与替代医学和传统健康方法相结合的患者的护理质量。鉴于自然疗法从业者在当代医疗保健系统中的重要作用,这些挑战需要进一步的研究和政策关注。