Zörgő Szilvia, Purebl György, Zana Ágnes
Semmelweis University, Institute of Behavioural Sciences, 4 Nagyvárad tér, Budapest, 1089, Hungary.
BMC Complement Altern Med. 2018 Jan 22;18(1):25. doi: 10.1186/s12906-018-2093-0.
Within the intercultural milieu of medical pluralism, a nexus of worldviews espousing distinct explanatory models of illness, our research aims at exploring factors leading to complementary and alternative medicine (CAM) use with special attention to their cultural context.
The results are based on medical anthropological fieldwork (participant observation and in-depth interviews) spanning a period from January 2015 to May 2017 at four clinics of Traditional Chinese Medicine in Budapest, Hungary. Participant observation involved 105 patients (males N = 42); in-depth interviews were conducted with patients (N = 9) and practitioners (N = 9). The interviews were coded with Interpretative Phenomenological Analysis; all information was aggregated employing Atlas.ti software.
In order to avoid the dichotomization of "push and pull factors," results obtained from the fieldwork and interviews were structured along milestones of the patient journey. These points of reference include orientation among sources of information, biomedical diagnosis, patient expectations and the physician-patient relationship, the biomedical treatment trajectory and reasons for non-adherence, philosophical congruence, and alternate routes of entry into the world of CAM. All discussed points which are a departure from the strictly western therapy, entail an underlying socio-cultural disposition and must be scrutinized in this context.
The influence of one's culturally determined explanatory model is ubiquitous from the onset of the patient journey and exhibits a reciprocal relationship with subjective experience. Firsthand experience (or that of the Other) signifies the most reliable source of information in matters of illness and choice of therapy. Furthermore, the theme of (building and losing) trust is present throughout the patient journey, a determining factor in patient decision-making and dispositions toward both CAM and biomedicine.
在医学多元主义的跨文化环境中，存在着一系列支持不同疾病解释模型的世界观，我们的研究旨在探索导致补充和替代医学（CAM）使用的因素，并特别关注其文化背景。
研究结果基于2015年1月至2017年5月在匈牙利布达佩斯的四家中医诊所进行的医学人类学实地调查（参与观察和深入访谈）。参与观察涉及105名患者（男性N = 42）；对患者（N = 9）和从业者（N = 9）进行了深入访谈。访谈采用解释现象学分析进行编码；所有信息使用Atlas.ti软件进行汇总。
为了避免“推动因素和拉动因素”的二分法，从实地调查和访谈中获得的结果按照患者就医过程的各个阶段进行组织。这些参考点包括信息来源的导向、生物医学诊断、患者期望和医患关系、生物医学治疗过程以及不依从的原因、哲学一致性以及进入补充和替代医学领域的其他途径。所有讨论的与严格的西方治疗方法不同的要点，都蕴含着潜在的社会文化倾向，必须在这种背景下进行审视。
一个人由文化决定的解释模型的影响从患者就医过程开始就无处不在，并与主观体验呈现出相互关系。第一手经验（或他人的经验）在疾病问题和治疗选择方面是最可靠的信息来源。此外，（建立和失去）信任的主题贯穿患者就医过程，是患者决策以及对补充和替代医学与生物医学态度的决定性因素。
Zotero 插件