Integrative Medicine Service, Division of Survivorship and Supportive Care, Bendheim Center for Integrative Medicine, Memorial Sloan Kettering Cancer Center, 1429 First Avenue, New York, NY, 10021, USA.
Support Care Cancer. 2018 Jun;26(6):2063-2069. doi: 10.1007/s00520-018-4053-0. Epub 2018 Jan 24.
Cancer patients often use complementary and alternative medicine (CAM) based on recommendations from family. However, the relationship between family endorsement of CAM and the patient's expectation of its benefits has never been quantified.
Between 2010 and 2011, we conducted a cross-sectional survey study among patients with a diagnosis of cancer recruited from thoracic, breast, and gastrointestinal medical oncology clinics at a single academic cancer center. We performed multivariate linear regression analyses to evaluate the relationship between perceived family endorsement of and expected benefits from CAM, adjusting for covariates.
Among the 962 participants, 303 (31.3%) reported family endorsement of CAM use. Younger patients and those who had college or higher education were more likely to report family endorsement (both p < 0.05). Patients with family support had expectation scores that were 15.9 higher than patients without family support (coefficient 15.9, 95% CI 13.5, 18.2, p < 0.001). Participants with family encouragement of CAM use were also more likely to expect CAM to cure their cancer (12 vs. 37%) and prolong their life (24 vs. 61%). These relationships remained highly significant after adjusting for covariates).
Family endorsement of CAM use is strongly associated with patient expectation of its clinical efficacy, including expectations for cure and improved survival. These findings underscore the importance of including family in counseling and education on CAM use in order to achieve realistic patient expectations, maximize benefits, and avoid potential medical adverse effects through herb-drug interactions or rejections of conventional care.
癌症患者常根据家人的建议使用补充和替代医学（CAM）。然而，家人对 CAM 的认可与患者对其益处的期望之间的关系从未被量化过。
我们于 2010 年至 2011 年在一家学术癌症中心的胸科、乳腺和胃肠肿瘤内科诊所招募了癌症诊断患者，进行了一项横断面调查研究。我们进行了多元线性回归分析，以评估感知到的家庭对 CAM 的认可与对 CAM 益处的预期之间的关系，并调整了协变量。
在 962 名参与者中，有 303 名（31.3%）报告了家人对 CAM 使用的认可。年轻患者和受过大学或更高教育的患者更有可能报告家庭认可（均 p < 0.05）。有家庭支持的患者的期望评分比没有家庭支持的患者高 15.9 分（系数 15.9，95%CI 13.5，18.2，p < 0.001）。有家庭鼓励使用 CAM 的患者也更有可能期望 CAM 治愈他们的癌症（12%比 37%）和延长他们的寿命（24%比 61%）。在调整了协变量后，这些关系仍然非常显著。
CAM 使用的家庭认可与患者对其临床疗效的期望密切相关，包括对治愈和生存改善的期望。这些发现强调了在咨询和教育患者使用 CAM 时包括家人的重要性，以实现现实的患者期望、最大限度地发挥益处，并避免因草药与药物相互作用或拒绝常规治疗而产生潜在的医疗不良影响。
