Stub Trine, Quandt Sara A, Arcury Thomas A, Sandberg Joanne C, Kristoffersen Agnete E
Wake Forest School of Medicine, Department of Epidemiology and Prevention, Division of Public Health Sciences, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
Wake Forest School of Medicine, Department of Family and Community Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
BMC Complement Altern Med. 2018 Jan 31;18(1):44. doi: 10.1186/s12906-018-2106-z.
Many complementary therapies offer benefits for patients with cancer. Others may be risky for patients due to negative interactions with conventional treatment and adverse effects. Therefore, cancer patients need guidance from health care providers to assess complementary modalities appropriately to receive benefits and avoid harm.
In a self-administered questionnaire-based cross-sectional study, we compared knowledge and attitudes of health care providers with no training in complementary modalities to that of health care providers with training in complementary modalities about the risks for patients who combine complementary modalities with conventional treatment in cancer care. The analysis was based on responses from 466 participants.
The attitudes and knowledge about direct risk followed provider specialty. Ninety-four percent of the medical doctors, 93% of the nurses, and 87% of the providers with dual training, but 70% of the complementary therapists, believed that complementary modalities can cause adverse effects (p < 0.001). The majority of the medical doctors and nurses believed that it is risky to combine complementary and conventional cancer treatments (78% and 93%, respectively), compared to 58% of the providers with dual training and 43% of the complementary therapists (p < 0.001). Eighty-nine percent of the medical doctors and nurses believed that complementary modalities should be subjected to more scientific testing before being accepted by conventional health care providers, in contrast to 56% of the dually trained and 57% of the complementary therapists (p < 0.001). The majority of the medical doctors (61%) and nurses (55%) would have neither discouraged nor encouraged the use of complementary modalities if patients asked them for advice. Moreover, less than 1% of the complementary therapists would have discouraged the use of conventional cancer treatments. The study participants believed that the most important factor to recommend a complementary cancer modality to patients is evidence for safety.
The health care providers in this study believed that complementary modalities are associated with direct risk and can cause adverse effects, and that it is risky to combine conventional and complementary treatments due to potential harmful interactions.
许多补充疗法对癌症患者有益。其他一些疗法可能因与传统治疗产生负面相互作用及不良反应而对患者有风险。因此，癌症患者需要医疗保健提供者的指导，以便适当评估补充疗法，从而获益并避免伤害。
在一项基于自填问卷的横断面研究中，我们比较了未接受补充疗法培训的医疗保健提供者与接受过补充疗法培训的医疗保健提供者，对于癌症护理中患者将补充疗法与传统治疗相结合的风险的知识和态度。分析基于466名参与者的回复。
关于直接风险的态度和知识因提供者的专业而异。94%的医生、93%的护士以及87%接受双重培训的提供者认为补充疗法会导致不良反应，但只有70%的补充疗法治疗师持此观点（p < 0.001）。大多数医生和护士认为将补充疗法与传统癌症治疗相结合有风险（分别为78%和93%），相比之下，接受双重培训的提供者中有58%，补充疗法治疗师中有43%持此观点（p < 0.001）。89%的医生和护士认为补充疗法在被传统医疗保健提供者接受之前应接受更多科学测试，相比之下，接受双重培训的提供者中有56%，补充疗法治疗师中有57%持此观点（p < 0.001）。如果患者向他们寻求建议，大多数医生（61%）和护士（55%）既不会劝阻也不会鼓励使用补充疗法。此外，不到1%的补充疗法治疗师会劝阻使用传统癌症治疗方法。研究参与者认为向患者推荐补充癌症疗法的最重要因素是安全性证据。
本研究中的医疗保健提供者认为补充疗法与直接风险相关且会导致不良反应，并且由于潜在的有害相互作用，将传统疗法与补充疗法相结合有风险。
