柬埔寨初级卫生保健中心门诊患者中草药使用的患病率及相关因素。
Prevalence of and factors associated with utilization of herbal medicines among outpatients in primary health centers in Cambodia.
作者信息
Pearson Hattie, Fleming Tyler, Chhoun Pheak, Tuot Sovannary, Brody Carinne, Yi Siyan
机构信息
College of Osteopathic Medicine, Touro University California, Vallejo, CA, USA.
Public Health Program, Touro University California, Vallejo, CA, USA.
出版信息
BMC Complement Altern Med. 2018 Apr 2;18(1):114. doi: 10.1186/s12906-018-2181-1.
BACKGROUND
Traditional, complementary and alternative medicine (TCAM) is seen as a way to provide healthcare in both developed and developing countries across the world. In Cambodia, there is a long tradition of using TCAM. However, scant studies have been conducted on the extent of Cambodian TCAM use and how it interacts with allopathic health care to date. In this study, we examined the prevalence of and factors associated with utilization of herbal medicines among patients with chronic diseases in primary health care settings in Cambodia.
METHODS
A cross-sectional survey was conducted in 2015 with outpatients receiving treatment and care for chronic diseases in two urban and two rural primary health centers purposively selected from Phnom Penh, Kampong Cham and Siem Reap. Every eligible patient was randomly selected at the health centers using a systematic sampling procedure. I-CAM-Q was used to measure TCAM use. A multivariate logistic regression model was constructed to identify factors associated with herbal medicine use.
RESULTS
In total, 1602 patients were included in this study, of whom 77.7% were female, and 51.2% were recruited from urban primary health centers with a mean age of 46.5 years (SD = 15.2). Of total, 27.0% reported at least one consultation with a TCAM provider in the past 12 months. The most common modality of TCAM used was herbal medicine (89%). Herbs were obtained at drug or folk stores (36.9%), from herbalists directly (28.5%) or from their own gardens (18.6%). Of herb users, 55.2% reported that herbs were somewhat helpful. After adjustment, herb users were significantly more likely to be female (AOR = 1.42, 95% CI = 1.12-2.67), have completed less schooling (AOR = 0.66, 95% CI = 0.45-0.96), were unemployed or homemakers (AOR = 0.23, 95% CI = 0.13-0.52) and have a gastrointestinal illness (AOR = 0.49, 95% CI = 0.39-0.62).
CONCLUSIONS
Herbal medicines are broadly used among chronic disease patients in Cambodia. Understanding TCAM use in the general population will support health care practitioners and policy makers to make informed decisions about the use of TCAM. Integration of TCAM into the primary health system should be further explored.
背景
传统、补充和替代医学(TCAM)被视为全球发达国家和发展中国家提供医疗保健的一种方式。在柬埔寨,使用TCAM有着悠久的传统。然而,迄今为止,关于柬埔寨TCAM的使用程度及其与对抗疗法医疗保健如何相互作用的研究很少。在本研究中,我们调查了柬埔寨初级卫生保健机构中慢性病患者使用草药的患病率及相关因素。
方法
2015年进行了一项横断面调查,在从金边、磅湛和暹粒有目的地选取的两个城市和两个农村初级卫生中心,对接受慢性病治疗和护理的门诊患者进行调查。在卫生中心使用系统抽样程序随机选取每一位符合条件的患者。使用I-CAM-Q来衡量TCAM的使用情况。构建多变量逻辑回归模型以确定与使用草药相关的因素。
结果
本研究共纳入1602名患者,其中77.7%为女性,51.2%来自城市初级卫生中心,平均年龄46.5岁(标准差=15.2)。在总共1602名患者中,27.0%报告在过去12个月中至少咨询过一次TCAM提供者。使用最普遍的TCAM形式是草药(89%)。草药购自药店或民间商店(36.9%)、直接从草药医生处获得(28.5%)或自家花园(18.6%)。在使用草药的患者中,55.2%报告草药有些帮助。经过调整后,使用草药的患者更可能为女性(调整后比值比[AOR]=1.42,95%置信区间[CI]=1.12 - 2.67)、受教育程度较低(AOR = 0.66,95% CI = 0.45 - 0.96)、失业或为家庭主妇(AOR = 0.23,95% CI = 0.13 - 0.52)以及患有胃肠道疾病(AOR = 0.49,95% CI = 0.39 - 0.62)。
结论
草药在柬埔寨慢性病患者中广泛使用。了解普通人群中TCAM的使用情况将有助于医疗保健从业者和政策制定者就TCAM的使用做出明智决策。应进一步探索将TCAM纳入初级卫生系统。
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