Institute for Applied Epistemology and Medical Methodology at the University of Witten Herdecke, Zechenweg 6, D-79111 Freiburg, Germany; Center for Complementary Medicine, Institute for Infection Prevention and Hospital Epidemiology, Medical Center - University of Freiburg, Faculty of Medicine, Breisacher Str. 115B, 79106 Freiburg, Germany.
Institute for Applied Epistemology and Medical Methodology at the University of Witten Herdecke, Zechenweg 6, D-79111 Freiburg, Germany.
Explore (NY). 2018 Sep;14(5):342-351. doi: 10.1016/j.explore.2018.03.007. Epub 2018 Aug 1.
Integrative cancer care (ICC) is used by approximately 50% of cancer patients to complement oncologic treatments and to address unmet needs. One ICC practice is anthroposophic medicine, integrating conventional and complementary cancer care. It specifically provides mistletoe therapy (MT), but also intensive counselling, natural remedies, creative and movement therapies, nursing procedures, nutrition, and others. The objective of this study was to explore perceptions, themes, goals, procedures, and observations of experienced AM doctors with regard to the subjective dimensions of ICC.
A guideline-based qualitative interview study was conducted with 35 AM doctors working in hospitals and office-based practices in Germany and other countries. Structured qualitative content analysis was applied to examine the data. Triangulation was done with published studies investigating patients' perspectives on AM and MT.
The interviewed doctors integrated conventional and holistic cancer concepts. Overarching therapeutic themes were: to enable patients to live with or overcome their disease, to find their own way through their disease, and to possibly reframe their situation. A broad variety of therapeutic goals were pursued, depending on the situation and priorities of the particular patient. Doctors described varying levels of patients' improved strength; increased vitality, thermal comfort, and recovery; relief from suffering, particularly in the areas of fatigue, appetite, sleep, pain, infections, and reactions to toxic anti-cancer therapies. The doctors also described how they perceived changes of patients' emotional level, their coping, autonomy, functional abilities, and finding their own way to deal with the disease. This is consistent with patients' perspectives described in published studies.
Themes, goals, and described benefit of ICC from doctors' and patients' perspective may be an important complementation of conventional cancer care, as it meets important needs, distresses and conditions of patients which often stay unmet and unrelieved. Further research should investigate these goals and procedures.
约有 50%的癌症患者采用整体癌症治疗（ICC）来补充肿瘤治疗并满足未满足的需求。整体癌症治疗的一种做法是顺势疗法医学，将常规和补充癌症治疗相结合。它特别提供槲寄生疗法（MT），但也提供强化咨询、自然疗法、创意和运动疗法、护理程序、营养等。本研究的目的是探讨有经验的顺势疗法医生对 ICC 主观方面的看法、主题、目标、程序和观察结果。
对在德国和其他国家的医院和诊所工作的 35 名顺势疗法医生进行了基于指南的定性访谈研究。采用结构化定性内容分析来检验数据。与调查患者对顺势疗法和 MT 看法的已发表研究进行三角剖分。
接受采访的医生整合了常规和整体癌症概念。治疗的总体主题是：帮助患者与疾病共存或战胜疾病，找到自己的疾病应对方式，并有希望重新审视自己的状况。根据患者的具体情况和优先事项，追求广泛的治疗目标。医生描述了患者不同程度的增强力量；增加活力、热舒适度和恢复；减轻痛苦，特别是在疲劳、食欲、睡眠、疼痛、感染和对癌症毒性治疗的反应方面。医生还描述了他们如何感知患者情绪水平、应对能力、自主性、功能能力和寻找自己应对疾病方式的变化。这与已发表研究中描述的患者观点一致。
从医生和患者的角度来看，ICC 的主题、目标和描述的益处可能是常规癌症治疗的重要补充，因为它满足了患者的重要需求、减轻了患者的痛苦和不适，而这些需求和不适往往得不到满足和缓解。应进一步研究这些目标和程序。
