Berretta Massimiliano, Rinaldi Luca, Taibi Rosaria, Tralongo Paolo, Fulvi Alberto, Montesarchio Vincenzo, Madeddu Giordano, Magistri Paolo, Bimonte Sabrina, Trovò Marco, Gnagnarella Patrizia, Cuomo Arturo, Cascella Marco, Lleshi Arben, Nasti Guglielmo, Facchini Sergio, Fiorica Francesco, Di Francia Raffaele, Nunnari Giuseppe, Pellicanò Giovanni Francesco, Guglielmino Aurelio, Danova Marco, Rossetti Sabrina, Amore Alfonso, Crispo Anna, Facchini Gaetano
Department of Medical Oncology, Istituto Nazionale Tumori, IRCCS - CRO, Aviano (PN), Italy.
Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
Front Oncol. 2020 Apr 28;10:594. doi: 10.3389/fonc.2020.00594. eCollection 2020.
Complementary and Alternative Medicine (CAM) interventions are widely used by patients with chronic disorders, including cancer, and may interact with cancer treatment. Physicians are often unaware of this, probably due to poor patient-physician communication on CAM. The purpose of this study was to evaluate physicians' knowledge, attitudes and practice patterns regarding CAM in a survey conducted in Italy. A questionnaire was administered to 438 physicians (11 Italian hospitals) who predominantly treat patients with chronic disease, to collect personal and professional data and information on attitudes toward CAM and its possible role in Conventional Medicine (CM). Of the 438 participants, most were specialists in oncology (18%), internal medicine (17%), surgery (15%), and radiotherapy (11%). Most worked at university (44%) or research hospitals (31%). Forty-two percent of participants believed that CAM could have an integrative role within CM. Oncologists were the physicians who were best informed on CAM (58%). Physicians working at research institutes or university hospitals had a greater knowledge of CAM than those employed at general hospitals ( < 0.0001), and those who were also involved in research activity had a greater knowledge of CAM than those who were not ( < 0.003). Length of work experience was significantly related to CAM knowledge. Moreover, 55% of participants suggest CAM interventions to their patients and 44% discuss CAM with them. The best-known interventions were acupuncture, and high-dose vitamin C. CAM use by patients with chronic disease and/or cancer has become a topical issue for the scientific community and for physicians. Knowing the reasons that prompt these patients to use CAM and guiding them in their decisions would improve treatment and outcomes and also benefit healthcare systems. Our findings contribute to a greater understanding of CAM knowledge, attitudes, and practice among Italian physicians. Further research is needed to identify the more effective CAM treatments and to work toward an integrated healthcare model.
补充和替代医学（CAM）干预措施被包括癌症患者在内的慢性病患者广泛使用，并且可能与癌症治疗相互作用。医生往往对此并不知晓，这可能是由于患者与医生之间关于补充和替代医学的沟通不畅所致。本研究的目的是在意大利进行的一项调查中评估医生关于补充和替代医学的知识、态度及实践模式。向438名主要治疗慢性病患者的医生（来自11家意大利医院）发放了一份问卷，以收集个人和专业数据以及关于对补充和替代医学的态度及其在传统医学（CM）中可能作用的信息。在438名参与者中，大多数是肿瘤学（18%）、内科（17%）、外科（15%）和放射治疗（11%）方面的专家。大多数人在大学医院（44%）或研究医院（31%）工作。42%的参与者认为补充和替代医学在传统医学中可以起到综合作用。肿瘤学家是对补充和替代医学了解最多的医生（58%）。在研究机构或大学医院工作的医生比在综合医院工作的医生对补充和替代医学的了解更多（<0.0001），并且参与研究活动的医生比未参与研究活动的医生对补充和替代医学的了解更多（<0.003）。工作经验的长短与补充和替代医学知识显著相关。此外，55%的参与者会向患者推荐补充和替代医学干预措施，44%的参与者会与患者讨论补充和替代医学。最广为人知的干预措施是针灸和高剂量维生素C。慢性病和/或癌症患者使用补充和替代医学已成为科学界和医生关注的热门话题。了解促使这些患者使用补充和替代医学的原因并在他们的决策过程中给予指导，将改善治疗效果和治疗结局，也会使医疗保健系统受益。我们的研究结果有助于更深入地了解意大利医生对补充和替代医学的知识、态度及实践情况。需要进一步开展研究以确定更有效的补充和替代医学治疗方法，并朝着综合医疗保健模式努力。
