全球顺势疗法教育、监管和实践框架的特点：国际调查结果。
Characteristics of global naturopathic education, regulation, and practice frameworks: results from an international survey.
机构信息
University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia.
World Naturopathic Federation, 20 Holly St, Suite, Toronto, 200, Canada.
出版信息
BMC Complement Med Ther. 2021 Feb 18;21(1):67. doi: 10.1186/s12906-021-03217-1.
BACKGROUND
This descriptive study provides the first examination of global naturopathic education, regulation and practice frameworks that have potential to constrain or assist professional formation and integration in global health systems. Despite increasing public use, a significant workforce, and World Health Organization calls for national policy development to support integration of services, existent frameworks as potential barriers to integration have not been examined.
METHODS
This cross-sectional survey utilized purposive sampling of 65 naturopathic organisations (educational institutions, professional associations, and regulatory bodies) from 29 countries. Organizational representatives completed an on-line survey, conducted between Nov 2016 - Aug 2019. Frequencies and cross-tabulation statistics were analyzed using SPSSv.25. Qualitative responses were hand-coded and thematically analysed where appropriate.
RESULTS
Sixty-five of 228 naturopathic organizations completed the survey (29% response rate) from 29 of 46 countries (63% country response rate). Most education programs (68%) were delivered via a national framework. Higher education qualifications (60%) predominated. Organizations influential in education were professional associations (75.4%), particularly where naturopathy was unregulated, and accreditation bodies (41.5%) and regulatory boards (33.8%) where regulated. Full access to controlled acts, and to health insurance rebates were more commonly reported where regulated. Attitude of decision-makers, opinions of other health professions and existing legislation were perceived to most impact regulation, which was globally heterogeneous.
CONCLUSION
Education and regulation of the naturopathic profession has significant heterogeneity, even in the face of global calls for consistent regulation that recognizes naturopathy as a medical system. Standards are highest and consistency more apparent in countries with regulatory frameworks.
背景
本描述性研究首次考察了全球自然疗法教育、监管和实践框架，这些框架有可能限制或协助全球卫生系统中的专业形成和整合。尽管公众对自然疗法的使用越来越多，从业人员数量庞大，世界卫生组织也呼吁制定国家政策以支持服务整合，但现有的框架作为整合的潜在障碍尚未得到检验。
方法
本横断面调查采用 29 个国家的 65 个自然疗法组织（教育机构、专业协会和监管机构）的目的性抽样。组织代表于 2016 年 11 月至 2019 年 8 月期间在线完成了调查。使用 SPSSv.25 对频率和交叉表统计数据进行分析。对定性回复进行了手工编码，并在适当的情况下进行了主题分析。
结果
228 个自然疗法组织中有 65 个（29%的回复率）完成了来自 46 个国家中的 29 个国家（63%的国家回复率）的调查。大多数教育项目（68%）是通过国家框架提供的。高等教育资格（60%）占主导地位。对教育有影响力的组织是专业协会（75.4%），尤其是在自然疗法不受监管的地方，以及认证机构（41.5%）和监管委员会（33.8%）在受监管的地方。在受监管的地方，更常报告能够全面获得控制行为和健康保险回扣。决策者的态度、其他卫生专业人员的意见和现有立法被认为对监管的影响最大，而监管在全球范围内存在差异。
结论
即使面对全球呼吁建立一致的监管框架，承认自然疗法是一种医疗体系，自然疗法专业的教育和监管仍然存在显著的差异。在有监管框架的国家，标准最高，一致性更为明显。
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