Sikand A, Laken M
Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit 48201, USA.
Arch Pediatr Adolesc Med. 1998 Nov;152(11):1059-64. doi: 10.1001/archpedi.152.11.1059.
To assess (1) pediatricians' attitudes toward and practice of complementary and alternative medicine (CAM) for their patients; (2) their knowledge, experience, and referral patterns for selected CAM therapies; and (3) their desire for continuing medical education courses on CAM therapies.
An anonymous, self-report, 25-item questionnaire was mailed to fellows of the Michigan chapter of the American Academy of Pediatrics.
Of 860 pediatricians, 348 (40.5%) responded; their median age ranged from 35 to 45 years, 54.3% were men, 67.6% were white, 67.9% were general pediatricians, and 65.2% were trained in the United States. Of the respondents, 83.5% believed their patients use CAM therapies, but 55.1% believed this constituted less than 10% of patients. Of the pediatricians who talked about CAM (53.8%), 84.7% said the discussion was initiated generally by the patient's family. More than half of the physicians (55.2%) said they would use CAM therapies personally, and 50.3% would refer for CAM therapies. Therapies referred for were biofeedback (23.6%), self-help groups (23.3%), relaxation (14.9%), hypnosis (13.8%), and acupuncture or acupressure (10.9%). Of the physicians who responded, 54.1% were interested in continuing medical education courses on CAM therapies. White respondents, US medical school graduates, and general pediatricians were most likely to believe their patients use CAM and discuss or refer for CAM therapies (P<.01). Female pediatricians were most likely to discuss or refer for CAM and to want more continuing medical education on CAM therapies (P<.05).
A majority of pediatricians sampled believed a small percentage of their patients were seeking alternatives to conventional medicine. Half would consider referring patients for CAM, and most were interested in continuing medical education courses on CAM. Larger studies surveying pediatricians, along with more education and research on CAM therapies, need to be considered for the future.
评估（1）儿科医生对其患者使用补充和替代医学（CAM）的态度及实践情况；（2）他们对选定的CAM疗法的知识、经验及转诊模式；（3）他们对CAM疗法继续医学教育课程的需求。
向美国儿科学会密歇根分会的会员邮寄一份包含25个条目的匿名自填式问卷。
860名儿科医生中，348名（40.5%）做出回应；他们的年龄中位数在35至45岁之间，54.3%为男性，67.6%为白人，67.9%为普通儿科医生，65.2%在美国接受培训。在受访者中，83.5%认为他们的患者使用CAM疗法，但55.1%认为使用CAM疗法的患者不到10%。在谈论过CAM疗法的儿科医生中（53.8%），84.7%表示讨论通常由患者家属发起。超过一半的医生（55.2%）表示他们自己会使用CAM疗法，50.3%会为患者转诊接受CAM疗法。转诊的疗法包括生物反馈疗法（23.6%）、自助小组（23.3%）、放松疗法（14.9%）、催眠疗法（13.8%）以及针灸或指压疗法（10.9%）。在做出回应的医生中，54.1%对CAM疗法的继续医学教育课程感兴趣。白人受访者、美国医学院毕业生以及普通儿科医生最有可能认为他们的患者使用CAM疗法，并讨论或转诊患者接受CAM疗法（P<0.01）。女性儿科医生最有可能讨论或转诊患者接受CAM疗法，并希望获得更多关于CAM疗法的继续医学教育（P<0.05）。
大多数参与调查的儿科医生认为他们的患者中只有一小部分在寻求替代传统医学的方法。一半的医生会考虑为患者转诊接受CAM疗法，并且大多数医生对CAM疗法的继续医学教育课程感兴趣。未来需要考虑开展更大规模的针对儿科医生的研究，以及对CAM疗法进行更多的教育和研究。
