1
|
Papathanassoglou E, Park T, Punjani N, Pokharel B, Taha M, Hegadoren K. Implementing integrative therapies in adult critical care: Barriers and strategies. Aust Crit Care 2024; 37:563-570. [PMID: 38218673 DOI: 10.1016/j.aucc.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/10/2023] [Accepted: 11/24/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Critically ill patients experience intense physical and psychological stressors in the intensive care unit (ICU). More than half of ICU survivors report overwhelming mental health symptoms after ICU discharge, such as post-traumatic stress symptoms, anxiety, and depression. Relaxation-inducing integrative therapies such as guided imagery, massage, therapeutic touch, music therapy, and spirituality-based healing practices have the potential to promote comfort and relaxation and improve patient outcomes. OBJECTIVES The aim of this study was to explore the attitudes of healthcare professionals towards the implementation of relaxation-inducing integrative therapies in critical care, barriers to implementation, and potential strategies to overcome them. METHODS We conducted seven focus group interviews with 23 critical care clinicians (70% nurses, 17% allied health professionals, 13% physicians). Interviews were audiotaped and transcribed verbatim. Data were thematically analysed using an inductive content analysis approach. FINDINGS Results reveal a constant interplay between mostly positive personal attitudes towards implementation of integrative therapies and the perceived culture and priorities of the unit. The main benefits for critically ill patients as perceived by participants were promotion of comfort, sleep, and coping, increase of trust, and decrease of pain and stress. As for barriers, dominant themes were a perceived lack of evidence, cost, and time constraints and the fear of loss of professional credibility. Participants related nurses' education and training, family involvement, and leadership were seen as main strategies for implementation. CONCLUSIONS The dominant ICU culture needs to be considered when implementing integrative therapies. Education, access to evidence, and role modelling are proposed as means to shift the ICU culture towards utilisation of integrative therapies in critical care.
Collapse
|
2
|
Shalgouny M, Bertz-Lepel J, Fischer V Weikersthal L, Herbin J, Meier-Höfig M, Mücke R, Rohe U, Stauch T, Stoll C, Troeltzsch D, Wittmann S, Kurz O, Naumann R, Huebner J. Introducing a standardized assessment of patients' interest in and usage of CAM in routine cancer care: chances and risks from patients' and physicians' point of view. J Cancer Res Clin Oncol 2023; 149:16575-16587. [PMID: 37715831 PMCID: PMC10645655 DOI: 10.1007/s00432-023-05182-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 07/12/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Cancer patients often use complementary and alternative medicine (CAM), however, standardized assessment in clinical routine is missing. The aim of this study was to evaluate a screening questionnaire on CAM usage that was published in the S3 Guideline Complementary Medicine in the Treatment of Oncological Patients. METHODS We developed a survey questionnaire to assess the practicability of the guideline questionnaire and communication on CAM between health care providers (HCPs) and patients. We collected 258 guideline questionnaires and 116 survey questionnaires from ten clinics and held twelve semi-structured interviews with HCPs. RESULTS 85% used at least one of the listed CAM methods, 54 participants (N = 77) never disclosed usage to a physician. The most frequently used CAM methods were physical activity (76.4%) and vitamin D (46.4%). 25.2% used at least one method, that was labeled risky by the guideline. 53.4% did not know of CAM's risk of interactions and side effects. Introducing the guideline questionnaire in routine cancer care increased the rate of patients talking to an HCP regarding CAM significantly from 35.5 to 87.3%. The HCPs stated positive effects as an initiation of conversation, increased safety within CAM usage and patients feeling thankful and taken seriously. However, due to the limited amount of time available for discussions on CAM, generalized distribution to all patients was not feasible. CONCLUSION Institutions should focus on implementing standard procedures and resources that help HCPs discuss CAM on a regular basis. HCPs should meet the patient's demands for CAM counseling and make sure they are equipped professionally.
Collapse
Affiliation(s)
- M Shalgouny
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - J Bertz-Lepel
- Klinik für Hämatologie, Helios Klinikum Bad Saarow, Bad Saarow, Germany
| | - L Fischer V Weikersthal
- Praxis für Hämatologie und Internistische Onkologie, Gesundheitszentrum St. Marien GmbH, Amberg, Germany
| | - J Herbin
- Onkologische Schwerpunktpraxis Berlin, Berlin, Germany
| | - M Meier-Höfig
- 3. Medizinische Klinik, Städtisches Krankenhaus Kiel, Kiel, Germany
| | - R Mücke
- MVZ Strahlentherapie RheinMainNahe GmbH, Mainz, Germany
| | - U Rohe
- St. Barbara Klinik Hamm, Hamm, Germany
| | - T Stauch
- Klinik für Onkologie, Median Adelsbergklinik Bad Berka, Bad Berka, Germany
| | - C Stoll
- Rehaklinik für Orthopädie, Klinik Herzoghöhe Bayreuth, Bayreuth, Germany
| | - D Troeltzsch
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - S Wittmann
- Klinik für Onkologie, Hämatologie und Palliativmedizin, Helios Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
| | - O Kurz
- Medizinische Klinik III, Marien Kliniken Siegen, Siegen, Germany
| | - R Naumann
- Medizinische Klinik III, Marien Kliniken Siegen, Siegen, Germany
| | - J Huebner
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| |
Collapse
|
3
|
Ammar A, Soua A, Ezzi O, Chelly S, Ammar N, Ezzairi F, Khenissi N, Chabchoub I, Ben Ahmed S, Mahjoub M, Njah M. Complementary and alternative medicine in oncology: knowledge, attitude and practice among Tunisian healthcare workers. J Cancer Res Clin Oncol 2023; 149:11585-11594. [PMID: 37401941 DOI: 10.1007/s00432-023-05040-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 06/28/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE Over the past years, there has been a considerable increase in complementary and alternative medicine (CAM) use among cancer patients. However, guidance from health care workers (HCWs) is not always provided. We aimed to determine the knowledge, attitude and practice of Tunisian HCWs regarding the use of CAM in cancer patients. METHODS We conducted a multicenter cross-sectional study over 5 months from February to June 2022 among HCWs caring for cancer patients in the Tunisian center region. Data were collected using a self-administered questionnaire developed by our investigators. RESULTS The level of knowledge about CAM was declared limited by 78.4% of our population. The best known CAM therapies were herbal medicine and homeopathy while chiropractic and hypnosis where the least. HCWs who had sought information on CAM represented 54.3% of our sample and the main source of information was the Internet (37.1%). A positive attitude towards the use of CAM was found in 56% of HCWs. The integration of CAM into supportive care in oncology was approved by 78% of HCWs. Concerning training on CAM, 78% declared its necessity for HCWs and 73.3% expressed a desire to have it. A personal use of CAM was found in 53% of HCWs while 38.8% had previously used CAM in the treatment of their cancer patients. CONCLUSION The majority of HCWs had a positive attitude towards the use of CAM in oncology despite their poor knowledge about it. Our study emphasizes the need to train HCWs dealing with cancer patients on CAM.
Collapse
Affiliation(s)
- Asma Ammar
- Department of Hospital Hygiene, Farhat Hached University Hospital, Sousse, Tunisia
| | - Asma Soua
- Department of Hospital Hygiene, Farhat Hached University Hospital, Sousse, Tunisia.
| | - Olfa Ezzi
- Department of Hospital Hygiene, Farhat Hached University Hospital, Sousse, Tunisia
| | - Souhir Chelly
- Department of Hospital Hygiene, Farhat Hached University Hospital, Sousse, Tunisia
| | - Nouha Ammar
- Department of Medical Oncology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Faten Ezzairi
- Department of Medical Oncology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Nouha Khenissi
- Higher Institute of Nursing Sciences of Sousse, Sousse, Tunisia
| | - Imene Chabchoub
- Department of Medical Oncology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Slim Ben Ahmed
- Department of Medical Oncology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Mahjoub
- Department of Hospital Hygiene, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mansour Njah
- Department of Hospital Hygiene, Farhat Hached University Hospital, Sousse, Tunisia
| |
Collapse
|
4
|
Youn B, Cha J, Cho S, Jeong S, Kim H, Ko S. Perception, attitudes, knowledge of using complementary and alternative medicine for cancer patients among healthcare professionals: A mixed-methods systematic review. Cancer Med 2023; 12:19149-19162. [PMID: 37676102 PMCID: PMC10557909 DOI: 10.1002/cam4.6499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/19/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND With the rapid increase in the prevalence of cancer worldwide, the utilization of complementary and alternative medicine (CAM) has increased among cancer patients. This review aimed to understand the perception, attitudes, and knowledge of healthcare professionals toward using CAM for cancer patients. METHODS A mixed-methods systematic review was undertaken in four databases. Inclusion criteria were primary studies reporting perception, attitudes, and knowledge of healthcare professionals for using CAM for cancer patients were eligible. A mixed-methods convergent synthesis was carried out, and the findings were subjected to a GRADE-CERQual assessment of confidence. RESULTS Forty-two studies were chosen. The majority of the studies were quantitative and had less than 100 participants. Most publications were from European countries, and oncology was the highest among the specialties. The review found the following themes: feasibility of having negative adverse effects, low expectations of using CAM among HCPs, potential positive effects of using CAM, specific CAM training may be helpful, no concrete regulations to promote CAM practice, and poor physician-patient communication. CONCLUSIONS Nurses had more positive views than other professions; oncologists were concerned regarding herb-drug interactions; integration of CAM into the healthcare system was favorable; HCPs felt the need to participate in specific CAM training; and HCPs agreed that CAM education should be provided more regularly. Future studies should explore the studies views of cancer patients and details of in-depth evidence of CAM in oncology settings.
Collapse
Affiliation(s)
- Bo‐Young Youn
- Department of Preventive Medicine, College of Korean MedicineKyung Hee UniversitySeoulSouth Korea
| | - Jie‐Won Cha
- Department of Applied Korean Medicine, Graduate SchoolKyung Hee UniversitySeoulSouth Korea
| | - Sungsu Cho
- Department of Korean Medicine, Graduate SchoolKyung Hee UniversitySeoulSouth Korea
| | - So‐Mi Jeong
- Department of Clinical Korean Medicine, Graduate SchoolKyung Hee UniversitySeoulSouth Korea
| | - Hyo‐Jung Kim
- Department of Clinical Korean Medicine, Graduate SchoolKyung Hee UniversitySeoulSouth Korea
| | - Seong‐Gyu Ko
- Department of Preventive Medicine, College of Korean MedicineKyung Hee UniversitySeoulSouth Korea
| |
Collapse
|
5
|
Hammond J, Schneiderhan J, Taylor L, Marks A. Off the Beaten Path: Caring for People Engaging in Potentially Unsafe Low Evidence Therapies. Am J Hosp Palliat Care 2023; 40:129-135. [PMID: 35531986 DOI: 10.1177/10499091221101181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Palliative care clinicians regularly care for patients with serious illnesses, many of whom are engaging in the use of complementary and alternative medicine (CAM) either alone or along with conventional medical therapies. A subset of these patients may be engaging in therapies that have little or no evidence for efficacy and carry significant potential risks to their health. These therapies, however, may carry a great deal of significance for the patient and family for whom conventional medicine has failed or is otherwise deemed untenable. Dismissing such therapies as "quackery" risks alienating patients and damaging or even severing a therapeutic relationship. When faced with patients who are engaging in potentially unsafe low-evidence therapies (PULETs), clinicians themselves may experience a great deal of moral distress when deciding how to balance supporting the hope PULETs may represent with the principles of nonmaleficence and autonomy. In this article, we will review the definition of PULETs and distinguish them from most CAM therapies. Drawing upon existing writings in the CAM literature, we will then review a framework to evaluate the relative risk/benefit ratio of such therapies followed by a review of the ethical and legal aspects of care. Finally, utilizing existing principles and tools in emotion-based communication, we present a communication approach to foster continued collaboration and care for patients who engage in PULETs.
Collapse
Affiliation(s)
- John Hammond
- 12266University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jill Schneiderhan
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Laura Taylor
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Adam Marks
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
6
|
Goel AR, Elhassan H, Patterson M, Reid MC. Characteristics of Provider-Focused Research on Complementary and Integrative Medicine in Palliative Care: A Scoping Review. Am J Hosp Palliat Care 2022; 39:370-387. [PMID: 33887994 PMCID: PMC9109423 DOI: 10.1177/10499091211011708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The use of complementary and integrative medicine (CIM) continues to grow in palliative care. While research supports the use of many CIM therapies for symptom relief, the scope of provider-focused research on CIM remains poorly characterized. OBJECTIVES We conducted a scoping review to characterize provider-focused research on CIM in palliative care in order to map existing evidence and identify knowledge gaps. METHODS We developed a protocol outlining the study population, concept, and context; then used a validated approach per the JBI manual and searched MEDLINE, EMBASE, CINAHL, and AMED. RESULTS We identified 34 studies that were conducted primarily in the US (n = 9) and UK (n = 6), focused mostly on nurse (n = 29) and physician (n = 22) providers, and employed questionnaires (n = 16) or qualitative (n = 15) methods. Studies investigated 58 CIM modalities, including massage (n = 13), music therapy (n = 12), and aromatherapy (n = 10), to address common symptoms including pain (n = 17), fatigue (n = 6), and nausea/vomiting (n = 6). Study outcomes included perceived benefits of CIM (n = 17) and types of CIM modalities that providers offer (n = 15). Uncommonly studied phenomena included referral patterns (n = 4), facilitators of provider recommendation of CIM (n = 3), and rates of CIM use (n = 3). CONCLUSION Provider-focused research on CIM in palliative care can expand its scope by addressing perspectives of interdisciplinary providers, examining CIM modalities that patients report using, addressing symptoms commonly encountered in palliative care, and researching provider-use-focused outcomes. We identify these possibilities for future studies in addition to opportunities for systematic investigations to enhance the safe and efficacious delivery of CIM in the palliative care setting.
Collapse
Affiliation(s)
| | - Hana Elhassan
- MD Program, Weill Cornell Medicine, New York, NY, USA
| | - Melissa Patterson
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine/New York-Presbyterian, NY, USA
| | - M. Carrington Reid
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine/New York-Presbyterian, NY, USA
| |
Collapse
|
7
|
Phutrakool P, Pongpirul K. Acceptance and use of complementary and alternative medicine among medical specialists: a 15-year systematic review and data synthesis. Syst Rev 2022; 11:10. [PMID: 35027078 PMCID: PMC8759198 DOI: 10.1186/s13643-021-01882-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 12/27/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Complementary and Alternative Medicine (CAM) has gained popularity among the general population, but its acceptance and use among medical specialists have been inconclusive. This systematic review aimed to identify relevant studies and synthesize survey data on the acceptance and use of CAM among medical specialists. METHODS We conducted a systematic literature search in PubMed and Scopus databases for the acceptance and use of CAM among medical specialists. Each article was assessed by two screeners. Only survey studies relevant to the acceptance and use of CAM among medical specialists were reviewed. The pooled prevalence estimates were calculated using random-effects meta-analyses. This review followed both PRISMA and SWiM guidelines. RESULTS Of 5628 articles published between 2002 and 2017, 25 fulfilled the selection criteria. Ten medical specialties were included: Internal Medicine (11 studies), Pediatrics (6 studies), Obstetrics and Gynecology (6 studies), Anesthesiology (4 studies), Surgery (3 studies), Family Medicine (3 studies), Physical Medicine and Rehabilitation (3 studies), Psychiatry and Neurology (2 studies), Otolaryngology (1 study), and Neurological Surgery (1 study). The overall acceptance of CAM was 52% (95%CI, 42-62%). Family Medicine reported the highest acceptance, followed by Psychiatry and Neurology, Neurological Surgery, Obstetrics and Gynecology, Pediatrics, Anesthesiology, Physical Medicine and Rehabilitation, Internal Medicine, and Surgery. The overall use of CAM was 45% (95% CI, 37-54%). The highest use of CAM was by the Obstetrics and Gynecology, followed by Family Medicine, Psychiatry and Neurology, Pediatrics, Otolaryngology, Anesthesiology, Internal Medicine, Physical Medicine and Rehabilitation, and Surgery. Based on the studies, meta-regression showed no statistically significant difference across geographic regions, economic levels of the country, or sampling methods. CONCLUSION Acceptance and use of CAM varied across medical specialists. CAM was accepted and used the most by Family Medicine but the least by Surgery. Findings from this systematic review could be useful for strategic harmonization of CAM and conventional medicine practice. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42019125628.
Collapse
Affiliation(s)
- Phanupong Phutrakool
- School of Global Health and Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Patumwan, Bangkok, 10330, Thailand
| | - Krit Pongpirul
- School of Global Health and Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, 1873 Rama IV Road, Patumwan, Bangkok, 10330, Thailand. .,Department of International Health and Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. .,Bumrungrad International Hospital, Bangkok, Thailand.
| |
Collapse
|
8
|
Vogel J, Zomorodbakhsch B, Stauch T, Josfeld L, Hübner J. The role of the general practitioner in cancer care in general and with respect to complementary and alternative medicine for patients with cancer. Eur J Cancer Care (Engl) 2021; 31:e13533. [PMID: 34708899 DOI: 10.1111/ecc.13533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/10/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Cancer patients often use complementary and alternative medicine (CAM). The aim of this study was to assess the expectations of cancer patients towards their general practitioner (GP) regarding information on and offers of CAM procedures. METHODS A standardised anonymous questionnaire was developed and handed out to cancer patients in GP practices and oncology clinics in Germany. RESULTS One hundred and eighty questionnaires were evaluable. For 88.1% of the patients, it was important that their GP regularly receives information on cancer therapy. Only a minority consulted with the GP regarding diagnosis and therapy of the cancer (32.4%) or approached him about side effects of the therapy (46.9%). About one fifth of the GPs offered CAM. Before the cancer diagnosis, only 7% of the patients received a CAM offer from the GP; after the diagnosis, it was 14%. A large majority wanted the GP to offer more complementary (70.9%) and alternative (54.3%) medicine. CONCLUSION Our survey points to a clear mismatch of supply and demand regarding CAM for cancer patients in the primary care sector. Training for GPs on scientific evidence of as well as communication skills on CAM will be indispensable in the future to optimise the care of cancer patients by GPs.
Collapse
Affiliation(s)
- Johanna Vogel
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | | | - Thomas Stauch
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Lena Josfeld
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Jutta Hübner
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| |
Collapse
|
9
|
Bagot JL, Theunissen I, Serral A. Perceptions of homeopathy in supportive cancer care among oncologists and general practitioners in France. Support Care Cancer 2021; 29:5873-5881. [PMID: 33763723 PMCID: PMC8410724 DOI: 10.1007/s00520-021-06137-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 03/04/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES In France, homeopathy is the most frequently used complementary therapy in supportive care in oncology (SCO); its use is steadily increasing. However, data is limited about the perception and relevance of homeopathy by oncologists and general practitioners (GPs) both with and without homeopathic training (HGPs and NHGPs, respectively). Our aim was to evaluate French physicians' perceptions of homeopathy to clarify its place in SCO through two original observation survey-based studies. MATERIALS AND METHODS Two cross-sectional surveys of French physicians were conducted involving (1) 150 specialist oncologists; (2) 97 HGPs and 100 NHGPs. Questions evaluated physician attitudes to homeopathy and patterns of use of homeopathic therapies in patients requiring SCO. Survey responses were described and analyzed on the basis of physician status. RESULTS Ten percent of oncologists stated they prescribe homeopathy; 36% recommend it; 54% think that homeopathy is potentially helpful in SCO. Two-thirds of the NHGPs sometimes prescribe homeopathy in the context of SCO and 58% regularly refer their patients to homeopathic doctors. HGPs have a positive perception of homeopathy in SCO. CONCLUSIONS Homeopathy is viewed favorably as an integrated SCO therapy by the majority of French physicians involved with cancer patients-oncologists and GPs. Symptoms of particular relevance include fatigue, anxiety, peripheral neuropathy, sleep disturbance, and hot flashes. In such clinical situations, response to conventional therapies may be suboptimal and homeopathy is considered a reliable therapeutic option. These two studies highlight the fact that homeopathy has gained legitimacy as the first complementary therapy in SCO in France.
Collapse
Affiliation(s)
- J. L. Bagot
- Main General Practice Surgery, Strasbourg, France
- Department of Integrative Medicine, Saint Vincent Hospital Group, Toussaint Hospital, Strasbourg, France
- Institut Rafaël-Maison de l’Après-Cancer, Levallois-Perret, France
| | - I. Theunissen
- Breast Cancer Clinic, CHIREC Delta Hospital, Brussels, Belgium
| | - A. Serral
- Laboratoires Boiron, Messimy, France
| |
Collapse
|
10
|
Muecke R, Gosenheimer R, Schulz C, Heim G, Schmitz V, Harvey C, Zosel-DeIturri A, Nissen A, Hemberger U, Romeis V, Lochhas G, Metzmann U, Bussmann M, Paschold M. Counseling on Complementary Methods in the Treatment of Side Effects of Oncological Therapies: A Project of the Breast and Bowel Center Nahe at the Hospital Sankt Marienwoerth Bad Kreuznach. Integr Cancer Ther 2021; 20:15347354211043199. [PMID: 34581221 PMCID: PMC8481747 DOI: 10.1177/15347354211043199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Increasingly, patients with cancer are asking for additional, complementary therapy options for treating the side effects of oncological therapy. Thus, the members of the Breast and Bowel Center Nahe at the Sankt Marienwörth Hospital Bad Kreuznach decided to define the content of this type of counseling for patients before treatment. METHODS In 2018, a team of internal oncologists, gynecological oncologists, radio-oncologists, nutritionists, psycho-oncologists, and study nurses met several times to define the content of counseling. To inform the team, an intensive literature review was conducted. RESULTS Counseling content was determined for complementary treatment options for the most frequent side effects of oncological therapies. Counseling sessions were formulated as frontal lectures (slide presentations), given at regular intervals for patients and relatives. These lectures were highly appreciated by patients. CONCLUSION These counseling sessions increased patient understanding of both useful complementary measures and harmful measures they should not use.
Collapse
Affiliation(s)
- Ralph Muecke
- Mainz-Ruesselsheim-Bad Kreuznach, Bad Kreuznach, Germany.,Ruhr University Bochum, Bochum, Germany.,German Cancer Society, Berlin, Germany
| | | | | | - Gabor Heim
- Hospital Sankt Marienwoerth, Bad Kreuznach, Germany
| | | | | | | | | | | | | | | | - Ute Metzmann
- Mainz-Ruesselsheim-Bad Kreuznach, Bad Kreuznach, Germany
| | | | | |
Collapse
|
11
|
A pre-post evaluation of oncology healthcare providers' knowledge, attitudes, and practices following the implementation of a complementary medicine practice guideline. Support Care Cancer 2021; 29:7487-7495. [PMID: 34100136 DOI: 10.1007/s00520-021-06318-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Complementary medicine (CM) use is prevalent among cancer patients, yet it is often not assessed by oncology healthcare providers (HCPs). The purpose of this study was to evaluate oncology HCPs' knowledge, attitudes, and practices surrounding CM use before and after the implementation of a practice guideline focusing on standardizing assessment and documentation of CM. METHODS Oncology HCPs across a provincial cancer agency were invited to participate in the study. The implementation strategy included an initial education session for HCPs and standardized CM assessment forms. Pre-post surveys assessing knowledge, attitudes, and practices related to CM were completed by HCPs prior to attending the education session and following the 4-month implementation period. Paired t-tests were conducted to determine differences between baseline and follow-up surveys. RESULTS A total of 31 oncology HCPs completed both baseline and follow-up surveys, with over 3700 patient CM assessment forms being completed during the 4-month study period. At the end of the study, HCPs reported greater CM knowledge (p < 0.001), readiness to support cancer patients' CM decisions (p = 0.002), and willingness to consult with another HCP about CM (p = 0.004). No significant change in HCPs' reported attitudes towards CM, or other clinical practices related to CM were observed. CONCLUSION Implementing a practice guideline, including a CM education session and a standardized assessment form, was found to improve oncology HCPs' self-reported CM knowledge and readiness to answer cancer patients' questions about CM. The findings provide support for future knowledge translation research aimed at standardizing how CM is addressed within cancer care settings.
Collapse
|
12
|
Lin YJ, Chang HT, Lin MH, Chen RY, Chen PJ, Lin WY, Hsieh JG, Wang YW, Hu CC, Liou YS, Chiu TY, Tu CY, Wang YJ, Cheng BR, Chen TJ, Chen FP, Hwang SJ. Professionals' experiences and attitudes toward use of Traditional Chinese Medicine in hospice palliative inpatient care units: A multicenter survey in Taiwan. Integr Med Res 2021; 10:100642. [PMID: 33163357 PMCID: PMC7607421 DOI: 10.1016/j.imr.2020.100642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Medical staff may have difficulties in using conventional medicine to manage symptoms among terminally ill patients, including adverse effects of the treatment. Traditional Chinese medicine (TCM) is regarded as a complementary or alternative medicine, and has been increasingly used in the field of palliative medicine in recent years. This study aimed to investigate the experiences of and attitudes toward using TCM among palliative care professionals, and to provide preliminary information about its use in palliative care. METHODS This was a cross-sectional survey study conducted in eight inpatient hospice wards in Taiwan between December 2014 and February 2016. The questionnaire was self-administered, and was analyzed with descriptive statistics including Pearson's Chi-square test and Fisher's exact test. RESULTS A total of 251 palliative care professionals responded to the questionnaire, of whom 89.7% and 88.9% believed that the use of TCM could improve the physical symptoms and quality of life in terminally ill patients, respectively. Overall, 59.8%, of respondents suggested that TCM had rare side effects, and 58.2% were worried that TCM could affect the liver and kidney function of patients. In total, 89.7% and 88.0% of professionals agreed there were no suitable clinical practice guidelines and educational programs, respectively, for TCM use in palliative care. CONCLUSIONS Most of the respondents agreed there was insufficient knowledge, skills-training, and continuing education on the use of TCM in terminally ill patients in Taiwan. These results show that to address patient safety considerations, guidelines about use of TCM in palliative care should be established.
Collapse
Affiliation(s)
- Yu-Jia Lin
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsiao-Ting Chang
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ming-Hwai Lin
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ru-Yih Chen
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ping-Jen Chen
- Department of Family Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
| | - Wen-Yuan Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Jyh-Gang Hsieh
- Department of Family Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Ying-Wei Wang
- Department of Family Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
| | - Chung-Chieh Hu
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yi-Sheng Liou
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tai-Yuan Chiu
- Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chun-Yi Tu
- Department of Family Medicine, Taipei Veterans General Hospital Taoyuan Branch, Taoyuan, Taiwan
| | - Yi-Jen Wang
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Bo-Ren Cheng
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fang-Pey Chen
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shinn-Jang Hwang
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
13
|
Demand for integrative medicine among women with breast and gynecological cancer: a multicenter cross-sectional study in Southern and Northern Germany. Arch Gynecol Obstet 2020; 303:1315-1330. [PMID: 33263787 PMCID: PMC8053147 DOI: 10.1007/s00404-020-05880-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/04/2020] [Indexed: 02/01/2023]
Abstract
Purpose The aim of this multicenter cross-sectional study was to analyze a cohort of breast (BC) and gynecological cancer (GC) patients regarding their interest in, perception of and demand for integrative therapeutic health approaches. Methods BC and GC patients were surveyed at their first integrative clinic visit using validated standardized questionnaires. Treatment goals and potential differences between the two groups were evaluated. Results 340 patients (272 BC, 68 GC) participated in the study. The overall interest in IM was 95.3% and correlated with older age, recent chemotherapy, and higher education. A total of 89.4% were using integrative methods at the time of enrolment, primarily exercise therapy (57.5%), and vitamin supplementation (51.4%). The major short-term goal of the BC patients was a side-effects reduction of conventional therapy (70.4%); the major long-term goal was the delay of a potential tumor progression (69.3%). In the GC group, major short-term and long-term goals were slowing tumor progression (73.1% and 79.1%) and prolonging survival (70.1% and 80.6%). GC patients were significantly more impaired by the side-effects of conventional treatment than BC patients [pain (p = 0.006), obstipation (< 0.005)]. Conclusion Our data demonstrate a high overall interest in and use of IM in BC and GC patients. This supports the need for specialized IM counseling and the implementation of integrative treatments into conventional oncological treatment regimes in both patient groups. Primary tumor site, cancer diagnosis, treatment phase, and side effects had a relevant impact on the demand for IM in our study population.
Collapse
|
14
|
Steel A, Schloss J, Diezel H, Palmgren PJ, Maret JB, Filbet M. Complementary medicine visits by palliative care patients: a cross-sectional survey. BMJ Support Palliat Care 2020; 12:e47-e58. [PMID: 32788276 DOI: 10.1136/bmjspcare-2020-002269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND The paucity of empirical research examining complementary medicine (CM) use in palliative care in France compared with other countries results in a gap in scientific knowledge. This study aims to describe the frequency and the cause of palliative care patients consulting with a CM clinician along with the conventional physicians. METHODS This study is an observational cross-sectional survey conducted in three palliative care centres in Lyon, France, between July 2017 and May 2018: two tertiary hospitals and one palliative care unit in a private hospital. Inpatients and outpatients visiting the palliative care clinics with a primary diagnosis of cancer were invited to participate in the study. Using a 19-item paper-based survey instrument, we collected data on the participants' personal characteristics, health service utilisation and attitudes towards CM. RESULTS From the 138 participants meeting the inclusion criteria, 100 (72.4%) were included in the study. On average, they were 62.9 years old (SD 12.4) and the majority were women (60%). The primary cancer site was mostly colorectal (29.0%), breast (15.0%) and gynaecological (11.0%). The most commonly visited CM clinician was the aromatherapist (72.7%), recording more than six consultations (78.1%) for symptom management (21.9%). Visits to an osteopath were reported by 28.6% of patients, and 45.8% of osteopathy users reported visiting an osteopath more than six times for symptom management (62.5%). Participants visiting a naturopath (15.3%) reported less than four visits and indicated symptom management as the most common reason (76.9%). CONCLUSIONS Our findings show a substantial proportion of palliative care patients visit CM clinicians and primarily seek symptom management from CM clinical care.
Collapse
Affiliation(s)
- Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Janet Schloss
- Office of Research, Endeavour College of Natural Health, Brisbane, Queensland, Australia.,Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Helene Diezel
- Office of Research, Endeavour College of Natural Health, Brisbane, Queensland, Australia
| | - Per J Palmgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Stockholm, Sweden
| | - Jean Baptiste Maret
- Département de Soins Palliatifs, Centre Hospitalier Lyon-Sud Service de Radiologie, Pierre-Benite, Auvergne-Rhône-Alpes, France
| | - Marilène Filbet
- Département de Soins Palliatifs, Centre Hospitalier Lyon-Sud Service de Radiologie, Pierre-Benite, Auvergne-Rhône-Alpes, France
| |
Collapse
|
15
|
Berretta M, Rinaldi L, Taibi R, Tralongo P, Fulvi A, Montesarchio V, Madeddu G, Magistri P, Bimonte S, Trovò M, Gnagnarella P, Cuomo A, Cascella M, Lleshi A, Nasti G, Facchini S, Fiorica F, Di Francia R, Nunnari G, Pellicanò GF, Guglielmino A, Danova M, Rossetti S, Amore A, Crispo A, Facchini G. Physician Attitudes and Perceptions of Complementary and Alternative Medicine (CAM): A Multicentre Italian Study. Front Oncol 2020; 10:594. [PMID: 32411599 PMCID: PMC7202223 DOI: 10.3389/fonc.2020.00594] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 03/31/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose: 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. Methods: 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). Results: 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 (p < 0.0001), and those who were also involved in research activity had a greater knowledge of CAM than those who were not (p < 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, Aloe vera and high-dose vitamin C. Conclusion: 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.
Collapse
Affiliation(s)
- Massimiliano Berretta
- Department of Medical Oncology, Istituto Nazionale Tumori, IRCCS - CRO, Aviano (PN), Italy
| | - Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Rosaria Taibi
- Department of Medical Oncology, Istituto Nazionale Tumori, IRCCS - CRO, Aviano (PN), Italy
| | - Paolo Tralongo
- Division of Medical Oncology, "Umberto I" Hospital, Siracusa, Italy
| | - Alberto Fulvi
- Division of Medical Oncology, "Gemelli" Hospital, Roman, Italy
| | | | - Giordano Madeddu
- Division of Infectious Diseases, University of Sassari, Sassari, Italy
| | - Paolo Magistri
- Department of Surgery, University of Modena and Reggio Emilia, Modena, Italy
| | - Sabrina Bimonte
- Department of Anaesthesia and Pain Medicine, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy
| | - Marco Trovò
- Division of Radiotherapy, "Santa Maria della Misericordia" Hospital, Udine, Italy
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Arturo Cuomo
- Department of Anaesthesia and Pain Medicine, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy
| | - Marco Cascella
- Department of Anaesthesia and Pain Medicine, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy
| | - Arben Lleshi
- Department of Medical Oncology, Istituto Nazionale Tumori, IRCCS - CRO, Aviano (PN), Italy
| | - Guglielmo Nasti
- Division of Medical Oncology B, Istituto Nazionale Tumori "Fondazione G. Pascale" IRCCS, Naples, Italy
| | - Sergio Facchini
- Department of Urology, University of Naples "Federico II", Naples, Italy
| | | | | | - Giuseppe Nunnari
- Division of Infectious Disease, University of Messina, Messina, Italy
| | | | - Aurelio Guglielmino
- Division of Anaesthesia, Policlinico Universitario, University of Catania, Catania, Italy
| | - Marco Danova
- Department of Internal Medicine and Medical Oncology, Vigevano Civic Hospital, ASST of Pavia, Vigevano, Italy
| | - Sabrina Rossetti
- Medical Oncology, Department of Uro-Gynaecological Oncology 'Istituto Nazionale Tumori' 'Fondazione G. Pascale' IRCCS, Naples, Italy
| | - Alfonso Amore
- Division of Surgery Melanoma and Skin Cancer, 'Istituto Nazionale Tumori' 'Fondazione G. Pascale' IRCCS, Naples, Italy
| | - Anna Crispo
- Unit of Epidemiology, 'Istituto Nazionale Tumori' 'Fondazione G. Pascale' IRCCS, Naples, Italy
| | - Gaetano Facchini
- Medical Oncology, Department of Uro-Gynaecological Oncology 'Istituto Nazionale Tumori' 'Fondazione G. Pascale' IRCCS, Naples, Italy
| |
Collapse
|
16
|
Pharmacy employees’ self-rated knowledge, use and attitudes toward homeopathy: A comparative survey in Sweden and Germany. EUROPEAN PHARMACEUTICAL JOURNAL 2019. [DOI: 10.2478/afpuc-2018-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Background: Homeopathy is being increasingly practiced within different medical areas of use. Homeopathic medicines are sold in German pharmacies, whereas the assortment of Swedish pharmacies does not include homeopathic medicines. Despite differences between Sweden and Germany, homeopathic medicines are classified as drugs in both countries.
Objective: The aim of this study was to compare the pharmacy employees’ self-rated knowledge, use and attitudes toward homeopathy in Sweden and Germany.
Methods: A quantitative web-survey was sent to 30 pharmacies in Sweden and 30 pharmacies in Germany, which were selected by using a multi-stage clustering sampling. The questionnaire contained closed-ended rating scales. To compare the self-rated knowledge, use and attitudes toward homeopathy of Swedish and German pharmacy employees, chi-square tests and Mann-Whitney tests were performed in SPSS.
Results: A total of 209 pharmacy employees answered the survey (108 in Sweden and 101 in Germany). German participants estimated their knowledge higher than the Swedish participants (p < 0.01). In both countries, most participants thought that pharmacy employees should have knowledge about homeopathy. Although most Swedish participants stated that they receive questions about homeopathy, the German pharmacy employees receive questions about homeopathy more frequently (p < 0.01). Swedish participants reported less experience of own use of homeopathic medicines and less belief in their effectiveness as compared to the German participants (p < 0.01). However, in both countries, most participants stated that homeopathic medicines should be sold in pharmacies.
Conclusion: As pharmacy employees should act professionally to advice customers on all drugs, increased homeopathic knowledge in pharmacy employees could potentially improve pharmaceutical practice.
Collapse
|
17
|
Freuding M, Keinki C, Micke O, Buentzel J, Huebner J. Mistletoe in oncological treatment: a systematic review : Part 1: survival and safety. J Cancer Res Clin Oncol 2019; 145:695-707. [PMID: 30673873 DOI: 10.1007/s00432-018-02837-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 12/31/2018] [Indexed: 12/01/2022]
Abstract
PURPOSE Mistletoe treatment of cancer patients is discussed highly controversial in the scientific literature. Aim of this systematic review is to give an extensive overview about current state of research concerning mistletoe therapy of oncologic patients regarding survival, quality of life and safety. METHODS In September and October 2017 Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, CINAHL and "Science Citation Index Expanded" (Web of Science) were systematically searched. RESULTS The search strategy identified 3647 hits and 28 publications with 2639 patients were finally included in this review. Mistletoe was used in bladder cancer, breast cancer, other gynecological cancers (cervical cancer, corpus uteri cancer, and ovarian cancer), colorectal cancer, other gastrointestinal cancer (gastric cancer and pancreatic cancer), glioma, head and neck cancer, lung cancer, melanoma and osteosarcoma. In nearly all studies, mistletoe was added to a conventional therapy. Patient relevant endpoints were overall survival (14 studies, n = 1054), progression- or disease-free survival or tumor response (10 studies, n = 1091). Most studies did not show any effect of mistletoe on survival. Especially high quality studies do not show any benefit. CONCLUSIONS With respect to survival, a thorough review of the literature does not provide any indication to prescribe mistletoe to patients with cancer.
Collapse
Affiliation(s)
- M Freuding
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - C Keinki
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - O Micke
- Klinik für Strahlentherapie und Radioonkologie, Franziskus Hospital, Kiskerstraße 26, 33615, Bielefeld, Germany
| | - J Buentzel
- Klinik für Hals-Nasen-Ohren-Heilkunde, Südharzklinikum Nordhausen, Dr.-Robert-Koch-Straße 39, 99734, Nordhausen, Germany
| | - Jutta Huebner
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
| |
Collapse
|
18
|
Pehlivan S, Süner A, Yıldırım Y, Fadıloğlu Ç. Investigation into Complementary and Integrative Health Approaches for Turkish Patients with Gastrointestinal Cancer. JOURNAL OF RELIGION AND HEALTH 2018; 57:1497-1508. [PMID: 29299785 DOI: 10.1007/s10943-017-0546-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The study was conducted to determine the levels of usage of complementary and integrative health (CIH) approaches and the symptoms experienced by Turkish patients with gastrointestinal cancer. A descriptive study was conducted on 81 patients with gastrointestinal cancer attending the medical oncology department of an oncology hospital. In the data collection stage, the patient description form that prepared by the researchers and the "Edmonton Symptom Assessment Scale" were used. Data were evaluated via Chi-square and student t test. It was determined that 55.6% of the patients with gastrointestinal cancer applied at least one CIH approaches, and these CIH approaches were praying (80.0%), herbal medicine (57.7%), a special diet (40.0%), therapeutic touch (15.6%), exercise (13.3%) and psychotherapy (4.4%). 68.8% of patients who used the CIH approach stated that they applied the CIH approaches in order to supplement the medical treatment, and 91.1% stated that they did not inform health employees about that they using the CIH approach. It was also found that the use of CIH approaches was not related to socio-demographic characteristics, disease characteristics and experienced symptoms. It is very important that patients with gastrointestinal cancer be questioned in terms of CIH approaches used.
Collapse
Affiliation(s)
- Seda Pehlivan
- Department of Nursing, Health Science Faculty, Uludag University, 16059, Bursa, Turkey.
| | - Ali Süner
- Department of Medical Oncology, School of Medicine, Başkent University, 42080, Konya, Turkey
| | - Yasemin Yıldırım
- Nursing of Internal Medicine, Nursing Faculty, Ege University, 35100, İzmir, Turkey
| | - Çiçek Fadıloğlu
- Nursing of Internal Medicine, Nursing Faculty, Ege University, 35100, İzmir, Turkey
| |
Collapse
|
19
|
Admi H, Eilon-Moshe Y, Ben-Arye E. Complementary Medicine and the Role of Oncology Nurses in an Acute Care Hospital: The Gap Between Attitudes and Practice. Oncol Nurs Forum 2018; 44:553-561. [PMID: 28820508 DOI: 10.1188/17.onf.553-561] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe hospital nurses' knowledge, attitudes, and practices regarding complementary medicine (CM); to compare the knowledge and attitudes of nurse managers to staff nurses with diverse oncology experience; and to assess attitudes toward integrating CM into the role of the hospital oncology nurse.
. DESIGN Descriptive, cross-sectional study.
. SETTING Rambam Health Care Campus in northern Israel.
. SAMPLE A convenience sample of 434 hospital nurses with varied oncology experience.
. METHODS Nurses completed a knowledge and attitude questionnaire developed for the current study. Data were analyzed using parametric and nonparametric statistical tests.
. MAIN RESEARCH VARIABLES Hospital nurses' knowledge of and attitudes toward CM, and attitudes toward integrating CM into the role of the hospital oncology nurse.
. FINDINGS Nurses lack knowledge and are unaware of the risks associated with CM. However, they believe this approach can improve the quality of life of patients with cancer; 51% expressed an interest in receiving training. Oncology nurses were ambivalent about the feasibility of applying an integrative approach, whereas nurse managers expressed significantly more positive attitudes toward integrating CM within the scope of nursing practices.
. CONCLUSIONS A large discrepancy remains between nurses' strong interest in CM and awareness of associated benefits, and their ambivalence toward its integration in their nursing practice.
. IMPLICATIONS FOR NURSING Although improving nurses' knowledge should be mandatory, it remains insufficient; a shift in the approach to integrating CM into conventional health care is needed, from practitioners' responsibility to healthcare policymakers' responsibility. Legislations and policies are necessary, along with providing respectable infrastructures.
Collapse
|
20
|
Abstract
Biological-based (BbCAM) methods from complementary and alternative medicine (CAM) may interact with cancer treatments, reduce efficacy, or enhance adverse effects. Although CAM usage has been evaluated well in other cancer entities, data on melanoma patients are still missing. The aim of this study was to determine CAM usage of melanoma patients using a standardized questionnaire to identify potential interactions with established and new systemic melanoma therapies. This multicenter study was carried out in seven German skin cancer centers. During routine care contact, CAM usage of former and current melanoma treatment was assessed in melanoma patients. The probability of interaction was classified into four categories ranging from 'interaction unlikely' (I), 'possible' (II), 'likely' (III), or 'no data' (IV). The questionnaire was filled out by 1157 patients, of whom 1089 were eligible for evaluation. CAM usage was reported by 41% of melanoma patients, of whom 63.1% took BbCAM such as vitamins, trace elements, supplements, or phytotherapeuticals. Of 335 patients with former or current therapy, 28.1% used BbCAM. The melanoma treatment included interferon, radiotherapy, chemotherapy, BRAF-inhibitor, or other tyrosine kinase inhibitors and ipilimumab. On the basis of our model of likelihood of interaction, we found that 23.9% of those on cancer therapy and 85.1% of those also using BbCAM were at some risk of interactions. The main limitation of our study is that no reliable and comprehensive database on clinical relevant interactions with CAM in oncology exists. Most patients receiving a melanoma-specific treatment and using BbCAM methods are at risk for interactions, which raises concerns on the safety and treatment efficacy of these patients. To protect melanoma patients from potential harm by the combination of their cancer treatment and CAM usage, patients should systematically be encouraged to report their CAM use, while oncologists should be trained on evidence of CAM, and patient guidance for saver CAM use.
Collapse
|
21
|
Klein E, Beckmann MW, Bader W, Brucker C, Dobos G, Fischer D, Hanf V, Hasenburg A, Jud SM, Kalder M, Kiechle M, Kümmel S, Müller A, Müller MAT, Paepke D, Rotmann AR, Schütz F, Scharl A, Voiss P, Wallwiener M, Witt C, Hack CC. Gynecologic oncologists' attitudes and practices relating to integrative medicine: results of a nationwide AGO survey. Arch Gynecol Obstet 2017; 296:295-301. [PMID: 28597400 PMCID: PMC5509774 DOI: 10.1007/s00404-017-4420-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 06/01/2017] [Indexed: 02/07/2023]
Abstract
Purpose The growing popularity and acceptance of integrative medicine is evident both among patients and among the oncologists treating them. As little data are available regarding health-care professionals’ knowledge, attitudes, and practices relating to the topic, a nationwide online survey was designed. Methods Over a period of 11 weeks (from July 15 to September 30, 2014) a self-administered, 17-item online survey was sent to all 676 members of the Research Group on Gynecological Oncology (Arbeitsgemeinschaft Gynäkologische Onkologie) in the German Cancer Society. The questionnaire items addressed the use of integrative therapy methods, fields of indications for them, advice services provided, level of specific qualifications, and other topics. Results Of the 104 respondents (15.4%) using integrative medicine, 93% reported that integrative therapy was offered to breast cancer patients. The second most frequent type of tumor in connection with which integrative therapy methods were recommended was ovarian cancer, at 80% of the participants using integrative medicine. Exercise, nutritional therapy, dietary supplements, herbal medicines, and acupuncture were the methods the patients were most commonly advised to use. Conclusion There is considerable interest in integrative medicine among gynecological oncologists, but integrative therapy approaches are at present poorly implemented in routine clinical work. Furthermore there is a lack of specific training. Whether future efforts should focus on extending counseling services on integrative medicine approaches in gynecologic oncology or not, have to be discussed. Evidence-based training on integrative medicine should be implemented in order to safely guide patients in their wish to do something by themselves.
Collapse
Affiliation(s)
- Evelyn Klein
- Klinik und Poliklinik für Frauenheilkunde, Technische Universität München, Munich, Germany
| | - Matthias W Beckmann
- Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg (CCC ER-EMN), Erlangen, Germany
| | - Werner Bader
- Zentrum für Frauenheilkunde, Klinikum Bielefeld Mitte, Bielefeld, Germany
| | - Cosima Brucker
- Universitätsklinik für Frauenheilkunde und Geburtshilfe, Paracelsus Medizinische Privatuniversität, Nuremberg, Germany
| | - Gustav Dobos
- Klinik für Naturheilkunde und Integrative Medizin der Kliniken Essen-Mitte, Essen, Germany
| | - Dorothea Fischer
- Klinik für Gynäkologie und Geburtshilfe, Klinikum Ernst von Bergmann, Potsdam, Germany
| | - Volker Hanf
- Frauenklinik und Brustzentrum Nathanstift, Klinikum Fürth, Fürth, Germany
| | - Annette Hasenburg
- Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Universitätsmedizin Mainz, Mainz, Germany
| | - Sebastian M Jud
- Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg (CCC ER-EMN), Erlangen, Germany
| | - Matthias Kalder
- Klinik für Frauenheilkunde und Geburtshilfe, Philipps-Universität Marburg, Marburg, Germany
| | - Marion Kiechle
- Klinik und Poliklinik für Frauenheilkunde, Technische Universität München, Munich, Germany
| | - Sherko Kümmel
- Interdisziplinäres Brustkrebszentrum der Kliniken Essen-Mitte, Essen, Germany
| | - Andreas Müller
- Frauenklinik, Städtisches Klinikum Karlsruhe gGmbH, Karlsruhe, Germany
| | | | - Daniela Paepke
- Klinik und Poliklinik für Frauenheilkunde, Technische Universität München, Munich, Germany
| | | | - Florian Schütz
- Universitätsfrauenklinik, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Anton Scharl
- Brustzentrum Klinikum St. Marien Amberg, Amberg, Germany
| | - Petra Voiss
- Klinik für Naturheilkunde und Integrative Medizin der Kliniken Essen-Mitte, Essen, Germany
- Interdisziplinäres Brustkrebszentrum der Kliniken Essen-Mitte, Essen, Germany
| | - Markus Wallwiener
- Universitätsfrauenklinik, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Claudia Witt
- Institut für komplementäre und integrative Medizin, UniversitätSpital Zürich und Universität Zürich, Zurich, Switzerland
| | - Carolin C Hack
- Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen-Europäische Metropolregion Nürnberg (CCC ER-EMN), Erlangen, Germany.
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-European Metropolitan Area Nuremberg (CCC ER-EMN), Universitätsstrasse 21-23, 91054, Erlangen, Germany.
| |
Collapse
|
22
|
Giovannini C, Baglioni M, Baron Toaldo M, Cescon M, Bolondi L, Gramantieri L. Vidatox 30 CH has tumor activating effect in hepatocellular carcinoma. Sci Rep 2017; 7:44685. [PMID: 28322221 PMCID: PMC5359575 DOI: 10.1038/srep44685] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 12/02/2016] [Indexed: 12/12/2022] Open
Abstract
Complementary and alternative medicine (CAM) is the term used to describe many kinds of products, practices, and systems that are not part of conventional medicine. Cancer patients usually do everything they can to combat the disease, manage its symptoms, and cope with the side effects of treatment. Unfortunately, patients who use CAM underestimate the risk of interaction with cancer therapy or worse they omit conventional therapy thus reducing the possibility of cancer remission. Herein we analyzed the effects of Vidatox 30 CH (venom extracted from the Junceus Rhopalurus scorpion) on hepatocellular carcinoma (HCC), the second leading cause of cancer-related deaths. We found out that Vidatox increases HCC proliferation and invasion whereas it does not seem to interact with sorafenib, the orally active multikinase inhibitor approved for the treatment of advanced hepatocellular carcinoma. Our results suggest that the concentration of Vidatox used in the present study has not anti-neoplastic effects and care must be taken in hiring Vidatox in patients with HCC.
Collapse
Affiliation(s)
- Catia Giovannini
- Center for Applied Biomedical Research (CRBA), S. Orsola-Malpighi University Hospital, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Michele Baglioni
- Center for Applied Biomedical Research (CRBA), S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Marco Baron Toaldo
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell’Emilia, Bologna, Italy
| | - Matteo Cescon
- Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Luigi Bolondi
- Center for Applied Biomedical Research (CRBA), S. Orsola-Malpighi University Hospital, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Laura Gramantieri
- Center for Applied Biomedical Research (CRBA), S. Orsola-Malpighi University Hospital, Bologna, Italy
| |
Collapse
|
23
|
Loquai C, Dechent D, Garzarolli M, Kaatz M, Kaehler KC, Kurschat P, Meiss F, Micke O, Muecke R, Muenstedt K, Stein A, Nashan D, Stoll C, Schmidtmann I, Huebner J. Use of complementary and alternative medicine: A multicenter cross-sectional study in 1089 melanoma patients. Eur J Cancer 2017; 71:70-79. [DOI: 10.1016/j.ejca.2016.10.029] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/01/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
|
24
|
Klafke N, Homberg A, Glassen K, Mahler C. Addressing holistic healthcare needs of oncology patients: Implementation and evaluation of a complementary and alternative medicine (CAM) course within an elective module designed for healthcare professionals. Complement Ther Med 2016; 29:190-195. [PMID: 27912946 DOI: 10.1016/j.ctim.2016.10.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 09/28/2016] [Accepted: 10/13/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Patients, and especially oncology patients, increasingly demand information and application of complementary therapies to supplement their conventional medical treatment and follow-up care. Due to the widespread interest in holistic treatment opportunities in oncology populations, healthcare professionals need to be prepared in differentiating evidence-based methods of the complementary and alternative medicine (CAM) spectrum and how to consult with patients about it. OBJECTIVE This paper reports on the implementation and evaluation of a newly designed module "Complementary and Alternative Medicine in oncological healthcare" in the bachelor degree program Interprofessional Health Care (B.Sc.). DESIGN The study applied a developed evaluation questionnaire to capture students' perspectives on the CAM contents. This assessment instrument was administered pre and post the CAM teaching unit. SETTING Interprofessional medical education, University Hospital Heidelberg, Germany. RESULTS The integration of the CAM elective module was possible and was met by positive response. Students' interest was reflected in an increase of their self-reported knowledge gain and positive CAM attitude. Comparison of pre and post evaluation data demonstrate that, particularly, students' expectations on developing their own opinion about CAM, and getting an overview of the evidence-base of different CAM methods have been met. CONCLUSIONS Evaluation results indicate that the module content was in line with the students' expectations and may have positively impacted on their general CAM attitude. The results support us in continuing to offer this CAM course within the elective module to prepare today's healthcare professionals for patient-oriented healthcare delivery.
Collapse
Affiliation(s)
- Nadja Klafke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, Marsilius-Arkaden, Turm West, D-69120 Heidelberg, Germany.
| | - Angelika Homberg
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, Marsilius-Arkaden, Turm West, D-69120 Heidelberg, Germany
| | - Katharina Glassen
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, Marsilius-Arkaden, Turm West, D-69120 Heidelberg, Germany
| | - Cornelia Mahler
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, Marsilius-Arkaden, Turm West, D-69120 Heidelberg, Germany
| |
Collapse
|
25
|
Gschwendtner KM, Holmberg C, Weis J. [Beweggründe von Krebspatienten für und gegen die Inanspruchnahme der Misteltherapie]. FORSCHENDE KOMPLEMENTARMEDIZIN (2006) 2016; 23:215-22. [PMID: 27606463 DOI: 10.1159/000448745] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Einleitung: Die Misteltherapie ist im deutschsprachigen Raum ein häufig angewandtes komplementärmedizinisches Verfahren (KM) in der Onkologie. Diese Studie hatte das Ziel, die Beweggründe für oder gegen eine Inanspruchnahme der Misteltherapie zu untersuchen und Themenfeldern zuzuordnen. Patienten und Methoden: Es wurden qualitative leitfadengestützte Interviews mit Krebspatienten geführt. Der Interviewleitfaden fragte nach der Inanspruchnahme von KM, der Motivation zur Inanspruchnahme, Informationsverhalten und -bedürfnissen zu KM sowie nach der Krebserkrankung. Um die Beweggründe für die Inanspruchnahme oder Nichtinanspruchnahme der Misteltherapie zu verstehen, wurden die Interviews inhaltsanalytisch ausgewertet. Ergebnisse: Insgesamt wurden Interviews mit 88 Krebspatienten geführt, davon nutzen 18 (20,5%) die Misteltherapie. Die Beweggründe für oder gegen eine Inanspruchnahme der Misteltherapie ließen sich den 2 Themenfeldern «Wahrgenommene Indikation» und «Abwägungen bei der Entscheidungsfindung» zuordnen. Diskussion und Schlussfolgerungen: Mit der Misteltherapie wird sowohl ein Einfluss auf das Tumorwachstum als auch eine supportive Wirkung assoziiert. Anwender sehen die Misteltherapie als sicheres Verfahren; Nichtnutzer befürchten eher Neben- oder Wechselwirkungen. Die Empfehlung von Fachpersonal spielt eine wichtige Rolle bei der Inanspruchnahme. Zum Teil waren die Nichtnutzer interessiert an der Anwendung der Misteltherapie, befanden sich jedoch noch im Klärungsprozess.
Collapse
Affiliation(s)
- Kathrin M Gschwendtner
- Klinik für Tumorbiologie, UKF Reha Gmbh, Universitätsklinikum Freiburg, Freiburg i.Br., Deutschland
| | | | | |
Collapse
|
26
|
Ciarlo G, Liebl P, Zell J, Fessler J, Koester M, Ruetters D, Mugele K, Huebner J. Information needs of oncologists, general practitioners and other professionals caring for patients with cancer. Eur J Cancer Care (Engl) 2016; 25:1015-1023. [DOI: 10.1111/ecc.12557] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2016] [Indexed: 11/28/2022]
Affiliation(s)
- G. Ciarlo
- Dr. Senckenberg Chronomedical Institute; J.W. Goethe University; Frankfurt Germany
| | - P. Liebl
- German Cancer Society; Berlin Germany
| | - J. Zell
- Max-Planck-Straße 6-8; Köln Germany
| | - J. Fessler
- Institut für hausärztliche Fortbildung im Deutschen Hausärzteverband (IhF) e. V.; Cologne Germany
| | | | | | - K. Mugele
- German Cancer Society; Berlin Germany
| | - J. Huebner
- Dr. Senckenberg Chronomedical Institute; J.W. Goethe University; Frankfurt Germany
| |
Collapse
|
27
|
Use of complementary and alternative medicine by patients with cancer: a cross-sectional study at different points of cancer care. Med Oncol 2016; 33:78. [DOI: 10.1007/s12032-016-0790-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 06/04/2016] [Indexed: 10/21/2022]
|
28
|
Jors K, Seibel K, Bardenheuer H, Buchheidt D, Mayer-Steinacker R, Viehrig M, Xander C, Becker G. Education in End-of-Life Care: What Do Experienced Professionals Find Important? JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:272-278. [PMID: 25773135 DOI: 10.1007/s13187-015-0811-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
End-of-life care is an essential element of quality cancer care. Nevertheless, a majority of physicians and nurses working at cancer centers feel unprepared for this task. As part of a larger survey study, we investigated what suggestions experienced physicians and nurses have to improve education/training on end-of-life care. In an open question, participants were requested to suggest changes to the end-of-life curriculum for physicians and nurses. Answers to this question were content analyzed using the qualitative data analysis software MAXQDA. Physicians and nurses at 10 cancer centers throughout Baden-Wuerttemberg were surveyed. From the total 1131 survey participants, 675 (483 nurses, 167 physicians, 25 unknown) responded to the open question regarding suggestions for education/training in end-of-life care. Two main categories were inductively developed: (1) format (i.e., structure and method of teaching) and (2) content (i.e., knowledge and know-how required for care of the dying). Regarding format, both professional groups most often wished for more practical experiences with dying patients (e.g., internships at hospices). Regarding content, physicians and nurses most frequently requested (1) more basic information on palliative care, (2) increased skills training in communication, and (3) knowledge of how to appropriately care for patients' caregivers. The results of our analysis reflect already trained physicians' and nurses' interest in furthering their knowledge and skills to care for dying patients. The suggestions of experienced physicians and nurses should be integrated into the further development of palliative care curricula.
Collapse
Affiliation(s)
- Karin Jors
- Department of Palliative Care, Comprehensive Cancer Center, University Medical Center Freiburg, Robert-Koch-Str. 3, 79106, Freiburg, Germany.
| | - Katharina Seibel
- Department of Palliative Care, Comprehensive Cancer Center, University Medical Center Freiburg, Robert-Koch-Str. 3, 79106, Freiburg, Germany
| | - Hubert Bardenheuer
- Department of Anesthesiology, Comprehensive Cancer Center, University Medical Center Heidelberg, Heidelberg, Germany
| | - Dieter Buchheidt
- Department of Hematology and Oncology, Comprehensive Cancer Center, Mannheim University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Regine Mayer-Steinacker
- Department of Hematology and Oncology, Comprehensive Cancer Center, University Medical Center Ulm, Ulm, Germany
| | - Marén Viehrig
- Department of Radiation Oncology, Comprehensive Cancer Center, University Medical Center Tuebingen, Tuebingen, Germany
| | - Carola Xander
- Department of Palliative Care, Comprehensive Cancer Center, University Medical Center Freiburg, Robert-Koch-Str. 3, 79106, Freiburg, Germany
| | - Gerhild Becker
- Department of Palliative Care, Comprehensive Cancer Center, University Medical Center Freiburg, Robert-Koch-Str. 3, 79106, Freiburg, Germany
| |
Collapse
|
29
|
Huebner J, Mohr P, Simon JC, Fluck M, Berking C, Zimmer L, Loquai C. Gebrauch von Komplementärmedizin bei Patienten mit metastasierendem Melanom unter Therapie mit Ipilimumab innerhalb einer klinischen Studie. J Dtsch Dermatol Ges 2016; 14:508-13. [DOI: 10.1111/ddg.12750_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jutta Huebner
- Arbeitsgruppe Integrative Onkologie; Dr. Senckenbergisches Chronomedizinisches Institut, J.W. Goethe-Universität; Frankfurt am Main Deutschland
| | - Peter Mohr
- Klinik für Dermatologie; Elbe Kliniken in Buxtehude; Buxtehude Deutschland
| | - Jan-Christoph Simon
- Klinik und Poliklinik für Dermatologie; Venerologie und Allergologie, Universitätsklinikum Leipzig; Leipzig Deutschland
| | - Michael Fluck
- Abteilung für Internistische Onkologie; Fachklinik Hornheide; Hornheide Deutschland
| | - Carola Berking
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München; München Deutschland
| | - Lisa Zimmer
- Klinik für Dermatologie; Universitätsklinik Duisburg-Essen; Essen Deutschland
| | - Carmen Loquai
- Hautklinik und Poliklinik; Universitätsmedizin der Johannes Gutenberg-Universität Mainz; Mainz Deutschland
| |
Collapse
|
30
|
Huebner J, Mohr P, Simon JC, Fluck M, Berking C, Zimmer L, Loquai C. Use of complementary medicine in metastatic melanoma patients treated with ipilimumab within a clinical trial. J Dtsch Dermatol Ges 2016; 14:508-13. [PMID: 27119474 DOI: 10.1111/ddg.12750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES In Germany, 40-90 % of all cancer patients use complementary and alternative medicine (CAM). So far, no data are available on the use of CAM by melanoma patients. The objective of our study was to gather data on CAM use, sources of information, and goals of patients with metastatic melanoma. PATIENTS AND METHODS One hundred and fifty-six patients from 25 study centers participated in the DecOG-MM-PAL-Multibasket Study. These individuals were also asked to participate in a side study addressing CAM use. A standardized CAM questionnaire was distributed at defined points during the treatment. RESULTS Overall, 55 questionnaires from 32 (21 %) melanoma patients were received. Of those, 17 (53 %) stated an interest in CAM, and seven (22 %) actually used CAM. Family and friends were the main source of information (31 %), followed by physicians (19 %). The main reasons for using CAM were boosting the immune system (41 %) and strengthening the body (34 %). Supplements (vitamins and trace elements) were most commonly used (28 %). CONCLUSIONS A relatively high number of metastatic melanoma patients used CAM despite their participation in a clinical trial. Interactions may be due to biologically based CAM, especially immunomodulatory CAM strategies. In order to avoid risks, communication between physicians and patients should be improved.
Collapse
Affiliation(s)
- Jutta Huebner
- Working Group Integrative -Oncology, Dr. Senckenberg -Chronomedical Institute, J.W. -Goethe University, Frankfurt am Main, Germany
| | - Peter Mohr
- Department of Dermatology, Elbe Medical Center Buxtehude, Buxtehude, Germany
| | - Jan-Christoph Simon
- Department of Dermatology, Venereology and Allergology, University Hospital Leipzig, Leipzig, Germany
| | - Michael Fluck
- Department for Medical Oncology, Specialty Medical Center Hornheide, Hornheide, Germany
| | - Carola Berking
- Department of Dermatology and Allergology, University Hospital -Munich, Munich, Germany
| | - Lisa Zimmer
- Department of Dermatology, University Hospital, University -Duisburg-Essen, Essen, Germany
| | - Carmen Loquai
- Department of Dermatology, -University Hospital Mainz, Mainz, Germany
| |
Collapse
|
31
|
Loquai C, Dechent D, Garzarolli M, Kaatz M, Kaehler KC, Kurschat P, Meiss F, Stein A, Nashan D, Micke O, Muecke R, Muenstedt K, Stoll C, Schmidtmann I, Huebner J. Risk of interactions between complementary and alternative medicine and medication for comorbidities in patients with melanoma. Med Oncol 2016; 33:52. [PMID: 27090799 DOI: 10.1007/s12032-016-0764-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 04/07/2016] [Indexed: 11/24/2022]
Abstract
Complementary and alternative medicine (CAM) is used widely among cancer patients. Beside the risk of interaction with cancer therapies, interactions with treatment for comorbidities are an underestimated problem. The aim of this study was to assess prevalence of interactions between CAM and drugs for comorbidities from a large CAM usage survey on melanoma patients and to classify herb-drug interactions with regard to their potential to harm. Consecutive melanoma outpatients of seven skin cancer centers were asked to complete a standardized CAM questionnaire including questions to their CAM use and their taken medication for comorbidities and cancer. Each combination of conventional drugs and complementary substances was evaluated for their potential of interaction. 1089 questionnaires were eligible for evaluation. From these, 61.6% of patients reported taking drugs regularly from which 34.4% used biological-based CAM methods. Risk evaluation for interaction was possible for 180 CAM users who listed the names or substances they took for comorbidities. From those patients, we found 37.2% at risk of interaction of their co-consumption of conventional and complementary drugs. Almost all patients using Chinese herbs were at risk (88.6%). With a high rate of CAM usage at risk of interactions between CAM drugs and drugs taken for comorbidities, implementation of a regular assessment of CAM usage and drugs for comorbidities is mandatory in cancer care.
Collapse
Affiliation(s)
- Carmen Loquai
- Department of Dermatology, University Medical Center Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Dagmar Dechent
- Institute of Occupational Medicine, University Hospital, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Marlene Garzarolli
- Department of Dermatology, University Medical Center Dresden, Fetscherstraße 74, 01307, Dresden, Germany
| | - Martin Kaatz
- Department of Dermatology, Wald Klinikum Gera, Str. des Friedens 122, 07548, Gera, Germany
| | - Katharina C Kaehler
- Department of Dermatology, University Medical Center Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Peter Kurschat
- Practice of Dermatology, Bonner Str. 207, 50968, Cologne, Germany
| | - Frank Meiss
- Department of Dermatology, Klinikum Dortmund gGmbH, Beurhausstraße 40, 44137, Dortmund, Germany
| | - Annette Stein
- Practice of Dermatology, Sachsenwerkstr. 71, 01257, Dresden, Germany
| | - Dorothee Nashan
- Department of Dermatology, Klinikum Dortmund gGmbH, Beurhausstraße 40, 44137, Dortmund, Germany
| | - Oliver Micke
- Department of Radio-Oncology, St. Franziskus Hospital Bielefeld, Kiskerstraße 26, 33615, Bielefeld, Germany
| | - Ralph Muecke
- Department of Radio-Oncology, Ruhr University Bochum, Universitätsstraße 150, 44801, Bochum, Germany
| | - Karsten Muenstedt
- Department of Gynecology and Obstetrics, Clinic Offenburg, Ebertplatz 12, 77654, Offenburg, Germany
| | - Christoph Stoll
- Clinic Herzoghoehe Bayreuth, Kulmbacherstraße 103, 95445, Bayreuth, Germany
| | - Irene Schmidtmann
- Department of Medical Biometrie, Epidemiology and Informatics, University Medical Center Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Jutta Huebner
- Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
| |
Collapse
|
32
|
Muecke R, Paul M, Conrad C, Stoll C, Muenstedt K, Micke O, Prott FJ, Buentzel J, Huebner J. Complementary and Alternative Medicine in Palliative Care: A Comparison of Data From Surveys Among Patients and Professionals. Integr Cancer Ther 2015; 15:10-6. [PMID: 26721796 DOI: 10.1177/1534735415596423] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Many cancer patients use complementary and alternative medicine (CAM) during or after their therapy. Because little is known about CAM in palliative care, we conducted 2 surveys among patients and professionals in the palliative setting. PARTICIPANTS AND METHODS Patients of a German Comprehensive Cancer Center were interviewed, and an independent online survey was conducted among members of the German Society for Palliative Care (DGP). RESULTS In all, 25 patients and 365 professional members of the DGP completed the survey (9.8% of all members); 40% of the patients, 85% of the physicians, and 99% of the nurses claimed to be interested in CAM. The most important source of information for professionals is education, whereas for patients it is radio, TV, and family and friends. Most patients are interested in biological-based methods, yet professionals prefer mind-body-based methods. Patients more often confirm scientific evidence to be important for CAM than professionals. CONCLUSIONS To improve communication, physicians should be trained in evidence for those CAM methods in which patients are interested.
Collapse
Affiliation(s)
- Ralph Muecke
- Lippe Hospital Lemgo, Germany Ruhr University Bochum, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|