Doctors Who Integrate Spirituality and CAM in the Clinic: The Puerto Rican Case

Unani Tibb practitioners' perceptions and attitudes towards spirituality and spiritual care in Unani Tibb practice in South Africa

BACKGROUND

Unani Tibb is an Arabic term which means Greek medicine. It is an ancient holistic medical system based on the healing theories of Hippocrates, Galen and Ibn Sina (Avicenna). Despite this, spirituality and spiritual care practices are deficient in the clinical setting.

METHODS

This cross-sectional descriptive study was used to describe Unani Tibb practitioners' perceptions and attitudes regarding spirituality and spiritual care in South Africa. A demographic form, Spiritual Care-Giving Scale, Spiritual and Spiritual Care Rating Scale and Spirituality in Unani Tibb Scale were used to collect data.

RESULTS

A response rate of 64.7% (n = 44 out of 68) was achieved. Positive perceptions and attitudes regarding spirituality and spiritual care were recorded for Unani Tibb practitioners. The spiritual needs of their patients were considered vital towards enhancing the Unani Tibb treatment approach. Spirituality and spiritual care were regarded as fundamental to Unani Tibb therapy. However, most practitioners agreed that adequate training in spirituality and spiritual care was lacking and future training initiatives were imperative for Unani Tibb clinical practice in South Africa.

CONCLUSION

The findings of this study recommends further research in this field by means of qualitative and mixed methods approaches to provide a deeper understanding to this phenomenon. Clear guidelines on spirituality and spiritual care for Unani Tibb clinical practice are essential to ensure the integrity of the holistic approach required by the profession.

The Influence of Spirituality and Religiosity on US Oncologists' Personal Use of and Clinical Practices Regarding Complementary and Alternative Medicine

Background:

Cancer patients frequently use complementary and alternative medicine (CAM), and spirituality has been associated with CAM use among patients. We evaluated how oncologists’ spirituality and religiosity are associated with personal use and patient recommendations for CAM.

Methods:

A survey was mailed to 1000 medical oncologists in the United States. The questionnaire asked about oncologists’ approaches to CAM use by patients, focusing on the use of herbs and supplement (HS), and about religiosity and spirituality.

Results:

Of 937 deliverable questionnaires, 392 were returned (response rate 42%). Respondents were mostly men (71%) and Caucasian (76%), with a median age of 48. Approximately 16% reported no religion, 19% Jewish, 24% Catholic, 28% Christian, and 13% other religions. Eighteen percent reported attending religious services at least once a week, including 15% who attend several times per week. Twenty-eight percent reported high theological pluralism (skepticism regarding whether one religion is comprehensively and uniquely true); 58% described themselves as moderately or very spiritual. Self-reported spirituality and religious service attendance were associated with using CAM personally and recommending HS to patients. In multivariate analyses, moderate-high spirituality and attending religious services less than monthly was positively associated with personal use of CAM: odds ratio (OR) = 3.10 (confidence interval [CI] = 1.5-6.5) and OR = 3.04 (CI = 1.5-6.6), respectively. Physicians with moderate to high spirituality were more likely to report recommending CAM in general (OR = 3.07, CI = 1.3-7.1), but less likely to report recommending HS (OR = 0.33, CI = 0.14-0.75).

Conclusion:

Self-reported spirituality is a significant factor among US oncologists’ decision to use CAM and recommend CAM to patients.

Explaining Chronic Illness and Self-Rated Health Among Immigrants of Five Hispanic Ethnicities

The largest racial/ethnic minority group in the United States, Hispanics, especially Hispanic immigrants, have been considered healthier than groups of other ethnicity (including Whites, the majority). However, chronic illnesses such as cancer and diabetes are often seen in this culturally, ethnically diverse group. The present study had two aims. First was to explain two health outcomes, which were presence of chronic illness (any of the five common conditions cardiovascular disease, stroke, hypertension, cancer, and/or diabetes/prediabetes) and self-rated health, in terms of links to certain factors in acculturation, social status, health, social support, and lifestyle. Second was to determine how uniform these links might be across five ethnic groups: Mexican, Puerto Rican, Cuban, Dominican, Central/South American. We combined data from 17 years of the National Health Interview Survey (1999-2015) and subjected these secondary measures to logistic and linear regression, separately by ethnicity, to explain both outcomes. With few exceptions, results generally linked illness/health to the tested independent variables. Additionally, results confirmed ethnicity to moderate the outcomes' associations with the independent variables. Ethnicity-specific analysis showed the two outcomes to exhibit dissimilar relationships with certain independent variables across ethnic groups. Research that (as has been common) lumps together respondents whose Hispanic ethnicities may differ disregards some meaningful variation rather than accounting for it. In future research-and in subsequent evidence-based policy/practice development-all essential sociocultural factors, including ethnicity, should be carefully outlined, advancing good health for the entire Hispanic immigrant population.