The association between mental distress and the use of alternative medicine among cancer patients in North Norway

Demographic and psychometric predictors associated with engagement in risk-associated alternative healthcare behaviours

This paper builds on prior work exploring the use of risk-associated alternative healthcare (RAAH) in Canada. RAAH uptake was surveyed to explore the characteristics of adult RAAH users and the value of established psychometric instruments previously used in alternative healthcare studies in predicting RAAH behaviours: the Control Beliefs Inventory (CBI), the Reward Responsiveness Behavioural Activation System (RBAS) scale, the Positive Attitudes to Science (PAS) scale, the Satisfaction with Orthodox Medicine (SOM) scale, and the brief version of the Susceptibility to Persuasion-II (StP-II-B) scale. Findings suggest RAAH is influenced by gender, age, income, education, employment, chronic illness status, and ethnicity. Engagement in some form of RAAH was common (around 40%) and the most common types of RAAH use reported were physical manipulation and herbal/nutritional supplement use. Other higher-risk AH activities (such as use of toxins and physically invasive procedures) were also reported by about 5% of respondents. The StP-II-B and PAS instruments were predictive of the likelihood of engagement in RAAH behaviours, as illustrated by higher risk tolerance, desire for novelty, positive attitude to advertising and social influence, and positive beliefs about science. The CBI, RBAS, and SOM instruments were not predictive overall. However, the CBI and SOM instruments were predictive of engagement with physical manipulative RAAH activities, while the RBAS was predictive of herbal/nutritional RAAH engagement. These findings can help inform health professionals' understanding of public health-seeking behaviours with respect to risk.

Utilisation of complementary medicine in cancer patients and survivors: Expected benefits and its association to psychosocial factors

INTRODUCTION

Previous research showed that various factors are associated with the use of complementary medicine (CM) in cancer patients. This study aimed to analyse the expected benefits of CM use in its association with medical, sociodemographic and psychosocial variables.

METHODS

In a cross-sectional survey, we assessed the use of CM, expected benefits of CM, depression and quality of life. An exploratory factor analysis (EFA) was performed. Multiple regression analysis was carried out with the factors derived from the EFA as dependent variables.

RESULTS

Based on 292 cancer CM user, EFA revealed two factors: a supportive effect (SPE) and an antitumoral effect (ATE). In the multiple regression analysis, reduced emotional functioning and the diagnosis of breast cancer are associated with the higher expectation of a supportive effect of CM (p < 0.001), explaining 7.1% of the variance. Emotional functioning, educational level and metastases are associated with higher expectation of an antitumoral effect of CM (p < 0.001) and explained 14.8% of the variance.

DISCUSSION

This study provides evidence that two overall domains (supportive effect and anti-tumoural effect) characterise the benefits of CM expected by cancer patients. Psychosocial and medical variables are associated with both domains, but explain only small proportion of the variance.

Introduction of a National Minimum Wage Reduced Depressive Symptoms in Low-Wage Workers: A Quasi-Natural Experiment in the UK

Does increasing incomes improve health? In 1999, the UK government implemented minimum wage legislation, increasing hourly wages to at least £3.60. This policy experiment created intervention and control groups that can be used to assess the effects of increasing wages on health. Longitudinal data were taken from the British Household Panel Survey. We compared the health effects of higher wages on recipients of the minimum wage with otherwise similar persons who were likely unaffected because (1) their wages were between 100 and 110% of the eligibility threshold or (2) their firms did not increase wages to meet the threshold. We assessed the probability of mental ill health using the 12-item General Health Questionnaire. We also assessed changes in smoking, blood pressure, as well as hearing ability (control condition). The intervention group, whose wages rose above the minimum wage, experienced lower probability of mental ill health compared with both control group 1 and control group 2. This improvement represents 0.37 of a standard deviation, comparable with the effect of antidepressants (0.39 of a standard deviation) on depressive symptoms. The intervention group experienced no change in blood pressure, hearing ability, or smoking. Increasing wages significantly improves mental health by reducing financial strain in low-wage workers. © 2016 The Authors. Health Economics published by John Wiley & Sons Ltd.

Use of Complementary and Alternative Medicine (CAM) as Part of the Oncological Treatment: Survey about Patients' Attitude towards CAM in a University-Based Oncology Center in Germany

INTRODUCTION

To understand if and which patients would be open-minded to Complementary and Alternative Medicine (CAM) use parallel to their oncological treatment. Moreover, we sought to determine which methods are most accepted and which are the primary motivators to use CAM.

METHODS

We developed and anonymously conducted a questionnaire for patients in the oncology center (TU Munich). Questions focus on different CAM methods, previous experiences, and willingness to apply or use CAM when offered in a university-based setting.

RESULTS

A total of 171 of 376 patients (37.4% women, 62.0% men, 0.6% unknown) participated. This corresponds to a return rate of 45%. Median age was 64 years (17-87 years). Of all participants, 15.2% used CAM during their oncological therapy; 32.7% have used it in the past. The majority (81.9%) was not using CAM during therapy; 55.5% have not used CAM in the past respectively. The analysis revealed a significant correlation between education and CAM use during therapy (r = 0.18; p = 0.02), and CAM use in the past (r = 0.17; p = 0.04). Of all patients using CAM during therapy, favored methods were food supplements (42.3%), vitamins/minerals (42.3%), massage (34.6%). Motivations are especially the reduction of side effect and stress, the positive effect of certain CAM-treatments on the immune system and tumor therapy. Results showed no difference between women and men. Most patients not having had any experience with CAM complain about the deficiency of information by their treating oncologist (31.4%) as well as missing treatment possibilities (54.3%).

CONCLUSION

Since many patients believe in study results demonstrating the efficacy of CAM, it stresses our task to develop innovative study protocols to investigate the outcomes of certain CAM on symptom reduction or other endpoints. Thus, prospective trials and innovative evidence-based treatment concepts to include CAM into high-end oncology is what patients demand and what a modern oncology center should offer.

A longitudinal study on women?s experiences of life with breast cancer in anthroposophical (complementary) and conventional care

Earlier findings in different care settings have revealed that women with breast cancer admitted to anthroposophical clinics (complementary care) initially had lower quality of life scores compared with those in conventional care, but that the scores after 1 year increased significantly. The anthroposophical hospital in this study offers integrated conventional and anthroposophical healthcare therapies. The present study examines experiences of life among women with breast cancer during the 1-year follow-up of the original study. A second aim was to seek profiles of differences between 37 matched pairs of women with breast cancer. The mean age of the women was 48 years, and 17 of the 37 pairs had a local limited disease, whereas 20 pairs had an advanced disease. The findings highlight seven themes of described meaning. Important changes noticed after 1 year were an appreciation of the beauty of life, experiences of threat, introspection into self and meaning of life, and changes in the body. The experience of being stronger constitutes being existentially demanded, including weakness, vulnerability and strength. Some differences in profiles were noticed after 1 year, in that the group that received anthroposophical care seemed to be more orientated towards personal growth and meaning of life, whereas the matching group was more orientated towards external activities and bodily changes.

Factors predicting the use of complementary and alternative therapies among cancer patients in Iran

This study was carried out to examine the factors that predicting the use of complementary and alternative medicine (CAM) among cancer patients in Tehran, Iran. Predicting factors included were patients' demographic characteristics, type of cancer, the knowledge of diagnosis, time since diagnosis, satisfaction with their care physician, fear of recurrence and measures of anxiety, depression and global quality of life. In total, 625 cancer patients were studied, and 35% (n=219) reported that they used or were using CAM. The most commonly used CAM was prayer and spiritual healing (n=178, 75.7% of responses). The results of logistic regression analysis indicated that the use of CAM among cancer patients was associated with the fear of cancer recurrence (OR=2.03, 95% CI=1.45-2.85, P<0.0001) and dissatisfaction with their care physician (OR=1.98, 95% CI=1.36-2.89, P<0.0001). The results indicate that apart from the prayer and spiritual healing, the use of the other common methods of CAM among Iranian cancer patients is unpopular. However, the findings suggest that the use of CAM is more common among cancer patients who suffer from fears, uncertainties and dissatisfaction, and these might be a marker of greater psychological distress in users as compared with non-users.

A Five-year Follow-up of Quality of Life in Women with Breast Cancer in Anthroposophic and Conventional Care

Complementary and alternative medicine is used by many cancer patients in most parts of the world, and its use is increasing. The aim of the present study was to examine, over 5 years, the perceived quality of life/life satisfaction in two samples of women with breast cancer who were treated with anthroposophic care or conventional medical treatment only. Data from admission, after 1 year and after 5 years are used for the comparisons. On admission to the study the women in anthroposophic care perceived their quality of life to be lower than that of the women in the conventional treatment group, especially for emotional, cognitive and social functioning and overall quality of life. Sixty women who actively chose treatment with anthroposophic medicine and 60 individually matched women treated with conventional medicine participated. Quality of life was measured by the EORTC QLQ-C30 and the Life Satisfaction Questionnaire. Twenty-six women within anthroposophic care and 31 women within conventional medicine survived the 5 years. Effect size (ES) estimation favored the anthroposophic group in seven of the subscales mostly measuring emotional functioning. The ES for four of the subscales favored the conventional treatment group, mostly concerning physical functioning. After 5 years there were improvements in overall quality of life and in emotional and social functioning compared to admission for the women in anthroposophic care. The improvements took place between admission and 1 year, but not further on. Only minor improvements were found in the matching group.

Lifestyle and mental health

STUDY OBJECTIVE

To examine the relationship between healthy lifestyles and self-rated mental health.

DESIGN

A cross-section telephone survey involving multiple callbacks. Using a Behavioral Risk Factor Surveillance Survey, information about lifestyle, demographic characteristics, and self-rated mental health was collected.

SETTING

Amarillo, Texas, a city of approximately 170,000 in the Panhandle of Texas.

PARTICIPANTS

Six hundred and twenty-one adults.

MAIN RESULTS

Good mental health was independently associated with physical activity, being male, and being married. Poor mental health was associated with obesity, daily smoking, being Hispanic, and being non-Hispanic White.

CONCLUSIONS

Programs targeting risk factors for poor physical health also may improve mental health in the community.

Depression and the use of complementary medicine among breast cancer patients

This was a cross-sectional study to examine the association between anxiety, depression and quality of life and the use of complementary and alternative medicine. Anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS), and quality of life was measured using the global quality of life subscale selected from the European Organization for Treatment and Research of Cancer (EORTC) quality of life core questionnaire (QLQ-C30). In all, 177 breast cancer patients were studied, and 32% (n=57) reported that they used or were using complementary medicine. Users and nonusers did not differ significantly in almost all variables studied, with the exception of duration of their diagnosis. The most commonly used complementary medicine was prayer and spiritual healing (n=45, 73.8% of responses). Performing the logistic regression analysis controlling for age, marital status, educational level, knowledge of diagnosis, time since diagnosis, global quality of life, depression, and anxiety scores, the results indicated that the use of complementary medicine among breast cancer patients was associated with sever depression (odds ratio 2.49, 95% CI 1.06-5.89, P 0.04). The other variables studied did not show any significant results. The study findings confirm that the use of complementary medicine is more common among depressed breast cancer patients and might be a marker of greater psychological distress in this group of patients.