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Steel A, Foley H, Graham K, Harnett J, Adams J. Patient experiences of information-sharing and patient-centred care across the broad landscape of primary care practice and provision: a nationally representative survey of Australian adults. BMC PRIMARY CARE 2024; 25:151. [PMID: 38704562 PMCID: PMC11070095 DOI: 10.1186/s12875-024-02359-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/01/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Australian government strategies and frameworks have been developed in recent years to encourage the integration and coordination of primary care delivery; including patient-centred approaches to clinical and preventative care, and health promotion. This study aims to explore patient experiences of information-sharing and patient-centred care across various primary care clinical settings, with a particular focus on clinical encounters with GPs, naturopaths, osteopaths and acupuncturists. METHODS Data about healthcare utilisation and experiences from a 63-item cross-sectional survey obtained from a nationally representative sample of Australian adults aged ≥ 18 years were analysed. Chi-square and Kruskal-Wallis H tests were used to explore differences in the experiences of knowledge and information sharing during GP consultations among those who also consulted with a naturopath, osteopath or acupuncturist, compared those who had not. Logistic regression was used to investigate correlations between participants perceptions about GP consultation outcomes, and the GP's information-sharing behaviour or perceived experience of patient-centredness. RESULTS Across 2354 participants, verbal explanation (76.3%) and/or individualised handouts (16.8%) were the most common type of information shared in GP consultations. Individuals who consulted with a GP and a naturopath, an osteopath, or an acupuncturist reported a lower rate of receiving a verbal explanation from their GP but higher rate of receiving other types of information sources including handouts. Over one quarter of study participants who visited a GP did not discuss any of their health information with their GP. Information sharing was lower for individuals who also visited a naturopath, osteopath or acupuncturist. Participants scored their consultations with a GP as patient-centred, but these scores were lower among participants who also consulted with at least one other primary care practitioner type included in the study. CONCLUSIONS Public health and health services researchers, policymakers and leaders of primary care professions have a role and responsibility to ensure practitioners are confident and competent in sharing health information with their patients that considers their health literacy needs, and the importance of patient-centred care. Research focussed on a more in-depth understanding of the differences and relationships observed across the primary care landscape in this study is recommended.
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Affiliation(s)
- Amie Steel
- ARCCIM, School of Public Health, Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW, Australia.
| | - Hope Foley
- ARCCIM, School of Public Health, Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW, Australia
| | - Kim Graham
- ARCCIM, School of Public Health, Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW, Australia
| | - Joanna Harnett
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jon Adams
- ARCCIM, School of Public Health, Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW, Australia
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Morham S, Reichardt A, Toth A, Olin G, Pohlman K, Passmore SR. Patient Characteristics and Clinical Outcomes Associated With Conservative Treatment for Spine Pain in Women Experiencing Socioeconomic Challenges. J Manipulative Physiol Ther 2022; 45:633-640. [PMID: 37294217 DOI: 10.1016/j.jmpt.2023.04.001] [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: 09/30/2022] [Revised: 03/21/2023] [Accepted: 04/08/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The purpose of this study was to describe patient demographics and pain changes for women over the course of care in a chiropractic program. METHODS We performed a retrospective cross-sectional analysis of a prospective quality assurance database from the Mount Carmel Clinic (MCC) in Winnipeg, Manitoba, Canada. Pain scores were reported on an 11-point Numeric Rating Scale. Baseline and discharge Numeric Rating Scale scores were compared for each spinal and extremity region through Wilcoxon signed rank tests to determine if clinically meaningful or statistically significant differences were present. RESULTS The sample population attained was 348 primarily middle-aged (mean = 43.0, SD = 14.96) women with obesity (body mass index = 31.3 kg/m2, SD = 7.89) referred to the MCC chiropractic program by their primary care physician (65.2%) for an average of 15.6 (SD = 18.49) treatments. Clinically meaningful median baseline to discharge changes in pain by spine region were observed (Cervical = -2, Thoracic = -2, Lumbar = -3, Sacroiliac = -3), each of which yielded statistical significance (P < .001). CONCLUSION This retrospective analysis found that the MCC chiropractic program serves middle-aged women with obesity experiencing socioeconomic challenges. Pain reductions were reported, regardless of the region of complaint, temporally associated with a course of chiropractic care.
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Affiliation(s)
- Sophie Morham
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amber Reichardt
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Audrey Toth
- Chiropractic Program, Mount Carmel Clinic, Winnipeg, Manitoba, Canada
| | - Gerald Olin
- Canadian Chiropractic Protective Association, Winnipeg, Manitoba, Canada
| | | | - Steven R Passmore
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada.
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Weis CA, Pohlman K, Barrett J, Clinton S, da Silva-Oolup S, Draper C, Lee J, Kumar R, O'Beirne M, Stuber K, Hawk C. Best-Practice Recommendations for Chiropractic Care for Pregnant and Postpartum Patients: Results of a Consensus Process. J Manipulative Physiol Ther 2022; 45:469-489. [PMID: 34836673 DOI: 10.1016/j.jmpt.2021.03.002] [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] [Received: 04/24/2020] [Revised: 01/01/2021] [Accepted: 03/23/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The purpose of this project was to develop a best-practices document on chiropractic care for pregnant and postpartum patients with low back pain (LBP), pelvic girdle pain (PGP), or a combination. METHODS A modified Delphi consensus process was conducted. A multidisciplinary steering committee of 11 health care professionals developed 71 seed statements based on their clinical experience and relevant literature. A total of 78 panelists from 7 countries were asked to rate the recommendations (70 chiropractors and representatives from 4 other health professions). Consensus was reached when at least 80% of the panelists deemed the statement to be appropriate along with a median response of at least 7 on a 9-point scale. RESULTS Consensus was reached on 71 statements after 3 rounds of distribution. Statements included informed consent and risks, multidisciplinary care, key components regarding LBP during pregnancy, PGP during pregnancy and combined pain during pregnancy, as well as key components regarding postpartum LBP, PGP, and combined pain. Examination, diagnostic imaging, interventions, and lifestyle factors statements are included. CONCLUSION An expert panel convened to develop the first best-practice consensus document on chiropractic care for pregnant and postpartum patients with LBP or PGP. The document consists of 71 statements on chiropractic care for pregnant and postpartum patients with LBP and PGP.
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Affiliation(s)
- Carol Ann Weis
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
| | | | | | - Susan Clinton
- Embody Physiotherapy & Wellness (Private Practice), Andrews University, Sewickley, Pennsylvania
| | - Sophia da Silva-Oolup
- Undergraduate Department, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Crystal Draper
- Undergraduate Department, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Joyce Lee
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Rupali Kumar
- Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas Texas
| | - Maeve O'Beirne
- Department of Family Medicine, University of Calgary, Calgary, AB, Canada
| | - Kent Stuber
- Canadian Memorial Chiropractic College, Calgary, AB, Canada
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Barnes LAJ, Rolfe MI, Barclay L, McCaffery K, Aslani P. Demographics, health literacy and health locus of control beliefs of Australian women who take complementary medicine products during pregnancy and breastfeeding: A cross-sectional, online, national survey. Health Expect 2021; 25:667-683. [PMID: 34951097 PMCID: PMC8957740 DOI: 10.1111/hex.13414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/28/2022] Open
Abstract
Background Pregnant and breastfeeding women's use of complementary medicine products (CMPs) is common, and possibly associated with autonomous health care behaviours. However, the health literacy levels and health locus of control (HLOC) beliefs of women who use CMPs in pregnancy and lactation have not been previously assessed in a large Australian sample. Aim The aim of this study is to determine the health literacy levels and HLOC beliefs of women who use CMPs in pregnancy and lactation and determine the types of CMPs used. Methods A cross‐sectional, national, online survey of Australian pregnant or breastfeeding women aged 18 years and older, and currently using CMPs was conducted. Results A total of 810 completed surveys (354 pregnant and 456 breastfeeding women) were analysed. Most had adequate functional health literacy levels (93.3%). Health care practitioners (HCPs) HLOC mean scores were the highest for the sample, followed by Internal HLOC beliefs mean scores. Almost all (n = 809) took at least one dietary supplement, the most popular being pregnancy and breastfeeding multivitamins, iron supplements and probiotics. Use was generally in line with clinical recommendations, except for low rates of iodine supplementation. Herbal medicine use was lower for the total sample (57.3%, n = 464), but significantly higher (p < .0001) for the breastfeeding cohort, with consumers taking one to four herbal medicines each. The most popular herbs were raspberry leaf, ginger, peppermint and chamomile (pregnant respondents) and chamomile, ginger and fenugreek (breastfeeding respondents). Conclusions Respondents were health literate, with high scores for Internal and HCP HLOC scales, suggesting that they are likely to demonstrate self‐efficacy, positive health behaviours and work well in partnership with HCPs. HCPs can facilitate discussions with pregnant and breastfeeding women using CMPs, while considering women's health literacy levels, health beliefs and goals.
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Affiliation(s)
- Larisa A J Barnes
- Faculty of Medicine and Health, School of Pharmacy and University Centre for Rural Health, The University of Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University Centre for Rural Health and School of Public Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Margaret I Rolfe
- Faculty of Medicine and Health, University Centre for Rural Health and School of Public Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Lesley Barclay
- Faculty of Medicine and Health, University Centre for Rural Health and School of Public Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Kirsten McCaffery
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Parisa Aslani
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
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Abstract
Massage is systematic touch and manipulation of the soft tissues of the body that is increasingly being used as an adjunctive therapy for stress relief and to promote relaxation and wellbeing during pregnancy and as an alternative to pharmacologic or invasive forms of analgesia during labor. Literature to support the use of massage in pregnancy and labor is limited; however, evidence to support its use has been increasing over the past 30 years. Massage has been shown to be valuable to pregnant women with anxiety, depression, leg, and back pain, and has shown significant benefit in perception of pain during labor.
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Affiliation(s)
- Sarah L Pachtman Shetty
- Donald and Barbara Zucker School of Medicine at Hofstra-Northwell, Long Island Jewish Medical Center, New Hyde Park, New York
| | - Sarah Fogarty
- School of Medicine, Western Sydney University, Penrith, New South Wales, Australia
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Foley H, Steel A, Adams J. Consultation with complementary medicine practitioners by individuals with chronic conditions: Characteristics and reasons for consultation in Australian clinical settings. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:91-103. [PMID: 32562341 DOI: 10.1111/hsc.13072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 05/03/2020] [Accepted: 06/02/2020] [Indexed: 06/11/2023]
Abstract
The duration and complexity of chronic conditions leads patients to consult complementary medicine (CM) practitioners, yet such care-seeking by this clinical population has not been thoroughly examined. This study describes characteristics and reasons for consultation amongst those with chronic conditions who consult CM practitioners. A cross-sectional study surveyed patients in clinics of 39 CM practitioners from the five most accessed CM professions in Australia (chiropractic, massage, osteopathy, acupuncture, naturopathy). Between November 2018 and March 2019, CM practitioners invited 15 consecutive adult patients (n = 585 invited) to a self-administered, hard-copy survey covering socio-demographics, chronic condition diagnoses, CM service utilisation and reasons for consulting the CM practitioner. In total, 199 surveys were returned, producing a final sample of n = 191. Chronic conditions were reported by 153 (80.1%) participants, who were most commonly female (82.4%), aged over 65 years (29.0%), married (55.9%), vocational/trade qualified (40.1%), employed (62.5%), reported financial manageability as not too bad (48.0%), held private health insurance generally (79.0%) and specifically for CM (71.1%). Some socio-demographic differences were found depending on the profession consulted. Most participants (75.0%) had attended five or more consultations with the CM practitioner. The reasons most commonly given by participants with chronic conditions for consulting the CM practitioner were This healthcare professional is supportive and compassionate (n = 136, 97.1%), I believe this type of healthcare is safe (n = 131, 95.6%), Improve general wellbeing and prevent future health problems (n = 125, 89.3%) and This type of healthcare gives me hope about my future health (n = 108, 85.7%). These findings suggest that individuals with chronic conditions may consult CM practitioners to address unmet well-being or quality of life needs and for compassionate support. The role CM practitioners fill for those with chronic conditions requires further exploration to develop optimal policy and services to manage the growing challenges chronic conditions present to health systems.
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Affiliation(s)
- Hope Foley
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Australia
- Office of Research, Endeavour College of Natural Health, Brisbane, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Australia
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Steel A, Diezel H, Wardle J, Adams J. Working with women: Semi-structured interviews with Australian complementary medicine maternity care practitioners. Women Birth 2020; 33:e295-e301. [DOI: 10.1016/j.wombi.2019.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 04/30/2019] [Accepted: 04/30/2019] [Indexed: 10/26/2022]
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Barnes LAJ, Barclay L, McCaffery K, Aslani P. Women's health literacy and the complex decision-making process to use complementary medicine products in pregnancy and lactation. Health Expect 2019; 22:1013-1027. [PMID: 31116500 PMCID: PMC6803395 DOI: 10.1111/hex.12910] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/27/2019] [Accepted: 04/22/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Little is known about women's decision-making processes regarding using complementary medicine products (CMPs) during pregnancy or lactation. OBJECTIVES To explore the decision-making processes of women choosing to use CMPs in pregnancy and lactation; and to investigate how women's health literacy influences their decisions. DESIGN, SETTING AND PARTICIPANTS In-depth interviews and focus group discussions were held with twenty-five pregnant and/or breastfeeding women. Data were analysed using thematic analysis. RESULTS Key to women's decision making was the desire to establish a CMPs safety and to receive information from a trustworthy source, preferably their most trusted health-care practitioner. Women wanted positive therapeutic relationships with health-care practitioners and to be highly involved in the decisions they made for the health of themselves and their children. Two overarching components of the decision-making process were identified: (a) women's information needs and (b) a preference for CMP use. Women collated and assessed information from other health-care practitioners, other mothers and published research during their decision-making processes. They showed a strong preference for CMP use to support their pregnancy and breastfeeding health, and that of their unborn and breastfeeding babies. DISCUSSION AND CONCLUSIONS Complex decision-making processes to use CMPs in pregnancy and lactation were identified. The participants showed high levels of communicative and critical health literacy skills in their decision-making processes. These skills supported women's complex decision-making processes.
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Affiliation(s)
- Larisa A. J. Barnes
- School of PharmacyThe University of SydneySydneyNew South WalesAustralia
- University Centre for Rural HealthThe University of SydneyLismoreNew South WalesAustralia
| | - Lesley Barclay
- University Centre for Rural HealthThe University of SydneyLismoreNew South WalesAustralia
- School of Public HealthThe University of SydneySydneyNew South WalesAustralia
| | - Kirsten McCaffery
- School of Public HealthThe University of SydneySydneyNew South WalesAustralia
| | - Parisa Aslani
- School of PharmacyThe University of SydneySydneyNew South WalesAustralia
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Steel A, Hall H, Diezel H, Wardle J, Adams J. Filling the gaps in contemporary maternity care: The perceptions of complementary medicine practitioners providing care to women during pregnancy. Complement Ther Clin Pract 2019; 34:174-178. [DOI: 10.1016/j.ctcp.2018.11.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 11/29/2018] [Accepted: 11/29/2018] [Indexed: 12/23/2022]
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Utilization of complementary and alternative medicine and conventional medicine for headache or migraine during pregnancy: A cross-sectional survey of 1,835 pregnant women. Complement Ther Med 2018; 41:192-195. [DOI: 10.1016/j.ctim.2018.09.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/28/2018] [Accepted: 09/28/2018] [Indexed: 01/11/2023] Open
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Challenges and opportunities for Australian osteopathy: A qualitative study of the perceptions of registered osteopaths. INT J OSTEOPATH MED 2018. [DOI: 10.1016/j.ijosm.2018.10.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Women's motivation, perception and experience of complementary and alternative medicine in pregnancy: A meta-synthesis. Midwifery 2018; 59:81-87. [DOI: 10.1016/j.midw.2017.11.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 11/29/2017] [Accepted: 11/29/2017] [Indexed: 11/19/2022]
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13
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Hughes CM, Liddle SD, Sinclair M, McCullough JEM. The use of complementary and alternative medicine (CAM) for pregnancy related low back and/ or pelvic girdle pain: An online survey. Complement Ther Clin Pract 2018; 31:379-383. [PMID: 29429932 DOI: 10.1016/j.ctcp.2018.01.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 01/18/2018] [Accepted: 01/30/2018] [Indexed: 12/19/2022]
Abstract
Low back and pelvic girdle pain (LBPGP) is a common complaint among pregnant women, which increases throughout pregnancy and women use various complementary and alternative medicine (CAM) therapies to manage their pain. Using an online survey, CAM treatments used by pregnant women in the UK and their perceptions of these therapies to relieve LBPGP were investigated. 191 women completed the survey and 70% experienced LBPGP lasting more than one week. Over half of women who sought treatment from a GP or physiotherapist were dissatisfied. 25% of participants used CAM during pregnancy, the most popular being aromatherapy (21%), acupuncture (21%), and reflexology (15%). 81% of women used CAM to manage their LBPGP and 85% found it useful for pregnancy symptoms. Women experience high levels of pain during pregnancy with limited treatment options. Research into effective CAM treatments for LBPGP is required to allow women to make informed decisions regarding treatment options.
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Affiliation(s)
- Ciara M Hughes
- Institute of Nursing and Health Research, Ulster University, School of Nursing, Shore Road, Newtownabbey, Co Antrim, BT37 0QB, Northern Ireland, United Kingdom.
| | - S D Liddle
- Institute of Nursing and Health Research, Ulster University, School of Nursing, Shore Road, Newtownabbey, Co Antrim, BT37 0QB, Northern Ireland, United Kingdom.
| | - Marlene Sinclair
- Maternal Fetal and Infant Research Centre, Ulster University, Shore Road, Newtownabbey, Co Antrim, BT37 0QB, Northern Ireland, United Kingdom.
| | - Julie E M McCullough
- Institute of Nursing and Health Research, Ulster University, School of Nursing, Shore Road, Newtownabbey, Co Antrim, BT37 0QB, Northern Ireland, United Kingdom.
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Yang L, Peng W, Adams J, Sibbritt D. Prevalence and characteristics of Australian women aged 45 and older who consult acupuncturists for their osteoarthritis. Int J Clin Pract 2017; 71. [PMID: 29105234 DOI: 10.1111/ijcp.13040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 10/20/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND There is growing acupuncture use amongst people with osteoarthritis, and acupuncture has been shown to have a positive effect on osteoarthritis. The aim of the study is to identify the characteristics of Australian women who consult acupuncturists for osteoarthritis treatment in order to help inform patients, practitioners and policy makers about the range of health care options accessed by older women with osteoarthritis. METHODS The research reported here involved participants from a sub-study of the Sax Institute's 45 and Up Study in Australia. The data of 403 Australian women aged 45 and over with osteoarthritis were analysed. Chi-squared tests and stepwise multiple logistic regression modelling were used to determine the characteristics of women who used acupuncture for the treatment of their osteoarthritis. RESULTS Analysis revealed that 7.7% of women reported using acupuncture in the previous 12 months for their osteoarthritis. Acupuncture use is positively associated with women experiencing longer duration of time since initial diagnosis of osteoarthritis (OR = 1.04), undertaking more exercise (OR = 5.41), living in a rural area (OR = 3.62), having consulted a psychologist (OR = 12.21), and having consulted another complementary and alternative medicine practitioner (OR = 4.18). CONCLUSIONS Our study reveals considerable acupuncture use amongst women with osteoarthritis. There is a need for health care practitioners to be mindful of acupuncture use among their patients presenting with osteoarthritis. Further research is needed to examine the potential benefits of acupuncture for osteoarthritis and to help inform efficient and safe use of this treatment alongside conventional care.
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Affiliation(s)
- Lu Yang
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Ultimo, NSW, Australia
| | - Wenbo Peng
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Ultimo, NSW, Australia
| | - Jon Adams
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Ultimo, NSW, Australia
| | - David Sibbritt
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Ultimo, NSW, Australia
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Adams J, Steel A, Frawley J, Broom A, Sibbritt D. Substantial out-of-pocket expenditure on maternity care practitioner consultations and treatments during pregnancy: estimates from a nationally-representative sample of pregnant women in Australia. BMC Pregnancy Childbirth 2017; 17:114. [PMID: 28403816 PMCID: PMC5389012 DOI: 10.1186/s12884-017-1297-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 03/28/2017] [Indexed: 11/21/2022] Open
Abstract
Background A wide range of health care options are utilised by pregnant women in Australia. The out-of-pocket costs of maternity care in Australia vary depending on many factors including model of care utilised, health insurance coverage, and women’s decision to access health services outside of conventional maternity care provision. Methods Women from the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH) who identified as pregnant or as recently having given birth in 2009 were invited to complete a sub-study questionnaire investigating health service utilisation during their most recent pregnancy. Results A total of 1,835 women agreed to participate in the sub-study. The majority of women (99.8%) consulted with a conventional health care practitioner during pregnancy, 49.4% consulted with a complementary and alternative medicine practitioner at least once during pregnancy and 89.6% of the women used a complementary and alternative medicine product. Women reported an average of AUD$781.10 in out-of-pocket expenses for consultations with conventional health care practitioners, AUD$185.40 in out-of-pocket expenses for consultations with complementary and alternative medicine practitioners and AUD$179.60 in out-of-pocket expenses for complementary and alternative medicine products. From the study data we estimate Australian pregnant women spend over AUD$337 M on out-of-pocket health services. Conclusion While the majority of pregnant women in Australia may obtain health services via the publically-funded health care system and/or private health insurance coverage, our analysis identifies substantial out-of-pocket expenditure for health care by pregnant women – a trend in public spending for maternity care of importance to policy makers, health administrators, and health professionals.
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Affiliation(s)
- Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia. .,Office of Research, Endeavour College of Natural Health, Level 2, 269 Wickham St, Fortitude Valley, QLD, Australia, 4006.
| | - Jane Frawley
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Alex Broom
- School of Social Sciences, The University of New South Wales, Sydney, Australia
| | - David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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Steel A, Reid R. A need for a better understanding of the role, value and effectiveness of complementary and integrative medicine for women with endometriosis. ADVANCES IN INTEGRATIVE MEDICINE 2017. [DOI: 10.1016/j.aimed.2016.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Steel A, Adams J, Frawley J, Wardle J, Broom A, Sidebotham M, Sibbritt D. Does Australia's Health Policy Environment Create Unintended Outcomes for Birthing Women? Birth 2016; 43:273-276. [PMID: 27779328 DOI: 10.1111/birt.12251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Australia.,Office of Research, Endeavour College of Natural Health, Fortitude Valley, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Jane Frawley
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Alex Broom
- School of Social Sciences, University of New South Wales, Sydney, Australia
| | - Mary Sidebotham
- School of Nursing and Midwifery, Faculty of Health, Griffith University, Meadowbrook, Australia
| | - David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Australia
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Steel A, Adams J, Sibbritt D. The Characteristics of Women Who Use Complementary Medicine While Attempting to Conceive: Results from a Nationally Representative Sample of 13,224 Australian Women. Womens Health Issues 2016; 27:67-74. [PMID: 27810165 DOI: 10.1016/j.whi.2016.09.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 08/20/2016] [Accepted: 09/19/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Preconception is acknowledged globally as an important part of ensuring health for the next generation and is underpinned by principles of health promotion and preventive medicine. There is a demand for more holistic, preventive health care within preconception health services. Many women are also using complementary medicine during their reproductive years. MATERIALS AND METHODS This paper presents a longitudinal analysis of women's consultations with a complementary medicine practitioner while attempting to become pregnant, and the characteristics of women who choose to consult a complementary medicine practitioner during the preconception period. The cross-sectional and longitudinal analyses conducted in this study utilise data from the 1973 through 1978 cohort of the Australian Longitudinal Study on Women's Health (n = 13,224). Multivariate logistic regression models and generalized estimating equation models, with and without time lag, were used. RESULTS Women who identified as attempting to conceive were more likely to consult with an acupuncturist (adjusted odds ratio, 1.46) or a naturopath/herbalist (adjusted odds ratio, 1.30). Women who consulted with an acupuncturist were likely to be consulting with a specialist doctor (odds ratio, 3.73) and/or have previous fertility issues (odds ratio, 2.30). Women who consulted with a naturopath were more likely to report experiencing premenstrual tension (odds ratio, 2.30) but less likely to have had a previous miscarriage (odds ratio, 0.18). CONCLUSIONS Policymakers and other health professionals need to be aware that health professionals who are largely unregulated and structurally isolated from conventional health care may be actively contributing to women's reproductive and physical health during the preconception period.
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Affiliation(s)
- Amie Steel
- Endeavour College of Natural Health, Queensland, Australia; Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
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Reid R, Steel A, Wardle J, Trubody A, Adams J. Complementary medicine use by the Australian population: a critical mixed studies systematic review of utilisation, perceptions and factors associated with use. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:176. [PMID: 27289517 PMCID: PMC4902999 DOI: 10.1186/s12906-016-1143-8] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 05/25/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is increasing evidence that complementary medicine (CM) services are being used by a substantial proportion of the Australian population and this topic has attracted keen interest from primary health care providers and policy makers. This article outlines the first summative critical review of the predictors of CM use in Australia as well as the characteristics and perceptions of Australian CM users over the last 14 years. METHODS A literature search was conducted to ascertain original research from 2000 to 2014 in the AMED; CINAHL; and PubMed databases. Selected articles were subject to a critical appraisal analysis to identify the quality of the article. The search was confined to peer reviewed original articles published in English which identified the nature of CM services use in Australia. RESULTS The findings indicate a correlation between CM users and gender, with reports of a higher rate of use from females compared to males. Female CM users are more likely to be middle-aged with a higher education and higher annual income in comparison to female non-CM users. An association between resident location and use of CM disciplines was also identified with reports of rural residents utilising manual therapies more frequently compared to urban residents. CM users are more likely to seek CM services for a range of chronic conditions including diseases identified as National Health Priority Areas by the Australian Government. CONCLUSIONS This article provides the first comprehensive review examining the nature of CM use in Australia. The review findings offer important insights into the characteristics and features of CM use in Australia and provide insights for national and regional primary health care initiatives and of interest to medical doctors, allied health professionals, CM practitioners, researchers and policy makers.
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Affiliation(s)
- Rebecca Reid
- Endeavour College of Natural Health, 269 Wickham St, Fortitude Valley, QLD, 4006, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, University of Technology, Sydney, Ultimo, NSW, 2007, Australia.
- Endeavour College of Natural Health, 269 Wickham St, Fortitude Valley, QLD, 4006, Australia.
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, University of Technology, Sydney, Ultimo, NSW, 2007, Australia
| | - Andrea Trubody
- Endeavour College of Natural Health, 269 Wickham St, Fortitude Valley, QLD, 4006, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, University of Technology, Sydney, Ultimo, NSW, 2007, Australia
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Hall H, Lauche R, Adams J, Steel A, Broom A, Sibbritt D. Healthcare utilisation of pregnant women who experience sciatica, leg cramps and/or varicose veins: A cross-sectional survey of 1835 pregnant women. Women Birth 2016; 29:35-40. [DOI: 10.1016/j.wombi.2015.07.184] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 07/16/2015] [Accepted: 07/27/2015] [Indexed: 11/29/2022]
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Frawley J, Sibbritt D, Broom A, Gallois C, Steel A, Adams J. Complementary and alternative medicine practitioner use prior to pregnancy predicts use during pregnancy. Women Health 2016; 56:926-39. [DOI: 10.1080/03630242.2016.1145170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Shand AW, Walls M, Chatterjee R, Nassar N, Khambalia AZ. Dietary vitamin, mineral and herbal supplement use: a cross-sectional survey of before and during pregnancy use in Sydney, Australia. Aust N Z J Obstet Gynaecol 2015; 56:154-61. [DOI: 10.1111/ajo.12414] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 09/11/2015] [Indexed: 12/25/2022]
Affiliation(s)
- Antonia W. Shand
- Clinical and Population Perinatal Health Research; Kolling Institute; University of Sydney; St Leonards New South Wales Australia
- Department of Obstetrics; Royal Hospital for Women; Randwick New South Wales Australia
| | - Mariyam Walls
- Department of Obstetrics; Royal Hospital for Women; Randwick New South Wales Australia
| | - Rahul Chatterjee
- Clinical and Population Perinatal Health Research; Kolling Institute; University of Sydney; St Leonards New South Wales Australia
- University of Sydney; Sydney New South Wales Australia
| | - Natasha Nassar
- Clinical and Population Perinatal Health Research; Kolling Institute; University of Sydney; St Leonards New South Wales Australia
| | - Amina Z. Khambalia
- Clinical and Population Perinatal Health Research; Kolling Institute; University of Sydney; St Leonards New South Wales Australia
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Health-care utilisation amongst pregnant women who experience sleeping problems and/or tiredness or fatigue: secondary analysis of a cross-sectional survey of 1835 pregnant women. Sleep Breath 2015; 20:355-62. [PMID: 26407961 DOI: 10.1007/s11325-015-1250-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 07/14/2015] [Accepted: 08/25/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Sleeping problems and fatigue in pregnancy are often accepted as a normal part of pregnancy; however, these conditions can be linked to serious consequences for both the mother and child. Despite established links between sleeping disturbance and a wide range of pregnancy complications, little is known about the health-care utilisation of women experiencing sleeping problems and fatigue. This study addresses the existing gap in the literature by examining cross-sectional data to identify health service utilisation patterns of pregnant women experiencing sleeping problems and/or tiredness or fatigue. METHODS In 2010, a sub-study of the Australian Longitudinal Study on Women's Health was conducted as a cross-sectional survey of 2445 women who had recently given birth. Associations between reported symptoms of sleeplessness and/or tiredness or fatigue and health service utilisation were determined using logistic regression analysis. RESULTS During their pregnancy, 15.2 % of women experienced sleeping problems while 35.4 % experienced tiredness or fatigue. Women most commonly consulted with an obstetrician (n = 96) or a general practitioner (GP) (n = 74) for their tiredness or fatigue rather than a midwife (n = 56). A substantial number of women sought help from a complementary and alternative medicine (CAM) practitioner for sleeping problems (33 %) or tiredness/fatigue (28 %). DISCUSSION Sleeping problems and/or tiredness or fatigue is reported by a reasonable percentage of pregnant women, and women obtain assistance from conventional and CAM practitioners for their symptoms, but not all seek help. Given the serious implications of untreated sleep- and fatigue-related symptoms for mother and baby, this area of research deserves and requires more attention.
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Feijen-de Jong EI, Jansen DEMC, Baarveld F, Spelten E, Schellevis F, Reijneveld SA. Determinants of use of care provided by complementary and alternative health care practitioners to pregnant women in primary midwifery care: a prospective cohort study. BMC Pregnancy Childbirth 2015; 15:140. [PMID: 26104413 PMCID: PMC4479252 DOI: 10.1186/s12884-015-0555-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 05/12/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregnant women visit complementary/alternative health care practitioners in addition to regular maternal health care practitioners. A wide variation has been reported with regard to rates and determinants of use of complementary/alternative medicine (CAM), which may be due to heterogeneous populations. The aim of this study was to examine the prevalence and determinants of use of CAM practitioners by a homogeneous population of low-risk pregnant women in the Netherlands. METHODS Data from the population-based DELIVER study was used, concerning 1500 clients from twenty midwifery practices across the Netherlands in 2009 and 2010. CAM use was measured based on patient reports. Potential determinants were derived from Andersen's behavioural model of health care utilization. RESULTS The prevalence of CAM practitioner use by low-risk pregnant women was 9.4 %. Women were more likely to use CAM if they had supplementary health care insurance (OR 3.11; CI 1.41-6.85), rated their health as 'bad/fair' (OR 2.63; CI 1.65-4.21), reported a chronic illness or handicap (OR 1.93; CI 1.14-3.27), smoked during pregnancy (OR 1.88; CI 1.06-3.33), or used alcohol during pregnancy (OR 2.30; CI 1.46-3.63). CONCLUSIONS CAM is relatively frequently used by low-risk pregnant women. Determinants revealed in this study diverge from other studies using heterogeneous populations. Maternal health care practitioners must be aware of CAM use by low-risk pregnant women and incorporate this knowledge into daily practice by actively discussing this subject with pregnant women.
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Affiliation(s)
- Esther I Feijen-de Jong
- Department of Midwifery Science, AVAG, and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. .,Academy of Midwifery Amsterdam-Groningen, Dirk Huizingastraat 3-5, 9713 GL, Groningen, The Netherlands.
| | - Danielle E M C Jansen
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. .,Department of Sociology, Interuniversity Center for Social Science Theory and Methodology (ICS), University of Groningen, Groningen, The Netherlands. .,, PO Box 196, 9700 AD, Groningen, The Netherlands.
| | - Frank Baarveld
- National Association for Specialty Training for General Practice and GP Trainers, Utrecht, The Netherlands. .,, PO Box 20072, 3502 LB, Utrecht, The Netherlands.
| | - Evelien Spelten
- Department of Midwifery Science, AVAG, and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. .,Faculty of Medicine, Nursing, and Health Science, Monash University, Melbourne, Australia. .,Academy of Midwifery Amsterdam-Groningen, Dirk Huizingastraat 3-5, 9713 GL, Groningen, The Netherlands.
| | - François Schellevis
- Department of General Practice, Elderly Care Medicine/EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. .,Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands. .,, PO Box 1568, 3500 BN, Utrecht, The Netherlands.
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. .,, PO Box 196, 9700 AD, Groningen, The Netherlands.
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Steel A, Adams J, Sibbritt D, Broom A. The Outcomes of Complementary and Alternative Medicine Use among Pregnant and Birthing Women: Current Trends and Future Directions. WOMENS HEALTH 2015; 11:309-23. [DOI: 10.2217/whe.14.84] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Complementary and alternative medicine is used by a substantial number of pregnant women and maternity care providers are often faced with the task of ensuring women are using safe and effective treatments while respecting a woman's right to autonomous decision-making. In the era of evidence-based medicine maternity health professionals are expected to draw upon the best available evidence when making clinical decisions and providing health advice. This review will outline the current trends in research evidence associated with the outcomes of complementary and alternative medicine use amongst pregnant and birthing women as well as highlight some potential directions for future development in this important yet largely unknown topic in contemporary maternity care.
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Affiliation(s)
- Amie Steel
- Office of Research, Endeavour College of Natural Health, Fortitude Valley, Queensland, Australia
- Australian Research Centre in Complementary & Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Jon Adams
- Australian Research Centre in Complementary & Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - David Sibbritt
- Australian Research Centre in Complementary & Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Alex Broom
- School of Social Sciences, University of New South Wales, Kensington, New South Wales, Australia
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Smith CA, Armour M, Betts D. Treatment of women's reproductive health conditions by Australian and New Zealand acupuncturists. Complement Ther Med 2014; 22:710-8. [PMID: 25146076 DOI: 10.1016/j.ctim.2014.06.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 05/30/2014] [Accepted: 06/02/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Acupuncture is used by nine percent of the Australian population; however, we know relatively little about the practice of acupuncture to treat women's reproductive health in Australia and New Zealand. METHODS This study surveyed acupuncturists to examine their practice with treating women's reproductive health complaints. A cross sectional survey of 3406 Australian and New Zealand acupuncturists was conducted. A self-completion questionnaire explored the areas of acupuncture treatment for gynaecological pregnancy and fertility complaints. RESULTS Questionnaires were completed by 377 acupuncturists. Ninety-six percent of practitioners reported treating women's reproductive health conditions within the previous year. All three areas of women's reproductive health were commonly treated with 96% treating gynaecological health, 91% treating pregnancy conditions, and 90% fertility conditions. The most commonly treated gynaecological conditions were premenstrual syndrome (90.1%, 95% CI 86.2-93.0), menopause (89.4%, 95% CI 85.4-92.4) and primary dysmenorrhea (89.1%, 95% CI 85.1-92.2). Participants reported treating general fertility not related to assisted reproduction (93%, 95% CI 89.4-95.5), treatment for a diagnosed fertility related conditions (85.8%, 95% CI 81.1-89.4), and to decrease infertility related stress (86%, 95% CI 81.5-89.7). The most common pregnancy related conditions treated were nausea (90.3%, 95% CI 86.3-93.3), back or pelvic pain (89.3%, 95% CI 85.1-92.4), and prebirth labour preparation (86.8%, 95% CI 82.3-90.3). CONCLUSION Treating women's reproductive health complaints was commonly reported among the groups of acupuncturists in Australia and New Zealand responding to this survey; however, our findings cannot be generalised to the wider acupuncture communities in these two countries.
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Affiliation(s)
- Caroline A Smith
- National Institute for Complementary Medicine, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Michael Armour
- National Institute for Complementary Medicine, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Debra Betts
- National Institute for Complementary Medicine, University of Western Sydney, Locked Bag 1797, Penrith, NSW 2751, Australia
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