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Pérez-Ardanaz B, Peláez-Cantero MJ, González-Cano-Caballero M, Gutiérrez-Rodríguez L, Gómez-González AJ, Lupiáñez-Pérez I, Morales-Asencio JM, Canca-Sánchez JC. Utilization of Parallel Resources and Sociodemographic Factors in Treating Children with Complex Chronic Diseases: A Cross-Sectional Study. CHILDREN 2021; 8:children8110973. [PMID: 34828686 PMCID: PMC8624513 DOI: 10.3390/children8110973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/24/2021] [Accepted: 10/26/2021] [Indexed: 11/16/2022]
Abstract
Background: Children with complex chronic conditions have a high need for health and social care resources. Many parents explore parallel resources such as alternative therapies, associations, psychological support, private medical consultations, and other out-of-pocket expenses for healthcare. The use of these alternative health resources is sometimes unclear and may lead to health inequalities. To characterize the use made of alternative healthcare resources for children with complex chronic conditions. Additionally, we evaluate the influence of sociodemographic factors on the distribution of this utilization of resources; (2) Methods: Cross-sectional study. Children with complex chronic diseases were treated at a tertiary hospital in Granada, Spain in 2016. We analyzed their use of healthcare resources and socioeconomic variables. This research complies with STROBE guidelines for observational studies; (3) Results: In total, 265 children were analyzed (mean age 7.3 years, SD 4.63). A total of 105 children (39.6%) attended private consultations with specialists, and 12.1% (n = 32) of the children had additional private health insurance. One out three parents belonged to a mutual support association (n = 78), and 26% (n = 69) of the children used alternative therapies. Furthermore, 75.4% (n = 199) of the children received no psychological support. Children whose parents had a higher educational level and occupations status made greater use of parallel healthcare resources.; (4) Conclusions: A significant proportion of children used multiple health resources in addition to the public healthcare system depending on sociodemographic determinants. Studies are needed to determine whether the use of these alternative services achieves better levels of health.
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Affiliation(s)
- Bibiana Pérez-Ardanaz
- Faculty of Health Sciences, Universidad de Málaga, 29071 Málaga, Spain; (B.P.-A.); (L.G.-R.); (A.J.G.-G.); (I.L.-P.); (J.C.C.-S.)
| | | | | | - Laura Gutiérrez-Rodríguez
- Faculty of Health Sciences, Universidad de Málaga, 29071 Málaga, Spain; (B.P.-A.); (L.G.-R.); (A.J.G.-G.); (I.L.-P.); (J.C.C.-S.)
| | - Alberto José Gómez-González
- Faculty of Health Sciences, Universidad de Málaga, 29071 Málaga, Spain; (B.P.-A.); (L.G.-R.); (A.J.G.-G.); (I.L.-P.); (J.C.C.-S.)
| | - Inmaculada Lupiáñez-Pérez
- Faculty of Health Sciences, Universidad de Málaga, 29071 Málaga, Spain; (B.P.-A.); (L.G.-R.); (A.J.G.-G.); (I.L.-P.); (J.C.C.-S.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
| | - José Miguel Morales-Asencio
- Faculty of Health Sciences, Universidad de Málaga, 29071 Málaga, Spain; (B.P.-A.); (L.G.-R.); (A.J.G.-G.); (I.L.-P.); (J.C.C.-S.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
- Correspondence: ; Tel.: +34-951-952-833
| | - José Carlos Canca-Sánchez
- Faculty of Health Sciences, Universidad de Málaga, 29071 Málaga, Spain; (B.P.-A.); (L.G.-R.); (A.J.G.-G.); (I.L.-P.); (J.C.C.-S.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), 29010 Málaga, Spain
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Berretta M, Della Pepa C, Tralongo P, Fulvi A, Martellotta F, Lleshi A, Nasti G, Fisichella R, Romano C, De Divitiis C, Taibi R, Fiorica F, Di Francia R, Di Mari A, Del Pup L, Crispo A, De Paoli P, Santorelli A, Quagliariello V, Iaffaioli RV, Tirelli U, Facchini G. Use of Complementary and Alternative Medicine (CAM) in cancer patients: An Italian multicenter survey. Oncotarget 2018; 8:24401-24414. [PMID: 28212560 PMCID: PMC5421857 DOI: 10.18632/oncotarget.14224] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 11/20/2016] [Indexed: 11/25/2022] Open
Abstract
Introduction Complementary and Alternative Medicine (CAM) include a wide range of products (herbs, vitamins, minerals, and probiotics) and medical practices, developed outside of the mainstream Western medicine. Patients with cancer are more likely to resort to CAM first or then in their disease history; the potential side effects as well as the costs of such practices are largely underestimated. Patients and method We conducted a descriptive survey in five Italian hospitals involving 468 patients with different malignancies. The survey consisted of a forty-two question questionnaire, patients were eligible if they were Italian-speaking and receiving an anticancer treatment at the time of the survey or had received an anticancer treatment no more than three years before participating in the survey. RESULTS Of our patients, 48.9% said they use or have recently used CAM. The univariate analysis showed that female gender, high education, receiving treatment in a highly specialized institute and receiving chemotherapy are associated with CAM use; at the multivariate analysis high education (Odds Ratio, (OR): 1.96 95% Confidence Interval, CI, 1.27-3.05) and receiving treatment in a specialized cancer center (OR: 2.75 95% CI, 1.53-4.94) were confirmed as risk factors for CAM use. Conclusion Roughly half of our patients receiving treatment for cancer use CAM. It is necessary that health professional explore the use of CAM with their cancer patients, educate them about potentially beneficial therapies in light of the limited available evidence of effectiveness, and work towards an integrated model of health-care provision.
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Affiliation(s)
| | - Chiara Della Pepa
- Division of Medical Oncology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Paolo Tralongo
- Division of Medical Oncology, "Umberto I" Hospital, Syracuse, Italy
| | - Alberto Fulvi
- Department of Medicine and Surgery of Integrated Treatment, Division of Thoracic Oncology, "San Camillo Forlanini" Hospital, Rome, Italy
| | | | - Arben Lleshi
- Department of Medical Oncology, National Cancer Institute, Aviano (PN), Italy
| | - Guglielmo Nasti
- Department of Abdominal Oncology, Division of Medical Oncology B, National Cancer Institute, "G. Pascale" Foundation, Naples, Italy
| | | | - Carmela Romano
- Department of Abdominal Oncology, Division of Medical Oncology B, National Cancer Institute, "G. Pascale" Foundation, Naples, Italy
| | - Chiara De Divitiis
- Department of Abdominal Oncology, Division of Medical Oncology B, National Cancer Institute, "G. Pascale" Foundation, Naples, Italy
| | - Rosaria Taibi
- Department of Medical Oncology, National Cancer Institute, Aviano (PN), Italy
| | - Francesco Fiorica
- Department of Radiation Oncology University Hospital Ferrara, Division of Radiotherapy, "Arcispedale Sant'Anna" Hospital, Ferrara, Italy
| | - Raffaele Di Francia
- Department of Hematology, Istituto Nazionale Tumori 'Fondazione Giovanni Pascale', IRCCS, Naples, Italy.,Gruppo Oncologico Ricercatori Italiani, GORI, Pordenone, Italy
| | - Anna Di Mari
- Division of Medical Oncology, "Umberto I" Hospital, Syracuse, Italy
| | - Lino Del Pup
- Division of Gynaecological Oncology, National Cancer Institute, Aviano (PN), Italy
| | - Anna Crispo
- Unit of Epidemiology, Struttura Complessa di Statistica Medica, Biometria e Bioinformatica, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy
| | - Paolo De Paoli
- Scientific Directorate, National Cancer Institute, Aviano (PN), Italy
| | - Adriano Santorelli
- Department of Plastic Surgery, Regenerative Medicine, Health Park Hospital, Naples, Italy
| | - Vincenzo Quagliariello
- Department of Abdominal Oncology, Division of Medical Oncology B, National Cancer Institute, "G. Pascale" Foundation, Naples, Italy
| | - Rosario Vincenzo Iaffaioli
- Department of Abdominal Oncology, Division of Medical Oncology B, National Cancer Institute, "G. Pascale" Foundation, Naples, Italy
| | - Umberto Tirelli
- Department of Medical Oncology, National Cancer Institute, Aviano (PN), Italy
| | - Gaetano Facchini
- Division of Medical Oncology, Department of Uro-Gynaecological Oncology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy
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Shorofi SA, Arbon P. Complementary and alternative medicine (CAM) among Australian hospital-based nurses: knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users. Complement Ther Clin Pract 2017; 27:37-45. [PMID: 28438278 DOI: 10.1016/j.ctcp.2017.03.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 03/19/2017] [Accepted: 03/23/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE This study was intended to examine CAM among Australian hospital-based nurses, identifying their knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users. METHODS AND MATERIALS Nurses holding a qualification in nursing and working in surgical wards were included using a convenience sampling technique. A self-complete questionnaire was developed to achieve the aims of the study. Descriptive and non-parametric statistics were calculated to describe and analyse data. RESULTS Overall, 95.7% and 49.7% of nurses reported personal and professional use of CAM, respectively. The most popular CAM/CAM domain personally and professionally used by nurses was massage therapy and mind-body therapies. The primary reason for personal use of CAM was "[it] fits into my way of life/philosophy". Furthermore, massage therapists were the most commonly recommended CAM practitioners to patients. Only 15.8% of nurses would always ask patients about use of herbal medicines as part of nursing history taking. Over one-fifth (22.4%) of nurses rated their attitude as having a very positive, and 60.3% rated themselves as having very little or no knowledge of CAM. A positive correlation was also found between knowledge and attitude about CAM. Positive attitude and higher knowledge about CAM were positively correlated to CAM referrals. Several socio-demographic factors predicted personal and professional use of CAM. CONCLUSION This study revealed that nurses generally believe not to have sufficient knowledge of CAM but are open to use CAM with patients. Nurses' positive attitude toward and personal use of CAM could be an indication that they are poised for further integration of evidence-based CAM into nursing practice to treat whole person.
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Affiliation(s)
- Seyed Afshin Shorofi
- Traditional and Complementary Medicine Research Centre, Mazandaran University of Medical Sciences, Sari, Iran; Adjunct Research Fellow, Flinders University, Adelaide, Australia.
| | - Paul Arbon
- Flinders University, Adelaide, Australia
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