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Huemer M, Pansi A, Hofmann G, Terbuch A, Sciri E, Lipp R, Spiegelberg JA, Jahn-Kuch D, Pichler M. Symptom clusters associated with complementary and alternative medicine use by cancer patients: A cross-sectional study. PLoS One 2023; 18:e0294641. [PMID: 38096236 PMCID: PMC10721086 DOI: 10.1371/journal.pone.0294641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 10/04/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Complementary and alternative medicine (CAM) is a commonly used approach among cancer patients, with a reported prevalence of 14.8 to 73.1% depending on multiple factors. Even though a typical patient-reported reason for using CAM is symptom control, no conclusive evidence could be established for specific symptoms being a predictor for CAM use. Symptom clusters are a novel approach for assessing a multidimensional symptom burden, reflecting the impact of diseases on the patient's quality of life and considering the tendency of symptoms to occur in groups. MATERIAL AND METHODS A single-center cross-sectional study on cancer patients during oncological or palliative care was conducted to identify socio-demographical and clinical characteristics, including symptom clusters of CAM users and non-users. Symptom clusters were defined using latent profile analysis, and multivariable analyses were performed to assess significant factors influencing CAM use. RESULTS Of 171 cancer patients in this study, 63.7% used CAM alongside oncological treatment or palliative care. The most common CAM therapies were biological and physical therapies, including homeopathy (30.3%), supplements (27.4%), herbs (26.6%), massage (24.8%), and acupuncture (22.0%). Four distinct symptom clusters were identified, of which the cluster drowsiness-depression-anxiety was associated with a 3.83-fold increased chance of using CAM compared to low-symptomatic cancer patients. Multivariate analysis did not show any additional significant predictors of socio-demographical factors. CONCLUSION Using the concept of symptom clusters revealed a significant predictor for CAM use, suggesting to be a more conclusive method for assessing symptom burden in cancer patients. In addition, understanding why and how cancer patients turn to CAM can enhance the quality of multidisciplinary communication about its use.
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Affiliation(s)
- Matthias Huemer
- Division of Oncology, Department of Internal Medicine, Palliative Care Unit, Medical University of Graz, Graz, Austria
| | - Anna Pansi
- Division of Oncology, Department of Internal Medicine, Palliative Care Unit, Medical University of Graz, Graz, Austria
| | - Guenter Hofmann
- Division of Oncology, Department of Internal Medicine, Palliative Care Unit, Medical University of Graz, Graz, Austria
| | - Angelika Terbuch
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Elisabeth Sciri
- Division of Oncology, Department of Internal Medicine, Palliative Care Unit, Medical University of Graz, Graz, Austria
| | - Rainer Lipp
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Jasmin Alija Spiegelberg
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Daniela Jahn-Kuch
- Division of Oncology, Department of Internal Medicine, Palliative Care Unit, Medical University of Graz, Graz, Austria
| | - Martin Pichler
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
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Walker SL, Levoy K, Meghani SH. Use of complementary and integrative health in cancer pain management among patients undergoing cancer treatments: a qualitative descriptive study. Support Care Cancer 2022; 30:5147-5156. [PMID: 35237857 DOI: 10.1007/s00520-022-06928-4] [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: 10/20/2021] [Accepted: 02/19/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pain is a common symptom in patients undergoing cancer treatment. Despite recommendations for the stronger integration of complementary and integrative health (CIH) in cancer pain management, little is known about the individual experience of using this approach for cancer pain, particularly in certain populations such as African Americans. OBJECTIVE This study aimed to describe the experiences of using CIH for pain in African American and White patients with cancer undergoing cancer treatments. METHODS A secondary analysis of qualitative descriptive data from a subsample of patients with cancer in a parent study of their illness concerns was employed. Atlas.ti 8.0 was used for data management and qualitative analysis. Counts of participant-endorsed themes were tabulated to discern differences in themes by group. RESULTS Of 32 participants (16 African American, 16 White), 22 reported CIH usage for cancer pain management, with equal distribution between groups (11 each). Three themes emerged: Approach to, Reasons for, and Barriers to CIH Use. Psychological approaches were most common (n = 15). Nutritional, physical, and combination approaches were less common and more often employed by White participants. Reasons for CIH use were to reduce opioid consumption or for an opioid adjuvant. Personal limitations and access issues contributed to Barriers to CIH use. CONCLUSIONS Both African American and White patients used CIH for pain management while undergoing cancer treatments. However, some preferential differences in CIH approaches by race surfaced. Further research into these differences may uncover new ways of addressing disparities in cancer pain management with CIH.
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Affiliation(s)
- Suzanne L Walker
- Abramson Cancer Center, Penn Presbyterian Medical Center, Philadelphia, PA, USA.
| | - Kristin Levoy
- Department of Community and Health Systems, Indiana University School of Nursing, Indianapolis, IN, USA.,Indiana University Center for Aging Research, Regenstrief Institute, Indianapolis, IN, USA.,Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Salimah H Meghani
- Department of Biobehavioral Health Sciences, NewCourtland Center for Transitions and Health, Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, PA, USA
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Pedreira-Robles G, Vasco-Gómez A, Martínez-Delgado Y, Herrera-Morales C, Junyent-Iglesias E. Traditional and complementary medicine in a nephrology department: practitioner knowledge and advice. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:426-430. [PMID: 32279559 DOI: 10.12968/bjon.2020.29.7.426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Knowledge of traditional and complementary medicine (TCM) and its use by patients are essential for patient safety. AIMS To examine knowledge of TCM among practitioners in a nephrology unit and their advice to patients. METHODS This was a descriptive, observational, cross-sectional study. Sociodemographic data were collected and an ad hoc closed response survey was used. FINDINGS This study included 62 practitioners, of whom: 32.26% had been trained in TCM, with no significant differences between professional groups; 41.93% used TCM and 67.74% recommended TCM to patients, with no significant difference between personal use and training received. The majority (62.90%) approved of TCM being included in clinical practice, 77.42% were in favour of it being included in formal health teaching programmes, 27.42% said patients had requested information on TCM and 50% knew it could interact with conventional treatment. CONCLUSION Although the majority of practitioners had not been trained in TCM, they were interested in including such treatments in clinical practice. They recommended TCM to patients, but neither training nor personal experience were significant factors in relation to these recommendations. Training in TCM is required to ensure advice is safe.
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Affiliation(s)
| | - Ana Vasco-Gómez
- Nurse, Nephrology Department, Parc de Salut Mar, Barcelona, Spain
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Zhang X, Liu J, Zhu H, Zhang X, Jiang Y, Zhang J. Effect of Psychological Intervention on Quality of Life and Psychological Outcomes of Colorectal Cancer Patients. Psychiatry 2020; 83:58-69. [PMID: 31614095 DOI: 10.1080/00332747.2019.1672440] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective: This study was undertaken to evaluate the effect of psychological interventions on quality of life (QOL) and psychological outcomes in colorectal cancer patients. Methods: Three components-the Hospital Anxiety and Depression Scale (HADS), cancer-related distress, and QOL-were assessed at admission (T0/baseline), three-month follow-up (T1), and six-month follow-up (T2). Results: The general characteristics of participants were well balanced between the psychological intervention group and control group. Psychological intervention significantly improved the anxiety measured by HADS in the psychological intervention group at T1 and T2 compared with the control group (T1 = -2.83 versus 0.33, p = .002; T2 = -2.64 versus 0.13, p = .045). Both total and avoidance scores of cancer-related distress decreased significantly in the psychological intervention group at T1, and the amelioration maintained until T2. However, the psychological intervention group and the control group did not show any significant differences between global QOL and cognitive function. While the psychological intervention greatly improved physical function at T1 (4.30 versus -4.28, p = .012), the difference was not significant at T2 (3.36 versus -3.41, p = .116). However, the fatigue score in the psychological intervention group was reduced significantly compared with that in control group at T2 (-4.94 versus 3.61, p = .027). Conclusion: Our results suggest that psychological intervention benefits QOL and psychological outcomes of patients with colorectal cancer.
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Huang CW, Tran DNH, Li TF, Sasaki Y, Lee JA, Lee MS, Arai I, Motoo Y, Yukawa K, Tsutani K, Ko SG, Hwang SJ, Chen FP. The utilization of complementary and alternative medicine in Taiwan: An internet survey using an adapted version of the international questionnaire (I-CAM-Q). J Chin Med Assoc 2019; 82:665-671. [PMID: 31305349 DOI: 10.1097/jcma.0000000000000131] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND In Taiwan, numerous studies have been conducted to investigate the use of complementary and alternative medicine (CAM). However, most of them focused on specific diseases or the use of particular methods. Therefore, the results of those studies were quite different and difficult to compare with those of studies from other countries. The International CAM Questionnaire (I-CAM-Q), meanwhile, is a unified tool that can provide comparable results for studies conducted worldwide. Thus, the aim of this study was to discover the proportions of people in Taiwan receiving CAM treatments from different types of health care providers by using an adapted version of I-CAM-Q (I-CAM-QT). METHODS I-CAM-QT was developed by translating the Korean version of I-CAM-Q (I-CAM-QK) into traditional Chinese language because of the similarity of CAM usage and doctor licensing system. This study had two stages: the first was a pretest survey used to adjust the questionnaire, while the second was an internet-based survey used to collect data from the community. RESULTS Of the 1200 survey respondents, 37% and 37.7% were prescribed or advised to use Chinese herbal medicine (CHM) by Western medicine (WM) physicians and traditional Chinese medicine (TCM) doctors, respectively. Other than CHM, dietary supplements and massage were the forms of CAM most commonly prescribed or recommended by WM physicians or TCM doctors. Overall, walking and relaxation techniques were the most commonly used self-help practices (used by 61.9% and 40.4% of the respondents, respectively). Additionally, 70.3% of the respondents had used at least one kind of dietary supplement in the past 12 months. CONCLUSION Regarding the utilization of CAM in Taiwan, this internet-based survey revealed that CHM, dietary supplements, and massage were the types of CAM most commonly prescribed or recommended by WM physicians or TCM doctors.
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Affiliation(s)
- Ching-Wen Huang
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Diem Ngoc Hong Tran
- Institute of Traditional Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
| | - Tsai-Feng Li
- Institute of Traditional Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
- Center for Traditional Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Yui Sasaki
- Department of Applied Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Ju Ah Lee
- Hwa-pyeong Institute of Integrative Medicine, Incheon, South Korea
| | - Myeong Soo Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Ichiro Arai
- Department of Pharmaceutical Sciences, Nihon Pharmaceutical University, Saitama, Japan
| | - Yoshiharu Motoo
- Department of Medical Oncology, Kanazawa Medical University, Ishikawa, Japan
| | - Keiko Yukawa
- Department of Health Policy and Technology Assessment, National Institute of Public Health, Saitama, Japan
| | - Kiichiro Tsutani
- Faculty of Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan
| | - Seong-Gyu Ko
- Department of Science in Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
- Department of Applied Korean Medicine, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Shinn-Jang Hwang
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Family Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
| | - Fang-Pey Chen
- Institute of Traditional Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan, ROC
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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