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Choi EPH, Hui BPH, Wan EYF, Kwok JYY, Lok KYW, Lee JJ. Using the Revised Health Care System Distrust Scale to evaluate healthcare distrust among Chinese men in Hong Kong: An analysis from a prostate cancer screening behaviours survey. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4694-e4704. [PMID: 35698821 DOI: 10.1111/hsc.13875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 04/14/2022] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
Information about the level of distrust in healthcare systems is very limited in Chinese populations, and no validated instrument has been developed to measure this distrust. Therefore, to begin addressing this research gap, this study evaluated the psychometric properties of a traditional Chinese version of the Revised Health Care System Distrust Scale and used it to assess the level of distrust in a healthcare system. The study involved a community-based personal interview survey of individuals in Hong Kong. A total of 340 men were randomly recruited. In addition to the distrust instrument, the two-item Trust in Physician Scale and the Patient Health Questionnaire-9 were used. The two-factor structure of the distrust scale was confirmed. The item-total correlations corrected for overlap were >0.4 for both the Competence and Values Distrust subscales, confirming the internal construct validity of the scale. The Cronbach's alpha coefficient was 0.77 for both subscales. The scores of both the Competence and Values subscales were moderately negatively correlated with the total score of the Trust in Physician Scale, providing support for convergent validity. Regarding known-group validity, the scale could differentiate people according to marital status, monthly personal income and severity of depressive symptoms. Moreover, we found that men who had previously undergone prostate cancer screening had higher Values Distrust scores than those who had not. The descriptive analysis showed that only about half of the participants reported that they received high-quality medical care and that the healthcare system provided excellent medical care, suggesting that more effort is needed to improve the quality of care and people's satisfaction with healthcare in Hong Kong. In summary, the translated traditional Chinese version of the Revised Health Care System Distrust Scale used in this study is a valid and reliable scale for assessing the level of distrust in a healthcare system.
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Affiliation(s)
- Edmond P H Choi
- School of Nursing, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Bryant P H Hui
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Eric Y F Wan
- Department of Family Medicine and Primary Care, The University of Hong Kong, Pok Fu Lam, Hong Kong
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Jojo Y Y Kwok
- School of Nursing, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Kris Y W Lok
- School of Nursing, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Jung Jae Lee
- School of Nursing, The University of Hong Kong, Pok Fu Lam, Hong Kong
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Alsaraireh M, Albashtawy M, Abdalrahim A, Alkhawaldeh A, Khatatbeh M, Qaddumi J, Albashtawy S, Albashtawy Z, Ibnian A, Ayed A, Suliman M, Alhroub N. Cancer pain management program: Patients' experiences-A qualitative study. Nurs Forum 2022; 57:773-784. [PMID: 35690909 DOI: 10.1111/nuf.12761] [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: 02/04/2022] [Revised: 04/03/2022] [Accepted: 05/10/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Cancer patients frequently experience unrelieved pain as a significant symptom. However, several studies have found that cancer-related pain is frequently undertreated. PURPOSE This study aimed to understand the pain experiences of cancer patients who were newly engaged in a multidisciplinary pain management program (PMP) at King Hussein Cancer Centre and still receiving cancer treatments and cancer pain management. METHODS A qualitative study design and semi-structured interviews were used to obtain data from 21 cancer patients who were purposefully selected. All patients had advanced cancer, including skeleton metastases. All female participants had breast cancer, and all male participants had prostate cancer. RESULTS It was found that the patient-healthcare professional relationship and satisfaction with services emerged as two themes in healthcare professionals' pain management. CONCLUSION The results from this study can offer a new understanding of the knowledge related to satisfaction of patients with cancer in terms of the quality of pain management. Additional qualitative studies are required to replicate the findings in populations from different backgrounds, ethnicities, and cultures experiencing cancer pain.
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Affiliation(s)
| | | | - Asem Abdalrahim
- Community and Mental Health Department, Princess Salma Faculty of Nursing, AL al-Bayt University, Mafraq, Jordan
| | | | | | - Jamal Qaddumi
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | | | | | - Ali Ibnian
- Faculty of Medicine, JUST, Irbid, Jordan
| | - Ahmad Ayed
- Faculty of Nursing, Arab American University, Jenin, Palestine
| | - Mohammad Suliman
- Community and Mental Health Department, Princess Salma Faculty of Nursing, AL al-Bayt University, Mafraq, Jordan
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Wong YK, Low KL, Pooke TG. Factors Associated With Dimensions of Patients' Trust in Chiropractic Doctors in the International Medical University Healthcare Chiropractic Center: An Exploratory Study. J Chiropr Med 2022; 21:83-96. [PMID: 35774631 PMCID: PMC9237594 DOI: 10.1016/j.jcm.2022.02.003] [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: 11/12/2019] [Revised: 01/23/2022] [Accepted: 02/08/2022] [Indexed: 11/29/2022] Open
Abstract
Objective The purpose of this study was to investigate the association between patients' sociodemographic factors (age, sex, ethnicity, and education background) and dimensions of patients' trust in chiropractic doctors in Malaysia. Methods This cross-sectional study was conducted in the International Medical University Healthcare Chiropractic Center with a total of 302 respondents. Self-administered questionnaires were enclosed in an envelope and passed to participants by the researchers. Descriptive statistics are presented in tables and figures. Each dimension of the patients' trust was compared against the sociodemographic factors. The variables included were sex, age, ethnicity, and education background, along with their dimensions of trust. Results There were 106 male respondents (35.1%) and 196 female respondents (64.9%) between 21 and 40 years of age. In all of the trust dimensions, education background was the only statistically significant variable (P < .05). Conclusion Several sociodemographic factors were associated highly with the trust dimensions explored. Patients' education background was the only sociodemographic factor to show a statistically significant relationship to all 10 trust dimensions. Sex, age, and ethnicity showed significant associations with some of the trust dimensions explored in this study.
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Affiliation(s)
- Yi Kai Wong
- Chiropractic Department, Centre for Complementary and Alternative Medicine, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Ka Lok Low
- Chiropractic Department, Centre for Complementary and Alternative Medicine, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Tamara Gien Pooke
- Chiropractic Department, Centre for Complementary and Alternative Medicine, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
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Souček I, Hofreiter R. Medical Pluralism in East and West Europe: A Comparison of People Visiting Healthcare Practitioners Specializing in Complementary and Alternative Medicine. Complement Med Res 2022; 29:297-308. [PMID: 35350023 DOI: 10.1159/000524330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 03/24/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Interest in various forms of complementary and alternative medicine (CAM) (e.g., naturopathy, homeopathy, traditional Chinese medicine, osteopathy, and chiropractic) is continuing to grow throughout Europe. Very little is known as to whether the prevalence and patterns of CAM usage are another cross-cutting phenomenon, dividing Europe, or whether they indicate homogenous healthcare settings throughout the continent. By examining data from the general population, the main objective of the study is to conduct a cross-country comparison of medical pluralism in Eastern and Western European countries. METHODS The cross-country comparison was conducted using data obtained through the International Social Survey Programme (ISSP). Data addressing healthcare issues were last collected for the ISSP in 2011. By analysing existing similarities and/or differences in the prevalence of sociodemographic and socioeconomic determinants, which could encourage visits to complementary and alternative practitioners, data from 21 European societies only, were included. In addition, the aim was to investigate whether individuals' scarcity of trust in physicians, as well as a lack of confidence in healthcare systems, may explain visits to CAM practitioners across Europe. RESULTS While in Eastern countries, a total of 531 (5.5%) respondents reported a visit to/by a CAM healthcare practitioner during the preceding 12 months, in Western Europe, a visit to/by a CAM healthcare practitioner was reported by 11.6% of individuals. In Western Europe, the use of CAM is most prevalent among younger generations of women, those of a lower socioeconomic position and/or a low level of trust in conventional doctors. In Eastern Europe, CAM practitioners are mainly visited by older generations, city dwellers of a higher socioeconomic position and a relatively high level of trust in physicians. CONCLUSION After collating data from 21 societies, the study concludes that more than three decades after the collapse of the socialist experiment in Eastern Europe, there is evidence that the European continent remains divided in relation to the alternative healthcare sector. The field of non-conventional healthcare represents an indicator supporting the existence of a dividing line between Eastern and Western Europe.
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Affiliation(s)
- Ivan Souček
- Matej Bel University in Banská Bystrica, Banská Bystrica, Slovakia
| | - Roman Hofreiter
- Matej Bel University in Banská Bystrica, Banská Bystrica, Slovakia
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Bismire H, Nunn S, Malpas CB, Bilszta JLC. Doctor Who? Honorific titles and their influence on patients’ perceptions of healthcare professionals. J R Soc Med 2022; 115:91-94. [DOI: 10.1177/01410768221080775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Hugh Bismire
- Department of Medical Education, Melbourne Medical School, University of Melbourne, Parkville, 3010 Australia
| | - Stephen Nunn
- Department of Medical Education, Melbourne Medical School, University of Melbourne, Parkville, 3010 Australia
| | - Charles B Malpas
- Clinical Outcomes Research Unit (CORe), Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, 3050 Australia
- Department of Neurology, Royal Melbourne Hospital, Parkville, 3050 Australia
| | - Justin LC Bilszta
- Department of Medical Education, Melbourne Medical School, University of Melbourne, Parkville, 3010 Australia
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Community-based interventions to increase dairy intake in healthy populations: a systematic review. Public Health Rev 2020; 41:18. [PMID: 32774990 PMCID: PMC7401205 DOI: 10.1186/s40985-020-00135-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 06/18/2020] [Indexed: 12/03/2022] Open
Abstract
Background Considering the low frequency of dairy intake in the population, interventions aiming to increase its consumption can be a priority for any health system. Objective This study aims to summarize community-based interventions for improving dairy consumption and their effectiveness to help policy-makers in designing coherent public health strategies. Methods This study was conducted in 2019, using PubMed/MEDLINE, Scopus, EMBASE, Cochrane Library, Web of Science, ProQuest, and Google Scholar. Two independent reviewers selected the eligible studies, and the outcomes of interest were extracted. The quality of eligible studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for randomized controlled trials and quasi-experimental studies. Results Out of 521 initially identified articles, 25 studies were included. Interventions reported in 19 studies were effective in increasing dairy consumption. Interventions in high-income countries were more effective than those in middle- and low-income countries. Interventions in health centers and supermarkets were more effective than the community and school-level interventions. Interventions in supermarkets and adolescents as target groups were more effective than children, middle-aged people, and the elderly. Also, educational interventions and changing buying/selling pattern were more effective than multiple interventions. Interventions longer than 24 and 48 weeks were more effective than shorter interventions. Conclusion Three policy options including educational interventions, multiple interventions, and changing the purchase pattern are suggested. It seems that applying all of the interventions together can be more effective. Also, long-term and well-designed future studies in different settings are recommended to confirm these results.
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van de Pol JM, van Dijk L, Koster ES, de Jong J, Bouvy ML. How does the general public balance convenience and cognitive pharmaceutical services in community pharmacy practice. Res Social Adm Pharm 2020; 17:606-612. [PMID: 32534955 DOI: 10.1016/j.sapharm.2020.05.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 04/18/2020] [Accepted: 05/13/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Community pharmacy is shifting its focus from traditional, product-focused roles to the provision of cognitive pharmaceutical services (CPS). Previous research has indicated that community pharmacists predominantly want to devote their capacity to CPS. Ideally, services provided also address users' needs. The general public's preferences regarding the services provided by community pharmacists are currently less understood. AIM This study investigates the general public's preferences and perceived importance of CPS versus convenience in community pharmacy practice. METHOD An online survey of 1.500 members of the Dutch Health Care Consumer Panel containing questions regarding preferences for CPS and convenience was distributed. Descriptive statistics and linear regression analysis were performed to investigate the relationship between preferences and participant characteristics. RESULTS 516 panel members completed all questions regarding preferences and importance of the availability of services. The majority preferred convenience (68.2%) and a smaller proportion preferred CPS (27.7%). However, participants considered it important from a societal viewpoint that CPS is provided (45.0%). Participants who preferred CPS over convenience were generally older (p < 0.001) and used more medicines (p < 0.001). CONCLUSION Convenience of community pharmacy services is most preferred by the general public. However, CPS is perceived as important, especially for elderly who use more medicines. Elderly patients who use more medicines more often rate CPS as more important than convenience. These findings suggest that community pharmacists should ensure that pharmacy logistics are organized efficiently before focusing on the provision of CPS.
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Affiliation(s)
- Jeroen M van de Pol
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands.
| | - Liset van Dijk
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands; University of Groningen, Dept. of PharmacoTherapy, Epidemiology & -Economics (PTEE), Groningen Research Institute of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Groningen, Groningen, the Netherlands.
| | - Ellen S Koster
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands.
| | - Judith de Jong
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands; Maastricht University, Dept. of Health Services Research, Faculty of Health, Medicine and Life Sciences, the Netherlands.
| | - Marcel L Bouvy
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands; Academic Community Pharmacy Stevenshof, Leiden, the Netherlands.
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Campos-Romero S, Herskovic V, Fuentes C, Abarca E. Perceptions on Connecting Respite Care Volunteers and Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082911. [PMID: 32340190 PMCID: PMC7215678 DOI: 10.3390/ijerph17082911] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/19/2020] [Accepted: 04/20/2020] [Indexed: 11/16/2022]
Abstract
The most common requirement for informal caregivers is to experience a respite or temporary break from their caregiving routine. Some initiatives have been undertaken to provide respite care through volunteer providers. We report on a qualitative study carried out in Santiago, Chile, to learn about the willingness of potential volunteers to provide respite care for bedridden older persons, as well as their willingness to use information and communication technologies (ICT) to connect to caregivers in a low-income neighbourhood within their own geographic district. A trustworthy institution that mediates the volunteer–caregiver relationship is considered to be important by potential volunteers. Potential volunteers were found to be willing to use ICT to provide respite care, sharing basic information about themselves. However, they were also aware of the digital skill gap that may exist between them and the caregivers and were distrustful of unknown websites that could connect them to care recipients.
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Affiliation(s)
- Solange Campos-Romero
- School of Nursing, Pontificia Universidad Católica de Chile, Santiago 8940000, Chile; (S.C.-R.); (E.A.)
| | - Valeria Herskovic
- Department of Computer Science, Pontificia Universidad Católica de Chile, Santiago 8940000, Chile
- Correspondence:
| | - Carolina Fuentes
- School of Computer Science, University of Nottingham, Nottingham NG8 1BB, UK;
- School of Computer Science & Informatics, Cardiff University, Cardiff CF24 3AA, Wales, UK
| | - Esmeralda Abarca
- School of Nursing, Pontificia Universidad Católica de Chile, Santiago 8940000, Chile; (S.C.-R.); (E.A.)
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Witt CM, Helmer SM, Schofield P, Wastell M, Canella C, Thomae AV, Rogge AA. Training oncology physicians to advise their patients on complementary and integrative medicine: An implementation study for a manual‐guided consultation. Cancer 2020; 126:3031-3041. [DOI: 10.1002/cncr.32823] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/12/2019] [Accepted: 11/28/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Claudia M. Witt
- Institute for Complementary and Integrative Medicine University of Zurich, University Hospital Zurich Zurich Switzerland
- Institute for Social Medicine, Epidemiology, and Health Economics Charite ‐ University Medicine Berlin, Humboldt University Berlin, and Berlin Institute of Health Berlin Germany
| | - Stefanie M. Helmer
- Institute for Social Medicine, Epidemiology, and Health Economics Charite ‐ University Medicine Berlin, Humboldt University Berlin, and Berlin Institute of Health Berlin Germany
| | - Penelope Schofield
- Department of Psychology and Iverson Health Innovation Research Institute Swinburne University Melbourne Victoria Australia
- Behavioral Sciences Unit, Department of Cancer Experiences Research Peter MacCallum Cancer Center Melbourne Victoria Australia
- Sir Peter MacCallum Department of Oncology The University of Melbourne Parkville Victoria Australia
| | - Marisa Wastell
- Faculty of Behavioral and Social Sciences Institute of Sociology University of Technology Chemnitz Germany
| | - Claudia Canella
- Institute for Complementary and Integrative Medicine University of Zurich, University Hospital Zurich Zurich Switzerland
| | - Anita V. Thomae
- Institute for Complementary and Integrative Medicine University of Zurich, University Hospital Zurich Zurich Switzerland
| | - Alizé A. Rogge
- Institute for Social Medicine, Epidemiology, and Health Economics Charite ‐ University Medicine Berlin, Humboldt University Berlin, and Berlin Institute of Health Berlin Germany
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Use of Complementary and Alternative Medicine by Patients with Irritable Bowel Syndrome According to the Roma IV Criteria: A Single-Center Italian Survey. ACTA ACUST UNITED AC 2019; 55:medicina55020046. [PMID: 30781771 PMCID: PMC6409648 DOI: 10.3390/medicina55020046] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/25/2019] [Accepted: 02/08/2019] [Indexed: 12/12/2022]
Abstract
Aim: This study was conducted to evaluate the impact of complementary and alternative medicine (CAM) in patients with irritable bowel syndrome (IBS) as assessed by the Rome IV criteria. Methods: Consecutive patients referring for IBS were re-evaluated according to the Rome IV criteria. Demographic features and characteristics potentially associated with the use of CAM were collected. A validated, self-administered, survey questionnaire dealing with CAM and patients’ level of knowledge, motivation, perception, and information seeking-behavior toward the use of CAM was analyzed. Multivariate logistic regression analysis was performed in order to identify predictors of CAM use among participants. Results: Among 156 patients claiming IBS, 137 (88%) met the Rome IV criteria, and 62 of them (45%) were CAM users. Biologically based therapy was the most chosen CAM (78%). Significant risk factors (adjusted odds ratio, 95% confidence interval) for the use of CAM were female gender (7.22, 2.31–22.51), a higher BMI (1.16, 1.02–1.33), and a good knowledge of CAM (4.46, 1.73–11.45), while having children was a protective factor (0.25, 0.07–0.95). Only 19% of patients used CAM due to medical advice and over half (51%) thought it was a “more natural” approach. Although a minority of patients (16%) had full satisfaction from CAM, 81% of users would repeat the CAM experience for their IBS symptoms. Conclusions: The widespread use of CAM in IBS, the patients’ belief in its safety, and their willingness to re-use it suggest that knowledge of health-care providers and patient education should be improved.
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Patient factors that affect trust in physicians: a cross-sectional study. BMC FAMILY PRACTICE 2018; 19:187. [PMID: 30497400 PMCID: PMC6267873 DOI: 10.1186/s12875-018-0875-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 11/16/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND While trust in physicians has been rigorously investigated regarding its concept, measurement, and factors, the studies have mainly focused on the attributes of the physicians. This approach can lead to a limited understanding of trust in physicians as trust is based on the relationship, an interaction of both parties: patients and physicians. This study aimed to investigate the factors for trust in physicians among the Koreans by focusing on patients' traits which are related to their subjective perceptions. METHODS A web-based survey was conducted between August and September 2016 among 1000 Korean adults aged 18 to 59 years. Survey participants were selected by a proportionate quota sampling based on age, sex and place of residence. The t-test and analysis of variance (ANOVA) were performed to examine the difference in trust in physicians among the different groups in each variable of patient characteristics. An ordinal logistic regression model was employed to examine the association between trust in physicians and patient attributes. RESULTS Negative health-related traits, such as stress and low self-rated health, were likely to lower trust in physicians, and women were less likely to trust physicians. The negative attitudes toward the current health care system were strongly associated with low trust in physicians. Meanwhile, recent experience of hospitalization or outpatient visit was positively associated with trust in physicians, and experience of not being able to use health facilities showed no significant association. These results suggest that trust in physicians is more likely to be lowered by negative perception than by the objective conditions or experience. CONCLUSION In investigating the factors for trust in physicians, the patients' predispositions, which make them less likely to trust physicians, should be considered. The attributes of the patients in Korea, which could negatively affect trust in physicians, need to be investigated in consideration of the recent changes in patient-physician relationships and the medical environment in Korea.
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Larson HJ, Clarke RM, Jarrett C, Eckersberger E, Levine Z, Schulz WS, Paterson P. Measuring trust in vaccination: A systematic review. Hum Vaccin Immunother 2018; 14:1599-1609. [PMID: 29617183 PMCID: PMC6067893 DOI: 10.1080/21645515.2018.1459252] [Citation(s) in RCA: 362] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Vaccine acceptance depends on public trust and confidence in the safety and efficacy of vaccines and immunization, the health system, healthcare professionals and the wider vaccine research community. This systematic review analyses the current breadth and depth of vaccine research literature that explicitly refers to the concept of trust within their stated aims or research questions. After duplicates were removed, 19,643 articles were screened by title and abstract. Of these 2,779 were screened by full text, 35 of which were included in the final analysis. These studies examined a range of trust relationships as they pertain to vaccination, including trust in healthcare professionals, the health system, the government, and friends and family members. Three studies examined generalized trust. Findings indicated that trust is often referred to implicitly (19/35), rather than explicitly examined in the context of a formal definition or discussion of the existing literature on trust in a health context. Within the quantitative research analysed, trust was commonly measured with a single-item measure (9/25). Only two studies used validated multi-item measures of trust. Three studies examined changes in trust, either following an intervention or over the course of a pandemic. The findings of this review indicate a disconnect between the current vaccine hesitancy research and the wider health-related trust literature, a dearth in research on trust in low and middle-income settings, a need for studies on how trust levels change over time and investigations on how resilience to trust-eroding information can be built into a trustworthy health system.
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Affiliation(s)
- Heidi J Larson
- a Department of Infectious Disease Epidemiology , The Vaccine Confidence Project, London School of Hygiene & Tropical Medicine , Keppel Street, London WC1E 7HT , United Kingdom.,b Department of Global Health , University of Washington , Seattle , USA
| | - Richard M Clarke
- a Department of Infectious Disease Epidemiology , The Vaccine Confidence Project, London School of Hygiene & Tropical Medicine , Keppel Street, London WC1E 7HT , United Kingdom
| | - Caitlin Jarrett
- a Department of Infectious Disease Epidemiology , The Vaccine Confidence Project, London School of Hygiene & Tropical Medicine , Keppel Street, London WC1E 7HT , United Kingdom.,c Swiss Tropical and Public Health Institute , Basel , Switzerland
| | | | - Zachary Levine
- a Department of Infectious Disease Epidemiology , The Vaccine Confidence Project, London School of Hygiene & Tropical Medicine , Keppel Street, London WC1E 7HT , United Kingdom
| | - Will S Schulz
- a Department of Infectious Disease Epidemiology , The Vaccine Confidence Project, London School of Hygiene & Tropical Medicine , Keppel Street, London WC1E 7HT , United Kingdom
| | - Pauline Paterson
- a Department of Infectious Disease Epidemiology , The Vaccine Confidence Project, London School of Hygiene & Tropical Medicine , Keppel Street, London WC1E 7HT , United Kingdom
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Abdullah N, Borhanuddin B, Patah AEA, Abdullah MS, Dauni A, Kamaruddin MA, Shah SA, Jamal R. Utilization of Complementary and Alternative Medicine in Multiethnic Population: The Malaysian Cohort Study. J Evid Based Integr Med 2018; 23:2515690X18765945. [PMID: 29651870 PMCID: PMC5922489 DOI: 10.1177/2515690x18765945] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. This study aimed to identify the factors of CAM usage for general health and to determine the factors associated with the usage of different types of CAM after the diagnosis of chronic diseases among The Malaysian Cohort participants. Methods. This was a cross-sectional study derived from The Malaysian Cohort (TMC) project, a prospective population-based cohort aged between 35 to 65 years old that recruited from April 2006 to September 2012. Association between the CAM usage and contributing factors were determined via logistic regression. Results. The sample were mostly female (58.1%), Malays (43.1%), came from urban (71.9%), aged 44 years and below (26.8%) and had secondary education (45.9%). The prevalence of CAM usage varied across diseases; 62.8% in cancer patients, 53.3% in hypercholesterolemia, 49.4% in hypertensives and 48.6% in diabetics. General CAM usage was greater among female (OR: 1.54, 95% CI: 1.49, 1.59), Chinese (OR: 1.15, 95% CI: 1.12, 1.19), those with higher education (OR: 3.12, 95% CI: 3.00, 3.25), urban residents (OR: 1.55, 95% CI: 1.50, 1.61) and older people (OR ranging from 1.15 to 1.75) while for post-diagnosis of chronic diseases usage, the odds were higher among those with lower education and living in rural areas. Conclusion. Health status, educational level, age, living location and types of chronic diseases were significant factors that influence CAM usage for the intent of either health maintenance or disease treatment. Further exploration on CAM safety and benefit are crucial to minimize the adverse effect and to ensure the efficacy of CAM product.
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Affiliation(s)
- Noraidatulakma Abdullah
- 1 UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Boekhtiar Borhanuddin
- 1 UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Afzan Effiza Abdul Patah
- 1 UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Shaharom Abdullah
- 1 UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Andri Dauni
- 1 UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Arman Kamaruddin
- 1 UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Shamsul Azhar Shah
- 1 UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.,2 Department of Community Health, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rahman Jamal
- 1 UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Lacasse A, Choinière M, Connelly JA. Knowledge, beliefs, and attitudes of the Quebec population toward chronic pain: Where are we now? Can J Pain 2017; 1:151-160. [PMID: 35005351 PMCID: PMC8730576 DOI: 10.1080/24740527.2017.1369849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 08/15/2017] [Accepted: 08/17/2017] [Indexed: 01/07/2023]
Abstract
Background: Many chronic pain (CP) awareness and educational initiatives have been achieved, but it is time to take stock of where we are today. Aims: The aim of this study was to describe and identify determinants of knowledge, beliefs, and attitudes of different subgroups of the Quebec population regarding CP and especially toward people suffering from this condition. Methods: A web-based, cross-sectional study was conducted between May and June 2014. Results: A total of 1958 participants responded, among whom 70.9% reported suffering from CP and 14.4% reported being a health care professional (HCP). Almost half of the participants were not aware that the risk of developing CP is increased after undergoing surgery or that CP affects approximately one in five adults. A minority (10.30%) agreed that HCP are well trained in CP treatment. The two most frequent negative beliefs were that people suffering from CP become dependent on their medications as do drug addicts (16.7%) and that consulting a psychologist is useless unless the person with CP is depressed (16.9%). Multiple regression analysis showed that being a woman, being born in Canada, being unemployed, suffering from CP, and being an HCP were predictors of better knowledge and more positive attitudes toward people suffering from CP (all P values < 0.05). Older age and residing in a remote region were associated with poorer knowledge and more negative attitudes. Conclusions: Our results underline the importance of continuing the efforts and the need for more education programs, awareness campaigns, and stigma reduction activities about CP for HCP, patients, and the general public.
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Affiliation(s)
- Anaïs Lacasse
- Département des sciences de la santé, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada
- Quebec Pain Research Network (QPRN), Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Manon Choinière
- Quebec Pain Research Network (QPRN), Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM), Tour Saint-Antoine, Montréal, QC, Canada
- Département d’anesthésiologie, Faculté de médecine, Université de Montréal, Montreal, QC, Canada
| | - Judy-Ann Connelly
- Département des sciences de la santé, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC, Canada
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Kwon S, Heo S, Kim D, Kang S, Woo JM. Changes in trust and the use of Korean medicine in South Korea: a comparison of surveys in 2011 and 2014. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:463. [PMID: 28915876 PMCID: PMC5603087 DOI: 10.1186/s12906-017-1969-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 09/08/2017] [Indexed: 11/10/2022]
Abstract
Background Korean medicine (KM) has been widely used in Korea. This study aimed to assess the general perceptions of KM, to investigate the patterns of its usage in 2014, and to compare the results with those of an earlier survey from 2011. Methods A cross-sectional study was conducted with 1000 Korean people. The questionnaire included items regarding trust in KM, reasons for distrust of KM, and visit frequency to KM clinics. This study used methods consistent with those of a 2011 survey to examine changes in attitudes over 3 years. Results Despite high rates of trust in KM, the visit frequency decreased from 69.3% in 2011 to 63.2% in 2014. Usage among young adults (in their 20s and 30s) was significantly reduced compared to all other age groups. The KM modality most commonly used by participants was acupuncture, whereas the use of moxibustion and cupping therapies has decreased since 2011. Men and women were most likely to distrust KM due to a “lack of scientific evidence” (59.3%) and “suspicion of KM safety” (47.4%), respectively. Conclusions The findings suggested that KM use and trust in KM were slightly lower in 2014 than in 2011. The decreases were most notable among individuals in their 30s and in the use of moxibustion in KM therapy. This study aimed to produce practical insights by reviewing patterns of KM use and perceptions over time. Additional surveys must be considered to produce a more in-depth analysis. Electronic supplementary material The online version of this article (10.1186/s12906-017-1969-8) contains supplementary material, which is available to authorized users.
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Lin V, Canaway R, Carter B. Interface, interaction and integration: how people with chronic disease in Australia manage CAM and conventional medical services. Health Expect 2015; 18:2651-65. [PMID: 25069626 PMCID: PMC5810634 DOI: 10.1111/hex.12239] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2014] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To understand the extent to which conventional and complementary health care are integrated for CAM users with chronic conditions. METHODS In-depth interviews and a self-administered questionnaire were used to collect data on care-seeking, self-management and CAM use among people with type 2 diabetes and/or cardiovascular disease living in Victoria, Australia. RESULTS Many participants reported regular, frequent and long-term use of CAM therapies to maintain their health or assist in the management of their chronic condition. They generally managed the interface between convention and complementary health care on their own, as the perceived or expressed negative attitudes of some doctors, or the belief that the doctor did not need to know, were barriers to the disclosure of CAM use. For a smaller group, there was interaction between conventional and CAM providers, which limited the extent of uncertainty and conflicting information being (mis)interpreted by consumers. CONCLUSIONS Greater interaction between CAM and medical providers would be beneficial to consumers. Structural barriers, related to financing and service organization, need to be addressed. Attitudinal shifts of some health-care practitioners also need to be addressed, in the context of workforce development.
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Affiliation(s)
- Vivian Lin
- CAMELOT ProjectSchool of Public Health and Human BiosciencesLa Trobe UniversityBundooraVic.Australia
| | - Rachel Canaway
- CAMELOT ProjectSchool of Social SciencesMonash UniversityClaytonVic.Australia
| | - Bronwyn Carter
- CAMELOT ProjectSchool of Public Health and Human BiosciencesLa Trobe UniversityBundooraVic.Australia
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Lin V, Canaway R, Carter B, Manderson L. Room for improvement: complementary therapy users and the Australian health system. Health Expect 2015; 18:1451-62. [PMID: 23992199 PMCID: PMC5060902 DOI: 10.1111/hex.12125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2013] [Indexed: 11/30/2022] Open
Abstract
CONTEXT People with chronic conditions who are often in contact with the health-care system are well placed to reflect on how services meet their needs. Some research characterizes people who use complementary and alternative medicines (CAMs) as a distinct group who opt out of the mainstream health system. However, many CAM users are people with chronic or terminal health conditions who concurrently use mainstream health-care services. The difference in perspectives between people with chronic conditions who do or do not use CAM has received little attention by researchers. OBJECTIVE To explore the views of CAM users with chronic conditions and identify their perspectives on the health system. DESIGN AND SETTING In-depth interviews and a self-administered questionnaire were used to collect data on care-seeking, self-management and CAM use among people with type 2 diabetes and/or cardiovascular disease living in Victoria, Australia. RESULTS One in four CAM practitioner users was partly motivated to use CAM as a result of their dissatisfaction with the mainstream health system. In general, their dissatisfaction mirrored the concerns of the general population. This included the perceived lack of a humanistic or person-centred approach, which was central to problems relating to individuals' clinical encounters as well as to health system design. DISCUSSION AND CONCLUSION Participants' concerns suggest room for improvement in the Australian health system to better reflect patients' needs. A systems approach is needed to reorient health-care practitioners to modify the organization of care because of the incentives embedded in the structure of the health-care system.
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Affiliation(s)
- Vivian Lin
- CAMELOT ProjectSchool of Public HealthLa Trobe UniversityBundooraVic.Australia
| | - Rachel Canaway
- CAMELOT ProjectSchool of Psychology and PsychiatryMonash UniversityCaulfieldVic.Australia
| | - Bronwyn Carter
- CAMELOT ProjectSchool of Public HealthLa Trobe UniversityBundooraVic.Australia
| | - Lenore Manderson
- CAMELOT ProjectSchool of Psychology and PsychiatryMonash UniversityCaulfieldVic.Australia
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Pumthong G, Nathason A, Tuseewan M, Pinthong P, Klangprapun S, Thepsuriyanon D, Kotta P. Complementary and alternative medicines for diabetes mellitus management in ASEAN countries. Complement Ther Med 2015; 23:617-25. [PMID: 26275656 DOI: 10.1016/j.ctim.2015.01.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 12/03/2014] [Accepted: 01/21/2015] [Indexed: 11/24/2022] Open
Abstract
AIM The aim of this study was to explore complementary or alternative practices used to promote health and reduce complications of patients with diabetes mellitus (DM). DESIGN This qualitative, interpretative study recruited 30 adults including practitioners (n=15) and DM patients (n=15). The participants reside in the northeast of Thailand and in Vientiane of Lao People's Democratic Republic, and they have undergone treatment with at least a kind of complementary and alternative medicines (CAMs) for the care and management of DM. They were interviewed about their experiences, and the data were analyzed thematically. The study methodology was informed by hermeneutic phenomenology. RESULT After several years of ineffective treatments, practitioners looked for an alternative to conventional health care to treat patients on long-term antidiabetic drugs, yet the patients suffered from progressive complications. They sought out health care that would more effectively meet their self-perceived needs in treatment particularly of a chronic disease such as DM. The result suggested that CAMs such as acupuncture, massage, exercise, and herbalism were able to meet their requirement in terms of health-care effectiveness obtained from experiences, additional cheap cost and availability in their community, and in accordance with the culture and lifestyles in the context of the ASEAN (Association of Southeast Asian Nations) community. CONCLUSION The study explored and revealed the social perceptions of practitioners and patients using Chinese acupuncture, Thai massage, stretching exercise, and herbalism, as CAMs for DM management. The perceptions attributed to patient-practitioner consensus can hold a key to a more comprehensive health care, as a means to expand the boundaries for contemporary health-care provision. However, more study is needed in the future clinical trial research.
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Affiliation(s)
- Ganniga Pumthong
- Faculty of Thai Traditional and Alternative Medicine, Ubonratchathani Rajabhat University, Meung, Ubonratchathani 34000, Thailand.
| | - Amornrat Nathason
- Faculty of Nursing, Ubonratchathani Rajabhat University, Meung, Ubonratchathani 34000, Thailand
| | - Musikorn Tuseewan
- Faculty of Thai Traditional and Alternative Medicine, Ubonratchathani Rajabhat University, Meung, Ubonratchathani 34000, Thailand
| | - Pailin Pinthong
- Faculty of Nursing, Ubonratchathani Rajabhat University, Meung, Ubonratchathani 34000, Thailand
| | - Supathra Klangprapun
- Faculty of Thai Traditional and Alternative Medicine, Ubonratchathani Rajabhat University, Meung, Ubonratchathani 34000, Thailand
| | - Daracha Thepsuriyanon
- Faculty of Thai Traditional and Alternative Medicine, Ubonratchathani Rajabhat University, Meung, Ubonratchathani 34000, Thailand
| | - Paiwan Kotta
- Faculty of Nursing, Ubonratchathani Rajabhat University, Meung, Ubonratchathani 34000, Thailand
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Gureje O, Nortje G, Makanjuola V, Oladeji B, Seedat S, Jenkins R. The role of global traditional and complementary systems of medicine in treating mental health problems. Lancet Psychiatry 2015; 2:168-177. [PMID: 26052502 PMCID: PMC4456435 DOI: 10.1016/s2215-0366(15)00013-9] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 09/26/2014] [Indexed: 11/26/2022]
Abstract
Traditional and complementary systems of medicine (TCM) encompass a broad range of practices which are commonly embedded within contextual cultural milieu, reflecting community beliefs, experiences, religion and spirituality. Evidence from across the world, especially from low- and middle-income countries (LMIC), suggests that TCM is commonly used by a large number of persons with mental illness. Even though some overlap exists between the diagnostic approaches of TCM and conventional biomedicine (CB), there are major differences, largely reflecting differences in the understanding of the nature and etiology of mental disorders. However, treatment modalities employed by providers of TCM may sometimes fail to meet common understandings of human rights and humane care. Still, there are possibilities for collaboration between TCM and CB in the care of persons with mental illness. Research is required to clearly delineate the boundaries of such collaboration and to test its effectiveness in bringing about improved patient outcomes.
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Affiliation(s)
- Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Gareth Nortje
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | | | | | - Soraya Seedat
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rachel Jenkins
- Health Service and Population Research Department, Institute of Psychiatry, King's College, London
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Nunes FG, Anderson JE, Martins LM. Patient reactions to community pharmacies' roles: evidence from the Portuguese market. Health Expect 2014; 18:2853-64. [PMID: 25229450 DOI: 10.1111/hex.12269] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2014] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND There is little knowledge about how patients perceive and react to the extended role of community pharmacies. AIM To develop a model describing the expanded role of Portuguese community pharmacies as comprising three roles - medicines supplier, advice provider and community health promoter - and two important patient reactions: satisfaction and loyalty. DESIGN In 2010, 1200 face-to-face interviews were conducted with patients of community pharmacies in Portugal. A model comprising the three pharmacy roles and the two patient reactions was developed and tested using structural equation modelling. RESULTS The results showed that the model was appropriate and that the roles of medicines supplier, advice provider and community health promoter were positively related to patients' satisfaction and loyalty. CONCLUSIONS These results show that patients are aware of the different roles played by community pharmacies in Portugal. The data support the idea that the movement of Portuguese pharmacists' extended role, framed within a global context where society sends expectations regarding the role of organizations in the community in which they operate, is producing positive results for both patients and pharmacists.
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Affiliation(s)
- Francisco G Nunes
- Department of Human Resources Management and Organizational Behavior, ISCTE-IUL, Lisbon, Portugal
| | - Janet E Anderson
- Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK
| | - Luis M Martins
- Department of Human Resources Management and Organizational Behavior, ISCTE-IUL, Lisbon, Portugal
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Affiliation(s)
| | - Jorge Rakela
- Transplant Center, Mayo Clinic, Phoenix, Arizona
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Liu CH, Tang WR, Wang HM, Lee KC. How cancer patients build trust in traditional Chinese medicine. Eur J Integr Med 2013. [DOI: 10.1016/j.eujim.2013.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Eskandari M, Abbaszadeh A, Borhani F. The outcomes of health care process in Iran's rural society. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2013; 18:384-90. [PMID: 24403941 PMCID: PMC3877461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Health care systems in rural areas face numerous challenges in meeting the community's needs and adequate attention has not been paid to this problem. The aim of this study was to describe the outcomes of health care process in rural society. MATERIALS AND METHODS Twenty-six participants including twenty-one rural health care providers and five clients were selected according to purposive sampling. The data were collected via semi-structured individual interviews and a mini focus group. Data were analyzed by using qualitative content analysis based on methods described by Granheme and Landman. RESULTS Data analysis eventually led to formation of one category of inefficiency in health care process in rural society including subcategories such as arbitrary self-therapy, slow care process, dissatisfaction with the care process, superficial caring, job stress and burn out of caregivers, and ineffective caring relationship. CONCLUSION Outcomes in health care in rural society of Iran represents inefficiency of the current health care process. These outcomes are related to the cultural and social context of rural communities and the structure of the health system. These outcomes in health care in the rural society of Iran represent impairment of the current health care process. The necessity of modifying the existing care trend with new models designed to improve the health care process is felt.
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Affiliation(s)
- Manije Eskandari
- Depatment of Nursing and Midwifery, Arsanjan Branch, Islamic Azad University, Arsanjan, Iran
| | - Abbas Abbaszadeh
- Abbaszadeh Abbas, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran,Address for correspondence: Abbaszadeh Abbas, Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran. E-mail:
| | - Fariba Borhani
- Borhani Fariba, Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Shuval JT, Averbuch E. Complementary and alternative health care in Israel. Isr J Health Policy Res 2012; 1:7. [PMID: 22913721 PMCID: PMC3424827 DOI: 10.1186/2045-4015-1-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 02/20/2012] [Indexed: 11/10/2022] Open
Abstract
The paper explores the patterns of coexistence of alternative/complementary health care (CAM) and conventional medicine in Israel in the cultural, political, and social contexts of the society. The data are drawn from over ten years of sociological research on CAM in Israel, which included observation, survey research, and over one hundred in-depth interviews with a variety of CAM practitioners - many with bio-medical credentials - and with policy makers in the major medical institutions. The analysis considers the reasons for CAM use, number of practitioners, the frequency of CAM use and some of its correlates, and how CAM is regulated. The structure of the relationship between the conventional health care system and CAM is discussed in the public sector, which provides two-thirds of CAM services, and in the private sector, which provides about one-third. The history of the development of these structures and some of the dilemmas of their operation are discussed. A number of policy issues are considered against this background: regulation and licensing, CAM in primary care, reimbursement for CAM treatment, and the inclusion of CAM in education and training for the health professions.
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Affiliation(s)
- Judith T Shuval
- Rose Chair in the Sociology of Health, School of Public Health and Department of Sociology and Anthropology, Hebrew University of Jerusalem, Avizohar 8-671, Jerusalem 96267, Israel
| | - Emma Averbuch
- School of Public Health, Hebrew University of Jerusalem and Israel Ministry of Health, Ben Tabai 2, Jerusalem 91010, Israel
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Viksveen P, Steinsbekk A. Undergraduate homeopathy education in Europe and the influence of accreditation. HOMEOPATHY 2012; 100:253-8. [PMID: 21962200 DOI: 10.1016/j.homp.2011.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 06/12/2011] [Accepted: 06/22/2011] [Indexed: 11/20/2022]
Abstract
CONTEXT The safety of patients consulting with practitioners of complementary and alternative medicine (CAM) partially depends on practitioners' competence, and thus the standard of undergraduate education. OBJECTIVES Describe undergraduate homeopathy courses in Europe, student/graduate numbers and whether there were differences between recognised/accredited and non-recognised/non-accredited courses. METHODS Cross sectional survey of current homeopathy undergraduate education in Europe in 2008. Data from 145 (94.8%) out of 153 identified courses were collected. Eighty-five (55.6%) responded to a questionnaire survey. For others some data was extracted from their websites. Only data from the questionnaire survey is used for the main analysis. FINDINGS The average course in the questionnaire survey had 47 enrolled students and 142 graduates, and lasted 3.6 years part-time. An estimated 6500 students were enrolled and 21,000 had graduated from 153 identified European undergraduate homeopathy courses. Out of 85 courses most had entry requirements and provided medical education (N = 48) or required students to obtain this competence elsewhere (N = 33). The average number of teaching hours were 992 (95% confidence interval (CI) 814, 1170) overall, with 555 h (95%CI 496, 615) for homeopathy. Four out of five courses were recognised/accredited. Recognised/accredited part-time courses lasted significantly longer than non-recognised/non-accredited courses (difference 0.6 years, 95%CI 0.0-1.2, P = 0.040), and offered significantly larger numbers of teaching hours in homeopathy (difference 167 h, 95%CI 7-327, P = 0.041). CONCLUSIONS About 6500 currently enrolled students are doing undergraduate homeopathy education in Europe and 21,000 have graduated from such courses over a period of about 30 years. Undergraduate homeopathy education in Europe is heterogeneous. Recognised/accredited courses are more extensive with more teaching hours.
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Affiliation(s)
- Petter Viksveen
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
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Kadayat TM, Bist G, Parajuli A, Karki R, Kaundinnyayana A, Dhami N. Patterns and perception of complementary and alternative medicine use by patients in western Nepal. J Public Health (Oxf) 2011. [DOI: 10.1007/s10389-011-0446-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Personal health budgets: A new way of accessing complementary therapies? Complement Ther Clin Pract 2011; 17:76-80. [DOI: 10.1016/j.ctcp.2010.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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van der Schee E, Groenewegen PP. Determinants of public trust in complementary and alternative medicine. BMC Public Health 2010; 10:128. [PMID: 20226015 PMCID: PMC2848199 DOI: 10.1186/1471-2458-10-128] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Accepted: 03/12/2010] [Indexed: 12/02/2022] Open
Abstract
Background In the Netherlands, public trust in conventional medicine is relatively high. There is reason to believe that public trust in complementary and alternative medicine (CAM) is rated lower. The aim of this study is to gain insight into public trust in CAM and the determinants that lie at the root of it. We hypothesized that public trust in CAM is related to (perceived) institutional guarantees, media information on CAM, information from people's social network, personal experiences, the role of general practitioners (GPs) and trust in conventional medicine. Methods A postal questionnaire on public trust in CAM was mailed to 1358 members of the Health Care Consumer Panel. 65% of the questionnaires were returned. Data were analysed using frequencies, ANOVA, post hoc testing and linear regression analyses. Results In the total sample, the level of public trust in CAM was a 5.05 on average on a scale of 1-10. 40.7% was CAM user (current or past) and displayed significantly higher levels of trust toward CAM than CAM non users. In the total sample, public trust in CAM was related to institutional guarantees, negative media information, positive and negative information reported by their social network and people's personal experiences with CAM. For non users, trust is mostly associated with institutional guarantees. For users, personal experiences are most important. For both users and non users, trust levels in CAM are affected by negative media information. Public trust in CAM is for CAM users related to positive information and for non users to negative information from their network. Conclusions In the Netherlands, CAM is trusted less than conventional medicine. The hypotheses on institutional guarantees, media information, information from the network and people's personal experiences are confirmed by our study for the total sample, CAM non users and users. The other hypotheses are rejected.
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Affiliation(s)
- Evelien van der Schee
- ParnassiaBavogroep, Brijder Addiction Care, Parnassia Addiction Research Center, The Hague, Monsterseweg 83, 2553 RJ, The Netherlands.
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Heiligers PJM, de Groot J, Koster D, van Dulmen S. Diagnoses and visit length in complementary and mainstream medicine. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2010; 10:3. [PMID: 20100343 PMCID: PMC2833139 DOI: 10.1186/1472-6882-10-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Accepted: 01/25/2010] [Indexed: 12/02/2022]
Abstract
Background The demand for complementary medicine (CM) is growing worldwide and so is the supply. So far, there is not much insight in the activities in Dutch CM practices nor in how these activities differ from mainstream general practice. Comparisons on diagnoses and visit length can offer an impression of how Dutch CM practices operate. Methods Three groups of regularly trained physicians specialized in CM participated in this study: 16 homeopathic physicians, 13 physician acupuncturists and 11 naturopathy physicians. Every CM physician was asked to include a maximum of 75 new patients within a period of six months. For each patient an inclusion registration form had to be completed and the activities during a maximum of five repeat visits were subsequently registered. Registrations included patient characteristics, diagnoses and visit length. These data could be compared with similar data from general practitioners (GPs) participating in the second Dutch national study in general practice (DNSGP-2). Differences between CM practices and between CM and mainstream GP data were tested using multilevel regression analysis. Results The CM physicians registered activities in a total of 5919 visits in 1839 patients. In all types of CM practices general problems (as coded in the ICPC) were diagnosed more often than in mainstream general practice, especially fatigue, allergic reactions and infections. Psychological problems and problems with the nervous system were also diagnosed more frequently. In addition, each type of CM physician encountered specific health problems: in acupuncture problems with the musculoskeletal system prevailed, in homeopathy skin problems and in naturopathy gastrointestinal problems. Comparisons in visit length revealed that CM physicians spent at least twice as much time with patients compared to mainstream GPs. Conclusions CM physicians differed from mainstream GPs in diagnoses, partly related to general and partly to specific diagnoses. Between CM practices differences were found on specific domains of complaints. Visit length was much longer in CM practices compared to mainstream GP visits, and such ample time may be one of the attractive features of CM for patients.
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Lourenco MT, Walsh A, Boon H, Al-Khabouri M, Brandwein J, Gupta V, Schuh A, Yee K, Rodin G, Schimmer AD. Superstition but not distrust in the medical system predicts the use of complementary and alternative medicine in a group of patients with acute leukemia. Leuk Lymphoma 2009; 49:339-41. [DOI: 10.1080/10428190701742480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Harris LR, Roberts L. Treatments for irritable bowel syndrome: patients' attitudes and acceptability. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2008; 8:65. [PMID: 19099570 PMCID: PMC2633319 DOI: 10.1186/1472-6882-8-65] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Accepted: 12/19/2008] [Indexed: 12/11/2022]
Abstract
BACKGROUND Irritable Bowel Syndrome, a highly prevalent chronic disorder, places significant burden on the health service and the individual. Symptomatic distress and reduced quality of life are compounded by few efficacious treatments available. As researchers continue to demonstrate the clinical efficacy of alternative therapies, it would be useful to gain a patient-perspective of treatment acceptability and identify patient's attitudes towards those modalities considered not acceptable. METHODS Six hundred and forty-five participants identified from an earlier IBS-prevalence study received a postal questionnaire to evaluate preferences and acceptability of nine forms of treatment. Proportions accepting each form of treatment were calculated and thematic analysis of qualitative data undertaken. RESULTS A total of 256 (39.7%) of 645 potential respondents completed the questionnaire (mean age 55.9 years, 73% female). Tablets were most acceptable (84%), followed by lifestyle changes (diet (82%), yoga (77%)). Acupuncture (59%) and suppositories (57%) were less acceptable. When explaining lack of acceptability, patient views fell into four broad categories: dislike treatment modality, do not perceive benefit, general barriers and insufficient knowledge. Scepticism, lack of scientific rationale and fear of CAM were mentioned, although others expressed a dislike of conventional medical treatments. Past experiences, age and health concerns, and need for proof of efficacy were reported. CONCLUSION Most patients were willing to accept various forms of treatment. However, the reservations expressed by this patient-population must be recognised with particular focus directed towards allaying fears and misconceptions, seeking further evidence base for certain therapies and incorporating physician support and advice.
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Affiliation(s)
- Lynsey R Harris
- School of Medicine, C/O Lesley Roberts, Primary Care Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Lesley Roberts
- Primary Care Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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Joos S, Musselmann B, Miksch A, Rosemann T, Szecsenyi J. The role of complementary and alternative medicine (CAM) in Germany - a focus group study of GPs. BMC Health Serv Res 2008; 8:127. [PMID: 18549476 PMCID: PMC2442431 DOI: 10.1186/1472-6963-8-127] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2007] [Accepted: 06/12/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There has been a marked increase in the use of complementary and alternative medicine (CAM) in recent years worldwide. In Germany, apart from 'Heilpraktiker' (= state-licensed, non-medical CAM practitioners), some general practitioners (GPs) provide CAM in their practices. This paper aims to explore the attitudes of GPs about the role of CAM in Germany, in relation to the healthcare system, quality of care, medical education and research. Furthermore, experiences of GPs integrating CAM in their daily practice were explored. METHODS Using a qualitative methodological approach 3 focus groups with a convenience sample of 17 GPs were conducted. The discussions were transcribed verbatim and analysed using qualitative content analysis. RESULTS The majority of the participating GPs had integrated one or more CAM therapies into their every-day practice. Four key themes were identified based on the topics covered in the focus groups: the role of CAM within the German healthcare system, quality of care, education and research. Within the theme 'role of CAM within the healthcare system' there were five categories: integration of CAM, CAM in the Statutory Health Insurance, modernisation of the Statutory Health Insurance Act, individual healthcare services and 'Heilpraktiker'. Regarding quality of care there were two broad groups of GPs: those who thought patients would benefit from standardizing CAM and those who feared that quality control would interfere with the individual approach of CAM. The main issues identified relating to research and education were the need for the development of alternative research strategies and the low quality of existing CAM education respectively. CONCLUSION The majority of the participating GPs considered CAM as a reasonable complementary approach within primary care. The study increased our understanding of GPs attitudes about the role of CAM within the German healthcare system and the use of 'Heilpraktiker' as a competing CAM-provider. It seems to be a need for increased funding for research, better education and remuneration by the Statutory Health Insurance in order to improve access to 'Integrative medicine' in Germany.
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Affiliation(s)
- Stefanie Joos
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Vossstrasse 2, 69115 Heidelberg, Germany.
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Enhancing chronic disease management: a review of key issues and strategies. Complement Ther Clin Pract 2007; 13:232-9. [PMID: 17950178 DOI: 10.1016/j.ctcp.2007.06.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2007] [Revised: 04/20/2007] [Accepted: 06/10/2007] [Indexed: 11/21/2022]
Abstract
This paper highlights three selected issues and potential strategies towards meeting chronic disease management needs. First, the orientation of the biomedical science model often gives insufficient attention to chronic health care needs. A second issue is that the use of complementary and alternative medicine (CAM) may offer for some an opportunity to enhance their chronic disease management efforts. A third issue is that our understanding of this potential is limited, as many who use CAM do not disclose such use. With reference to proposed solutions/strategies, first, an improved focus to respect patient/client values and goals may encourage people to disclose their use of CAM. Second, a community-based participatory approach shows promise in enhancing communication plus helps integrate CAM within new models of chronic disease management. Lastly, those in public health could help facilitate such an approach plus be a monitor of CAM practices. Overall, this review provides a springboard for further research and practice in CAM and the management of chronic diseases.
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