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Shim JM, Kim J. Contextualizing geneticization and medical pluralism: How variable institutionalization of traditional, complementary, and alternative medicine (TCAM) conditions effects of genetic beliefs on utilization. Soc Sci Med 2020; 267:113349. [PMID: 33008647 DOI: 10.1016/j.socscimed.2020.113349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/21/2020] [Accepted: 09/03/2020] [Indexed: 12/17/2022]
Abstract
As genetic models are increasingly incorporated in medicine, health service users seem to accept these models to varying degrees. To appreciate these differences, this paper examines how health service users' genetic beliefs of health are associated with their use of traditional, complementary, and alternative medicine (TCAM) via responses from 31 countries in the 2011 ISSP survey. It finds an interesting contrast between East Asian countries and other countries in the world. The negative association between genetic beliefs and TCAM use is strong in the latter, whereas it is weak in the former. More intriguingly, the analysis demonstrates significant cross-national differences within East Asian countries. Chinese and Koreans reveal a negative relationship between genetic beliefs and TCAM use, while Japanese show a positive relationship. The paper provides an explanation to these cross-national differences by drawing on comparative studies of medical systems. When TCAM is institutionalized as valid and distinct medical resources, and when TCAM is practically available to everyday use, health service users who subscribe to genetic beliefs are likely to use TCAM as well. These findings contribute to revealing the pragmatic nature of health-seeking action and the institutional context in which geneticization and medical pluralism are conditioned to form.
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Affiliation(s)
- Jae-Mahn Shim
- Department of Sociology, Korea University, Seoul, Republic of Korea.
| | - Jibum Kim
- Department of Sociology, Sungkyunkwan University, Seoul, Republic of Korea.
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Petkova V, Hadzhieva B, Nedialkov P. Phytotherapeutic approaches to treatment and prophylaxis in pediatric practice. PHARMACIA 2019. [DOI: 10.3897/pharmacia.66.e37954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Medicinal plants, their extracts and herbal medicinal products occupy a growing share of medicines in the pharmacy worldwide.
Historically, the first medicines were products of plants, as well as some of the most important medicines still in use today. With the development of phytochemistry, as part of the pharmaceutical science, great progress has been made in the isolation and in determining the value of a number of biologically active substances (BAS).
Many plants have yielded pure substances (or natural products) that are applied in modern medical practice. Other compounds are potentially useful or have toxic effects.
Traditional medicine incorporating many herbal medicines remains an important (and in some cases, the only) form of treatment in some countries, with increasing use in medical practice.
On the other hand, the fact that in pediatric patients there is a limitation, mainly moral and ethical, of the number of medications to be administered due to the difficulty of conducting clinical trials in children, stimulates the use of herbal medicines of proven quality, effectiveness and safety among this group of patients.
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Krueger K, Cless JD, Dyster M, Reves M, Steele R, Nelson Goff BS. Understanding the Systems, Contexts, Behaviors, and Strategies of Parents Advocating for Their Children With Down Syndrome. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 57:146-157. [PMID: 30920907 DOI: 10.1352/1934-9556-57.2.146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In the current qualitative research study, we focused on understanding the ecological systems, contexts, behaviors, and strategies of parents ( N = 435) advocating for their children with an intellectual and developmental disability diagnosis, specifically Down syndrome (DS). Based on the data analysis, parents of children with DS advocate for their children frequently, in a variety of settings, with different actions, attitudes, motivations, and outcomes. The most common settings where advocacy occurred were primarily school and healthcare systems. The goals of parents often included inclusiveness, equality, and acceptance, whereas a few parents reported advocating due to discrimination and judgment. Implications for further research and professional practice also are described.
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Affiliation(s)
- Kristen Krueger
- Kristen Krueger, Kansas State University; Jessica D. Cless, Washburn University; and Meghan Dyster, Mollie Reves, Robert Steele, and Briana S. Nelson Goff, Kansas State University
| | - Jessica D Cless
- Kristen Krueger, Kansas State University; Jessica D. Cless, Washburn University; and Meghan Dyster, Mollie Reves, Robert Steele, and Briana S. Nelson Goff, Kansas State University
| | - Meghan Dyster
- Kristen Krueger, Kansas State University; Jessica D. Cless, Washburn University; and Meghan Dyster, Mollie Reves, Robert Steele, and Briana S. Nelson Goff, Kansas State University
| | - Mollie Reves
- Kristen Krueger, Kansas State University; Jessica D. Cless, Washburn University; and Meghan Dyster, Mollie Reves, Robert Steele, and Briana S. Nelson Goff, Kansas State University
| | - Robert Steele
- Kristen Krueger, Kansas State University; Jessica D. Cless, Washburn University; and Meghan Dyster, Mollie Reves, Robert Steele, and Briana S. Nelson Goff, Kansas State University
| | - Briana S Nelson Goff
- Kristen Krueger, Kansas State University; Jessica D. Cless, Washburn University; and Meghan Dyster, Mollie Reves, Robert Steele, and Briana S. Nelson Goff, Kansas State University
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Can EGCG Alleviate Symptoms of Down Syndrome by Altering Proteolytic Activity? Int J Mol Sci 2018; 19:ijms19010248. [PMID: 29342922 PMCID: PMC5796196 DOI: 10.3390/ijms19010248] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 01/10/2018] [Accepted: 01/10/2018] [Indexed: 12/12/2022] Open
Abstract
Down syndrome (DS), also known as "trisomy 21", is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. Silencing these extra genes is beyond existing technology and seems to be impractical. A number of pharmacologic options have been proposed to change the quality of life and lifespan of individuals with DS. It was reported that treatment with epigallocatechin gallate (EGCG) improves cognitive performance in animal models and in humans, suggesting that EGCG may alleviate symptoms of DS. Traditionally, EGCG has been associated with the ability to reduce dual specificity tyrosine phosphorylation regulated kinase 1A activity, which is overexpressed in trisomy 21. Based on the data available in the literature, we propose an additional way in which EGCG might affect trisomy 21-namely by modifying the proteolytic activity of the enzymes involved. It is known that, in Down syndrome, the nerve growth factor (NGF) metabolic pathway is altered: first by downregulating tissue plasminogen activator (tPA) that activates plasminogen to plasmin, an enzyme converting proNGF to mature NGF; secondly, overexpression of metalloproteinase 9 (MMP-9) further degrades NGF, lowering the amount of mature NGF. EGCG inhibits MMP-9, thus protecting NGF. Urokinase (uPA) and tPA are activators of plasminogen, and uPA is inhibited by EGCG, but regardless of their structural similarity tPA is not inhibited. In this review, we describe mechanisms of proteolytic enzymes (MMP-9 and plasminogen activation system), their role in Down syndrome, their inhibition by EGCG, possible degradation of this polyphenol and the ability of EGCG and its degradation products to cross the blood-brain barrier. We conclude that known data accumulated so far provide promising evidence of MMP-9 inhibition by EGCG in the brain, which could slow down the abnormal degradation of NGF.
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Provenzi L, Barello S, Saettini F, Scotto di Minico G, Borgatti R. Paediatricians should encourage the parents of children with special healthcare needs to disclose their use of complementary and alternative medicine. Acta Paediatr 2017; 106:1883-1884. [PMID: 28664664 DOI: 10.1111/apa.13967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Livio Provenzi
- 0-3 Center for the at-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Serena Barello
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Francesco Saettini
- Department of Pediatrics, San Gerardo Hospital, Università Degli Studi Milano-Bicocca, Monza, Italy
| | - Giunia Scotto di Minico
- 0-3 Center for the at-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Renato Borgatti
- Department of Child and Adolescent Neurology and Psychiatry, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Italy
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Douglas T, Redley B, Ottmann G. The need to know: The information needs of parents of infants with an intellectual disability-a qualitative study. J Adv Nurs 2017; 73:2600-2608. [DOI: 10.1111/jan.13321] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Tracy Douglas
- School of Nursing and Midwifery; Deakin University; Burwood Vic. Australia
| | - Bernice Redley
- School of Nursing and Midwifery; Deakin University; Burwood Vic. Australia
- Centre for Nursing Research-Deakin University and Monash Health Partnership; Burwood Vic. Australia
| | - Goetz Ottmann
- School of Health and Social Development; Deakin University; Burwood Vic. Australia
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Provenzi L, Saettini F, Barello S, Borgatti R. Complementary and alternative medicine (CAM) for children with special health care needs: A comparative usage study in Italy. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2015.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Utilization patterns of conventional and complementary/alternative treatments in children with autism spectrum disorders and developmental disabilities in a population-based study. J Dev Behav Pediatr 2014; 35:1-10. [PMID: 24399100 PMCID: PMC3896860 DOI: 10.1097/dbp.0000000000000013] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To compare the utilization of conventional treatments and utilization of complementary and alternative medicine in preschoolers with autism spectrum disorders (ASD) and other developmental disabilities (DD). METHODS Participants were 578 children who were part of an ongoing population-based, case-control study of 2- to 5-year olds with ASD, DD, and the general population. Parents completed an interview on past and current services. RESULTS Four hundred fifty-three children with ASD and 125 DD children were included. ASD families received more hours of conventional services compared with DD families (17.8 vs 11; p < .001). The use of psychotropic medications was low in both groups (approximately 3%). Overall, complementary and alternative medicine (CAM) use was not significantly different in ASD (39%) versus DD (30%). Hispanic families in both groups used CAM less often than non-Hispanic families. Variables such as level of function, immunization status, and the presence of an identified neurogenetic disorder were not predictive of CAM use. A higher level of parental education was associated with an increased CAM use in ASD and DD. Families who used >20 hours per week of conventional services were more likely to use CAM, including potentially unsafe or disproven CAM. Underimmunized children were marginally more likely to use CAM but not more likely to have received potentially unsafe or disproven CAM. CONCLUSION Use of CAM is common in families of young children with neurodevelopmental disorders, and it is predicted by higher parental education and non-Hispanic ethnicity but not developmental characteristics. Further research should address how health care providers can support families in making decisions about CAM use.
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Ho EY, D'Agostino TA, Yadegar V, Burke A, Bylund CL. Teaching patients how to talk with biomedical providers about their complementary and alternative medicine use. PATIENT EDUCATION AND COUNSELING 2012; 89:405-410. [PMID: 22503146 DOI: 10.1016/j.pec.2012.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Revised: 03/09/2012] [Accepted: 03/10/2012] [Indexed: 05/31/2023]
Abstract
OBJECTIVE The goal was to examine the feasibility and impact of a face-to-face communication skills training intervention based on a current public health campaign to encourage patients to talk about complementary and alternative medicine (CAM) with their biomedical health providers. METHODS Current CAM users were invited to complete a survey about current/past CAM use and communication with biomedical providers before beginning a communication skills training workshop. In the 6-month period following the training, participants were asked to record information on any CAM conversations with those providers. RESULTS Of the 38 participants who received training, 32 finished the entire study. Over half of those participants reported discussing CAM in post-training visits with biomedical providers. Participants initiated the conversation in most cases, and were more likely to disclose CAM use than they were to ask questions about CAM. Participants who talked about CAM were significantly more likely to perceive CAM as relevant to their visit, compared with individuals who did not talk about CAM. CONCLUSIONS Participants positively evaluated this patient communication workshop. Consistent with previous research, most CAM conversations were patient-initiated. PRACTICE IMPLICATIONS These findings reinforce the importance of patient education interventions for improving patient-provider communication in general, and CAM communication specifically.
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Affiliation(s)
- Evelyn Y Ho
- Department of Communication Studies, University of San Francisco, San Francisco, CA 94117, USA.
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Cassell CH, Mendez DD, Strauss RP. Maternal Perspectives: Qualitative Responses about Perceived Barriers to Care among Children with Orofacial Clefts in North Carolina. Cleft Palate Craniofac J 2012; 49:262-9. [DOI: 10.1597/09-235] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To examine maternal perceptions of barriers to care of children with orofacial clefts (OFC) in a population-based survey that solicited open-ended qualitative responses. Design and Setting In 2006, a combination mail/phone survey was sent to all mothers of children with OFC. The questionnaire included 76 items. A final open-ended question was included for additional information about cleft-related care. The analysis included responses to the open-ended question and sociodemographic characteristics of the respondents. Qualitative responses were transcribed and entered into a qualitative software package for analysis, and common themes were elucidated. Participants/Patients The North Carolina Birth Defects Monitoring Program was used to identify all resident infants born with OFC from 2001 to 2004. Of 478 eligible mothers, 52.9% (n = 248) responded to the survey, and 39.5% (n = 98) responded to the final open-ended question. Main Outcome Measures Percentage reporting problems accessing care, frequency of positive and negative comments, and indicators of financial, personal, and structural barriers to care. Results Of the 98 respondents, the majority (n = 95, 96.99%) were the biological mother. Almost 40% of mothers indicated that accessing primary craniofacial care was a problem. Of those citing perceived barriers to care, the major issues cited were financial, structural, and personal barriers. Conclusions Collaborative efforts between craniofacial centers and teams, health care systems, and birth defects registries are warranted to reduce perceived barriers to care among families of children with OFC. Further exploration of the themes and factors associated with barriers to care and services is needed.
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Affiliation(s)
- Cynthia H. Cassell
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina
| | - Dara D. Mendez
- University of Pittsburgh, Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Ronald P. Strauss
- Departments of Dental Ecology, Epidemiology, and Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Birdee GS, Phillips RS, Davis RB, Gardiner P. Factors associated with pediatric use of complementary and alternative medicine. Pediatrics 2010; 125:249-56. [PMID: 20100769 PMCID: PMC3057373 DOI: 10.1542/peds.2009-1406] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Limited data are available on the use of complementary and alternative medicine (CAM) and factors associated with use among the pediatric population in the United States. METHODS Using the 2007 National Health Interview Survey data among individuals <18 years of age (n = 9417), we compared CAM users (excluding those using vitamins and minerals) and non-CAM users. Using bivariable and multivariable logistic regression models, we examined independent associations of CAM use with sociodemographic factors, prescription medication use, delays in health care caused by access difficulties, and common medical conditions/symptoms. RESULTS In an adjusted multivariable logistic model, CAM users were more likely than non-CAM users to be adolescents rather than infants or toddlers (adjusted odds ratio [aOR]: 1.61 [95% confidence interval (CI): 1.11-2.34]); live in the West (aOR: 2.05 [95% CI: 1.62-2.59]), Northeast (aOR: 1.36 [95% CI: 1.02-1.80]), or Midwest (aOR: 1.35 [95% CI: 1.04-1.74]) compared with those in the South; more likely to have a parent with a college education (aOR: 4.33 [95% CI: 2.92-6.42]); and more likely to use prescription medication (aOR: 1.51 [95% CI: 1.19-1.92]). Pediatric CAM users were more likely to have anxiety or stress (aOR: 2.54 [95% CI: 1.89-3.42]), dermatologic conditions (aOR: 1.35 [95% CI: 1.03-1.78]), musculoskeletal conditions (aOR: 1.94 [95% CI: 1.31-2.87]), and sinusitis (aOR: 1.54 [95% CI: 1.11-2.14]). Use of CAM by a parent was strongly associated with the child's use of CAM (aOR: 3.83 [95% CI: 3.04-4.84]). CONCLUSIONS In 2007, pediatric CAM users were more likely to take prescription medications, have a parent who used CAM, and have chronic conditions such as anxiety or stress, musculoskeletal conditions, dermatologic conditions, or sinusitis. Research is required to guide pediatricians in making recommendations on CAM modalities for children including potential risks and/or benefits and interactions with conventional therapies.
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Affiliation(s)
- Gurjeet S. Birdee
- Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School Osher Research Center, Boston, Massachusetts,Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Russell S. Phillips
- Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School Osher Research Center, Boston, Massachusetts,Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Roger B. Davis
- Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School Osher Research Center, Boston, Massachusetts,Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Paula Gardiner
- Department of Family Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
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Kemper KJ, Vohra S, Walls R. American Academy of Pediatrics. The use of complementary and alternative medicine in pediatrics. Pediatrics 2008; 122:1374-86. [PMID: 19047261 DOI: 10.1542/peds.2008-2173] [Citation(s) in RCA: 191] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The American Academy of Pediatrics is dedicated to optimizing the well-being of children and advancing family-centered health care. Related to these goals, the American Academy of Pediatrics recognizes the increasing use of complementary and alternative medicine in children and, as a result, the need to provide information and support for pediatricians. From 2000 to 2002, the American Academy of Pediatrics convened and charged the Task Force on Complementary and Alternative Medicine to address issues related to the use of complementary and alternative medicine in children and to develop resources to educate physicians, patients, and families. One of these resources is this report describing complementary and alternative medicine services, current levels of utilization and financial expenditures, and associated legal and ethical considerations. The subject of complementary and alternative medicine is large and diverse, and consequently, an in-depth discussion of each method of complementary and alternative medicine is beyond the scope of this report. Instead, this report will define terms; describe epidemiology; outline common types of complementary and alternative medicine therapies; review medicolegal, ethical, and research implications; review education and training for complementary and alternative medicine providers; provide resources for learning more about complementary and alternative medicine; and suggest communication strategies to use when discussing complementary and alternative medicine with patients and families.
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Baum RA, Nash PL, Foster JEA, Spader M, Ratliff-Schaub K, Coury DL. Primary care of children and adolescents with down syndrome: an update. Curr Probl Pediatr Adolesc Health Care 2008; 38:241-61. [PMID: 18722332 DOI: 10.1016/j.cppeds.2008.07.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Rebecca A Baum
- Ohio State University, College of Medicine, Section of Developmental/Behavioral Pediatrics, Nationwide Children's Hospital, Columbus, Ohio, USA
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Communicating with children and parents: recommendations for a child-parent-centred approach for paediatric dentistry. Eur Arch Paediatr Dent 2008; 9 Suppl 1:16-22. [PMID: 18328244 DOI: 10.1007/bf03262651] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The European Academy of Paediatric Dentistry has called for a series of evidence-based statements to inform their guidelines on the behavioural management of the child patient. Communication between dentist, parent and child based upon scientifically robust research evidence was felt to be central to this request in order to provide empathetic and child-centred care for children and their parents attending for dental health care. REVIEW PROCESS Shekelle and colleagues [1999] devised a series of steps to develop an evidence-based clinical guideline. This framework allows first, the identification and refinement of the subject area and secondly, the identification and assessment of the evidence-base. Four areas of communication were identified as being of central importance. These were identification of the mother-child dyad; affective communication skills; problem solving and negotiation skills. CONCLUSION It was recommended that paediatric dentists should become knowledgeable and competent in these skills in order to provide patient-centred care for the children and parents attending their clinics for dental treatment.
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Sidora-Arcoleo K, Yoos HL, Kitzman H, McMullen A, Anson E. Don't ask, don't tell: parental nondisclosure of complementary and alternative medicine and over-the-counter medication use in children's asthma management. J Pediatr Health Care 2008; 22:221-9. [PMID: 18590866 PMCID: PMC2517627 DOI: 10.1016/j.pedhc.2007.07.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2007] [Revised: 07/09/2007] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Parent-health care provider (HCP) communication is an important component of pediatric asthma management. Given the high prevalence of complementary and alternative medicine (CAM) and over-the-counter (OTC) medication use among this population, it is important to examine parental nondisclosure of these asthma management strategies. METHOD One-time interview and 1-year retrospective medical record review with 228 parents of 5- to 12-year-old children with asthma enrolled from six pediatric primary care practices examining parental nondisclosure of CAM and OTC medication use, reasons for nondisclosure, medical record documentation of CAM usage, and association between parent-HCP relationship and nondisclosure. RESULTS Seventy-one percent of parents reported using CAM and/or OTC medication for children's asthma management, and 54% of those parents did not disclose usage. Seventy-five percent "did not think" to discuss it. Better parent-HCP relationship led to decreased nondisclosure. DISCUSSION HCPs can play an important role in creating an environment where parents feel comfortable sharing information about their children's asthma management strategies in order to arrive at a shared asthma management plan for the child, leading to improved asthma health outcomes.
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Affiliation(s)
- Kimberly Sidora-Arcoleo
- Arizona State University College of Nursing & Healthcare Innovation, Phoenix, Arizona 85004, USA.
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Abstract
BACKGROUND Use of complementary and alternative medical therapies is common and increasing, particularly for children with chronic disease. OBJECTIVES The purpose of this work was to describe the use of complementary and alternative medicine by children and to identify factors that may influence the use of complementary and alternative medicine. PATIENTS AND METHODS We conducted a cross-sectional descriptive study with children who were visiting a pediatric outpatient clinic. Parent's satisfaction about primary care was evaluated with the Parent's Perceptions of Pediatric Primary Care Quality questionnaire. RESULTS Fifty-four percent of children used > or = 1 type of complementary and alternative medicine in the previous year. No sociodemographic characteristic difference was found between user and nonuser groups. Children most often used complementary and alternative medicine to treat musculoskeletal problems (27%), psychological problems (24%), or infections (20%). Factors that influenced complementary and alternative medicine use were "word of mouth" (36%), "reference by a physician" (28%), "personal experience by parents" (28%), and "no adequate resources in 'traditional' medicine" (21%). Forty-seven percent of complementary and alternative medicine users used prescribed medications simultaneously. Most users (75%) believed that complementary and alternative medicine had no potential adverse effects or interactions with prescribed medication. Only 44% of complementary and alternative users were known as such by their physician. The primary care satisfaction was significantly lower in complementary and alternative users versus nonusers. Parents of complementary and alternative users were less satisfied in the areas of accessibility, knowledge of the patient, and communication. CONCLUSIONS Complementary and alternative medicine was used by 54% of the children in our cohort. Complementary and alternative medicine users were less satisfied with primary care than nonusers. Only 44% of complementary and alternative medicine users were known by their physician. It is important that physicians systematically elicit families' expectations of treatment and be aware of the range of therapies used by children.
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Affiliation(s)
- Dany Jean
- Département de Pédiatrie, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, Canada
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Samdup DZ, Smith RG, Il Song S. The Use of Complementary and Alternative Medicine in Children with Chronic Medical Conditions. Am J Phys Med Rehabil 2006; 85:842-6. [PMID: 16998432 DOI: 10.1097/01.phm.0000233183.17059.b9] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objectives of this study were to examine whether progressive medical conditions lead to greater use of complementary and alternative medicine (CAM) as compared with more stable conditions, to see whether disease severity influences CAM use, and to identify the main motivations behind CAM use. METHODS Subjects were selected from outpatient clinics at Hotel Dieu Hospital. Surveys were conducted by mail and telephone. Medical diagnosis and severity were obtained from medical files. Statistical tests included chi, Kruskal-Wallis, and correlations. RESULTS One hundred ninety-four children were surveyed. The "progressive" group included 15 patients with Duchenne muscular dystrophy and 22 patients with cystic fibrosis. The "nonprogressive" group included 85 patients with cerebral palsy (CP), 49 with diabetes mellitus, and 23 with spina bifida. Twenty-three percent were using CAM. CP had the highest use; diabetes mellitus had the lowest. Popular therapies included massage and dietary/herbal remedies. Progressiveness had no impact on CAM use. Within the CP group, greater disease severity was associated with higher use (P < 0.001). The main reason for CAM use was to complement conventional medicine. CONCLUSIONS Disease progressiveness had no impact on CAM use, but severity within the CP group did. Complementing conventional medicine was the main motive. Understanding the reasons and patterns of use of CAM is beneficial in efforts to improve the care of children with chronic medical conditions.
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Affiliation(s)
- Dawa Z Samdup
- Faculty of Health Sciences, Queens University, Kingston, Ontario, Canada
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Abstract
In their role as committed advocates, parents of children with Down syndrome have always sought alternative therapies, mainly to enhance cognitive function but also to improve their appearance. Nutritional supplements have been the most frequent type of complementary and alternative therapy used. Cell therapy, plastic surgery, hormonal therapy, and a host of other therapies such as massage therapy have been used. There is a lack of well-designed scientific studies on the use of alternative therapies in individuals with Down syndrome. Antioxidants hold theoretical promise for treatment of the cognitive, immune, malignancy, and premature aging problems associated with Down syndrome. Medications for treatment of Alzheimer's disease may also result in benefit for the population of individuals with Down syndrome.
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Affiliation(s)
- Nancy J Roizen
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, New York 13210, USA.
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Abstract
Developmental disabilities (DD) are defined as a diverse group of severe chronic conditions due to mental and/or physical impairments. Individuals with developmental disabilities have difficulty with major life activities including language, mobility, and learning. Developmental disabilities can begin anytime during development--from prenatal up to 22 years of age, and the disability usually lasts throughout a person's lifetime. Autism spectrum disorders, cerebral palsy, mental retardation, and attention deficit hyperactivity disorder are common conditions falling within the definition of developmental disabilities. Complementary and alternative medicine (CAM) is becoming increasingly utilized in the general population for treatment of everything from the common cold to complex and chronic medical conditions. This article reviews the prevalence of different types of CAM used for various developmental disabilities.
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Affiliation(s)
- Kelly A Brown
- Kalamazoo Center for Medical Studies, Michigan State University College of Human Medicine, Kalamazoo, Michigan, USA
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