Predictors of Complementary and Alternative Medicine Use by Breast Cancer Patients in Bandung, Indonesia

Alternative Medicine-Seeking Behavior among Cancer Patients at The Indonesian Cancer Foundation

Background: A large proportion of cancer deaths are caused by patient delay in accessing hospital treatment. One of the causes of such delays is the use of alternative medicine. Purpose: This research is conducted to determine the characteristics and factors related to the behavior of seeking treatment in the form of alternative medicine among cancer patients at the Indonesian Cancer Foundation (Yayasan Kanker Indonesia). Methods: This research is a quantitative descriptive research with a cross-sectional study design. The target of the research is all patients who temporarily stayed at the Yayasan Kanker Indonesia from February–April 2020, a total of 45 patients aged ≥ 17 years who had been diagnosed with cancer. The data was obtained via questionnaires and interviews. The variables examined are the predisposition factors (sex, age, education, occupation, stage of cancer, time ranges for accessing health services after symptom onset, prior illness, family history), enabling factors (distance to health services, income, health insurance), and reinforcing factors (family support and information resources). Analysis of research data was conducted using frequency tables and Chi-Square or Fisher's Exact test. Results: The factors related to the behavior of seeking treatment via alternative medicine in cancer patients at Yayasan Kanker Indonesia are the stage of cancer (p=0.04), the time span between symptom onset and checking into health services (p=0.02), and length of illness (p=0.03). Conclusion: Alternative treatment search behavior is influenced by several factors, namely the stage of cancer, the time span between symptom onset and checking into health services, and the length of illness.

Use of Complementary and Alternative Medicine in Patients with Primary Immunodeficiency: a Multicentric Analysis of 101 Patients

The term complementary and alternative medicine (CAM) describes a broad spectrum of health care practices that are not an integral part of the conventional health care system. Many patients worldwide use CAM on their own initiative, often in combination with their conventional medical therapy. CAM use is attractive especially to patients with primary immunodeficiency, since they suffer from frequent infections and autoimmunity. Those are frequently addressed by CAM providers. The aim of this multicentric study was to collect information on the use of CAM by these patients and to define characteristics that are associated with the use of CAM. A total of 101 patients with primary immunodeficiencies at German hospitals were surveyed on their CAM use (further 14 patients rejected to participate). Multiple psychological tests (MARS-D, WHO-5, PHQ9, EFQ) were conducted to investigate variations among personality traits associated with CAM use. Additionally, clinical and sociodemographic patient data was collected. A total of 72% of patients used CAM to treat their primary immunodeficiency. The three most frequently used methods were physical exercise or fitness training (65%), dietary supplements (58%), and homeopathy (49%). Most patients did not discuss CAM use with their doctors, mostly because they felt that there was no time for it. CAM plays an important role for patients with primary immunodeficiency in a high-resource health care setting such as Germany. In clinical practice, doctors should create a platform to discuss needs that go beyond conventional therapy.

A Self-Help Guided Psychoeducational Intervention for Indonesian Women with Breast Cancer Symptoms: Development and Pilot Feasibility Study

Background:

Delay in the diagnosis of breast cancer (BC) may lead to an advanced stage of the disease and a poor prognosis. A psychoeducational intervention can be crucial in helping women with BC symptoms complete the examination procedures and reduce diagnosis delay of BC.

Objective:

To develop a psychoeducational intervention to reduce the delay of BC diagnosis among Indonesian women with BC symptoms.

Methods:

The development of the intervention included an inventory of crucial elements in developing psychoeducation through literature review as well as consultation with BC patients and healthcare providers. Additionally, we developed PERANTARA as the first pilot version of the self-help guided psychoeducational intervention. PERANTARA is an abbreviation for “Pengantar Perawatan Kesehatan Payadura”, which means an introduction to breast health treatment. The pilot feasibility study combined an expert review and a pilot testing in hospital settings. A semi-structured interview and the client satisfaction inventory were utilized to measure feasibility and acceptability of the intervention for Indonesian women with BC symptoms.

Results:

PERANTARA contained an oncologist’s explanation about BC and the BC survivors’ testimony to reduce the time to diagnosis. The pilot study results showed that most patients were satisfied with and trusted on PERANTARA.

Conclusion:

PERANTARA was feasible and acceptable for Indonesian patients with BC symptoms. The development framework suggested in this study can be applied to develop psychoeducational packages for other patients group, in particular, those interventional packages aimed at reducing diagnosis and treatment delays and non-adherence.