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Background: Complementary and alternative veterinary medicine (CAVM) is becoming increasingly popular in horses., Methods: Online, cross-sectional survey in 1532 horse owners. Attitude towards CAVM, subjective norms, perceived behavioural control and intention for future CAVM use were measured based on the theory of planned behaviour. Structural equation modelling was performed to characterize factors influencing intention to use CAVM., Results: Past use of CAVM, predominantly manual therapies and herbal supplements, was reported by 72.5% of all participants. Frequently reported indications were improving horse's well-being, illness which did not resolve after conventional treatment and chronic illness. The attitude towards CAVM was positive with a median (interquartile range) score of 6 of 7 (4.75-7.00). Predictors for past CAVM use were higher owner age, alternative medicine self-use and higher education (non-university). The strongest predictor of future CAVM usage was perceived behavioural control and perceived CAVM efficacy, as well as positive attitude towards and perceived knowledge about CAVM. The veterinarian was reported as a source of information about CAVM by 86.4% of all participants., Conclusions: Horse owners showed a high intention to use CAVM with the owners' perceived behavioural control and perceived CAVM efficacy as the strongest predictor. Veterinarian-client communication is important to inform horse owners correctly., (© 2021 British Veterinary Association.)

Background: Little is known about women's decision-making processes regarding using complementary medicine products (CMPs) during pregnancy or lactation., Objectives: To explore the decision-making processes of women choosing to use CMPs in pregnancy and lactation; and to investigate how women's health literacy influences their decisions., Design, Setting and Participants: In-depth interviews and focus group discussions were held with twenty-five pregnant and/or breastfeeding women. Data were analysed using thematic analysis., Results: Key to women's decision making was the desire to establish a CMPs safety and to receive information from a trustworthy source, preferably their most trusted health-care practitioner. Women wanted positive therapeutic relationships with health-care practitioners and to be highly involved in the decisions they made for the health of themselves and their children. Two overarching components of the decision-making process were identified: (a) women's information needs and (b) a preference for CMP use. Women collated and assessed information from other health-care practitioners, other mothers and published research during their decision-making processes. They showed a strong preference for CMP use to support their pregnancy and breastfeeding health, and that of their unborn and breastfeeding babies., Discussion and Conclusions: Complex decision-making processes to use CMPs in pregnancy and lactation were identified. The participants showed high levels of communicative and critical health literacy skills in their decision-making processes. These skills supported women's complex decision-making processes., (© 2019 The Authors Health Expectations published by John Wiley & Sons Ltd.)

Objectives: We estimated prevalence of complementary and alternative medicine (CAM) use by reason for use (treatment, wellness, or both) among non-institutionalized adults with cancer in the United States. We also examined health-related quality of life (HRQOL) outcomes among adults with cancer who used CAM., Methods: We used data from the 2012 National Health Interview Survey (NHIS), which represents non-institutionalized adults with cancer (n = 2967 unweighted). Using a cross-sectional design with survey sampling techniques, we estimated past year prevalence of CAM use. We ran multivariable logistic regression analyses to investigate the odds of perceived benefits of CAM., Results: In the past 12 months, 35.1% of adults with cancer reported using some form of CAM. Among CAM users, 56.0% used CAM for both treatment and wellness, and 32.4% used CAM for wellness only. Only 11.6% used CAM for treatment only. Regardless of reason for use, the most commonly used CAM types in the past year were herbal therapies (56.8%), chiropractic (27.1%), and massage (24.9%). Among CAM users, those using CAM for wellness only and for a combination of treatment and wellness reported significantly higher odds of "a better sense of controlling health" and "improved overall health and feeling better" compared with treatment only users. Similar patterns were found in other HRQOL outcomes, but they were not statistically different., Conclusions: CAM is widely used among adults with cancer for wellness only or a combination of treatment and wellness. Given improved HRQOL outcomes, CAM may be a promising approach for enhancing health promotion and well-being among adults with cancer., (© 2019 John Wiley & Sons, Ltd.)

Purpose: This study was conducted to determine the pediatric usage of complementary/alternative medicine (CAM) by parents in Turkey, the incidence of using these methods, and the factors affecting their use., Design and Methods: The sectional and relational design of the study included a sample of 497 parents who took children for treatment at the Maternity and Children's Hospital in Giresun, Turkey. Data for the study were collected via the Personal Information Form and the Evaluation Form for Complementary/Alternative Treatment Use. The data collection tools were filled out by the researchers during the face-to-face interviews. Data obtained from the study were analyzed by Pearson chi-square, Fisher-Freeman-Halton and Fisher's exact (posthoc Bonferroni) tests and Z-test., Results: It was determined that 97.7% of the parents had used at least one CAM method. Moreover, the parents had used CAM methods mostly for respiratory complaints. The CAM methods were most commonly used for the symptoms of fever, diarrhea, and cough. It was observed that the most commonly used alternative methods in the past were vitamin/mineral remedies, cold treatments, and hodja (Islamic teacher) consultations, while the most common alternative methods currently used are massage, music, and cold treatment. In addition, the differences found between CAM users in terms of sociodemographic characteristics were not statistically significant., Practice Implications: It is crucial for nurses to learn the characteristics of the health/disease treatments used by those with whom they work in order to increase the efficiency of the service they provide. Thus, it was recommended that nurses should be knowledgeable and aware of the benefits/side effects, treatment methods, and contraindications of CAM., (© 2017 Wiley Periodicals, Inc.)

Introduction: Complementary and alternative medicine (CAM) is used for treating cyclic perimenstrual pain and discomfort. This critical review examines women's reported CAM use, its perceived effectiveness and information relating to women's attitudes, behaviors, motivations and patterns of CAM use in its treatment., Material and Methods: An extensive search of the main medical databases EBSCO, CINAHL, Medline, AMED and SCOPUS, as well as additional hand searches, was conducted. Papers included were confined to those that had been peer-reviewed, written in English and that contained original research into CAM use for cyclic perimenstrual pain and discomfort among adult women., Results: CAM, particularly herbal medicine, nutritional supplements and massage, is widely used for a range of cyclic perimenstrual pain and discomfort symptoms. A large number of CAM modalities are adopted, often simultaneously and with little professional oversight. Women's assessment of efficacy of different CAM modalities is positive, though the majority of users are self-prescribing apparently without professional guidance. Although the uptake of CAM for cyclic perimenstrual pain and discomfort is widespread, few empirical data are available regarding which women are using CAM, their motivations for doing so and, importantly, the sources through which women receive information about CAM., Conclusions: This review highlights the extensive use of (often self-prescribed) CAM in a number of countries to alleviate the widespread symptoms of cyclic perimenstrual pain and discomfort. An understanding of all health care use by women with perimenstrual pain and discomfort is vital to help ensure safe, effective and coordinated health care that can lead to optimal patient outcomes., (© 2016 Nordic Federation of Societies of Obstetrics and Gynecology.)

Background: Cancer survivors' disclosure of complementary health approaches (CHAs) to their follow-up care physicians is necessary to ensure the safe and optimal use of such approaches. Rates of disclosure of CHAs are variable and may be facilitated by patient-centered communication., Methods: This cross-sectional study conducted in 2003-2004 examined a population-based sample of leukemia, colorectal, and bladder cancer survivors (n=623) who were 2 to 5 years after their diagnosis. A subset of participants who reported using CHAs (n=196) was analyzed with multivariate logistic regression to examine the association between patients' perceptions of their physician's patient-centered communication (ie, information exchange, affective behavior, knowledge of patients as persons) and patients' disclosure of CHA use to their physician with adjustments for physician, patient, and patient-physician relationship factors., Results: Thirty-one percent of the full sample used CHAs, and 47.6% of CHA users disclosed their use to their physicians. Disclosure was significantly associated with patient-centered communication even with adjustments for hypothesized covariates (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.09-1.71). Perceived physician knowledge of the patient as a person (OR, 1.28; 95% CI, 1.10-1.48) and information exchange (OR, 1.27; 95% CI, 1.02-1.60) were the aspects of patient-centered communication that contributed to this association. The main reason for nondisclosure assessed in the survey was that survivors did not think that it was important to discuss CHAs (67.0%). A majority of physicians encouraged continued use of CHAs when they were disclosed (64.8%)., Conclusions: Results support the idea that improving the overall patient centeredness of cancer follow-up care and improving the disclosure of CHA use are potentially synergistic clinical goals., (© 2014 American Cancer Society. This article has been contributed to by US Government employees and their work is in the public domain in the USA.)

Objective: The aim of this study was to explore how and why Australian men with cancer practice complementary therapies (CTs) and how their significant others (SOs) contribute to the regular uptake of CTs., Methods: This qualitative study employed semi-structured interviews with 26 male cancer patients and 24 SOs. Participants were purposefully sampled from a preceding Australian survey investigating the use of CTs in men with cancer (94% response rate and 86% consent rate for follow-up interview). Interviews were conducted in a metropolitan location, and the 43 interview transcripts were analyzed thematically., Results: Three core themes were identified: men used CTs as (a) problem-focused coping (e.g., diet modification), (b) emotion-focused coping (e.g., meditation), and (c) meaning-based coping (e.g., prayer). Practicing CTs helped men to cope with physical, emotional, and spiritual concerns, although some men spoke of difficulties with practicing meditation to regulate their emotions. SOs were supportive of men's coping strategies but were only rarely involved in men's emotion-focused coping., Conclusions: Complementary therapies have the potential to facilitate coping with cancer, independent of any measurable physiological benefit. Our findings suggest that when clinicians engage in conversations about CTs use, they should consider the type of coping strategy employed by their patient. Such information may enhance the efficacy of some interventions (e.g., meditation) and also provide for an opportunity to discuss patients' expectations concerning CTs., (Copyright © 2014 John Wiley & Sons, Ltd.)

Objective: The aim of the present study was to test the association between psychosocial factors and delay in uptake of treatment and treatment non-adherence in Indonesian women with breast cancer., Methods: Seventy consecutive patients with breast cancer who were treated at the Hasan Sadikin Hospital in Indonesia were recruited. They completed a demographic form, the non-adherence questionnaire, the Breast Cancer Knowledge Test, the Brief Illness Perception Questionnaire, the Multidimensional Health Locus of Control Scales, the Satisfaction with Cancer Information Profile and the Distress Thermometer., Results: Seventeen (24%) out of 70 patients reported that they had delayed initiating treatment at the hospital, and nine (13%) out of 70 patients had missed two or more consecutive treatment sessions. In the bivariate analyses, we found no significant differences on any of the psychological variables between patients who delayed initiating treatment and those patients who did not, whereas patients who had missed two or more consecutive sessions had lower satisfaction with the type and timing of information provided and more negative illness perceptions than patients who had not missed their sessions. In multivariate regression analyses, consulting a traditional healer before diagnosis was associated with treatment delay (β = 1.27, p = 0.04). More negative illness perceptions (β = 0.10, p = 0.02) and whether a traditional healer had been consulted after diagnosis (β = 1.67, p = 0.03) were associated with missing treatment sessions., Conclusions: Indonesian health professionals need to be aware of patients' negative illness perceptions and their unrealistic belief in traditional healers., (Copyright © 2014 John Wiley & Sons, Ltd.)

Many users of Complementary and Alternative Medicines (CAMs) claim that participation leads to improved well-being; however, contradictory evidence exists, with some studies linking CAM use with poorer quality of life (QoL) or increased distress. This study explored whether an individual's experience of post-traumatic growth (PTG) following cancer may play a role in explaining these disparate outcomes. One hundred and sixty-one cancer survivors (mean age = 58.96, SD = 12.12) completed measures comprised of PTG (Post-Traumatic Growth Inventory), CAM use, QoL (Functional Assessment of Cancer Therapy scale + Functional Assessment of Chronic Illness Therapy Spiritual Well-Being Scale), post-traumatic stress disorder symptoms (Impact of Event Scale Revised) and depression, anxiety and stress (21-item short-form Depression Anxiety Stress Scale). A multiple regression controlling for gender, age, general and cancer-specific distress indicated support for PTG as a mediator of the relationship between CAM and QoL. An individual's experience of PTG following cancer may be an important determinant of gaining benefit from participation in CAMs. Future research aimed at identifying potential facilitators of PTG may result in increased benefits of interventions aimed at improving adjustment among cancer survivors., (© 2013 John Wiley & Sons Ltd.)

Allopathic practitioners in India are outnumbered by practitioners of traditional Indian medicine, such as Ayurveda and Siddha. These forms of traditional medicine are currently used by up to two-thirds of its population to help meet primary healthcare needs, particularly in rural areas. Gandeepam is one of the pioneering Siddha clinics in rural Tamil Nadu that is specialized in providing palliative care to HIV/AIDS patients with effective treatment. This article examines and critically discusses the perceptions of patients regarding the efficacy of Siddha treatment and their motivation in using this form of treatment. The issues of gender equality in the access of HIV/AIDS treatment as well as the possible challenges in complementing allopathic and traditional/complementary health sectors in research and policy are also discussed. The article concludes by emphasizing the importance of complementing allopathic treatment with traditional medicine for short-term symptoms and some opportunistic diseases present among HIV/AIDS patients., (Copyright © 2012 John Wiley & Sons, Ltd.)

While 50% of cancer patients use complementary therapies (CT) during treatment, few studies have examined why individuals choose not to use CT. This study aimed to address this gap in knowledge using a focus group methodology, where 36 participants took part in one of eight groups; participants were recruited until saturation of themes was achieved. Three categories of participants were investigated: patients/recent survivors (n= 14); volunteers/advocates (n= 16), the majority of whom were also long-term survivors; and health professionals (n= 6). Focus groups were digitally audio-recorded, transcribed, and coded thematically using NVivo software. Reasons for non-use fell into four broad themes: (1) Resource barriers, particularly the cost and lack of time; (2) fear and distrust, including the potential for drug interactions; (3) lack of evidence, including the unproven nature of many CT practices; and (4) satisfaction with conventional treatment. Two further themes related to the benefits of non-use and reasons for discontinuation. A sub-analysis indicated that reasons for non-use differed by CT category, with non-use being mentioned more frequently for biologically based and body-based therapies. Differences in understanding CT non-use emerged between patients, volunteers and health professionals. Findings have clinical implications regarding tailoring information for patients during and after cancer., (© 2011 Blackwell Publishing Ltd.)

Objective: Recent reports suggest that Black breast cancer patients receive adjuvant therapies less often than their White counterparts; however, few studies have examined the self-reported experiences of Black breast cancer patients making treatment decisions. This study examined cultural beliefs and healthcare factors that impacted Black women's treatment decisions., Methods: In-depth interviews were conducted with 49 Black women with early stage breast cancer (stages 0-III). Participants resided in Washington, DC (n = 13), and Philadelphia, Pennsylvania (n = 36). Women's ages ranged from 26 to 85 (m = 53.9). All interviews were transcribed verbatim and then entered into a qualitative software program. Three coders independently read and coded transcripts using this software., Results: The data did not reveal common cultural themes that influenced women's treatment decisions. Spiritual beliefs were important to all participants and did seem to help them cope with and reframe their illness experiences. The patient-provider relationship was the most notable factor that influenced treatment decisions. While most women reported that they were satisfied with their provider relationships, their narratives revealed that many lacked knowledge about their diagnoses and treatment regimens. Those patients who demonstrated a better understanding of their disease and treatments also seemed to adhere to recommendations for adjuvant therapy., Conclusions: Poor communication may impact treatment decision-making and, ultimately, outcomes. Important next steps will include quantifying Black women's patient-provider interactions and examining how these factors influence adherence behaviors. Ensuring that patients understand their diagnosis and treatment options will also be important for clinical practice., (Copyright © 2010 John Wiley & Sons, Ltd.)

Objective: Complementary and alternative medicine (CAM) is frequently used by patients with advanced cancer, for a variety of reasons. We examined the use of CAM in this population, and associations of use for potential cure with spiritual faith and existential well-being., Methods: Patients with advanced cancer on a palliative care unit completed a measure of spiritual well-being (existential well-being and faith), and a survey assessing complementary therapy use and reasons for such use. Information was also gathered on demographic data, previous cancer treatment, performance status, and symptom distress. Regression analyses assessed the association between the spirituality domains of existential well-being and faith, and the use of CAM for cure., Results: Of 123 participants, 85% had used CAM, 42% with curative intent. More than 95% would consider future use of CAM, 48% for potential cure. Previous use for cure predicted current interest in using CAM for cure (p<0.0001). Spiritual faith was associated with previous (p<0.02) and interest in future use for cure (p<0.0001). Poor existential well-being was associated with interest in future use of CAM for cure (p=0.04)., Conclusions: Interest in considering CAM for cure was relatively high in this group of inpatients on a palliative care unit, and was associated with increased spiritual faith and decreased existential well-being. Understanding factors associated with seeking CAM for cure may help health-care professionals to support and educate patients with advanced cancer., (Copyright © 2010 John Wiley & Sons, Ltd.)

Background: The medical and demographic correlates of complementary and alternative medicine (CAM) use among cancer survivors have been well documented. However, the role of psychological functioning in cancer survivors' CAM use and the degree to which such factors apply to survivors of colorectal cancer require additional study. In addition, sex differences in CAM use and its correlates among colorectal cancer survivors are not well understood., Methods: By using data from a large-scale national population-based study of quality of life and health behaviors among cancer survivors, the authors examined the prevalence and psychological correlates of CAM use among 252 male and 277 female colorectal cancer survivors., Results: Use of CAM was more common among women, those with more education, and recipients of chemotherapy and radiation therapy. Several psychological factors predicted increased use of CAM among female colorectal cancer survivors, including anxiety, fear of cancer recurrence, fatigue, vigor, anger, mental confusion, and overall emotional distress. Depression was associated with decreased CAM use among female survivors, both for overall CAM use and across several standard CAM domains. In contrast, psychological functioning had little impact on male colorectal cancer survivors' CAM use. The only nonmedical/demographic variable associated with men's use of CAM was fatigue, which predicted use only of biologically based practices, such as diet and nutritional supplements., Conclusions: Psychological functioning has a significant impact on CAM use among female colorectal cancer survivors. Decreased use of CAM among women with depressive symptoms was unexpected and warrants additional investigation., (Copyright (c) 2009 American Cancer Society.)

The study aims were to determine the use of complementary therapies (CT) by men with prostate cancer, and to explore factors influencing CT use and attitudes toward CT use. A cross-sectional survey design was used in which a postal questionnaire was mailed to an eligible sample of 405 patients with prostate cancer receiving outpatient treatment in a London teaching hospital. The primary outcomes were the prevalence of CT use and the relationship between CT use and mental health status. Two hundred and ninety-four patients (73%) responded, of whom 25% were using CT. The most frequently used CTs were vitamins, low-fat diets, lycopene and green tea. Multivariate analyses revealed no differences in mental health scores between CT users and non-users. CT users were younger (OR 0.93, 95% CI 0.89-0.97) and were more likely to be receiving conservative management in the form of 'active surveillance' (OR 5.23, 95% CI 1.78-15.41) compared with non-users. Over half of the participants (55%) wanted to learn more about CT. Forty-three per cent of CT users had not informed any doctor about their CT use. Clinicians need to be aware of the prevalence of CT use amongst patients with prostate cancer, considering the potential harm that could be caused by interactions with conventional treatments.

The use of complementary and alternative medicine (CAM) by cancer survivors is high, particularly among those with psychosocial distress, poor quality of life, culturally based health beliefs, and those who experience health disparities in the mainstream healthcare system. As the number of cancer survivors continues to increase, so does the diversity of the survivorship population, making it increasingly important to understand and address the CAM culture in different survivor groups. Given the known communication barriers between cancer patients and their physicians regarding CAM, it would be useful for oncology providers to have a platform from which to discuss CAM-related issues. It is proposed that mind-body therapies with some basis in evidence could provide such a platform and also serve as a possible means of connecting cancer survivors to psychosocial supportive services. This article reviews a few mind-body therapies that may have particular relevance to cancer survivors, such as hypnosis and meditation practices. A theoretical foundation by which such therapies provide benefit is presented, with particular emphasis on self-regulation.

Patients in hospitals must authorize do-not-resuscitate (DNR) orders or the default cardiopulmonary resuscitation (CPR) occurs. Using discursive analysis, we examined the speech of 28 cancer patients, judged as within 3 months of death, to determine how they justified preferences for DNR orders. Most saw these as a positive outcome of not interfering with a natural death with the decision being personal and the legal right of a competent autonomous person. If surrogates were required, they needed knowledge of the medical facts and the patient's wishes. The doctor was crucial, while family although likely to be supportive may be burdened by the responsibility. Some favored an early DNR discussion, but the majority favored a later discussion when it was applicable. At interview, 58% patients had a DNR order, rising to 82% by the time of death. Written orders were favored, yet 9 of 21 who did not want CPR had no DNR order. Hope was mentioned spontaneously by 25 patients, both as a thing over which patients had little control and as the desire of a positive future outcome. If doctors' and patients' assessments of eligibility for DNR orders do not coincide, the process and documentation of decision-making needs revision., (Copyright 2007 John Wiley & Sons, Ltd.)

Objective: The aim of the study was to assess the prevalence of and factors associated with use of complementary or alternative medicine (CAM) in a multistate, multisite cohort of HIV-infected patients., Methods: During 2003, 951 adult patients from 14 sites participated in face-to-face interviews. Patients were asked if they received treatment from any alternative therapist or practitioner in the previous 6 months. Logistic regression was performed to examine associations between demographic and clinical variables and CAM use., Results: The majority of the participants were male (68%) and African American (52%) with a median age of 45 years (range 20-85 years). Sixteen per cent used any CAM in the 6 months prior to the interview. Factors associated with use of CAM were the HIV risk factor injecting drug use [adjusted odds ratio (AOR) 0.51] compared with men who have sex with men (MSM), former drug use (AOR=2.12) compared with never having used drugs, having a college education (AOR=2.43), and visiting a mental health provider (AOR=2.76)., Conclusions: This study demonstrated similar rates of CAM use in the current highly active antiretroviral therapy (HAART) era compared with the pre-HAART era. Factors associated with CAM - such as education, use of mental health services, and MSM risk factor - suggest that CAM use may be associated with heightened awareness regarding the availability of such therapies. Given the potential detrimental interactions of certain types of CAM and HAART, all HIV-infected patients should be screened for use of CAM.

The aim of this study was to gain a greater understanding of complementary and alternative medicine (CAM) use among cancer patients and survivors. Specific objectives included types used and timing, motivations for use and benefits received, sources of information on CAM and communication with doctors. Semi-structured in-depth interviews were conducted with 19 patients and survivors (mean age = 57 years). Findings on frequency and type of CAM use were consistent with previous studies. Additionally, we found that the main expected benefit from using CAM was to boost the immune system, that participants could not readily explain the nature of the benefits they received, that CAM practitioners and books were the main sources of CAM information, and that the majority reported some discussion of CAM with a doctor. A greater range of questions needs to be asked of cancer patients in future quantitative studies. Reasons for commencing and stopping use of CAM and the quality of the CAM information source will be imperative to uncover, especially as the Internet is increasing in importance as a source for health information.

Complementary and alternative medicine (CAM) is a rapidly growing specialty within the healthcare field. One concept that appears central to the notion of CAM therapies is the concept of self-healing. Although "self-healing" is addressed within several bodies of literature, the concept is ill-defined within the context of CAM therapies, specifically energy-based healing modalities such as reiki therapy. The purpose of this paper is to investigate the concept of self-healing through a concept analysis using Walker and Avant's technique (1995). The resultant operational definition of self-healing was the result of 6 weeks of study and is not considered to be a final product, but merely a beginning step to understanding this unique phenomenon.

Complementary and alternative medicine (CAM) is frequently employed by patients with cancer. An extensive survey was conducted among Brazilian cancer physicians to understand their attitude towards CAM. A questionnaire was sent to all 655 members of the Brazilian Cancer Society asking what is their opinion regarding CAM and if they would prescribe any CAM modality for their patients. They were also questioned regarding their degree of awareness of CAM self-administration by their patients. Overall, 119 questionnaires were returned to us (18%). Most oncologists knew at least one type of CAM (96.6%) and 76.7% had previously made use of at least one type of CAM for themselves. We observed that 76 (63.8%) of the oncologists used to ask their patients about CAM utilization and 37.8% described at least one reason to stimulate its use (68.8% as complementary treatment). Only 10% of the oncologists would prescribe at least one type of CAM and this attitude correlated significantly with previous physicians' use of CAM and with being a clinical oncologist as well as with having questioned patients about CAM use. Most oncologists (80.7%) would not indicate the use of CAM, mainly for lack of scientific proof of its efficacy (56.2%). Physicians knew many kinds of CAM and had frequently used some of them themselves, but only a minority of Brazilian oncologists would indicate them. As CAM use is very prevalent in our population, we believe that most of its utilization depends, probably, on patient's own and independent initiatives. However, these results should be viewed with caution because of the low response rate we observed in this study.

Patients with advanced cancer frequently express positive attitudes and can be unduly optimistic about the potential benefits of treatment. In order to evaluate an illusory domain in the context of advanced cancer, we developed a scale of will to live and characterized the beliefs that patients held about the curability of their cancer, and how committed they were to using alternative treatments. A measure of quality of life was used as the dependent variable in order to assess the association between these attributes. After a preliminary exploration confirmed the presence of an illusory domain, these concepts were prospectively tested in 149 ambulant patients with advanced cancer who attended for palliative systemic treatment, radiation treatment or supportive care. The scale of global quality of life was reliable (Cronbach's alpha coefficient 0.72). The distribution of the scores of will to live was skewed, with no respondent scoring poorly, and the scale was reliable (Cronbach's alpha coefficient 0.82). The scale of belief in curability showed diverse beliefs. In some cases, there was a discrepancy between respondents' beliefs in curability and what they believed to be the report by their doctors. There was also an association between a committed use of alternative treatments and a belief in the curability of the cancer (p<0.001). In a multiple regression analysis, both will to live and performance status remained associated with better quality of life scores after adjustment for other relevant variables (p<0.05 and <0.001, respectively). These results suggest that positive illusory beliefs can be measured and are an important component of adaption for some patients with advanced cancer. Furthermore, this illusory domain may influence the perception and measurement of quality of life., (Copyright 2003 John Wiley & Sons, Ltd.)

This study describes physicians' attitudes towards the use of complementary therapies (CTs) by cancer patients in Finland. Responses to 33 Likert-type statements were received from 234 physicians; the response rate was 50.6%. The questionnaire items were analysed separately and using five sum variables. Data analysis was based on descriptive statistics, chi-square and t-tests and analysis of variance. Attitudes among physicians and oncologists in particular were quite critical. Over four-fifths of the physicians (86%) were doubtful whether CTs should be used at all, given the scarcity of solid research evidence on their benefits. Three quarters (75%) referred to unknown risk factors, half (51%) were of the opinion that CTs should not be used in cancer care at all. On the other hand 58% believed that CTs could help to relieve stress and anxiety among cancer patients, and 79% wanted to see scientific testing to establish the effects of CTs. The most positive attitude towards CTs was shown by general practitioners and non-specialized physicians. Positive attitudes were associated with personal CT use, with recommending CTs to patients and with a high level of interest to participate in CT training. The physicians did not believe the specific CTs singled out for investigation would help patients to recover from cancer. They thought that the use of CTs by cancer patients was motivated by future hope, a determination to do everything possible to cure the cancer and the perception of CTs as a last resort. The result that professional attitudes towards CTs are quite critical in Finland presents a very special challenge to the relationship between physicians and patients: it is crucial that physicians know enough about CTs so that they can discuss the issue with patients and provide relevant advice and guidance on their use.

Purpose: To characterize the local population that turns to complementary medicine., Methods: Participants were selected randomly: Medicine [A] (201 patients); Surgery [B] (100 patients); Control [C] (128 patients). The answers to the first two questions determined whether the questionnaire was to be completed., Results: More females sought complementary medicine treatment, with no significant demographic differences among the groups. Nearly 20% of the subjects had academic education while 43% had completed high school. The results of the 16 significant questions were statistically different when comparing groups C and A (p = 0.025) and B (p = 0.011) respectively. A total of 16%, 12.4% and 9% of the subjects respectively preferred a physician MD as their complementary medicine practitioner and 49% [C], 34% [A] and 29% [B] respectively, favored teaching complementary medicine in medical and nursing schools., Conclusions: A total of 37% [C], 21% [B] and 27% [A] of the subjects experienced complementary medicine intervention at least once. The percentage of individuals holding academic degrees was higher in the group utilizing complementary medicine than those who did not. Only 21% of C and A groups and 12% of B group knew about adverse reactions to complementary therapies. More than 30% favored 'legalizing' complementary medicine.

This study investigated how parents' preferred level of control in treatment decision-making is related to their personal health care involvement and to their decision to use complementary therapies (CTs) for their child. One hundred-eighteen parents of pediatric oncology patients completed an anonymous CT survey. The Krantz Health Opinion Survey (KHOS) was used to determine parents' preferred involvement in personal health care, and the Control Preferences Scale for Pediatrics (CPS-P) measured preferred role in pediatric treatment decision-making. Unlike previous studies of adult cancer patients, most parents preferred active or collaborative decision-making. The KHOS and CPS-P were significantly correlated, indicating that parents' preferred role in children's treatment decisions was related to their own personal health care involvement. Forty-six percent of parents used CTs for their child, and 33% began using a new CT after diagnosis. The hypothesized relationship between CT use and parents' own health care involvement was partially supported. Preference for control in decision-making was not associated with CT use. These findings provide validation for the newly developed CPS-P and indicate that parents' decisions to use CT for their child are related in part to individual health care preferences., (Copyright 2003 John Wiley & Sons, Ltd.)