Background This study aimed to evaluate the association between complementary and alternative medicine (CAM) use and fear of cancer recurrence (FCR) among breast cancer survivors, using a validated multidimensional FCR-assessing instrument. Despite the debate over its medical effects, the use of CAM in breast cancer survivors is increasing.
Methods We recruited 326 breast cancer survivors who had completed the primary cancer treatment. Information on CAM use was obtained using a self-administered questionnaire, and FCR was assessed using the Korean version of the FCR Inventory (FCRI). Multivariate linear regression analysis was performed to evaluate the association between CAM use and FCR.
Results CAM users had higher total FCR scores than CAM non-users after covariate adjustment (CAM users: 74.6 vs. CAM non-users: 68.7; P=0.047). Among the FCRI subscales, CAM users showed higher coping strategy scores (CAM users: 22.3 vs. CAM non-users: 20.6; P=0.034) in the multivariable adjusted analysis. The use of multiple types of CAM was associated with increased FCR in a dose-dependent manner (P=0.002).
Conclusion Breast cancer survivors who used CAM had a higher FCR than CAM non-users. The dose-response relationship between the use of multiple types of CAM and FCR suggests that breast cancer survivors who use multiple types of CAM should be provided with appropriate psychological interventions to decrease FCR.
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Background Although, its efficacy is unclear, the application of complementary and alternative medicine (CAM) is increasing among patients worldwide. The physician's role is very important to help patients understand and use CAM properly. The aim of this study is to examine the perceptions, attitudes and physician-patient communication of about CAM in two distinguished specialty physicians. Methods: A web-based survey was performed to list oncologists and family physicians in Korea between May 2007 and July 2007. E-mails were sent to total of 5,429 physicians and 547 physicians replied on survey (response rate: 10.1%). Of them, 500 participants comprising 174 clinical oncologists and 326 family physicians were involved in this study. The study questionnaire consisted of 26 questions including questions about general characteristics of CAM and intentions of introduction and education to their patients. Results: Of 500 physicians, males were 73.4%, and 82.0% were middle-aged 30-49. Family physicians had more interest than oncologists about CAM (79.5% and 57.5%, respectively). In addition to, family physicians preferred introducing CAM to their patients than oncologists (34.1% and 18.4%, respectively). Almost 85% of the oncologists and family physicians thought that it was necessary to introduce CAM to their patients. However, 60.2% of them had hesitated their practice because 70.3% of them did not have suffi cient knowledge in CAM. Both specialty physicians responded that usefulness of CAM information when regarding practice, should contain evidence-based evaluation (59.2%) and consensus guideline(37.0%). Conclusion: The results of this study showed that most physicians did not have sufficient information regarding CAM(87.2%). The result implies that evidence based information on complementaryand alternative medicine should be offered in the national level to improve communication between physicians and patients.
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Background : There is a widespread increase in the use of CAM by patients with rheumatic disease. This study was performed to identify the prevalence of CAM use and determining factors affecting CAM use by patients with rheumatic disease.
Methods : From October 23 to November 31 in 2003, face-to-face structured interviews were conducted in a rheumatology hospital in Seoul. A total of 182 patients with rheumatic disease, who visited the hospital, participated.
Results : CAM was used by 59.3% (95% CI=52.1∼66.2%) of the patients with rheumatic disease. The most common use of CAM was traditional Chinese medicine such as acupuncture and herbs. Demographic variables were not predictive for the use of CAM. As the duration of disease was longer, probability on CAM use was lower (odd ratio: 0.922, 95% CI=0.855∼0.994). CAM use on disabled people who registered were 4.623 (95% CI=1.105∼19.348) times higher than non-disabled.
Conclusion : CAM use is common in patients with rheumatic disease. The duration of disease and physical disability were the influencing factors for using CAM. These findings support a need for outcome studies on the effectiveness of CAM in rheumatic disease, as well as the improvement of providing patients with information on CAM usage.
Background : Use of Complementary and Alternative Medicine(CAM) is common among patients with chronic conditions such as rheumatic disorder. This study was conducted to know rate and behavior of using CAM and to improve doctor-patient relationship in rheumatic patients.
Methods : Among patients visiting a tertiary hospital rheumatology clinic, 867 persons (15.8% of total) were selected conveniently and interviewed by a trained nurse according to structured questionnaire from July 1st through July 31st 1999. Three hundred and sixty two CAM users completed the interview.
Results : Among 867 persons interviewed, 372 persons had used CAM (use rate 44%). Use rate of Chinese medicine was 26%, CAM except Chinese medicine 21%. Herb medicine(49.4%) was the commonest single category of all CAM. Twenty four percents of users had used two or more types of CAM, 6.8% had experienced adverse effects. The average yearly cost for CAM was 704,000 won/person, 64% of the one for hospital use, 1,100,000 won/person. The subjectively rated degree of effectiveness was 6.3 points which was significantly higher when compared with 5.9 points for hospital services. The degree of satisfaction with CAM was 5.6 points which was higher than that of hospital services, 4.8 points. The most frequently reported reason for using CAM was the hope for synergistic treatment effect(32%). The proportion of experiencing adverse effects from CAM was 7% of all users. Only one fourth of the users had discussed on the CAM use with the western doctors. The commonest reason for not discussing CAM was that the respondents had no need to discuss about it (40%). Among doctor's attitudes when discussing CAM with patient, limited aproval was most common(40%).
Conclusion : Among patients with rheumatic conditions, 44% use CAM. Herb medicine was most commonly used CAM. Comparing with hospital services, cost for CAM is 2/3 but its subjective effectiveness and satisfaction are higher. Western doctors must consider appropriately the need from users of alternative medicine.
Background : Recently live blood analysis was populated in korean society. So we evaluated clinical utility of Live blood analysis, as compared the Live blood analysis result of patients who have confirmed diagnosis of disease with that of controls who have no known health problems.
Methods : We carried out Live blood analysis to patients(n=30) who was entered to an admission in Yongdong severance hospital from February 2000 to March 2000 and to controls (n=30) who worked in that hospital at same time. We examined 3 abnormal finding; rouleau formation, spicule, protoplast, which were often observed in Live blood analysis.
Results : At comparison of parient group and control grup, rouleau formation was observed in 27 patients except 3 partients and it was observed in all 30 controls. Spicule was observed 2 in 9 partients except 1 patients and it was observed in all 30 controls. Protoplast was observed in 16 patients and 13 controls. There was no difference between patients and controls in observing 3 abnormal fingding.
Conclusion : We conclude that Live blood analysis may have no clinical significance.
Background : Primary care physicians(PCPs) and oriental medical doctors(OMDs), as primary healthcare providers, could directly affect patients' use of complementary and alternative medicine(CAM). This study was carried out o compare the practice experience with, the knowledge about, and the attitudes toward CAM between PCPs and OMDs in Korea.
Methods : A total of 502 PCPs and 500 OMDs in urban area of Korea were selected by the proportionate quota and systematic sampling method. Face-to-face interviews were done with structured questionnaire.
Results : The rate of practice experience with and referral rate of CAM were reported 13.7% and 38.6% in PCPs, 76.8% and 85.4% in OMDs respectively. OMDs evaluated the efficacy of each CAM higher than PCPs. Both doctors had wide variations of knowledge in how to practice each CAM. However more than half OMDs knew how to practice chiropractic, taping therapy. aromatherapy, and iridology respectively, about 30% of PCPs high colic/enema and chiropractic. PCPs had more negative attitudes toward CAM and the advertisement of the other professional medicine(Korean traditional medicine) than OMDs. OMDs more strongly supported the natural healing process, health-disease continuum, and psychological effect on health, and opposed Descares' view on human body than PCPs.
Conclusion : This study showed OMDs had more experience with, knowledge about, positive attitudes toward, and supportive health concepts to CAM than PCPs. CAM practice would be diffused with chiropractic, taping therapy, aromatherapy, and iridology in OMDs; high colic/enema and chiropractic in PCPs.
Background : Alternative medicine is defined as a non-orthodox therapeutic practices including chiropractic, acupuncture, herbal medicine, faith spiritual therapy or as all sorts of medical care that do not follow the medical community standards. Patients do not think of modern medicine as the absolute solution to their health problems and they will sometimes ask for complementary therapy and in want of referral to alternative practitioner. We have investigated the primary physician's attitude and behavior towards alternative medicine.
Methods : Randomly selected 770 practitioners, in primary care practice in Seoul, were questioned from July to September in 1996 about the attitude to wards alternative medicine, the reasons and symptoms when referring, and experience in alternative medicine practice.
Results : 150 questionnaires were returned and among them 139 completed one(18.1%) were analyzed. Among 770 doctors, 35(25.2%) have refereed patients to alternative practitioner before and more referrals were made when they worked together closely or had some prior training. The belief of special effect of alternative medicine on certain disease was the first reason to refer. Other reasons were for herbal medicine, acupunture, and chiropractics in the order of sequence. The standard way to learn alternative medicine was to attend seminars available through certain institutions. On referral either chronic pain or musculoskeletal disease were the most chief complaints or main diseases of patients. 15 doctors(10.8%) had some experience in practicing an alternative approach and the patient subjects were more likely to be women, and there was increased tendency to be working with another doctor, and to have been trained for such practice. The items used by alternative practitioners were acupuncture, herbs in the order of sequence. Conclusions：Alternative medicine is accepted somewhat by primary physicians in Seoul although the rate of referral and practice is lower than 54% compared to 16% in Canada.
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