This article is intended to raise the question of whether sacrifice can be regarded stituting a deep ethical structure in the relationship between patient and carer. The significance of sacrifice in a patient-carer relationship cannot, however, be fully understood from the standpoint of the consistently utilitarian ethic that characterizes today's ethical discourse. Deontological ethics, with its universal principles, also does not provide a suitable point of departure. Ethical recommendations and codices are important and serve as general sources of knowledge when making decisions, but they should be supplemented by an ethic that takes into consideration contextual and situational factors that make every encounter between patient and carer unique. Caring science research literature presents, on the whole, general agreement on the importance of responsibility and devotian with regard to sense of duty, warmth and genuine engagement in caring. That sacrifice may also constitute an important ethical element in the patient-carer relationship is, however, a contradictory and little considered theme. Caring literature that deals with sacrifice/self-sacrifice indicates contradictory import. It is nevertheless interesting to notice that both the negative and the positive aspects bring out importance of the concept for the professional character of caring. The tradition of ideas in medieval Christian mysticism with reference to Lévinas' ethic of responsibility offers a deeper perspective in which the meaningfulness of sacrifice in the caring relationship can be sought. The theme of sacrifice is not of interest merely as a carer's ethical outlook, but sacrifice can also be understood as a potential process of transformation health. The instinctive or conscious experience of sacrifice on the part of the individual patient can, on a symbolic level, be regarded as analogous to the cultic or religious sacrifice aiming at atonement. Sacrifice appears to the patient as an act of transformation to achieve atonement and healing. Atonement then implies finding meaningfulness in one's suffering. The concept of sacrifice, understood in a novel way, opens up a deeper dimension in the understanding of suffering and makes caring in 'the patient's world' possible.
Background Population based studies have shown large differences in the estimated prevalence of complementary and integrative health (CIH) usage between studies. This is in part due to there being no golden standard definition for CIH. In Finland, an updated and internationally comparable study on the prevalence of CIH usage is needed. In the present study, a modified Finnish version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-QFI) was utilised to examine prevalence of use of different CIH modalities and their experienced helpfulness in the general Finnish population. Methods Respondents aged 16 and above were invited to take part in this descriptive cross-sectional study through an online panel in December 2022. The usage of CIH and the experienced helpfulness were calculated with SPSS (v28) as the proportion of users per each modality. The data were weighted based on gender, age and place of residence. Results A total of 3244 respondents completed the survey. CIH was used by 51.1% (95%CI: 49.4–52.8) of the respondents in the 12 months prior to the survey. Self-help practices were the most used category of CIH (28.8%; 95%CI: 27.3–30.4). The prevalence of usage of CIH natural remedies excluding vitamins and minerals was 27.0% (95%CI: 25.5–28.6). CIH providers were visited by 20.4% of the respondents (95%CI: 19.0–21.8). Getting help for a long-term illness or improvement of well-being were often mentioned as the most important reason for the use of different CIH modalities. CIH was generally used more by women compared to men. The large majority found the modalities they used helpful. Conclusions The results increase current understanding on CIH usage in Finland. As the majority of users experience CIH as helpful, there is a need to study CIH in the context of public health policies. The estimates of CIH usage are highly dependent on what is considered as CIH, and this should be paid attention to in future studies.
Tämä katsausartikkeli käsittelee suomalaista täydentävän ja vaihtoehtoisen lääkinnän tutkimusta. Käytämme siitä lyhennettä CAM-tutkimus (CAM eli Complementary and Alternative Medicine, täydentävä ja vaihtoehtoinen lääkintä). Artikkelin tavoitteena on selvittää, millaista CAM-tutkimusta Suomessa on tehty ja mihin tutkimus on kohdistunut. Tutkimusaineisto koostui CAM-hoitoja käsittelevistä 53 tutkimusartikkelista ja 12 väitöskirjasta ajanjaksolta 1980–2014. Aineisto haettiin kotimaisista ja ulkomaisista tietokannoista. Tutkimusmenetelmä oli sisällönanalyysi. CAM-tutkimusta tehtiin erityisesti 1990-luvulla ja 2000-luvun alussa. Useimmiten tutkimukset tehtiin yliopistossa tai yhteistyössä yliopistojen kanssa. Valtaosa aineistomme julkaisuista käsitteli CAM-hoitoja kokonaisuutena erittelemättä eri hoitomuotoja toisistaan. CAM-hoidoiksi tutkimuksissa luettiin erilaisia terveyden ylläpitoon tai sairauden hoitoon tarkoitettuja yrttejä, rohdoksia, homeopaattisia ja antroposofisia lääkkeitä, ruokavaliohoitoja sekä kehomielihoitoja, joista useimmin mainittiin henkiparannus, akupunktio ja vyöhyketerapia. Erittelemme artikkelissa suomalaisen CAM-tutkimuksen luokittelun kansainvälistä luokittelua mukaillen seuraavasti: 1) CAM-hoitojen vaikuttavuuden ja käytettävyyden tutkimus, 2) CAM-hoitojen historian ja kansanperinteen tutkimus, 3) CAM-hoitojen käytön yleisyyden ja käyttäjäryhmien tutkimus, 4) hoitohenkilökunnan asenteiden ja suhtautumisen tutkimus. Lisäksi hahmottelimme viidennen – tosin Suomen kontekstissa hyvin vähäisen – luokan: CAM-ammattien tutkimus, tieteentutkimus ja hoitonäkemysten tutkimus. Suurin osa tutkimuksista kohdistui CAM-hoitojen käyttöön ja käyttäjätyyppeihin. Tulosten mukaan vähintään kolmannes aikuisista oli käyttänyt tai kokeillut jotakin CAM-hoitoa. Muita tutkimuskohteita olivat CAM-hoitojenvaikutukset, terveydenhuoltohenkilökunnan asenteet ja hoitojen historia. Vaikutustutkimuksista suurin osa kohdistui jäsenkorjaukseen, jolla todettiin olevan myönteisiä vaikutuksia. Lääkärien ja sairaanhoitajien CAM-asenteet osoittautuivat jakautuneiksi.
Background: Population based studies have shown large differences in the estimated prevalence of complementary and integrative health (CIH) usage between studies. This is in part due to there being no golden standard definition for CIH. In Finland, an updated and internationally comparable study on the prevalence of CIH usage is needed. In the present study, a modified Finnish version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-QFI) was utilised to examine prevalence of use of different CIH modalities and the experienced helpfulness in the general Finnish population. Methods: Respondents (n = 3244) aged 16 and above were invited to take part in the I-CAM-QFI through an online panel in December 2022. The usage of CIH and the experienced helpfulness were described as the proportion of users per each modality. The data were weighted based on gender, age and place of residence. Results: CIH was used by 51.1% (95%CI: 49.4-52.8) of the respondents in the 12 months prior to the survey. Self-help practices were the most used category of CIH (28.8%; 95%CI: 27.3-30.4). The prevalence of usage of CIH natural remedies excluding vitamins and minerals was 27.0% (95%CI: 25.5 -28.6). CIH providers were visited by 20.4% of the respondents (95%CI: 19.0-21.8). CIH was generally used more by women compared to men. The large majority found the modalities they used helpful. Conclusions: The results increase current understanding on CIH usage in Nordic countries. As the majority of users experience CIH as helpful, there is a need to study CIH in the context of public health policies. The estimates of CIH usage are highly dependent on what is considered as CIH, and this should be paid attention to in future studies.
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