A qualitative study of culturally embedded factors in complementary and alternative medicine use

Abstract

BackgroundWithin the intercultural milieu of medical pluralism, a nexus of worldviews espousing distinct explanatory models of illness, our research aims at exploring factors leading to complementary and alternative medicine (CAM) use with special attention to their cultural context.MethodsThe results are based on medical anthropological fieldwork (participant observation and in-depth interviews) spanning a period from January 2015 to May 2017 at four clinics of Traditional Chinese Medicine in Budapest, Hungary. Participant observation involved 105 patients (males N = 42); in-depth interviews were conducted with patients (N = 9) and practitioners (N = 9). The interviews were coded with Interpretative Phenomenological Analysis; all information was aggregated employing Atlas.ti software.ResultsIn order to avoid the dichotomization of “push and pull factors,” results obtained from the fieldwork and interviews were structured along milestones of the patient journey. These points of reference include orientation among sources of information, biomedical diagnosis, patient expectations and the physician-patient relationship, the biomedical treatment trajectory and reasons for non-adherence, philosophical congruence, and alternate routes of entry into the world of CAM. All discussed points which are a departure from the strictly western therapy, entail an underlying socio-cultural disposition and must be scrutinized in this context.ConclusionsThe influence of one’s culturally determined explanatory model is ubiquitous from the onset of the patient journey and exhibits a reciprocal relationship with subjective experience. Firsthand experience (or that of the Other) signifies the most reliable source of information in matters of illness and choice of therapy. Furthermore, the theme of (building and losing) trust is present throughout the patient journey, a determining factor in patient decision-making and dispositions toward both CAM and biomedicine.

Factors determining choice of complementary and alternative medicine in acute and chronic diseases

“…The importance of social factor has been the point of discussion in many recent studies [29][30][31].This study also establishes importance of social factor. However, it contradicts the argument by Flynn et al that disease burden and socio-demographic factors are poor predictors of preference towards a particular treatment modality [32].…”

“…With static enabling resources, the difference in cognition about efficacy, cost-effectiveness and philosophical congruence results into varied CAM preference in acute and chronic disease. McFadden [10] and Zorgo [31] conclude that philosophical congruence is more observed with CAM than conventional medicine. In this study, philosophical congruence with CAM is the most important cognitive component, in case of both acute and chronic disease.…”

A study on the motivation of Indian patients to consult complementary and alternative medicine practitioners to treat coronary artery disease

“…Existing literatures also supports our findings on the role of push and pull forces. [12][13][14][15][16] Many of the push and pull forces identified are similar to those in previous studies, while some of these factors are atypical to Indian society. One such factor is choosing CAM to avoid 'surgical intervention'.…”

Epistemic Network Analysis for Semi-structured Interviews and Other Continuous Narratives: Challenges and Insights

“…Our inquiry pre-supposes that patient cognitive and behavioral patterns can be accessed via semi-structured interviews and their scrutiny. The study takes place in Budapest, Hungary, as a continuation of a previous exploratory research project dealing with the same general topic (15). Data collection began in February 2019 and is on-going; at the time of submission, 30 interviews have been conducted with patients, at least another 18 are planned.…”