From the conventional to the alternative: exploring patients’ pathways of cancer treatment and care

Mulkins, Andrea; McKenzie, Emily; Balneaves, Lynda G.; Salamonsen, Anita; Verhoef, Marja J.

doi:10.1515/jcim-2014-0070

Cited by 4 publications

(8 citation statements)

References 35 publications

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“…Thirty-seven out of the 231 included publications were qualitative studies (16%) mainly from the United Kingdom (UK) [ 29 – 34 ], the United States (US) [ 35 – 38 ], Australia [ 39 – 41 ] or Canada [ 42 – 44 ]; a survey or cross-sectional study were the most commonly employed quantitative methods in the included publications (80.5%). Only eight mixed method papers (3.5%) reported the reasons for CAM use [ 32 , 45 – 51 ]. Eleven papers (4.8%) were conducted in elderly populations [ 35 , 39 , 42 , 43 , 52 – 58 ], and six (2.6%) in women only populations [ 29 , 38 , 39 , 59 – 61 ].…”

Section: Resultsmentioning

confidence: 99%

Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review

Tangkiatkumjai

Boardman

Walker

2020

BMC Complement Med Ther

120

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Objectives To determine similarities and differences in the reasons for using or not using complementary and alternative medicine (CAM) amongst general and condition-specific populations, and amongst populations in each region of the globe. Methods A literature search was performed on Pubmed, ScienceDirect and EMBASE. Keywords: ‘herbal medicine’ OR ‘herbal and dietary supplement’ OR ‘complementary and alternative medicine’ AND ‘reason’ OR ‘attitude’. Quantitative or qualitative original articles in English, published between 2003 and 2018 were reviewed. Conference proceedings, pilot studies, protocols, letters, and reviews were excluded. Papers were appraised using valid tools and a ‘risk of bias’ assessment was also performed. Thematic analysis was conducted. Reasons were coded in each paper, then codes were grouped into categories. If several categories reported similar reasons, these were combined into a theme. Themes were then analysed using χ2 tests to identify the main factors related to reasons for CAM usage. Results 231 publications were included. Reasons for CAM use amongst general and condition-specific populations were similar. The top three reasons for CAM use were: (1) having an expectation of benefits of CAM (84% of publications), (2) dissatisfaction with conventional medicine (37%) and (3) the perceived safety of CAM (37%). Internal health locus of control as an influencing factor was more likely to be reported in Western populations, whereas the social networks was a common factor amongst Asian populations (p < 0.05). Affordability, easy access to CAM and tradition were significant factors amongst African populations (p < 0.05). Negative attitudes towards CAM and satisfaction with conventional medicine (CM) were the main reasons for non-use (p < 0.05). Conclusions Dissatisfaction with CM and positive attitudes toward CAM, motivate people to use CAM. In contrast, satisfaction with CM and negative attitudes towards CAM are the main reasons for non-use.

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Section: Resultsmentioning

confidence: 99%

Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review

Tangkiatkumjai

Boardman

Walker

2020

BMC Complement Med Ther

120

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“…Studies have also revealed that 50% of all cancer patients turn to CAM during their patient pathways 43. Their use of CAM is often linked to experiences of biomedical focus, failing communication, and unmet health care needs in conventional health care systems 35,44–47. The participants pointed at specially trained cancer nurses as the most suitable health care professionals to cover complex health care needs in their everyday life.…”

Section: Discussionmentioning

confidence: 99%

“…Qualitative research has therefore the potential to be meaningfully translated into practice in ways that place patients at the center of care 57. With respect to confirmability, researchers from three study sites were involved in the international PATH study and agreed on the study design 47,58. Furthermore, the disruption literature corresponds very well with the perspectives of the participants in this study.…”

Section: Discussionmentioning

confidence: 99%

“My cancer is not my deepest concern”: life course disruption influencing patient pathways and health care needs among persons living with colorectal cancer

Salamonsen

Kiil

Kristoffersen

et al. 2016

PPA

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BackgroundThe concept of “patient pathways” in cancer care is most commonly understood as clinical pathways, operationalized as standardized packages of health care based on guidelines for the condition in question. In this understanding, patient pathways do not address multimorbidity or patient experiences and preferences. This study explored patient pathways understood as the individual and cultural life course, which includes both life and health events. The overall aim was to contribute to supportive and targeted cancer care.Materials and methodsNine Norwegian patients recently diagnosed with rectal cancer Tumor-Node-Metastasis stage I–III participated in qualitative interviews, five times over 1 year. Five patients later participated in a workshop where they made illustrations of and discussed patient pathways.ResultsPatient pathways including both health and life events were illustrated and described as complex and circular. Stress, anxiety, and depression caused by life events had significant disruptive effects and influenced patient-defined health care needs. The participants experienced the Norwegian public health service as focused on hospital-based standardized cancer care. They expressed unmet health care needs in terms of emotional and practical support in their everyday life with cancer, and some turned to complementary and alternative medicine.ConclusionThis study suggests that acknowledging life course disruption before cancer diagnosis may have significant relevance for understanding complex patient pathways and individual health care needs. Approaching patient pathways as individual and socially constructed may contribute important knowledge to support targeted cancer care.

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“…Central elements in many CAM modalities have been associated with person-centeredness, empowerment, salutogenic care and self-management (e.g., Author 1, 2015b;Berger et al, 2012;Launsø, 1996;Maciocia, 1994;Mulkins et al, 2015;Rakel et al, 2012).…”

Section: Cam Use In Public Healthcare Contextsmentioning

confidence: 99%

“…Coulter, 2004). Situations where there is a clash between personal goals and professional goals of care, such as when cancer patients decide to use alternative treatments only (Coulter, 2004;Mulkins et al, 2015;Salamonsen 2013Salamonsen , 2015Salamonsen et al, 2012a), will remain an ethical and practical dilemma to health professionals (Salamonsen 2015(Salamonsen , 2016Starr and Zawacki, 1999).…”

Section: The Need For Complementary Epistemologies In Future Public Hmentioning

confidence: 99%

Epistemological challenges in contemporary Western healthcare systems exemplified by people’s widespread use of complementary and alternative medicine

Salamonsen

Ahlzén

2017

Health (London)

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Modern Western public healthcare systems offer predominantly publicly subsidized healthcare traditionally based on biomedicine as the most important basis to cure persons who suffer from disorders of somatic or psychiatric nature. To which extent this epistemological position is suitable for this purpose is under scientific debate and challenged by some people's personal understandings of health and illness, their individual illness experiences and their decision-making. Current studies show decreasing levels of patient trust in Western public healthcare and a widespread patient-initiated use of complementary and alternative medicine which is often linked to unmet patient-defined healthcare needs. Patients'/complementary and alternative medicine users' understandings of their afflictions are often based on elements of biomedical knowledge as well as embodied and experience-based knowledge. We believe this points to the need for a phenomenologically and socially based understanding of health and illness. In this article, we analyze challenges in contemporary healthcare systems, exemplified by people's widespread use of complementary and alternative medicine and based on three ways of understanding and relating to unhealth: disease (the biomedical perspective), illness (the phenomenological perspective), and sickness (the social perspective). In public healthcare systems aiming at involving patients in treatment processes, acknowledging the coexistence of differing epistemologies may be of great importance to define and reach goals of treatment and compliance.

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From the conventional to the alternative: exploring patients’ pathways of cancer treatment and care

Abstract: The results of this examination of the longitudinal treatment and decision-making trajectory provide important information to support health care professionals in their quest for individualized, targeted support at each stage of the patient pathway.

Cited by 4 publications

References 35 publications

Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review

Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review

“My cancer is not my deepest concern”: life course disruption influencing patient pathways and health care needs among persons living with colorectal cancer

Epistemological challenges in contemporary Western healthcare systems exemplified by people’s widespread use of complementary and alternative medicine

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From the conventional to the alternative: exploring patients’ pathways of cancer treatment and care

Abstract: The results of this examination of the longitudinal treatment and decision-making trajectory provide important information to support health care professionals in their quest for individualized, targeted support at each stage of the patient pathway.

Cited by 4 publications

References 35 publications

Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review

Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review

&ldquo;My cancer is not my deepest concern&rdquo;: life course disruption influencing patient pathways and health care needs among persons living with colorectal cancer

Epistemological challenges in contemporary Western healthcare systems exemplified by people’s widespread use of complementary and alternative medicine

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“My cancer is not my deepest concern”: life course disruption influencing patient pathways and health care needs among persons living with colorectal cancer