|
|
|
|
|
|
|
|
Complementary and Alternative Medicine
Updated: April 16, 2008
CAM - Overview
Investigator:
Anne Leis, PhD
Experts in the field of ethno-medicine and trans-cultural nursing advocate paying attention to the health beliefs of minorities in order to improve care and health outcomes for minority patients1. Research indicates that reliance on an alternative health care system and use of self-care behaviours and practices are common among ethno-cultural minorities2. For example, a study conducted in San Francisco used data from telephone interviews with 379 women with breast cancer to better understand the prevalence of CAM in four ethnic groups and factors influencing choice of therapy -- ethnicity was identified as an important factor in alternative therapy use3.
Although several recent studies document CAM use in Canada4, very little is known about CAM and alternative health services utilization in ethno-cultural minority groups in the country.
The CIHR Cross-Cultural Palliative Care NET has conducted several pilot studies in this area with the goal to:
- Determine alternative health services utilization in cultural minority groups.
- Compare the use of CAM among BC Chinese cancer patients with other groups in a national study.
- Replicate work done with the black Nova Scotian community.
1. Berger, 1998
2. Cuellar et al.2003;Maskarinec et al, 2000
3. Lee et al., 2000
4. Millar, 2001; Boon et al, 2000; Leis et al, 2003
CAM - Pilot Projects
Pilot 1: The use of CAM by Chinese cancer patients in British Columbia, Canada: prevalence, characteristics, and patterns of use
Pilot 1
Title:
The use of CAM by Chinese cancer patients in British Columbia, Canada: prevalence, characteristics, and patterns of use
Background:
Interest in and use of CAM by cancer patients have been increasing over the past ten years. Research findings suggest that between 25-65% of persons living with cancer are using other therapies in addition to those prescribed by conventional medicine.
However, little information is available on how this usage affects ethnic groups, more specifically, the Chinese cancer population in a Canadian context.
A qualitative study on the "Use of complementary and alternative medicine by Chinese cancer patients in British Columbia" was conducted by Chiu et al., with fourteen patients in the Vancouver area. All informants used at least one form of traditional Chinese medicine (TCM) during or after conventional cancer treatment. A few patients did not see a relationship between CAM and TCM, because from their perspective TCM was part of their daily lives. Reasons for CAM use included whole body care, management of side effects, and dissatisfaction with conventional treatment. The use of CAM was noted to be further affected by social cultural factors such as Chinese cultural beliefs/practice, place of origin, and social network/accessibility. The informants were currently using both conventional medicine and CAM. The results of this pilot work informed the way the original survey instrument was modified for the proposed study in order to be culturally sensitive and appropriate.
With this background, the main goal of the research is to estimate the prevalence and characteristics and to investigate the influence of culture on CAM use by Chinese cancer patients in BC.
Objectives
- Estimate the response rate and the prevalence of CAM use by Chinese cancer patients within three months of diagnosis
- Identify socio-demographic and heritage consistency/acculturation characertistics of Chinese cancer patients who are CAM users in comparison with those who are not
- Compare characteristics of CAM use among this sample to a representative sample of cancer patients who also use CAM
NET Objectives
1. Enhance capacity building with interdisciplinary communication among collaborators
2. Provide a thesis project for a graduate student
3. Facilitate knowledge translation and to build partnerships with the BC Chinese Community Advisory Group and clinicians/staff at the BCCA
Study Design and Methods
Using a cross-sectional design, approximately 200 Mandarin- and Cantonese-speaking cancer patients will participate in this pilot study. Chinese cancer patients will be approached at the Vancouver Cancer Centre within three months of their diagnosis during a four-month period.
In phase I, study information will be given and interested patients will have the opportunity to complete a short-form structured questionnaire on a newly devised instrument used in a previous survey and culturally adapted for a Chinese population. The questionnaire was devised using simple language due to anticipated communication barriers with patients (e.g. fluency in English, education levels). Questions take the form of “yes/no”, and “check all that apply”. The questionnaire will focus on three domains to answer the research objectives:
a) prevalence of CAM use (use before and after cancer diagnosis, specific modalities used)
b) socio-demographics (age, gender, income, education)
c) heritage consistency/acculturation (place of origin, language spoken at home, generation).
A research assistant will administer the five-minute questionnaire in the language of choice and provide any clarification support to patients.
In phase II, patients who agreed to follow-up will be contacted by a research assistant who speaks their language and an in-depth structured interview will be conducted to ellicit further information and more detailed data regarding the cultural influences in CAM use for cancer care.
Anticipated Outcomes:
• Revise protocol and re-submit grant application to CIHR and NCIC
• Publish an updated literature review article on CAM and cancer
• Graduate thesis project
• Presentation of preliminary results at national conferences (IN-CAM, World Congress of Cancer Control)
• Manuscripts will be prepared for publication in scientific journals
|
|
|