期刊论文详细信息
BMC Complementary and Alternative Medicine
The Red flag! risk assessment among medical homeopaths in Norway: a qualitative study
Anita Salamonsen1  Terje Alræk1  Trine Stub1 
[1]Department of Community Medicine, NAFKAM (The National Research Center in Complementary and Alternative medicine), University of Tromsø, Tromsø, 9037, Norway
关键词: Risk assessment;    Patient safety;    Medical homeopaths;    Adverse effects;    Homeopathic aggravations;    Conventional medicine;    Homeopathy;   
Others  :  1232018
DOI  :  10.1186/1472-6882-12-150
 received in 2012-03-13, accepted in 2012-09-08,  发布年份 2012
PDF
【 摘 要 】

Background

Homeopathy is widely used, and many European physicians practice homeopathy in addition to conventional medicine. Adverse effects in homeopathy are not expected by homeopaths due to the negligible quantities of active substances in a remedy. However, we questioned if homeopathic aggravation, which is described as a temporary worsening of existing symptoms following a correct homeopathic remedy, should be regarded as adverse effects or ruled out as desirable events of the treatment. In order to improve knowledge in an unexplored area of patient safety, we explored how medical homeopath discriminate between homeopathic aggravations and adverse effects, and how they assessed patient safety in medical practice.

Method

A qualitative approach was employed using focus group interviews. Two interviews with seven medical homeopaths were performed in Oslo, Norway. The participants practiced homeopathy besides conventional medicine. Qualitative content analysis was used to analyze the text data. The codes were defined before and during the data analysis.

Results

According to the medical homeopaths, a feeling of well-being may be a criterion to distinguish homeopathic aggravations from adverse effects. There was disagreement among the participants whether or not homeopathic treatment produced adverse effects. However, they agreed when an incorrect remedy was administrated, it may create a disruption or suppressive reaction in the patient. This was not perceived as adverse effects but a possibility to prescribe a new remedy as new symptoms emerge. This study revealed several advantages for the patients as the medical homeopaths looked for dangerous symptoms which may enhance safety. The patient was given time and space, which enabled the practitioner to see the complete picture. A more comprehensive toolkit gave the medical homeopaths a feeling of professionalism.

Conclusion

This explorative study investigated how Medical Homeopaths understood and assessed risk in their clinical practice. A feeling of well-being emerging soon after taking the remedy was the most important criterion for discriminating between Homeopathic Aggravations and Adverse Effects in clinical practice. The Medical Homeopaths used the view of both professions and always looked for red flag situations in the consultation room. They combined knowledge from two treatment systems which may have advantages for the patient. These tentative results deserve further research efforts to improve patient safety among users of homeopathy. For further research we find it important to improve and develop concepts that are unique to homeopathy in order to validate and modernize this medical practice.

【 授权许可】

   
2012 Stub et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20151112054757300.pdf 340KB PDF download
Figure 1. 17KB Image download
【 图 表 】

Figure 1.

【 参考文献 】
  • [1]Walach H, Jonas WB, Ives J, Wijk RV, Weingärtner O: Research on Homeopathy: State of the Art. The Journal of Alternative and Complementary Medicine 2005, 11(5):813-829.
  • [2]Owen D: Principles and Practice of Homeopathy. The Therapeutic and Healing Process. Southampton University: Churchill Livingstone Elsevier; 2007.
  • [3]Schabe W: Elementa Homoeopathica. Karlsruhe ( Baden): Karlsruhe Engelhardt & Bauer; 1960.
  • [4]Lockie A: Encyclopedia of Homeopathy. London: Dorling Kindersley Limited. A Penguin Company; 2005.
  • [5]Bornhöft G, Wolf U, von Ammon K, Righetti M, Maxion-bergemann S, Baumgartner S, Thurneysen A, Matthiessen P: Effectiveness, Safety and Cost-Effectiveness of Homeopathy in General Practice-Summarized Health Technology Assessment. Forsch Komplementärmed 2006, 13(2):19-29.
  • [6]Dantas F: Reproting and investigating adverse effects of homeopathy. Br Hom J 1999, 88:99-100.
  • [7]Thompson E, Barron S, Spence D: A preliminary audit investigating remedy reactions including adverse events in routine homeopathic practice. Homeopathy 2004, 93(4):203-209.
  • [8]European Council for Classical Homeopathy: The Safety of Homeopathy An ECCH Report. In European Council for Classical Homeopathy. United Kingdom: Norfolk; 2009:1-35.
  • [9]Dantas F, Rampes H: Do homeopathic medicines provoke adverse effects? A systematic review. Br Homeopath J 2000, 89:35-38.
  • [10]Abbot N, White AR, Ernst E: Complementary medicine. Nature 1996, 381:361.
  • [11]Fisher P, Dantas F, Rampes H: The safety of homeopathic products. J R Soc Med 2002, 95(9):474-476.
  • [12]Kirkby BJ: Safety of homeopathic products. Journal of the Royal Society of Medicine 1995, 5:221-222.
  • [13]Paterakis S, Bachas I, Vithoulkas G: Statistical data on aggravation after the similimum. Hahnemann Homeopathic Sand 1990, 14(8):155-159.
  • [14]Close S: The Genious of Homeopathy - Lectures and Essays on Homeopathic Philosophy. New-Delhi: B.Jain Publishers (P) LTD; 2005.
  • [15]Pashero TP: Homeopathy. Buenos Aires: Beaconsfield Publisher LTD; 2000.
  • [16]Popova T: Homeopathic aggravations. Br Hom J 1991, 80:228-229.
  • [17]Ernst E: Intangible risks of complementary and alternative medicine. J Clin Oncol 2001, 19(8):2365-2366.
  • [18]National Health Service (NHS) Quality Improvement Scotland: Outcome of the Scoping for a Health Technology Assessment in Homeopathy. Edinburgh: Healthcare Improvement Scotland; 2006:1-22.
  • [19]Aggebo A: Hvorfor alltid den Hippokrates?. Aarhus: Universitetsforlaget i Aarhus; 1964.
  • [20]Aase K: Pasientsikkerhet - teori og praksisi i helsevesenet. Oslo: Universitetsforlaget; 2010.
  • [21]Braut GS: The requirement to practice in accordance with sound professional standards. In Healthcare, Welfare and Law Health legislation as a mirror of the Norwegian welfare state. Edited by Ferkis J. Oslo: Gyldendal Akademiske; 2011.
  • [22]Moelven O: Helse og jus. En innføring for helsepersonell. Oslo: Gyldendal; 2006.
  • [23]Olsen J: Helseøkonomi, effektivitet og rettferdighet. Oslo: Cappelen Akademiske Forlag; 2006.
  • [24]Gandhi TK, Weingart SN, Borus J, Seger AC, Peterson J, Burdick E, Seger DL, Shu K, Federico F, Leape LL, et al.: Adverse Drug Events in Ambulatory Care. N Engl J Med 2003, 348(16):1556-1564.
  • [25]Rogers TB: The psycological testing enterprice: An introduction. Pacific Grove, CA: Brooks/Cole; 1995.
  • [26]Gandhi TK, Lee TH: Patient Safety beyond the Hospital. N Engl J Med 2010, 363(11):1001-1003.
  • [27]Peat J: Health Science Research. A handbook of quantitative methods. London: SAGE Publications; 2002.
  • [28]Det Konglige H: Ot.prp. nr. 27 Om lov om alternativ behandling av sykdom mv. Oslo: Det Kongelige helsedepartement; 2002–2003:13-228.
  • [29]Stub T, Salamonsen A, Alræk T: Is it Possible to Distinguish Homeopathic Aggravation from Adverse Effects? A Qualitative Study. Forschende Komplementärmedizin / Research in Complementary Medicine 2011, 19(1):13-19.
  • [30]Morgan DL, Krueger RA: The Focus Group Kit, vol. I-IV. London: SAGE Publications Ltd; 1998.
  • [31]Fontana A, Frey JH: The Interview from Neutral Stance to Political Involvement. In Collecting and Interpreting Qualitative Materials. Edited by Knigth V. London: SAGE Publications; 2008:115-159.
  • [32]Minichiello V, Aroni R, Timewell E, Alexander L: In-depth interviewing. Researching people. Melbourne: Longman Cheshire; 1990.
  • [33]MacPherson H, Hammerschlag R, Lewith G, Schnyer R: Acupuncture Research Strategies for Establishing an Evidence Base. London: Churchill Livingstone; 2007.
  • [34]Fønnebø V, Grimsgaard S, Walach H, Ritenbaugh C, Norheim AJ, M H, Lewith G, Launsø L, Koithan M, Falkenberg T, et al.: Researching complementary and alternative treatments - the gatekeepers are not at home. BMC Medical Research Methodology 2007, 7(7):1-6.
  • [35]Pope C, Mays N: Qualitative Research: Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research. BMJ 1995, 311:42-45.
  • [36]Barbouer A, Kitzinger J: Introduction. R. Barbour & J. Kitzinger. In Developing Focus group Research: Politics, Theory and Practice. London: Sage; 1999:1-20.
  • [37]Peräkylä A: Analyzing Talk and Text. In Collecting and Interpreting Qualitative materials. Edited by Knigth V. London: SAGEPublications; 2008:351-374.
  • [38]Hsieh HF, Shannon SE: Three Approaches to Qualitative Content Analisis. Qual Heal Res 2005, 15(9):1277-1288.
  • [39]Vithoulcas G, van Woensel E: Levels of Health practical applications and cases. Athen: International Academy of Classical Homeopathy; 2010.
  • [40]Hahneman S: Organon of Medicine. 6th edition. New Delhi: J.J. Offset Printers; 1833, translated from the German; 1921.
  • [41]Vithoulkas G: Appendix B. In The Science of Homeopathy. New York: GROVE PRESS, INC; 1980:295-322.
  • [42]Anelli M, Scheepers L, Sermeus G, Van Wassenhoven M: Homeopathy and health related Quality of Life: A survey in six European countries. Homeopathy 2002, 91(1):18-21.
  • [43]Gobo G: Doing ethnography. Los Angeles: Sage Publications; 2008.
  • [44]Kvale S: Det kvalitative forskningsintervju. Oslo: Gyldendal Norsk Forlag AS; 2001.
  • [45]Cozby PC: Methods in Behavioral Research, Fifth edition edn. Mountain View: Mayfield Publishing Company; 1992.
  • [46]Wibeck V: Fokusgrupper. Om fokuserade gruppeintervjuer som undersökningsmetod. Lund: Studentlitteratur; 2000.
  文献评价指标  
  下载次数:5次 浏览次数:9次