Exploring the decision to disclose the use of natural products among outpatients: a mixed-method study

BMC Complementary and Alternative Medicine

Betty Siren²  Huai-Lu Chang¹  Hsiao-Yun Chang³ 

[1] Chief Executive Officer, H & L Medical Corporation, Kaohsiung, Taiwan;Department of Foreign Languages, Fooyin University, Kaohsiung, Taiwan;School of Nursing, Fooyin University, Kaohsiung, Taiwan

关键词: Mixed methods research;    Decision;    Communication;    Disclosure;    Natural products;   

Others  :  1220521
DOI  :  10.1186/1472-6882-13-319

 received in 2013-10-07, accepted in 2013-11-15,  发布年份 2013

【 摘 要 】

Background

There is little understanding of the reasons for the limited communication between patients and conventional healthcare professionals regarding patients’ use of complementary and alternative medicine (CAM). The purpose of this study is to explore the predictors of outpatients’ decision to disclose their use of natural products to conventional healthcare professionals.

Methods

A mixed method design was used. Quantitative data were obtained through a survey and qualitative data were obtained from semi-structured interviews. A total of 257 outpatients who fulfilled the criteria of having used natural products prior to the interview were recruited for this study. Subsequently, 39 patients of those who completed the survey were further selected to take part in an in-depth qualitative interview.

Results

Predictors of the decision to disclose the use of natural products to conventional healthcare professionals included age, frequency of clinic visits, knowledge of the natural products and the attitude towards the benefits of CAM use. The themes that emerged from the qualitative data included safeness of the natural products, consulting alternative sources of information, apprehension regarding the development of negative relationships with healthcare professionals and reactions from the healthcare professionals.

Conclusions

Understanding the factors and reasons affecting patients’ decision as to whether to disclose their use of natural products provides an opportunity for conventional healthcare professionals to communicate better with patients. It is important to encourage patients to disclose their use of natural products in order to provide responsible health care as well as increasing patient safety regarding medication usage.

【 授权许可】

   
2013 Chang et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]National Centre for Complementabry and Alternative Medicine: NCCAM Publication No. D347 What Is Complementary and Alternative Medicine?. 2011. http://nccam.nih.gov/health/whatiscam/ webcite
• [2]World Health Organization: Traditional Medicine: Definitions. 2000. http://www.who.int/medicines/areas/traditional/definitions/en/ webcite
• [3]Barnes PM, Bloom B, Nahin R: CDC National Health Statistics Report #12 – Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007. USA: NCCAM Clearinghouse; 2008. http://nccam.nih.gov/news/camstats/2007/camsurvey_fs1.htm webcite
• [4]MacLennan AH, Myers SP, Taylor AW: The continuing use of complementary and alternative medicine in South Australia: costs and beliefs in 2004. Med J Australia 2006, 184:27-31.
• [5]Lim MK, Sadarangani P, Chan HL, Heng JY: Complementary and alternative medicine use in multiracial Singapore. Complement Ther Med 2005, 13(1):16-24.
• [6]Yamashita H, Tsukayama H, Sugishita C: Popularity of complementary and alternative medicine in Japan: A telephone survey. Complement Ther Med 2002, 10(2):84-93.
• [7]Tan M, Uzun O, Akcay F: Trends in complementary and alternative medicine in eastern Turkey. J Altern Complement Med 2004, 10:861-865.
• [8]Lew-Ting CY: Who uses non-biomedical, complement and alternative health care? Socio-demographic undifferentiation and the effects of health needs. Taiwan Journal Public Health 2003, 22(3):155-166.
• [9]Chang HY, Wallis M, Tiralongo E: Use of Complementary and Alternative Medicine among people with type 2 diabetes in Taiwan: a cross-sectional survey. Evid Based Complement Alternat Med 2011, 2011:1-8.
• [10]Harrigan JT: Patient disclosure of the use of complementary and alternative medicine to their obstetrician/gynaecologist. J Obstet Gynaecol 2011, 31(1):59-61.
• [11]Shakeel M, Trinidade A, Jehan S, Ah-See KW: The use of complementary and alternative medicine by patients attending a general otolaryngology clinic: can we afford to ignore it? Am J Otolaryngol 2010, 31(4):252-260.
• [12]Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL: Unconventional medicine in the United States. Prevalence, costs, and patterns of use. N Engl J Med 1993, 328(4):246-252.
• [13]Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, Kessler RC: Trends in alternative medicine use in the United States, 1990–1997: Results of a follow-up national survey. JAMA 1998, 280:1569-1575.
• [14]Chiou C: Ancillary use of complementary therapies by ESRD patients receiving hemodialysis in Taiwan. Nurs Res (Taiwan) 1999, 7(5):398-407.
• [15]Chang HY, Wallis M, Tiralongo E: Use of complementary and alternative medicine among people living with diabetes: literature review. J Adv Nurs 2007, 58(4):307-319.
• [16]Hall HG, Griffiths DL, McKenna LG: The use of complementary and alternative medicine by pregnant women: a literature review. Midwifery 2011, 27(6):817-824.
• [17]Cassileth BR, Vickers AJ: Complementary and alternative therapies. Urol Clin North Am 2003, 30(2):369-376.
• [18]Leung VW, Shalansky SJ, Lo MK, Jadusingh EA: Prevalence of use and the risk of adverse effects associated with complementary and alternative medicine in a cohort of patients receiving warfarin. Ann Pharmacother 2009, 43(5):875-881.
• [19]Meijerman I, Beijnen JH, Schellens JH: Herb-drug interactions in oncology: focus on mechanisms of induction. Oncologist 2006, 11(7):742-752.
• [20]Morse JM: Approaches to qualitative-quantitative methodological triangulation. Nurs Res 1991, 40(2):120-123.
• [21]Patton MQ: Qualitative research and evaluation methods. 3rd edition. Thousand Oaks, California: Sage Publications; 2002.
• [22]Polit-O’Hara D, Beck CT: Nursing research: principles and methods. 7th edition. Philadelphia; London: Lippincott Williams & Wilkins; 2004.
• [23]Hsu MC, Moyle W, Creedy D, Venturato L, Ouyang WC, Sun GC: Attitudes toward and education about complementary and alternative medicine among adult patients with depression in Taiwan. J Clin Nurs 2010, 19(7–8):988-997.
• [24]Chang HYA, Wallis M, Tiralongo E: Predictors of complementary and alternative medicine use by people with type 2 diabetes. J Adv Nurs 2012, 68(6):1256-1266.
• [25]Holloway I, Wheeler S: Qualitative research in nursing. 2nd edition. Oxford: Blackwell Science; 2002.
• [26]Thomson P, Jones J, Evans JM, Leslie SL: Factors influencing the use of complementary and alternative medicine and whether patients inform their primary care physician. Complement Ther Med 2012, 20(1):45-53.
• [27]Liu C, Yang Y, Gange SJ, Weber K, Sharp GB, Wilson TE, Levine A, Robison E, Goparaju L, Gandhi M, Merenstein D: Disclosure of complementary and alternative medicine use to health care providers among HIV-infected women. AIDS Patient Care STDS 2009, 23(11):965-971.
• [28]Langlois-Klassen D, Kipp W, Rubaale T: Who’s talking? Communication between health providers and HIV-infected adults related to herbal medicine for AIDS treatment in western Uganda. Soc Sci Med 2008, 67(1):165-176.
• [29]Chung VCH, Ma PHX, Tang TSK, Lau CH, Kim JH, Griffiths SM: Do patients tell their clinicians they are using both prescribed and over the counter allopathic and traditional medicines? Eur J Integr Med 2011, 3(4):e289-e298.
• [30]Chao MT, Wade C, Kronenberg F: Disclosure of complementary and alternative medicine to conventional medical providers: variation by race/ethnicity and type of CAM. J Natl Med Assoc 2008, 100:1341-1349.
• [31]Sidora-Arcoleo K, Yoos HL, Kitzman H, McMullen A, Anson E: Don’t ask, don’t tell: parental nondisclosure of complementary and alternative medicine and over-the-counter medication use in children’s asthma management. J Pediatr Health Care 2008, 22(4):221-229.
• [32]Robinson A, McGrail MR: Disclosure of CAM use to medical practitioners: a review of qualitative and quantitative studies. Complement Ther Med 2004, 12(2):90-98.
• [33]Brown J, Cooper E, Frankton L, Steeves-Wall M, Gillis-Ring J, Barter W, McCabe A, Fernandez C: Complementary and alternative therapies: survey of knowledge and attitudes of health professionals at a tertiary pediatric/women’s care facility. Complement Ther Clin Pract 2007, 13(3):194-200.
• [34]Chu FY, Wallis M: Taiwanese nurses’ attitudes towards and use of complementary and alternative medicine in nursing practice: a cross-sectional survey. Int J Nurs Stud 2007, 44(8):1371-1378.