An exploratory typology of provider responses that encourage and discourage conversation about complementary and integrative medicine during routine oncology visits.
An exploratory typology of provider responses that encourage and discourage conversation about complementary and integrative medicine during routine oncology visits.
复制标题
提供者响应的探索性类型，鼓励和阻止在常规肿瘤就诊期间谈论补充和综合医学。
DOI：
10.1016/j.pec.2015.02.018
复制
发表时间：
2015
影响因子：
3.5
通讯作者：
Dohan,Daniel
中科院分区：
文献类型：
--
作者：
Koenig,ChristopherJ;Ho,EvelynY;Trupin,Laura;Dohan,Daniel
ObjectiveTo characterize how providers respond to patient mentions of complementary and integrative medicine (CIM) during routine oncology visits.MethodsEthnographic methods were used over a two and a half year period with 82 advanced cancer patients and their providers across four oncology clinics. Participant observation fieldnotes were analyzed using Discourse Analysis.ResultsCIM was mentioned in 78/229 (34%) of the total observed visits. Patients initiated talk about CIM (76%) more than providers (24%). Patients mentioning CIM may indicate a preference for or interest in non-pharmacological adjunctive treatment options. Providers’ responsesinhibitedfurther talk in 44% of observations andpromotedtalk in 56% of observations.ConclusionHow providers respond may indicate their willingness to discuss a range of treatment options and to collaboratively engage in treatment decision-making. Provider responses that inhibited CIM conversation passed on the opportunity to discuss patient preferences, and responses that promoted further conversation helped counsel patients about appropriate CIM use. Promoting discussion did not require additional time or extensive knowledge about CIM.Practice implicationsProviders can facilitate high quality communication without endorsing CIM to help patients make treatment decisions and to evaluate CIM appropriateness in response to patient values and preferences.
