Beliefs about asthma and complementary and alternative medicine in low-income inner-city African-American adults
Beliefs about asthma and complementary and alternative medicine in low-income inner-city African-American adults
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DOI：
10.1111/j.1525-1497.2006.00624.x
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发表时间：
2006-12-01
影响因子：
5.7
通讯作者：
Weaver, Terri E.
中科院分区：
文献类型：
--
作者：
George, Maureen;Birck, Kathleen;Weaver, Terri E.
与高加索人相比，低收入种族/少数民族人群中哮喘患病率、发病率和死亡率的差距正在增加。为了解决这些差异，需要确定替代的信念和行为。为了确定哮喘的因果模型以及低收入非洲裔美国人（AA）严重哮喘成年人使用常规处方与补充和替代药物（CAM）的背景。28次深入访谈的定性分析。26名女性和2名男性，年龄21至48岁，自认为是AA，低收入者和市中心居民。半结构化深入定性访谈的文字记录使用恒定比较法进行归纳分析。64%的参与者持有生物学上正确的哮喘因果模型，尽管100%的参与者报告使用至少1种CAM治疗哮喘。生物疗法、体液平衡和祈祷是最受欢迎的CAM。虽然大多数受试者信任哮喘处方药，但更倾向于将CAM与常规哮喘治疗相结合。补充和替代医学被认为是自然的，有效的，并可能治愈。63%的参与者报告在研究访谈前2周内不遵守常规治疗。CAM和非医学因果模型都没有改变大多数人（93%）使用处方药的意愿。三种可能危险的CAM被确定。临床医生应该了解患者产生的哮喘因果模型和CAM在这一人群中的使用。讨论患者对哮喘综合管理方法的需求和涉及社交网络是2种可能增强患者-提供者伙伴关系和治疗忠诚度的策略。
The gap in asthma prevalence, morbidity, and mortality is increasing in low-income racial/ethnic minority groups as compared with Caucasians. In order to address these disparities, alternative beliefs and behaviors need to be identified.To identify causal models of asthma and the context of conventional prescription versus complementary and alternative medicine (CAM) use in low-income African-American (AA) adults with severe asthma.Qualitative analysis of 28 in-depth interviews.Twenty-six women and 2 men, aged 21 to 48, who self-identified as being AA, low-income, and an inner-city resident.Transcripts of semi-structured in-depth qualitative interviews were inductively analyzed using the constant comparison approach.Sixty-four percent of participants held biologically correct causal models of asthma although 100% reported the use of at least 1 CAM for asthma. Biologically based therapies, humoral balance, and prayer were the most popular CAM. While most subjects trusted prescription asthma medicine, there was a preference for integration of CAM with conventional asthma treatment. Complementary and alternative medicine was considered natural, effective, and potentially curative. Sixty-three percent of participants reported nonadherence to conventional therapies in the 2 weeks before the research interview. Neither CAM nor nonmedical causal models altered most individuals (93%) willingness to use prescription medication. Three possibly dangerous CAM were identified.Clinicians should be aware of patient-generated causal models of asthma and use of CAM in this population. Discussing patients' desire for an integrated approach to asthma management and involving social networks are 2 strategies that may enhance patient-provider partnerships and treatment fidelity.