Interdisciplinary Relationship Models for Complementary and Integrative Health: Perspectives of Chinese Medicine Practitioners in the United States
Interdisciplinary Relationship Models for Complementary and Integrative Health: Perspectives of Chinese Medicine Practitioners in the United States
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DOI：
10.1089/acm.2018.0268
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发表时间：
2018-12-05
影响因子：
2.6
通讯作者：
Evans, Roni
中科院分区：
文献类型：
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作者：
Anderson, Belinda J.;Jurawanichkul, Sai;Evans, Roni
目的：生物医学与传统互补医学(T&CM)的结合通常被称为综合医学。然而，医学学科的整合程度在不同的医学环境中有所不同，一些人认为，由于认识论和范例的差异，这是不可能的。临床医生的观点是不同医学学科如何结合使用的重要决定因素。当被问及生物医学与中医药关系的最伦理模式(对立、整合或多元化)时，这项研究探索了经验丰富的中医的观点。设计：31名在太平洋东方医学院攻读博士学位的中医参与了这项研究。参与者被要求阅读一份讨论生物医学与中医药之间关系的三种模式(对立、整合和多元化)的出版物，然后通过Moodle学习管理系统中的在线论坛讨论最符合道德的模式。对论坛帖子进行了归纳内容分析，以确定共同主题，然后对成员进行检查。结果：数据包含六大主题和六个次要主题。人们明显倾向于多元化。中医师对综合模式有所保留，最重要的是关心病人护理的质素。围绕与医疗保健中的权力失衡有关的问题以及可能的增选问题进行了大量对话。生物医学研究模式与中医实践之间的聚合差异和缺乏兼容性被认为是研究结果有效性的问题。跨专业教育被认为对不同学科的临床医生之间的尊重、共享患者护理和转诊的发展至关重要。结论：本研究为中医将生物医学与中医药相结合的相关问题提供了洞察力。这些见解对于提供补充和综合医疗保健的临床环境的发展和管理非常重要，特别是在为T&CM提供保险范围增加的情况下。
Objectives: The combination of biomedicine and traditional and complementary medicine (T&CM) is often referred to as integrative medicine. However, the degree to which the medical disciplines are integrated varies between medical settings, and it is believed by some to be impossible due to epistemological and paradigmatic differences. Clinicians' perspectives are important determinants of how different medical disciplines are used together. This study explores the perspectives of experienced Chinese medicine practitioners when asked about the most ethical model (opposition, integration, or pluralism) for the relationship between biomedicine and T&CM. Design: Thirty-one Chinese medicine practitioners, undertaking a doctoral upgrade program at the Pacific College of Oriental Medicine, participated in this study. Participants were asked to read a publication discussing three models (opposition, integration, and pluralism) for the relationship between biomedicine and T&CM and then discuss, via an online forum within Moodle learning management system, the most ethical model. An inductive content analysis of the forum posts was undertaken to identify common themes, followed by member checking. Results: The data were found to contain six major and six minor themes. There was a clear preference for pluralism. The Chinese medicine practitioners expressed reservations about the integrative model, and, above all, cared about the quality of patient care. Much dialogue occurred around issues related to a power imbalance within health care, and possible cooptation issues. Paradigmatic differences and a lack of compatibility between biomedical research models and the practice of Chinese medicine were seen as problematic to the validity of research findings. Interprofessional education was viewed as critical for the development of respect, shared patient care, and referrals between clinicians from different disciplines. Conclusions: This study provides insight into the issues associated with combining biomedicine and T&CM that are perceived by Chinese medicine practitioners. Such insights are important for the development and management of clinical settings that provide complementary and integrative health care, especially as the provision of insurance coverage for T&CM increases.