Complementary and alternative medicine use in patients with chronic diseases in primary care is associated with perceived quality of care and cultural beliefs
Complementary and alternative medicine use in patients with chronic diseases in primary care is associated with perceived quality of care and cultural beliefs
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DOI：
10.1093/fampra/cmh613
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发表时间：
2004-12-01
期刊：
影响因子：
2.2
通讯作者：
Ng, TP
中科院分区：
文献类型：
--
作者：
Lee, GBW;Charn, TC;Ng, TP
目标.我们的研究的目的是确定补充和替代医学（CAM）的使用及其临床和心理社会相关因素，包括感知的满意度与护理和文化健康信念的流行。在新加坡的公共部门初级保健诊所进行了一项横断面研究，随机抽取了488名患有慢性病的成年患者。调查指标为CAM使用情况、护理满意度和传统健康观念。CAM使用的1年患病率为22.7%。在单变量分析中，与CAM使用相关的因素包括：中年，关节炎，肌肉骨骼疾病和中风，多种疾病，健康状况差，家庭使用CAM，密切的社会联系人的建议，强烈坚持传统的健康信念和对护理的满意度。对治疗费用[比值比（OR）= 1.79，95%置信区间（CI）1.15-2.82]和等待时间（OR = 1.96，95% CI 1.20-3.19）不满意/非常不满意的患者更有可能使用CAM。对治疗获益非常满意的患者不太可能使用CAM（OR = 0.49，95%CI 0.29-0.83）。医患互动的满意度与CAM的使用无关。总体护理满意度“非常满意”与CAM使用少得多显著相关（OR = 0.30，95%CI 0.14-0.68）。多变量分析证实CAM的使用是“慢性病三联征”的独立预测因素（关节炎/肌肉骨骼疾病/中风）（OR = 4.08，95% CI 2.45-6.83），对护理的总体满意度（OR = 0.32，95%CI 0.14-0.74）和对传统健康信念的强烈坚持（OR = 1.88，95%CI 1.07-3.31）。CAM在亚洲患者中的使用是普遍的，并且与“慢性疾病三联征”（关节炎、肌肉骨骼疾病和中风）、对护理的满意度和文化信仰相关。特别是，CAM的使用与医患互动的质量无关。
Objectives. The purpose of our study was to determine the prevalence of complementary and alternative medicine (CAM) use and its clinical and psycho-social correlates, including perceived satisfaction with care and cultural health beliefs.Methods. A cross-sectional study was carried out in public sector primary care clinics in Singapore using a random sample of 488 adult patients with chronic diseases. The measures were CAM use, satisfaction with care and traditional health beliefs.Results. The 1 year prevalence of CAM use was 22.7%. In univariate analyses, factors associated with CAM use included: middle age, arthritis, musculoskeletal disorders and stroke, multiple conditions, poor perceived health, family use of CAM, recommendation by close social contacts, strong adherence to traditional health beliefs and perceived satisfaction with care. Patients who were dissatisfied/very dissatisfied with the cost of treatment [odds ratio (OR) = 1.79, 95% confidence interval (CI) 1.15-2.82] and waiting time (OR = 1.96, 95% CI 1.20-3.19) were more likely to use CAM. Patients who were very satisfied with the benefit from treatment were much less likely to use CAM (OR = 0.49, 95% CI 0.29-0.83). Satisfaction with doctor-patient interaction was not associated with CAM use. Being 'very satisfied' on overall care satisfaction was significantly associated with much less CAM use (OR = 0.30, 95% CI 0.14-0.68). Multivariate analyses confirmed that CAM use was significantly and independently predicted by the 'chronic disease triad' (arthritis/musculoskeletal disorders/stroke) (OR = 4.08, 95% CI 2.45-6.83), overall satisfaction with care (OR = 0.32, 95% CI 0.14-0.74) and strong adherence to traditional health beliefs (OR = 1.88, 95% CI 1.07-3.31).Conclusion. CAM use in Asian patients is prevalent and associated with the 'chronic disease triad' (of arthritis, musculoskeletal disorders and stroke), satisfaction with care and cultural beliefs. In particular, CAM use is not associated with the quality of doctor-patient interaction.