Integrating CAMI Into Conventional Medicine

描述（由申请人提供）：本提案是一项多学科的 科学家、临床医生、教育工作者、医疗工作者 人类学家、统计学家、卫生服务提供者和社区治疗师， 查明纳入补充和 替代方法（CAM）进入传统医学。我们假设 将CAM模式整合到传统的 医学的基本前提，如能量，“生命力”， 大多数CAM模式所依赖的灵性并不是 大多数医生接受过的西方科学范式。而 而不是试图说服医生使用不符合 我们建议采取干预措施， 专注于培育一个新的范例。具体目标1是确定 体验计划，旨在培养CAM和西医的融合 范例可能导致向CAM从业者转诊的发生率增加。 我们会a）评估转介病人的意向有否改变 干预后立即; B）是否有变化， 干预后6个月。具体目标2是确定 这样的体验式项目是否能增加人们对 的基础CAM范例，以及增加的理解是否与 增加的转介。我们将评估是否有增加 与对照组相比，对基础CAM范例的理解; B） 计算对CAM范式的理解增加的频率 注意到在改变转介的一个重要特征; c）计算频率 与此同时，干预的其他组成部分也被认为是重要的 在改变转介的功能。为了实现这些目标，我们提出了一个 对心脏科医生的随机研究 克利夫兰临床基金会，其中一只手臂接受教育 干预实验组将参加为期两天的体验活动， 研讨会将由一位医学人类学家、一位教育家 经验丰富的教育理论整合的范式，一个研究 熟悉身心互动研究的科学家， 分子生物学、神经科学和免疫学，以及一位熟悉 量子物理学的概念与CAM的特征不一致 哲学参加者将有机会体验多项 CAM实践，并与CAM从业人员讨论问题，包括 综合中心的医学主任医师。文书将 旨在确定心脏病专家的行为变化是否受到 通过这种干预，如果是这样，评估积极的特点。我们预计 这些研究将确定一个可持续的，可重复的战略， 将CAM研究与传统实践相结合， 转化为有利于成功整合的功能。

DESCRIPTION (Provided by applicant): This proposal is a multi-disciplinary collaboration between a scientist, clinicians, educator, medical anthropologist, statistician, health service provider, and community healers to identify barriers and facilitators to incorporation of complementary and alternative approaches (CAM) into conventional medicine. We hypothesize that the major barrier to the integration of CAM modalities into conventional medicine is that the underlying premises such as energy, "life- force", and spirituality on which most CAM modalities rest are not an accepted part of the Western scientific paradigm in which most physicians have been trained. Rather than attempt to convince physicians to use modalities that are outside of the paradigm within which they operate, we propose an intervention in which we will focus on nurturing a new paradigm. Specific Aim 1 is to determine whether an experiential program designed to nurture a blending of CAM and Western medicine paradigms can lead to an increased incidence of referrals to CAM practitioners. We will a) assess whether there is a change in the intention to refer patients immediately after the intervention; b) whether there has been a change in behavior 6 months after the intervention. Specific Aim 2 is to determine whether such an experiential program can increase the perceived understanding of underlying CAM paradigms, and whether the increased understanding is related to the increased referrals. We will a) assess whether there is an increased understanding of underlying CAM paradigms compared to the controls; b) calculate the frequency with which increased understanding of CAM paradigms is noted as an important feature in changing referrals; c) calculate the frequency with which other components of the intervention are noted as being important features in changing referrals. To accomplish these aims, we propose a randomized study for physicians in the Department of Cardiology at The Cleveland Clinic Foundation, in which one arm receives an educational intervention. The experimental group will attend a two-day experiential workshop that will feature lectures by a medical anthropologist, an educator experienced in educational theories of integration of paradigms, a research scientist familiar with research for mind-body interactions provided by molecular biology, neuroscience, and immunology, and a physicist familiar with concepts of quantum physics that are not inconsistent with features of CAM philosophies. Participants will have the opportunity to experience a number of CAM practices and to discuss issues with CAM practitioners including a physician who is Medical Director of an integrated center. Instruments will be designed to determine whether a change in behavior of cardiologists is affected by this intervention and, if so, to assess positive features. We anticipate that these studies will identify a sustainable, reproducible strategy for integrating CAM research into conventional practice and should provide insight into features that favor successful integration.