Patient & Provider Perspectives on Homeopathic Treatment

描述（由申请人提供）：顺势疗法是补充和替代医学（CAM）中的一个主要护理系统，是一个有200年历史的领域，迄今为止，对其药物（补救措施）的性质引发了许多争论，但对其诊断和治疗过程的研究很少，因为提供者和患者在临床实践中都有经验。顺势疗法医生报告说，他们的病人比对抗疗法的病人在多个维度上经历了更广泛和更深层次的变化。这项为期2年的r21.2探索性提案的总体目标是从提供者和患者的角度，了解在以前不成功的顺势疗法治疗、其他辅助替代疗法干预和对抗疗法治疗的背景下，成功的顺势疗法治疗慢性疾病。三个不同的分析设计组成部分，每一个都有自己独特的定性研究方法，解决：具体目标1发展一个接地理论，阐明具有不同传统医学和CAM专业培训背景的经典顺势疗法提供者的护理过程。具体目标2描述患者的顺势疗法和其他医疗保健的生活经历。具体目标3评估在每个顺势疗法方向下，患者和提供者对治疗过程和结果的看法的异同。参与者将包括(a)传统的顺势疗法提供者（选择一种单一的疗法来解决整个人作为一个整体系统）将进行对抗疗法专业培训（MD， DU， NP， PA）；(b)经过CAM专业培训的经典顺势疗法提供者（ND、DC、HMA、非专业顺势疗法医师）；(c)每个医疗机构的典型患者，即患有任何先前确定的慢性对抗疗法诊断的患者，在医疗机构的整体临床印象中，在至少1年的随访中表现出持续的，“在其病情中表现出杰出或极其成功的结果”。先前的研究和临床观察表明，这些患者也会有不成功的顺势疗法、其他辅助治疗和对抗疗法治疗的经历，以与他们目前“成功”的结果进行比较。对于扎根理论部分（目标1），提供者（N=48）将接受个人访谈和焦点小组访谈。对于现象学部分（目标2），患者（N=48）将接受个别访谈。对于比较分析部分（目标3），我们将评估这两个数据集，以开发成功的顺势疗法治疗的解释模型。这个项目是Pi的长期互动顺势疗法研究项目的一部分，该项目以病人为中心的问题和顺势疗法治疗效果的心理生理标志。这项研究的发现应该有助于澄清顺势疗法未来前瞻性定性和定量研究的正确前提和参数。

DESCRIPTION (provided by applicant): Homeopathy, a major system of care within complementary and alternative medicine (CAM) is a 200-year-old field that has to date stimulated much debate over the nature of its medicines (remedies), but little research on its diagnostic and therapeutic process as experienced by providers and patients in clinical practice. Homeopaths report that their patients undergo a broader scope and deeper quality of change in multiple dimensions than do allopathic patients. The overarching goal of this R21, 2-year exploratory proposal is to understand successful homeopathic treatment of chronic diseases in the context of previously unsuccessful homeopathic treatment, other CAM interventions, and allopathic care, from both provider and patient perspectives. The three distinct analytic design components, each with its own unique qualitative research methodologies, address: Specific Aim 1 Develop a grounded theory that explicates the delivery of care process by classical homeopathic providers with differing conventional medical and CAM professional training backgrounds. Specific Aim 2 Describe the patient's lived experience of homeopathic and other health care. Specific Aim 3 Evaluate similarities and differences in perceptions of treatment course and outcomes between patients and providers within each homeopathic orientation. Participants will include (a) classical homeopathic providers (selecting a single remedy to address the entire person as a whole system) will allopathic professional training (MD, DU, NP, PA); (b) classical homeopathic providers with CAM professional training (ND, DC, HMA, lay professional homeopaths); and (c) exemplar patients of each provider, i.e., patients with any previously established, chronic allopathic diagnosis who, in the provider's global clinical impression, have exhibited a sustained, "outstanding or extremely successful outcome in their condition" for at least 1 year follow-up. Prior research and clinical observations suggest that such patients also will have had experiences with unsuccessful homeopathic, other CAM, and allopathic treatments to compare with their currently "successful" outcomes. For the Grounded Theory component (Aim 1), providers (N=48) will undergo both individual interviews and focus groups. For the Phenomenology component (Aim 2), patients (N=48) will undergo individual interviews. For the Comparative Analysis component (Aim 3), we will evaluate both data sets to develop an explanatory model of successful homeopathic treatment. This project is part of the Pi's long-term interactive homeopathy research program on patient-centered issues and psychophysiological markers of homeopathic remedy effects. Findings from this proposed study should help clarify the proper premises and parameters on which to base future prospective qualitative and quantitative research in homeopathy.