Patient & Provider Perspectives on Homeopathic Treatment

描述(由申请人提供)：顺势疗法，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，迄今引发了许多关于其药物(补救措施)性质的辩论，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经历了这一过程。顺势疗法报告说，他们的患者在多个维度上比对抗疗法患者经历了更广泛的范围和更深层次的变化。这份为期2年的R21探索性建议的主要目标是从提供者和患者的角度，在先前不成功的顺势疗法治疗、其他CAM干预和对症疗法护理的背景下，理解成功的顺势疗法治疗慢性疾病。三个不同的分析设计部分，每个都有自己独特的定性研究方法，旨在：特定目标1开发一个扎根的理论，解释具有不同传统医疗和CAM专业培训背景的经典顺势疗法提供者提供护理过程。具体目标2描述患者的顺势疗法和其他健康护理的生活经历。具体目标3评估患者和提供者在每个顺势疗法取向下对治疗过程和结果的感知的异同。参与者将包括(A)经典顺势疗法提供者(选择一种单一药物来将整个系统作为一个整体来对待)将接受对抗疗法专业培训(MD、DU、NP、PA)；(B)接受CAM专业培训(ND、DC、HMA、非专业顺势疗法)的传统顺势疗法提供者；(C)每个提供者的模范患者，即根据提供者的全球临床印象，在至少1年的全球临床印象中表现出持续的、“在其情况下表现出显著或极其成功的结果”的示范患者。先前的研究和临床观察表明，这些患者还将经历不成功的顺势疗法、其他CAM和对抗疗法治疗，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)将接受个人面谈和焦点小组。现象学部分(AIM 2)的患者(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性模型。这个项目是PI关于以患者为中心的问题和顺势疗法治疗效果的心理生理标记物的长期互动顺势疗法研究计划的一部分。这项拟议研究的结果应该有助于澄清适当的前提和参数，以此作为未来顺势疗法的前瞻性定性和定量研究的基础。

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.