Developing Patient-Centered Measures for Outcomes of CAM Therapies

描述（由申请人提供）：在补充和替代医学（CAM）中，许多疗法或药物针对整个人，重点是生命力，气，prana或类似的概念。这与生物医学形成对比，生物医学的重点是特定的疾病、器官、症状或机制（药物）。现代辅助医学研究通常研究生物医学术语定义的患者群体，并适当地使用与生物医学条件相关的结果测量方法。然而，通常缺乏与理解CAM系统相适应的结果，评估整个人的变化（例如能量，福祉）。此外，有证据表明，一些接受CAM疗法的个体，特别是那些可能被认为具有能量或精神成分的疗法（如顺势疗法、能量或精神治疗、针灸），报告了W.R.Miller和其他人所描述的所谓的转变体验。CAM研究人员还没有工具来衡量基于经验研究的结果，这些研究是基于对CAM客户经历全人结果或变革经验的研究。该应用程序提出要实现两个目标-确定与CAM疗法相关的重要的全人结果，以便在CAM研究中进行一致的评估，并为这些维度开发和验证一个测量工具，而没有可用的项目，如变革变化。具体目的是：(1)重新分析现有的五个关于辅助替代疗法患者的定性数据集和两个关于辅助替代疗法从业者的定性数据集，确定参与者自然语言中的全人体验描述符，用于开发新的问卷项目；(2)利用这些结果编制CAM全人结果问卷，包括现有问卷中的项目和量表，以最好地评估最常见的CAM结果，并根据定性数据根据需要添加新项目；(3)在根据种族多样性和CAM经验选择的适当人群中严格评估该工具。在这个项目中，来自四个美国机构和一个加拿大机构的科学家独立进行了同行评议的CAM研究，将他们的定性数据集和独特的CAM研究经验与适当的顾问结合起来，开发了一个在CAM和非CAM环境中具有潜在广泛适用性的结果工具。

DESCRIPTION (provided by applicant): Within complementary and alternative medicine (CAM), many therapies or medicines target the whole person, with focus on vital force, qi, prana, or similar concepts. This contrasts with biomedicine, where the focus is on specific diseases, organs, symptoms, or mechanisms (drugs). Modern CAM research often studies patient populations defined in biomedical terms, and appropriately uses outcome measures defined in relation to biomedical conditions. However, outcomes appropriate to the understanding of the CAM systems, evaluating changes at the level of the whole person (e.g. energy, well-being.) are often lacking. Further, there is evidence that some individuals receiving CAM therapies, especially those therapies that might be considered to have an energetic or spiritual component (e.g. homeopathy, energy or spiritual healing, acupuncture), report what can be called transformative experiences, as described by W.R.Miller and others. CAM researchers have not had tools to measure outcomes that are based on empirical studies of CAM clients experiencing whole person outcomes or transformative experiences. This application proposes to accomplish two goals - identifying important whole person outcomes associated with CAM therapies to propose for consistent evaluation in CAM research, and developing and validating a measurement instrument for those dimensions without available items, such as transformative change. The specific aims are (1) to reanalyze five existing qualitative data sets on CAM patients and two on practitioners relating to outcomes experienced through CAM therapies, identifying descriptors of whole person experiences in participants' natural language, to use in the development of new questionnaire items; (2) to use these results to develop (compile) a CAM whole person outcomes questionnaire, including items and scales from existing questionnaires identified to best evaluate the most common CAM outcomes, and new items as needed based on the qualitative data; and (3) to rigorously evaluate this tool in appropriate populations chosen for ethnic diversity and CAM experiences. In this project, scientists from four US and one Canadian institution who have independently conducted peer-reviewed CAM research combine their qualitative data sets and unique CAM research experiences with appropriate consultants to develop an outcomes instrument with potential broad applicability in CAM and non-CAM settings.