Integrating CAM into conventional medicine

描述(申请人提供)：本计划是一项多学科的计划 科学家、临床医生、教育工作者、医务人员之间的协作 人类学家、统计学家、卫生服务提供者和社区治疗师 确定整合互补性和 传统医学的替代方法(CAM)。我们假设 将CAM模式融入常规模式的主要障碍 医学是能量、“生命力”和 大多数CAM情态所依赖的灵性不是被接受的 大多数医生都受过训练的西方科学范式。宁可 而不是试图说服医生使用超出 他们在其中运作的范式，我们提出了一种干预，我们将在其中 着力培育新范式。具体目标1是确定一个 旨在培养CAM与西医融合的体验式课程 范式可能会导致转诊到CAM从业者的发生率增加。 我们将a)评估转介患者的意向是否发生了变化 在干预之后立即；b)是否发生了变化 干预后6个月的行为表现。具体目标2是确定 这样的体验式程序是否能增加感知的理解 潜在的CAM范例，以及增加的理解是否相关 转诊人数的增加。我们将a)评估是否增加了 与对照相比，理解基本的CAM范例；b) 计算增加对CAM范例的理解的频率 作为更改转诊的一个重要特征而被注意到；c)计算频率 哪些干预措施的其他组成部分被认为是重要的 改变推荐人的特点。为达致这些目标，我们建议 心脏内科医生的随机研究 克利夫兰诊所基金会，其中一只手臂接受教育 干预。试验组将参加为期两天的体验 工作坊将有一位医学人类学家、一位教育家的演讲 经验丰富的教育理论研究范式的整合 熟悉研究身心互动的科学家，由 分子生物学、神经科学和免疫学，以及一位熟悉 量子物理的概念与CAM的特征并不矛盾 哲学。参与者将有机会体验到许多 并与CAM从业者讨论问题，包括 是一家综合中心的医务主任。仪器将是 旨在确定心脏病专家的行为变化是否受到影响 通过这种干预，如果是的话，评估积极的特征。我们期待着 这些研究将确定一个可持续的、可重复的战略 将CAM研究整合到常规实践中，并应提供见解 转换为有利于成功集成的功能。

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.