OLDER PATIENT-PHYSICIAN-ALTERNATIVE HEALER RELATIONSHIPS

老年患者越来越有可能接受 医生和替代从业者，通常用于治疗相同的 条件然而，在绝大多数情况下，替代性照料并不 与生物医学护理相结合;事实上，大多数患者并没有告知他们的 同时使用补充和替代医学的医生 （CAM）。这是研究医疗保健关系的关键时刻 病人由不同医疗系统的医生治疗 他们通常不联系，也不知道彼此。的 这项为期四年的定性人类学研究的目的是描述 并研究新兴的医疗保健关系配置 被诊断患有乳腺癌的老年妇女接触和理解， 他们的医生和CAM从业者。这将是一个民族志 调查个人的年龄，民族文化 背景，和预期的老龄化，根据收集的数据，通过 深入的个人访谈。150名研究参与者将包括 年龄在55- 84岁之间的乳腺癌妇女，她们使用生物医学， CAM;他们的主要医生;和他们的主要CAM从业人员。患者将 包括非洲裔、华裔、欧洲裔和西班牙裔美国妇女。项目 将（1）调查健康信念和治疗策略， 老年乳腺癌患者同时向医生和CAM寻求护理 （2）检查患者参与者对 对他们与医生和CAM从业者关系的反应;和（3） 检查医生和CAM从业者对以下问题的理解和反应： 与老年乳腺癌患者的关系。这项研究将揭示 老年乳腺癌患者的综合治疗方法，阐明 生物医学和CAM系统的优点和缺点， 满足老年乳腺癌患者的需求，并提出未来的策略 加强新兴的医疗保健关系。

Older patients are increasingly likely to be under the care of both physicians and alternative practitioners, often for treatment of the same condition. In the vast majority of cases, however, alternative care is not integrated with biomedical care; indeed, most patients do not inform their physicians of their concurrent use of complementary and alternative medicine (CAM). This is a critical juncture at which to study health-care relationships in which the patient is treated by practitioners from different medical systems who are usually not in contact with, and often not aware of, one another. The objective of this four-year qualitative, anthropological study is to describe and examine the ways in which emerging health-care relationship configurations are approached and understood by older women diagnosed with breast cancer, their physicians, and their CAM practitioners. This will be an ethnographic investigation of the mediating effects of individuals' age, ethnocultural background, and expectations of aging, based on the collection of data through in-depth individual interviews. The 150 study participants will be comprised of linked triads of women with breast cancer, ages 55- 84, who use biomedicine and CAM; their main physicians; and their main CAM practitioners. The patients will include African-, Chinese-, European-, and Hispanic American women. The project will (1) investigate the health beliefs and healing strategies involved in older breast cancer patients' seeking care concurrently from physicians and CAM practitioners; (2) examine patient participants' understandings of and reactions to their relationships with physicians and CAM practitioners; and (3) examine physicians' and CAM practitioners' understandings of and reactions to their relationships with older breast cancer patients. This study will reveal older breast cancer patients' integrative healing approaches, elucidate benefits and deficiencies of biomedical and CAM systems with regard to addressing older breast cancer patients' needs, and suggest future strategies for strengthening emerging health-care relationships.