PMCC PMCC

Search tips
Search criteria

Advanced
Results 1-7 (7)
 

Clipboard (0)
None
Journals
Authors
more »
Year of Publication
Document Types
1.  Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers 
Background
Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care.
Methods
Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women’s health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage.
Results
Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion of treating the whole person within a health promotion model and focus on the relevance of diet and lifestyle factors as central to a CAM approach.
Conclusions
From the perspectives of the health service managers, these findings contribute to our understanding around the rationale to include CAM within mainstream health services that deal with psychological trauma and chronic disease. The broader implications of this study can help assist in the development of health service policy on CAM integration in mainstream healthcare services.
doi:10.1186/1472-6882-14-167
PMCID: PMC4048459  PMID: 24885066
Integrative healthcare; Integrative medicine; Complementary and alternative medicine (CAM); Health services research; Chronic disease management; Psychological trauma management; Drug and alcohol rehabilitation
2.  Current challenges and future directions for naturopathic medicine in Australia: a qualitative examination of perceptions and experiences from grassroots practice 
Background
Naturopaths are an increasingly significant part of the healthcare sector in Australia, yet despite their significant role there has been little research on this practitioner group. Currently the naturopathic profession in Australia is undergoing a period of rapid professional growth and change. However, to date most research exploring the perceptions of naturopaths has been descriptive in nature and has focused on those in leadership positions rather than grassroots practitioners. This article explores the perceptions and experiences of practising naturopaths on the challenges and future directions of their profession.
Methods
Semi-structured interviews were conducted with 20 naturopaths practising in the Darling Downs region of South-east Queensland, Australia to explore current perceived challenges in the naturopathic profession in Australia.
Results
Participants perceived a number of internal and external challenges relating to the profession of naturopathic medicine. These included a public misconception of the role of naturopathic medicine; the co-option of naturopathic medicine by untrained or unqualified practitioners; the devaluation of naturopathic philosophy as a core component of naturopathic practice; a pressure to move towards an evidence-based medicine model focused on product prescription; the increasing commercial interest infiltrating complementary medicine, and; division and fragmentation within the naturopathic profession. Naturopaths generally perceived government regulation as a solution for many of these challenges, though this may be representative of deeper frustrations and disconnections between the views of grassroots naturopaths and those in professional leadership positions.
Conclusions
Grassroots naturopaths identify a number of challenges that may have significant impacts on the quality, effectiveness and safety of naturopathic care. Given the significant role naturopaths play in healthcare in Australia the practice and policy implications of these challenges require further research attention.
doi:10.1186/1472-6882-13-15
PMCID: PMC3598391  PMID: 23311390
Naturopathy; Regulation; Professional issues; Practitioner perceptions
3.  Use of complementary and alternative medicine by mid-age women with back pain: a national cross-sectional survey 
Background
The use of complementary and alternative medicine (CAM) has increased significantly in Australia over the past decade. Back pain represents a common context for CAM use, with increasing utilisation of a wide range of therapies provided within and outside conventional medical facilities. We examine the relationship between back pain and use of CAM and conventional medicine in a national cohort of mid-aged Australian women.
Methods
Data is taken from a cross-sectional survey (n = 10492) of the mid-aged cohort of the Australian Longitudinal Study on Women’s Health, surveyed in 2007. The main outcome measures were: incidence of back pain the previous 12 months, and frequency of use of conventional or CAM treatments in the previous 12 months.
Results
Back pain was experienced by 77% (n = 8063) of the cohort in the previous twelve month period. The majority of women with back pain only consulted with a conventional care provider (51.3%), 44.2% of women with back pain consulted with both a conventional care provider and a CAM practitioner. Women with more frequent back pain were more likely to consult a CAM practitioner, as well as seek conventional care. The most commonly utilised CAM practitioners were massage therapy (26.5% of those with back pain) and chiropractic (16.1% of those with back pain). Only 1.7% of women with back pain consulted with a CAM practitioner exclusively.
Conclusions
Mid-aged women with back pain utilise a range of conventional and CAM treatments. Consultation with CAM practitioners or self-prescribed CAM was predominantly in addition to, rather than a replacement for, conventional care. It is important that health professionals are aware of potential multiple practitioner usage in the context of back pain and are prepared to discuss such behaviours and practices with their patients.
doi:10.1186/1472-6882-12-98
PMCID: PMC3493383  PMID: 22809262
Back pain; Complementary medicine; Survey
4.  Complementary and alternative medicine use among older Australian women - a qualitative analysis 
Background
The use of complementary and alternative medicines (CAM) among older adults is an emerging health issue, however little is known about older people's experiences of using CAM and the cultural, geographical and other determinants of CAM use in this population. This study used qualitative methods to explore older women's views of CAM and reasons for their use of CAM. Participants for the project were drawn from the Australian Longitudinal Study on Women's Health (ALSWH) 1921-1926 birth cohort. Women who responded positively to a question about CAM use in Survey 5 (2008) of the ALSWH were invited to participate in the study. A total of 13 rural and 12 urban women aged between 83 and 88 years agreed to be interviewed.
Results
The women expressed a range of views on CAM which fell into three broad themes: "push" factors such as dissatisfaction with conventional health services, "pull" factors which emphasised the positive aspects of choice and self-care in health matters, and barriers to CAM use. Overall, the "push' factors did not play a major role in the decision to use CAM, rather this was driven by "pull" factors related to health care self-responsibility and being able to source positive information about types of CAM. A number of barriers were identified such as access difficulties associated with increased age, limited mobility and restricted transport options, as well as financial constraints.
Conclusions
CAM use among older women was unlikely to be influenced by aspects of conventional health care ("push factors"), but rather was reflective of the personal beliefs of the women and members of their close social networks ("pull factors"). While it was also apparent that there were differences between the rural and urban women in their use of CAM, the reasons for this were mainly due to the difficulties inherent in accessing certain types of CAM in rural areas.
doi:10.1186/1472-6882-12-34
PMCID: PMC3342907  PMID: 22471758
CAM use; Women; Urban; Rural
5.  A comparison of complementary and alternative medicine users and use across geographical areas: A national survey of 1,427 women 
Background
Evidence indicates that people who reside in non-urban areas have a higher use of complementary and alternative medicine (CAM) than people who reside in urban areas. However, there is sparse research on the reasons for such differences. This paper investigates the reasons for geographical differences in CAM use by comparing CAM users from four geographical areas (major cities, inner regional, outer region, rural/remote) across a range of health status, healthcare satisfaction, neighbourhood and community factors.
Methods
A cross-sectional survey of 1,427 participants from the Australian Longitudinal Study on Women's Health (ALSWH) conducted in 2009.
Results
The average total cost of consultations with CAM practitioners was $416 per annum and was highest for women in the major cities, declining with increasing distance from capital cities/remoteness (p < 0.001). The average total cost of self-prescribed CAM was $349 per annum, but this did not significantly differ across geographical areas. The increased use of CAM in rural and remote areas appears to be influenced by poorer access to conventional medical care (p < 0.05) and a greater sense of community (p < 0.05) amongst these rural and remote residents. In contrast to the findings of previous research this study found that health status was not associated with the differences in CAM use between urban and non-urban areas.
Conclusion
It appears that a number of factors influence the different levels of CAM use across the urban/non-urban divide. Further research is needed to help tease out and understand these factors. Such research will help support health care policy and practice with regards to this topic.
doi:10.1186/1472-6882-11-85
PMCID: PMC3198987  PMID: 21981986
6.  The urban-rural divide in complementary and alternative medicine use: a longitudinal study of 10,638 women 
Background
Research has identified women in rural and remote areas as higher users of complementary and alternative medicine (CAM) practitioners than their urban counterparts. However, we currently know little about what influences women's CAM consumption across the urban/rural divide. This paper analyses 10,638 women's CAM use across urban and rural Australia.
Methods
Data for this research comes from Survey 5 of the Australian Longitudinal Study on Women's Health conducted in 2007. The participants were aged 56-61years. The health status and health service use of CAM users and non-users were compared using chi-square tests for categorical variables and t-tests for continuous variables.
Results
Women who consulted a CAM practitioner varied significantly by place of residence: 28%, 32% and 30% for urban, rural and remote areas respectively (P < .005). CAM users tended to be more dissatisfied with conventional care than CAM non-users, but this was consistent across the 3 areas of residence. CAM users have higher percentages of most symptoms but the only rural/urban differences were for severe tiredness, night sweats, depression and anxiety. For diagnosed diseases, CAM users have higher percentages of most diagnoses but only hypertension and skin cancer were statistically significantly higher for rural and remote but not urban women (P < .005).
Conclusions
In contrast to some recent claims, our analysis suggests the lack of access to and/or patient dissatisfaction with conventional health practitioners may not play a central role in explaining higher use of CAM by women in rural and remote areas when compared to women in urban areas.
doi:10.1186/1472-6882-11-2
PMCID: PMC3024269  PMID: 21208458
7.  The use of economic evaluation in CAM: an introductory framework 
Background
For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities.
In a world of scarce health care resources and an emphasis on efficiency and clinical efficacy, CAM, as indeed do all other treatments, requires rigorous evaluation to be considered in budget decision-making.
Methods
Economic evaluation provides the tools to measure the costs and health consequences of CAM interventions and thereby inform decision making. This article offers CAM researchers an introductory framework for understanding, undertaking and disseminating economic evaluation. The types of economic evaluation available for the study of CAM are discussed, and decision modelling is introduced as a method for economic evaluation with much potential for use in CAM. Two types of decision models are introduced, decision trees and Markov models, along with a worked example of how each method is used to examine costs and health consequences. This is followed by a discussion of how this information is used by decision makers.
Conclusions
Undoubtedly, economic evaluation methods form an important part of health care decision making. Without formal training it can seem a daunting task to consider economic evaluation, however, multidisciplinary teams provide an opportunity for health economists, CAM practitioners and other interested researchers, to work together to further develop the economic evaluation of CAM.
doi:10.1186/1472-6882-10-66
PMCID: PMC2992473  PMID: 21067622

Results 1-7 (7)