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PubMed2000

General practitioners, complementary therapies and evidence-based medicine: the defence of clinical autonomy.

Amidst the substantial change currently gripping primary health care are two developments central to contemporary debate regarding the very nature, territory and identity of general practice - the integration of complementary and alternative medicine (CAM) and the rise of evidence-based medicine (EBM). This paper reports findings from a study based upon 25 in-depth interviews with general practitioners (GPs) personally practising complementary therapies alongside more conventional medicine to treat their NHS patients. The paper outlines the GPs' perceptions of EBM, its relationship to their personal development of CAM, and their notions of good clinical practice more generally. Analysis of the GPs' accounts demonstrates how CAM can be seen as a useful resource with which some GPs defend their clinical autonomy from what they perceive to be the threat of EBM.

Complementary Therapies↗
PubMed2003

Complementary therapies: knowledge and attitudes of health professionals.

This cross-sectional, single-site project studied a random selection of qualified doctors and nurses in an NHS children's trust, using a combination of questionnaires and semi-structured interviews. The hypothesis tested was that: 'Health professionals at the trust neither feel able nor perceive a need to provide information about complementary therapies to families under their care'. Fifty questionnaires were distributed, 36 returned and 10 interviews completed. The study demonstrated complementary and alternative medicine (CAM) use was high among respondents and probably high among their patients. Attitudes were generally positive towards CAM use in children, although staff expressed concerns that CAM should do no harm. Knowledge of CAM was very limited but did not prevent staff from discussing CAM with patients or endorsing its use. It was felt CAM offered greatest benefit to children with chronic illnesses but that its most important role lay in the psychological support it could provide for both children and parents.

Attitude of Health Personnel↗
PubMed2007

A double-blind placebo-controlled randomized study of Chinese herbal medicine as complementary therapy for reduction of chemotherapy-induced toxicity.

BACKGROUND: Chinese herbal medicine (CHM) is a common complementary therapy used by patients with cancer for reduction of chemotherapy-induced toxic effects. This study applied the highest standard of clinical trial methodology to examine the role of CHM in reducing chemotherapy-induced toxicity, while maintaining a tailored approach to therapy. PATIENTS AND METHODS: Patients with early-stage breast or colon cancer who required postoperative adjuvant chemotherapy were eligible for the study. Enrolled patients were randomly assigned to one of three Chinese herbalists who evaluated and prescribed a combination of single-item packaged herbal extract granules. Patients received either CHM or placebo packages with a corresponding serial number. The placebo package contained nontherapeutic herbs with an artificial smell and taste similar to a typical herbal tea. The primary end points were hematologic and non-hematologic toxicity according to the National Cancer Institute Common Toxicity Criteria Version 2. RESULTS: One hundred and twenty patients were accrued at the time of premature study termination. Patient characteristics of the two groups were similar. The incidence of grade 3/4 anemia, leukopenia, neutropenia, and thrombocytopenia for the CHM and placebo groups were 5.4%, 47.3%, 52.7%, and 1.8% and 1.8%, 32.2%, 44.7%, and 3.6%, respectively (P = 0.27, 0.37, 0.63, and 0.13, respectively). Incidence of grade 2 nausea was the only non-hematologic toxicity that was significantly reduced in the CHM group (14.6% versus 35.7%, P = 0.04). CONCLUSIONS: Traditional CHM does not reduce the hematologic toxicity associated with chemotherapy. CHM, however, does have a significant impact on control of nausea.

Adult↗
PubMed2005

Improving stressful working lives: complementary therapies, counselling and clinical supervision for staff.

The aim of this paper is to briefly examine the contemporary phenomenon of "burnout" within oncology and palliative care. In discussing the suitable interventions to manage stress and avoid burnout, reference will be made to counselling and clinical supervision, but more substantially the paper will report on an innovative subsidised complementary therapy service for staff. The Government's Improving Working Lives Standard will be referred as an initiative that supports the development of supportive services for NHS staff.

Burnout, Professional↗
PubMed2000

Complementary therapy: complement or threat to modern medicine?

Some believe that medicine has lost its holistic perspective as a result of which many people now seek help from 'alternative' practitioners who seem able to devote time to their patients and listen to their concerns. Such practitioners also treat the 'whole person' rather than only their symptoms, a feature which seems to be valued by patients. The use of complementary therapies is, therefore, increasing world-wide. This paper explores this increase, questioning whether this truly reflects dissatisfaction with 'traditional' (allopathic) medicine or rather represents an increased satisfaction with 'alternative' therapies. It also investigates the use of such therapies in mainstream medicine revealing considerable variation in attitudes towards and use of such therapies in current medical practice questioning whether this should be seen as a threat to modern medicine or their use may enhance patient well-being and quality of life.

Complementary Therapies↗
PubMed2005

Relaxation and complementary therapies: an alternative approach to managing dental anxiety in clinical practice.

Dental anxiety is a widespread problem and has a significant impact on the provision of dental care for the general population. Anxiety leads to avoidance of dental treatment and increased stress for dental practitioners. Traditionally, dental anxiety has been managed using pharmacological techniques. This article reviews alternative treatment approaches, including psychological and complementary therapies which can be used in managing dental anxiety and facilitating dental treatment. Many of these approaches are currently being used within the dental profession. Others are gaining a wider acceptance as to their usage. Where available, the evidence of their efficacy will be reviewed.

Complementary Therapies↗
PubMed2002

Complementary therapies and health promotion.

Nurses have an important role to play in health promotions and it is important that they have a comprehensive knowledge and understanding of the theories of health promotion and conventional interventions. However, they are increasingly likely to be asked about the efficacy of non-conventional interventions and the likelihood of these interventions being of value to the client. This paper offers a review of the evidence to support the role of complementary therapies as adjunctive treatments to enable nurses to discuss their use with their clients as part of their health choice options.

Community Health Nursing↗