Examining CAM use disclosure using the Behavioral Model of Health Services Use
School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA. Electronic address: . Complementary therapies in medicine
(Impact Factor: 1.55).
10/2013; 21(5):501-8. DOI: 10.1016/j.ctim.2013.08.002
To improve understanding of factors that may influence disclosure of complementary and alternative medicine (CAM) use in the U.S.
Data are from the 2001 Health Care Quality Survey (HCQS), a nationally representative study of adults aged 18 and older living in the continental United States. Using the Behavioral Model of Health Services Use, we conducted multivariate logistic regressions to identify factors associated with disclosing CAM use among the sub-sample of recent CAM users (n=1995).
Disclosure of CAM use.
Most CAM users (71.0%) disclosed their use of CAM to their doctors. Contextual, individual, and health behavior factors were associated with CAM use disclosure. Of particular interest, disclosure was significantly more likely among those who perceived high quality relationships with their providers (AOR=1.59, CI: 1.01, 2.49) and among those who had a regular source of medical care (AOR=1.54, CI: 1.03, 2.29). The odds of disclosure were also higher among those who used practitioner-provided CAM, with (AOR=2.02, CI: 1.34, 3.06) or without (AOR=1.52, CI: 1.05, 2.20) concurrent herbal medicine use, compared to those who used herbal medicines only.
The Behavioral Model of Health Services Use is a useful framework for examining factors that may influence disclosure of CAM use. Further research should examine these relationships using more comprehensive measures.
Available from: Fuschia M Sirois
- "However, no studies to date have investigated if and how the quality of CAM care may be associated with CAM disclosure. This gap is rather striking especially given that CAM disclosure tends to be higher for provider-based CAM than for self-care CAM  , and that CAM care quality and satisfaction are important determinants of ongoing provider-based CAM use   . "
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Research on disclosure of CAM use to physicians has focused more on barriers to disclosure than factors that promote disclosure. The purpose of this study was to test a new conceptual model of CAM disclosure which posits that disclosure of CAM use is motivated by both practical (positive CAM outcomes) and symbolic (sense of control, quality of the CAM provider relationship) factors that arise from the CAM treatment experience.
Two general medical samples provider-based CAM consumers, undergraduates (N = 226) and community-dwelling adults (N = 128), completed a survey about their CAM use and disclosure, health-related control, CAM patient-centered care, and CAM outcomes.
Disclosure rates were 65% among students and 69% among the community adults. Univariate analyses revealed that disclosure of CAM use was associated with the symbolic factor provider patient-centered care in both samples, and perceived control over health in the student sample. In both samples positive CAM outcomes were associated with CAM disclosure. The multivariate logistic regression revealed that students who disclosed CAM use were more likely to report higher perceived control over health (OR = 1.5), patient-centered care (OR = 1.7), and positive behavioural CAM outcomes (OR = 1.4). However, the multivariate results for the community sample were non-significant.
The findings suggest that the benefits consumers experience from CAM treatments (practical factors) as well as the meaning of disclosing CAM use (symbolic factors) are associated with CAM disclosure, and underscore the importance of the patient-CAM provider relationship for promoting client initiated coordination of care.
Available from: Ngui Andre
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ABSTRACT: This study was designed to identify: (1) predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2) correlates associated with healthcare service utilization for mental health reasons among individuals with and without mental disorders respectively. Analyses comprised univariate, bivariate, and multiple regression analyses. Being male, having poor quality of life, possessing better self-perception of physical health, and suffering from major depressive episodes, panic disorder, social phobia, and emotional problems predicted healthcare service utilization for mental health reasons. Among individuals with mental disorders, needs factors (psychological distress, impulsiveness, emotional problems, victim of violence, and aggressive behavior) and visits to healthcare professionals were associated with healthcare service utilization for mental health reasons. Among individuals without mental disorders, healthcare service utilization for mental health reasons is strongly associated with enabling factors such as social support, income, environmental variables, and self-perception of the neighborhood. Interventions facilitating social cohesion and social solidarity in neighborhood settings may reduce the need to seek help among individuals without mental disorders. Furthermore, in their capacity as frontline professionals, general practitioners should be more sensitive in preventing, detecting, and treating mental disorders in routine primary care.
Available from: Razak Mohammed Gyasi
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ABSTRACT: Whilst over three-quarters of the world's population continues to use traditional medicine (TRM) with an increasing trend globally, limited data exist in the Ashanti Region regarding TRM utilisation. This study espoused a retrospective cross-sectional quantitative approach to examine the prevalence and pattern of TRM use among the general population in the Kumasi Metropolis and Sekyere South District, Ghana.
A sample of 324, drawn through systematic random sampling was used. The main instrument for data collection was formal face-to-face interviewer-administered questionnaire. Data were analysed using Chi-square and Fisher's exact tests from the PASW (V.17.0) with p≤0.05 as significant.
The survey found that TRM use alongside conventional medicines was pervasive with prevalence of 86.1%. Biologically-based therapies (88.5%) and distant prayer interventions (58.4%) were commonly used modalities through the influence of families (50.3%), friends (19.4%) and the mass media (18.0%). Whilst self-administration and purchases from pharmacy shops remained important sources of TRM, TMPs' consultation was less credible (p<0.005). The disclosure rate of TRM use to health care professionals remained low (12.2%; p<0.001).
Concomitant TRM use with conventional therapies without disclosure may interfere with the potency of treatment regimen and result in drug interactions. Inclusion of alternative medicines on the National Health Insurance Scheme's drug plan will fortify monitoring and professional administration of TRM. Information as regards TRM use needs to be incorporated into clinical and medical practice, hence the need to prioritise patient-physician communication.
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