Abstract：
BACKGROUND: Terminally ill patients often experience exacerbations of diseases that render mainstream medicine ineffective in relieving symptoms, prompting attempts at complementary and alternative medicine (CAM). This study collected data from terminally ill patients and their relatives to determine differences between CAM use, behavioral patterns, and perceptions of health information about CAM.
METHODS: A cross-sectional design using a self-administered questionnaire was adopted. Eight medical institutions in Taiwan with inpatient hospice palliative care units were chosen. Ninety-two terminally ill patients and 267 relatives met the inclusion criteria. The questions concerned the experience of CAM use, the kinds of products/services CAM provided, the purpose of CAM use, the source of CAM information, and the perceptions and attitudes toward CAM.
RESULTS: Both terminally ill patients and their relatives have a high proportion of lifetime and one-year prevalence of CAM use (88.0% vs. 88.4%; p = 0.929). CAM use for musculoskeletal and neurological discomfort is higher among terminally ill patients than among their relatives. Relatives/friends are the most frequent sources of information on CAM (53.3% vs. 62.2%; p = 0.133). The percentage of terminally ill patients who discontinued mainstream medical treatment because of CAM use was higher than that of their relatives (18.5% vs. 9.3%; p = 0.026). More than half the terminally ill patients and their relatives had never been asked about CAM by medical staff (64.1% vs. 66.7%), nor had they informed medical professionals about the use of CAM products and services (63% vs. 66.9%). Random inquiries by medical professionals may be associated with increased disclosure of CAM use (terminally ill patients: odds ratio, 9.75; 95% confidence interval, 1.97-48.35 vs. relatives: odds ratio, 5.61; 95% confidence interval, 2.66-11.83).
CONCLUSIONS: The high prevalence and concealment of CAM use in terminally ill patients should be considered. Medical professionals should establish a friendly and barrier-free communication model, encourage patients to share CAM experiences, and provide evidence-based information on the use of CAM products and services, to reduce the potential damage caused by harmful use.
METHODS: A cross-sectional design using a self-administered questionnaire was adopted. Eight medical institutions in Taiwan with inpatient hospice palliative care units were chosen. Ninety-two terminally ill patients and 267 relatives met the inclusion criteria. The questions concerned the experience of CAM use, the kinds of products/services CAM provided, the purpose of CAM use, the source of CAM information, and the perceptions and attitudes toward CAM.
RESULTS: Both terminally ill patients and their relatives have a high proportion of lifetime and one-year prevalence of CAM use (88.0% vs. 88.4%; p = 0.929). CAM use for musculoskeletal and neurological discomfort is higher among terminally ill patients than among their relatives. Relatives/friends are the most frequent sources of information on CAM (53.3% vs. 62.2%; p = 0.133). The percentage of terminally ill patients who discontinued mainstream medical treatment because of CAM use was higher than that of their relatives (18.5% vs. 9.3%; p = 0.026). More than half the terminally ill patients and their relatives had never been asked about CAM by medical staff (64.1% vs. 66.7%), nor had they informed medical professionals about the use of CAM products and services (63% vs. 66.9%). Random inquiries by medical professionals may be associated with increased disclosure of CAM use (terminally ill patients: odds ratio, 9.75; 95% confidence interval, 1.97-48.35 vs. relatives: odds ratio, 5.61; 95% confidence interval, 2.66-11.83).
CONCLUSIONS: The high prevalence and concealment of CAM use in terminally ill patients should be considered. Medical professionals should establish a friendly and barrier-free communication model, encourage patients to share CAM experiences, and provide evidence-based information on the use of CAM products and services, to reduce the potential damage caused by harmful use.
摘要：
背景：身患绝症的患者通常会经历疾病的恶化，使主流医学无法缓解症状，促使人们尝试补充和替代医学(CAM)。这项研究收集了绝症患者及其亲属的数据，以确定CAM使用之间的差异。行为模式，以及对CAM健康信息的看法。
方法：采用自编问卷的横断面设计。选择了台湾八家设有住院临终关怀姑息治疗单位的医疗机构。92名绝症患者和267名亲属符合纳入标准。问题涉及CAM使用的经验，CAM提供的产品/服务的种类，CAM使用的目的，CAM信息的来源，以及对CAM的看法和态度。
结果：绝症患者及其亲属使用CAM的终生和一年患病率都很高（88.0％vs.88.4%；p=0.929）。在绝症患者中，CAM用于肌肉骨骼和神经系统不适的比例高于其亲属。亲戚/朋友是CAM上最常见的信息来源(53.3%vs.62.2%；p=0.133）。因使用CAM而停止主流医学治疗的绝症患者的百分比高于其亲属（18.5％vs.9.3%；p=0.026）。超过一半的绝症患者及其亲属从未被医务人员询问过CAM(64.1%vs.66.7%），他们也没有告知医疗专业人员使用CAM产品和服务(63%与66.9%）。医疗专业人员的随机询问可能与CAM使用的披露增加有关(绝症患者：赔率比，9.75；95%置信区间，1.97-48.35vs.亲属：赔率比，5.61；95%置信区间，2.66-11.83)。
结论：应考虑在绝症患者中使用CAM的高患病率和隐蔽性。医务人员应建立友好、无障碍的沟通模式,鼓励患者分享CAM经验，并提供有关CAM产品和服务使用的循证信息，减少有害使用造成的潜在损害。
方法：采用自编问卷的横断面设计。选择了台湾八家设有住院临终关怀姑息治疗单位的医疗机构。92名绝症患者和267名亲属符合纳入标准。问题涉及CAM使用的经验，CAM提供的产品/服务的种类，CAM使用的目的，CAM信息的来源，以及对CAM的看法和态度。
结果：绝症患者及其亲属使用CAM的终生和一年患病率都很高（88.0％vs.88.4%；p=0.929）。在绝症患者中，CAM用于肌肉骨骼和神经系统不适的比例高于其亲属。亲戚/朋友是CAM上最常见的信息来源(53.3%vs.62.2%；p=0.133）。因使用CAM而停止主流医学治疗的绝症患者的百分比高于其亲属（18.5％vs.9.3%；p=0.026）。超过一半的绝症患者及其亲属从未被医务人员询问过CAM(64.1%vs.66.7%），他们也没有告知医疗专业人员使用CAM产品和服务(63%与66.9%）。医疗专业人员的随机询问可能与CAM使用的披露增加有关(绝症患者：赔率比，9.75；95%置信区间，1.97-48.35vs.亲属：赔率比，5.61；95%置信区间，2.66-11.83)。
结论：应考虑在绝症患者中使用CAM的高患病率和隐蔽性。医务人员应建立友好、无障碍的沟通模式,鼓励患者分享CAM经验，并提供有关CAM产品和服务使用的循证信息，减少有害使用造成的潜在损害。
