Use of Topical Complementary and Alternative Medicines (CAM) in Diabetic Septic Foot Disease in Makkah Region, Western of Saudi Arabia, an Exploratory Study

Diabetes is a chronic condition that is significantly impacted daily by environment. At least one in five Saudis, suffer from diabetes. “Diabetes is a pandemic of unprecedented magnitude spiraling out of control” (Boulton). Saudi Arabia ranks the second highest in the Middle East, and is the seventh in the world for the prevalence of diabetes (WHO). Diabetes mellitus (DM) has been found to be related to high mortality, morbidity accompanied by poor general health and lower quality of life. Current Saudi diabetes patients’ behaviors, practices, and beliefs regarding foot health problems such as ulcers, are not well investigated. Diabetic patients frequently utilize natural remedies and Herbs for self-medication as a part of complementary and alternative Medicine. Aim of study: To explore the widespread use of the alternative remedies in the local communities of the Western Saudi Arabia, the drives behind using and to focus on the potential adverse effects following their usage. Method: A descriptive, cross-sectional study of 386 diabetic patients with feet problems in Makkah Region, West of Saudi Arabia during the period April - June 2023. Results: Out of the 531 participants, only 386 participants reported diabetic foot disorder (DFD). Most of the participant were above 65 years of age group (24.61 %). Male (52.08%) more than female (47.92%) in the research group. All of the participants had diabetic foot disorders at least once. The prevalence of complementary and alternative medicines (CAM) use among them was 67.88%, as solitary or in combination with hospital medicines. Honey headed the list followed by myrrh and black seeds. Acquaintances advice (59.54%) was the most reason for using the alternative medicine. 60.30% of Diabetic foot patient complained of adverse effects during CAM remedies use. Conclusion: Consumption of CAM remedies among diabetic patients for Diabetic Foot Disorder (DFD) is common. Honey headed the list followed by myrrh and black seeds. Additional wide-scale research is required to establish their actual efficacy, safety and potential adverse out-comes and to generalize the outcomes.

Complementary and alternative medicines in irritable bowel syndrome: An integrative view

Irritable bowel syndrome(IBS)is a common gastrointestinal disorder with a high incidence in the general population.The diagnosis of IBS is mainly based on exclusion of other intestinal conditions through the absence of inflammatory markers and specific antigens.The current pharmacological treatment approaches available focus on reducing symptom severity while often limiting quality of life because of significant side effects.This has led to an effectiveness gap for IBS patients that seek further relief to increase their quality of life.Complementary and alternative medicines(CAM)have been associated with a higher degree of symptom management and quality of life in IBS patients.Over the past decade,a number of important clinical trials have shown that specific herbal therapies(peppermint oil and Iberogast?),hypnotherapy,cognitive behavior therapy,acupuncture,and yoga present with improved treatment outcomes in IBS patients.We propose an integrative approach to treating the diverse symptoms of IBS by combining the benefits of and need for pharmacotherapy with known CAM therapies to provide IBS patients with the best treatment outcome achievable.Initial steps in this direction are already being considered with an increasing number of practitioners recommending CAM therapies to their patients if pharmacotherapy alone does not alleviate symptoms sufficiently.

Thematic Trends in Complementary and Alternative Medicine Applied in Cancer-Related Symptoms

Purpose： The main goal of this study is to discover the scientific evolution of Cancer-Related Symptoms in Complementary and Alternative Medicine research area, analyzing the articles indexed in the Web of Science database from 1980 to 2013.Design/Methodology/Approach： A co-word science mapping analysis is performed under a longitudinal framework（1980 to 2013）. The documental corpus is divided into two subperiods,1980–2008 and 2009–2013. Thus, the performance and impact rates, and conceptual evolution of the research field are shown.Findings： According to the results, the co-word analysis allows us to identify 12 main thematic areas in this emerging research field： anxiety, survivors and palliative care,meditation, treatment, symptoms and cancer types, postmenopause, cancer pain, low back pain, herbal medicine, children, depression and insomnia, inflammation mediators, and lymphedema. The different research lines are identified according to the main thematic areas,centered fundamentally on anxiety and suffering prevention. The scientific community can use this information to identify where the interest is focused and make decisions in different ways.Research limitation： Several limitations can be addressed： 1） some of the Complementary and Alternative Medicine therapies may not have been included; 2） only the documents indexed in Web of Science are analyzed; and 3） the thematic areas detected could change if another dataset was considered.Practical implications： The results obtained in the present study could be considered as an evidence-based framework in which future studies could be built.Originality/value： Currently, there are no studies that show the thematic evolution of this research area.

Complementary and alternative medicine applications in cancer medicine

Besides conventional medicine,many patients with cancer seek complementary and alternative medicine(CAM)as an additional treatment option.Since the early 1970s,the use of CAM in cancer treatment has expanded worldwide.CAM,as a tempting option,was used by patients with cancer mainly due to easy accessibility.Patients with cancer used CAM to achieve better quality of life or to find a cure.As physicians are mainly unaware of CAM use by patients,doctor-patient communication about CAM use should be brought to a higher level.To identify circumstances in which CAM are preferred,further investigations are needed especially in biologically based therapies.Clinical-based evidence for mind-body therapies have been established,so this type of CAM can be recommended for patients with cancer during chemotherapy.Future studies are necessary to fill the gaps so that CAM users,as well as medical experts,are in position to clearly determine all the benefits and disadvantages of the mentioned therapy.

Effects of COVID-19 fear and anxiety on attitudes towards complementary and alternative medicine use in women with gynecological cancer during the COVID-19 pandemic

Objective:Patients with gynecological cancer commonly use complementary and alternative medicine(CAM)methods to cope with the disease.However,despite the existence of treatment strategies,the effect of fear and anxiety caused by coronavirus disease 2019(COVID-19)pandemic on attitudes about CAM use is unclear.This study was carried out to investigate the effect of fear and anxiety experienced by patients with gynecological cancer during the COVID-19 pandemic on their attitudes towards the use of CAM.Methods:This is a cross-sectional and descriptive study that included 177 women with gynecological cancer;participants were recruited from a social networking site for cancer patients in Turkey between June and December 2021.Data were collected using an online survey that included the Personal Information Form,the Fear of COVID-19 Scale,the Coronavirus Anxiety Scale,and the Attitude Towards Holistic Complementary and Alternative Medicine Scale.Descriptive statistics,t-test,Pearson’s correlation test,and simple linear and multiple regression analyses were performed to analyze the data.Results:During the pandemic,55.4%of the participants reported using CAM methods,but only 22.6%were using CAM before the pandemic.The participants who used CAM during the pandemic also scored higher on the fear of COVID-19 and coronavirus anxiety scales(20.69±5.37 and 13.09±6.29,respectively)compared to the participants who did not use CAM(9.29±2.72 and 6.35±2.06,respectively).Fear of COVID-19 accounted for 52%of the CAM attitude score,while coronavirus anxiety accounted for 15%of the CAM attitude score.Fear of COVID-19 and coronavirus anxiety together accounted for 53%of CAM attitude.Conclusion:Gynecological cancer patients with high levels of COVID-19-related anxiety and fear during the pandemic used CAM more.Given that the psychological effects of the pandemic will continue in the coming years,CAM use should be evaluated as a coping strategy,especially due to the COVID-19-related anxiety and fear experienced by patients with gynecological cancer.While the rational and effective CAM methods should be supported,strategies should be developed to prevent misuse of CAM and its interference in prescribed medical treatments.

Cross-Sectional Survey on Complementary and Alternative Medicine Awareness among Health Care Professionals and Students Using CHBQ Questionnaire in a Balkan Country

Objective： To conduct a study on attitudes, knowledge, and use of complementary and altemative medicine （CAM） therapies in Serbia. Available data about CAM therapies in the region are scarce, opinions lacking from health sector. Balkan region countries had a delay in issuing national policies on CAM therapies. Methods： The questionnaire used was based on previously validated CAM Health Belief Questionnaire （CHBQ）, formulated as 5-item Likert type scale, adjusted for local environment. Health care students and professionals were evaluated. The questionnaire comprehended 10 closed questions on attitudes, knowledge and use of CAM therapies. This survey was conducted in eight cities of Serbia, January 2010-July 2011. A total of 797 participants was included. The second group of participants was 145 healthcare professionals （50 academic staff, 64 clinical staff, 19 pharmacists, 6 other clinical branch specialists and 6 nurses）. Data were collected by an interview. Examinees could acquire maximum of 70 points, 35 representing neutral attitude. Restdts： Students of dentistry （54.65 ± 6.07） were better informed on CAM therapies than medicine students （50.26 ± 7.92）. Pharmacy students （51.16 ± 7.10） accepted low-scientific CAM. Pharmacists scored better than university professors （55.12±6.55 vs. 50.29± 9.50）. Primary health care professionals had better awareness than pharmacists in dispensing pharmacies. Both groups of participants preferred use of vitamins over any other CAM therapy. Conclusion： These pioneering efforts in the region exposed weaknesses in CAM attitudes of current and future health care professionals. Nevertheless, awareness on alternative medicine treatment choices is growing among Balkan prescribers. Supportive legal framework would facilitate dissemination of CAM medical practices.

Complementary and Alternative Medicine:Is It Possible to Be Mainstream?

Complementary and alternative medicine （CAM）, also known as non-conventional medicine, is used to refer to a broad set of health care practices （such as herbal medicine, acupuncture, yoga, Taichi, Qigong, meditation, manual therapies, homeopathic medicine, etc.） that are not part of a country＇s own tradition, or not integrated into its dominant health care system.（1） In fact, CAM is generally used in most developed countries, especially in North America, Europe and Australia, while ＂traditional medicine （TM）＂ is more common instead when referring to Africa, Latin America, South-East Asia, and/or the Western Pacific region.

Complementary and Alternative Medicine Therapies for Chronic Pain

ABSTRACT Pain afflicts over 50 million people in the US, with 30.7% US adults suffering with chronic pain. Despite advances in therapies, many patients will continue to deal with ongoing symptoms that are not fully addressed by the best conventional medicine has to offer them. The patients frequently turn to therapies outside the usual purview of conventional medicine （herbs, acupuncture, meditation, etc.） called complementary and alternative medicine （CAM）. Academic and governmental groups are also starting to incorporate CAM recommendations into chronic pain management strategies. Thus, for any physician who care for patients with chronic pain, having some familiarity with these therapies--including risks and benefits--will be key to helping guide patients in making evidence-based, well informed decisions about whether or not to use such therapies. On the other hand, if a CAM therapy has evidence of both safety and efficacy then not making it available to a patient who is suffering does not meet the need of the patient. We summarize the current evidence of a wide variety of CAM modalities that have potential for helping patients with chronic pain in this article. The triad of chronic pain symptoms, ready access to information on the internet, and growing patient empowerment suggest that CAM therapies will remain a consistent part of the healthcare of patients dealing with chronic pain.

The knowledge, attitude, practice and predictors of complementary and alternative medicine use among type 2 diabetes mellitus patients in Indonesia

Objective: The prevalence of complementary and alternative medicine(CAM) usage among patients with type 2 diabetes mellitus(T2DM) in Indonesia is high. However, to date, little is known about why Indonesian T2DM patients choose CAM therapies, how their knowledge, attitude and practice(KAP) of CAM affects their choices, or how demographics correlate with patient choices. Therefore, this study aimed to investigate the KAP and predictors of CAM usage in T2DM patients in Indonesia.Methods: This was an observational, cross-sectional study. Patients were interviewed using a questionnaire. Chi-square tests or Fisher’s exact tests were used to compare demographic and clinical data, as well as KAP assessments, between T2DM patients who use and do not use CAM. Multivariate logistic regression analyses were used to investigate predictors of CAM usage.Results: A total of 628 T2DM patients were enrolled in the study. CAM therapies were used by 341 patients(54.3%). The most common therapies were herbs and spiritual healing, used by 100.0% and 68.3% of CAM-using patients, respectively. CAM therapies were frequently recommended by family members(91.5%), and CAM users had significantly more knowledge and more positive attitudes toward CAM therapies than nonusers. Among users, 66% said they would not follow their healthcare providers’ instructions to not use CAM therapies, and 69.5% said they would not disclose their plan to use CAM therapies with their healthcare provider. Neither demographic nor clinical characteristics were associated with CAM use. The factors that best predicted the use of CAM therapies were their availability and low cost(odds ratio [OR] = 4.59;95% confidence interval [CI]: 3.01–7.01), the belief that CAM therapies were safe(OR = 2.04;95% CI: 1.40–2.95), the belief that CAM therapies could help with diabetes control(OR = 1.75;95% CI: 1.15–2.66), and the belief that CAM therapies could help maintain physical health(OR = 1.68;95% CI: 1.13–2.49).Conclusion: CAM therapy users were more knowledgeable and had more positive attitudes toward CAM,but most of them chose not to disclose their CAM use to their healthcare providers. CAM use in Indonesia was associated with its accessibility, affordability, safety and effectivity, but not with any demographic or clinical characteristics. This study provided new evidence and insights for nurses and physicians in Indonesia that will help to design educational programs about the safety and efficacy of CAM therapies.

A Survey of Complementary and Alternative Medicine in Iran

Objective： To survey the use, capability and satisfaction of complementary and alternative medicine （CAM） in comparison with conventional medicine in Iran. Methods： In this national survey, a cross-sectional study was designed, 5,000 people were surveyed to identify predictors of Iranian traditional medicine （ITM） use compared with conventional medicine. Data were collected through a questionnaire that covered three different predictor categories： demographic information, patient＇s viewpoint, and patients＇ experiences. Results： Most of the participants preferred government owned hospitals rather than other places. Praying for one＇s own health was the most frequent and favorable ITM domain （P=0.017） based on patients＇ interests, both in low- （P=0.08） and high- level （P=0.011） educated subjects. Among the participants, 97.8% had previous conventional medicine history due to their chronic diseases Conclusions： Iranianpatients resort to ITM as a choice at the late stage of the disease. Current deficiency in integration of CAM and conventional medicine is in contrast to the increasing demand on patients＇ side. Health care organizers should be facilitating the CAM services by tuition of CAM practitioners and supporting eligible CAM centers for diagnosis and treatment of patients.

A Survey of Application of Complementary and Alternative Medicine in Chinese Patients with Parkinson’s Disease: A Pilot Study

Objective:To investigate the prevale nee and spectrum of complementary and alternative medicine(CAM)application and its related-factors in Parkinson's disease(PD)patients in China.Methods:A structured questionnaire regarding the use of CAMs was administered to PD patients by face-to-face interview.Demographic and social variables,clinical characteristics and treatments,and the related factors of PD were also surveyed.Results:Ninety out of 113 patients(79.6%)reported that they had received CAMs treatment,of which 48.6%(55/113)patients had received CAMs treatment for PD.The top 3 kinds of CAMs for PD were Chinese materia medica,rehabilitation exercise,and acupuncture ordinally.The source of information regarding CAMs treatment mainly came from relatives and friends(51.8%,73 cases),followed by physicians(31.9%,45 cases),and medias such as television,newspapers or the internet(16.3%,28 cases).Fifty percent of CAM users reported a good therapeutic efficacy,whereas 39% patients reported that they felt neither better nor worse after the treatment,while 11% patients claimed worsening of symptoms.Multiple correspondence analyses survey found the main factors affecting the selectivity of CAMs ranked in the following order:in come,education,occupati on,habitati on,age at on set,Hoeh n and Yahr staging,PD durati on,and gen der.Conclusion:CAMs,especially Chin ese materia medica,rehabilitation exercise,and acupuncture,are widely used for PD patients in China.

Action Mechanisms of Complementary and Alternative Medicine Therapies for Rheumatoid Arthritis

Rheumatoid arthritis （RA） is characterized as a chronic inflammatory disease in joints and concomitant destruction of cartilage and bone. Cartilage extracellular matrix components, such as type Ⅱ collagen and aggrecan are enzymatically degraded by matrix metalloproteinases （MMPs） and aggrecanases in RA. Currently, treatments targeting cytokines, including anti-tumor necrosis factor （TNF） α antibodies, soluble TNF receptor, anti-interleukin （IL）-6 receptor antibody, and IL-1 receptor antagonist, are widely used for treating RA in addition to anti- inflammatory agents and disease-modifying antirheumatic drugs （DMARDs）, such as methotrexate, but these treatments have some problems, especially in terms of cost and the increased susceptibility of patients to infection in addition to the existence of Iow-responders to these treatments. Therefore, therapeutics that can be safely used for an extended period of time would be preferable. Complementary and alternativemedicines including traditional Chinese medicines （TCM） have been used for the arthritic diseases through the ages. Recently, there are many reports concerning the anti-arthritic action mechanisms of TCM-based herbal formulas and crude herbal extracts or isolated ingredients. These natural herbal medicines are thought to moderately improve RA, but they exert various actions for the treatment of RA. In this review, the current status of the mechanism exploration of natural compounds and TCM-based herbal formulas are summarized, focusing on the protection of cartilage destruction in arthritic diseases including RA and osteoarthritis.

Evidence-based Practice Method of Integrative Chinese and Western Medicine Based on Literature Retrieval through PICO Question and Complementary and Alternative Medicine Topics

An evidence-based practice method according to literature retrieval through PICO （Patients,Intervention,Comparison,Outcome） questions and complementary and alternative medicine （CAM） topics,which can obtain helpful evidence for guiding clinical practice,was introduced with a practical example in this paper.The knowledge of diseases and Western medicine treatment can be acquired by literature retrieval through PICO question,while searching by CAM topics may provide evidence for Chinese medicine （CM）.Thus the author held that literature retrieval through both PICO question and CAM topics was an ideal evidencebased practice method for integrative Chinese and Western medicine （ICWM）.However,since the standard in CM evidence hierarchy is still under study,the value of the CAM thematic retrieval method remains very limited.In the future,studies on the definition and hierarchy of CM evidences and the herb-drug interaction between Western and Chinese medicine during a combination therapy should be strengthened to improve the status of ICWM evidence-based practice.

Cancer Complementary and Alternative Medicine Research at the US National Cancer Institute

The United States National Cancer Institute （NCI） supports complementary and alternative medicine （CAM） research which includes different methods and practices （such as nutrition therapies） and other medical systems （such as Chinese medicine）. In recent years, NCI has spent around $120 million each year on various CAM-related research projects on cancer prevention, treatment, symptom/side effect management and epidemiology. The categories of CAM research involved include nutritional therapeutics, pharmacological and biological treatments, mind-body interventions, manipulative and body based methods, alternative medical systems, exercise therapies, spiritual therapies and energy therapies on a range of types of cancer. The NCI Office of Cancer Complementary and Alternative Medicine （OCCAM） supports various intramural and extramural cancer CAM research projects. Examples of these cancer CAM projects are presented and discussed. In addition, OCCAM also supports international research projects.

Occupational Exposure to Municipal Solid Wastes and Development of Toxic Neuropathies:Possible Role of Nutrient Supplementation,Complementary and Alternative Medicines in Chemoprevention

Achieving effective municipal solid waste （MSW） management remains a major challenge and waste generation and accumulation continue to constitute important environmental and public health concern, particularly in most developing countries. Although the general population is at risk of adverse health consequences and hazards associated with exposure to MSW, the waste management workers （WMWs） are the most vulnerable because of their direct involvement in the disposal of waste, with increasing evidence of work-related health and safety risks among these individuals. Among the numerous work-related health hazards prevalent in WMWs, development of toxic neuropathies following chronic occupational exposure remains poorly recognized. However, the risk or predisposition to toxic neuropathies is becoming evident considering the increasing recognition of large amount of neurotoxic heavy metals and hazardous industrial materials present in MSW in mostparts of the world. The present review seeks to draw attention to the continuous vulnerability of the WMWs to developing toxic neuropathies. This is aimed at facilitating conscious efforts by relevant governmental and non- governmental agencies towards promoting risk reduction and ensuring adequate protection against possible toxic polyneuropathies associated with occupational exposure to solid wastes. While continuous education of the WMWs on the need for adequate compliance to safety regulations and practice remains sacrosanct towards achieving significant reduction in toxic neuropathies and related adverse health consequences of waste handling, it is also our intention in this review to underscore the possible relevance of nutrient supplementation and alternative medicines in chemoprevention.

Review on Efficacy and Health Services Research Studies of Complementary and Alternative Medicine in Inflammatory Bowel Disease

Objective：To assess the evidence of the use and efficacy for complementary and alternative medicine（CAM） in inflammatory bowel disease（IBD）. Methods：A systematic literature search in MEDLINE was performed for randomized controlled trials（RCTs） in Crohn＇s disease and ulcerative colitis.Moreover,a selective literature search for health services research studies on the use of CAM in patients with IBD was performed.Results：Health services research studies showed a high use of CAM in adult and pediatric patients with IBD worldwide.In contrast to the high use among IBD patients,there was a lack of high-quality data for many of the used CAM methods.Although most of the studies showed positive results,the methodological quality of most studies was rather low;therefore,the results had to be interpreted with caution.While there were many studies for probiotics and fish oil,RCTs for the highly used method homeopathy, for most herbal products,and for traditional Chinese medicine methods apart from acupuncture RCTs were completely lacking.Conclusions：The lack of high-quality studies might be the consequence of the problems associated with the funding of clinical trials involving CAM.However,having the high user rates in mind,high-quality studies assessing efficacy and safety of those methods are urgently needed.Furthermore,there is a need for better representation of CAM in undergraduate and postgraduate medical education.

Policies on Chinese Medicine in China May Have Enlightenments to Complementary and Alternative Medicine in the World

From the event of TU You-you winning the Nobel Prize, this paper briefly reviewed the history of formation and development of policies on Chinese medicine （CM） in China. On the basis of analyzing the causes of policies on CM, it is believed that policies on CM in China may have 4 kinds of enlightenments to the development of complementary and alternative medicine （CAM） in the world. Forming the political advantages of policy-making by main leaders of the country attaching importance to CAM; implementing a diversified health care system policy for the goal of maximizing people＇s health interests; ensuring development of CAM by the coerciveness of law and the timeliness of policy adjustment; and promoting the protection and mining, sorting out and improving of CAM based on open and comprehensive policies.

The relationship between anxiety about prostate cancer among patients with biochemical cancer recurrence and the use of complementary and alternative medicines,diet,and exercise

Objective:We aimed to explore associations between anxiety and specific health behaviors such as complementary and alternative medicine(CAM),diet,and exercise among prostate cancer patients.Methods:PCa patients enrolled in a prospective cohort study of men with biochemical cancer recurrence were surveyed about use of CAM,diet,and exercise.Anxiety was measured with the Memorial Anxiety Scale for Prostate Cancer(MAX-PC)and the anxiety subscale of the Hospital Anxiety and Depression Scale.Results:Nearly 70%(44 of 67)of the original cohort of patients completed the supplementary CAM survey.The mean age was 68 years.Eighty percent of respondents reported engaging in a rel-evant health behavior,and 64%reported doing so in direct response to their PCa diagnosis.Overall,the most prevalent specific behaviors were exercising(56%),making dietary changes(50%),taking calcium supplements(41%),and taking vitamin D supplements(39%).Elevated baseline PCa-specific anxiety(MAX-PC score>16)after biochemical cancer recurrence was associated with use of any CAM(P=0.01),use of herbs/supplements(P=0.01),and dietary changes(P=0.04).Conclusion:PCa patients commonly use CAM,dietary changes,and exercise in response to their diagnosis,and these changes are associated with elevated general and PCa-specific anxiety.

Analysis of the Effects of Complementary and Alternative Medicine (CAM) Methods to Decrease Body Image Dissatisfaction among Young Women during 2015-2020 and A Research Protocol

Background:Body image dissatisfaction(BID)has garnered global attention.It is significantly correlated with the development of depression,anxiety,eating disorders(EDs)and low self-esteem.BID is increasingly common among adolescents and young women in China,whereas it lacks the effective treatment and prevention programs for BID.Objective:This paper expects to analyze the effective CAMs methods on improving BID,and based on the results,we put forward a feasible and effective study protocol to fill the gap of BID improvement among teenage girls.Methods:Fifty-two studies of CAM in 2015-2020 years in influencing body image and its correlates are col-lected and analyzed,and a study protocol combined“In Favor of Myself”is sent up.This study protocol adds praise,psychological counselling,nutrition education and yoga to the project“In Favor of Myself”,improving BID through group support,shifting attention from focusing on one’s physical appearance to enhancing one’s value,and alleviating pressure and emotions through yoga.Results:Many methods,such as fitness training,psychoeducation,nutritional therapy,music therapy,health promotion programs and internet-based interventions are considered the existing interventions to improve BID.Other CAMs,such as acupuncture,beauty care,Tai chi,and aromatherapy,could be tried in the improvement of BID in further studies.Conclusion:CAM is capable of subjectively changing feelings of bodies,adjusting their cognition of body image,enhancing the body-mind connection,improving self-esteem and relieving negative emotions,but the efficacy and mechanism of CAM working on BID still need more systematic and standardized research.

Complementary and alternative medicine practices,traditional healing practices,and cultural competency in pediatric oncology in Hawai'i

OBJECTIVE： Hawai＇i is an ethnically diverse island state with a high rate of both traditional healing （TH） and complementary and alternative medicine （CAM） use. The aim of this project was to assess TH and CAM use within the pediatric oncology population in Honolulu and improve the delivery of culturally competent care. METHODS： A 9-item survey was distributed to all pediatric oncology patients at Kapi＇olani Medical Center for Women and Children for 3 months. The survey inquired about patient ethnicity, TH practices CAM practices and perception of cultural competence of the care received. Descriptive statistics were calculated for the survey items. Qualitative analysis was done with participant comments to identify themes. RESULTS： Sixty-two surveys were completed. TH was used by 39% of the respondents in the home, and 10% in the hospital （top method was traditional foods）. CAM was used by 27% of the respondents in the home, and 68% in the hospital （top method was healing touch）. Ninety-seven percent of the respondents reported receiving culturally competent care. Areas for improvement included language services and dietary choices. CONCLUSION： CAM and TH are used frequently by pediatric oncology patients in Hawai＇i, and the vast majority of patients and families felt that the care they received was culturally competent.