around the globe, the relation- ship between public health and traditional or indigenous health use of alternative medicines In terms of control over social . and alternative medicine (CAM) and the use of biomedicine, this article . reimbursable medical practices in the government-run health insurance systems. Complementary and Alternative Medicine (CAM) and the Public Health: an . of the client-practitioner relationship, and included space for verbatim comments. . ensuring good model validity between the evaluation design and modality's.
The second case study, undertaken in the modality of shiatsu, a body-based life-energy therapy developed in Japan and influenced by Western knowledge, casts light on the potential of a CAM to enhance critical health literacy.
The case study is situated within a wider research study which aimed to provide cross-European insight into patientperceived experiences and effects of shiatsu [ 20 ].
The wider study used a longitudinal, observational study design. The clients, all to be18 years or over and receiving shiatsu for any reason were recruited by the practitioners.Community Health, Population Health and Public Health: Understanding the Differences
Following a pre-defined protocol, treatment was to be provided as in normal practice individualised and reviewed at each treatment session. Treatment included direct energy-based bodywork and, as appropriate, advice-giving on lifestyle and other factors.
Please Don’t Define “Complementary and Alternative Health Practices”!
Data were collected by self-administered postal-questionnaires professionally translated into the relevant language at four points in time: The content of the questionnaires was grounded in an earlier two-country Germany and the UK interview-based study [ 21 ]. Data analysis was restricted to those clients who completed all four questionnaires.
Full detail of the study methods can be found in [ 20 ] Long.
The case study [ 22 ] focuses on a sub-question which arose from a post-hoc investigation of the findings from the lens of critical health literacy. The case study drew on data on factors associated with advicegiving, for example: CAM comprises a diverse set of modalities and multiple healing systems.
These practices complement mainstream medicine.
Please Don’t Define “Complementary and Alternative Health Practices”! – Science-Based Medicine
CAM is thus an umbrella terms and multiple definitions are in use both in policy and practice discussions and in the published literature. Most importantly there is a perspective of its being complementary, and not necessarily alternative, to conventional medicine. It thus widens the possible options for individuals in resolving symptoms, coping with ill-health and promoting health and well-being.
There is also a highly varied legal context for CAM across countries and diversity in the regulation of CAM practice [ 2425 ]. For many, a key focus lies on enhancing self-awareness. The core goal involves assisting individuals in uncovering their own healing potential and in opening them up to the possibility of change. Focus lies initially on treating the presenting reasons for seeking treatment symptomsthen moving onto uncovering the underlying problem a root and branch approach and assisting the individual to become more aware of their own health and ways to sustain health and well-being.
For example, a US study reported 65 visits monthly per population to a CAM practitioner, compared with visits per to see a primary care physician [ 32 ]. There is however no definitive or accepted estimate of the prevalence of CAM across the European Union. Notwithstanding these difficulties, there are a number of valid and replicable national surveys of CAM prevalence. Other evidence can be found in systematic reviews. The most commonly used therapies were chiropractic manipulation, herbal medicine, massage and homoeopathy.
A consistent definition of CAM, a core set of CAMs with country specific variations and a standardised reporting strategy to enhance the accuracy of data pooling would improve reporting quality.
The top five most commonly reported therapies were: Dietary supplements were also commonly used, though it was not evident if these were bought over the counter or prescribed within a CAM consultation.
It is important to reflect that this widespread usage and popularity of CAM is situated within a context of a slowly emerging evidence base of the benefits of particular CAM modalities, their safety, effectiveness and cost-effectiveness [ 3536 ]. Moreover, individuals may be using CAM alongside conventional treatments and paying for their treatment.
At the same time, there is a varying picture of the recognition of CAM and its benefits by medical practitioners, along with a reluctance to mention or suggest exploring other treatment options such as CAM to their patients [ 37 ].
This co-exists with a hesitancy or avoidance by their patients to tell the medical practitioner either about their use of CAM or to ask about its possible benefits in treating the illness.
CAM practitioners are quite explicity about the potential that they see, as is evident from ways that they promote their particular modality and associated treatments. These talk in terms of their treatment: There is a strong body of emerging evidence to support these perceptions. There is also good evidence of the effectiveness of acupuncture to treat chronic knee, low back and neck pain, and a potential role in treating gastro-oesophageal reflux disease.
Alongside this explicit use of CAM modalities, the potential to reduce or avoid statin use is evident through sound and comprehensive self-care information.
As they argue, this range of examples suggest the importance and need and potential cost savings of giving more attention to non-drug alternatives to address the challenges of multi-morbidity.
Evaluations of the effectiveness of CAM must however be cognisant of and address two major issues: Each is illustrated in the following two case studies. Long [ 17 ] argued that at least three broad types of effects need to be measured: To these one must add effects arising from the wider treatment environment as a health environment [ 39 ].
Moreover, in order to appropriately measure the effects of a particular CAM, modified or new outcome measurement tools may be a need to be developed [ 1640 ] and potentially modalityspecific tools.
The second issue, of model validity, is closely linked.
As Verhoef et al. Broadening outcomes perspective In her wider research, [ 19 ] Price illustrated evidence from biomedical research in breast cancer on the high incidence of a wide range of symptom and treatment side-effects. However, rather than occurring singly and in isolation, women diagnosed with breast cancer tend to experience these symptoms in clusters CRF and nausea and painat the same time as facing existential issues arising from their life-threatening diagnosis.
Moreover, during chemotherapy these symptom clusters fluctuate unpredictably. It would thus seem highly appropriate to explore the effect of a CAM modality here, TA with its whole-person orientation in helping to mollify these effects, alongside inducing other patient benefits and through a prospective study design. A highly valued outcome was enabling coping through the alleviation of symptoms and increased well-being. Through their model of practice, practitioners attempted to deal with the presented symptom clusters the women described, most commonly fatigue and emotional upset along with disturbed sleep.
This research provides a vivid demonstration of how the way the CAM whole-system effects are experienced and realised within a practice context. The findings demonstrated TA practitioners treating patient concerns, leading onto the achievement of broader, nonsymptom specific outcomes.
Categories such as validated, non-validated, and invalidated should suffice to give consumers useful information for deciding what modalities of self-care are worth trying out. Tradition-based systems and supposed whole-system care are not uniquely Eastern. Is it only in Western societies that approaches from traditional systems get used separately from whole-system care?
As medicine became more science-based, it discarded treatment based upon the convention of manipulating body humors and progressed by developing healthcare consistent with progress in biological and physical sciences.
Since modern medicine makes progress by relying on science, it is iconoclastic—the antithesis of conventional. By contrast, the real allopathy practiced today as Unani medicine is bound to its ancient conventions.
However, this is misleading labeling. Professor Richard Dawkins has explained: Dodes and Marvin Schissel put it this way: Marcia Angell and Jerome Kassirer wrote: There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Medicine that has been tested and found to be safe and effective.
Use it; pay for it. And, medicine that has been tested and found to be unsafe or ineffective. And, medicine for which there is some plausible reason to believe that it might be safe and effective.
Test it and then place it into one of the other two categories. Although many people believe that acupuncture for pain is medicine that fits Dr. More than ten years of research funding by the National Center for Complementary and Alternative Medicine has failed to contribute to medical progress. The term integrative medicine is superfluous and should not be used by responsible health professionals.
Palliative care and adjunctive care are meaningful and useful terms for efforts to provide rational modalities of humane care, comfort, and support addressing the diverse needs of patients. It projects a misleading image of academic seriousness that serves only to obscure its hype and help secure funding for clinical research of dubious need.
The use of such euphemisms facilitates quackery: Today quackery is a far less popular term than the euphemisms.