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| Category: Complementary Medicine |
Date published: December 27, 2006 |
Effectiveness of Complementary Alternative Medicine (CAM) evaluation from patients point of view that have been visited in S.Mostafa Khomeini Hospital
by S.Hasan Abolhasani Ramin niazi
(Email: hasanbp3@excite.com)
Abstract-Complementary Alternative Medicine (CAM) is an independent medical aspect which based on World Health organization (WHO) definition for CAM, it's a great heritage including preventive , diagnostic and curative prescriptions for corporeal ,psychotic ,spiritual and social diseases which is inherited from past generations[1] .Conventional Fashion Medicine (CFM)'s incapability and CAM's effective output in prognosis and its role in making the patients optimistic lead us in this field which based on abroad CAM researcher results we decided to perform a same study in IRAN cooperating with "Dr.Naseri "in "S.Mostafa.Khomeini" Hospital . It's obvious which results of this study can be very helpful in future medical organization investments in IRAN and it may be a fabulous guideline for patients to use CAM. At last it's so important that CAM has heteroge functions and must be using in there certain place and situation and it can't be complete alternate instead of CFM. Keywords- Complementary Alternative Medicine (CAM) Conventional Fashion Medicine (CFM)'s
I. INTRODUCTION
This fact is proved that the current medicine which is taught in our medical centers is not capable enough to prevent, control, diagnose and cure many of human diseases. Even in so many cases patients are disappointed because of side effects or the inverted system (prevention is omitted and only treatment is important).on the other hand CAM's logic and its fountain of power in curing prolonged and complicated diseases which is usually used as final shot, and its few side effects and large number of customers and also the great CAM professors (that were experts in lots of scientific fields and considered human as an integrative and comprehensive coordination and Getting far away from our past heritage of medicine, all these reasons express the necessity of revising and reinvestigating this field of medicine. With a brief review of ancient CAM books which their contexts are very precious, every individual can realize that it is all based on human nature and logical circumstances and has no artificial logics. on the other hand western countries especially UK & USA , are full time working and discovering on CAM information sources which are inherited from ancient Iranians such as "Ibn Sina, Razi and Ali Bin Rabti,etc" and even they have put CAM courses in universities like Harvard and also in their medical organizations. But unfortunately in Iran authorities even don't care if they exist or not. CAM has carved a respectful situation in famous medical magazines and Internet websites, especially in recent years. Internet CAM institutes and clinics are being established very quickly they have found a large number of customers here are some of them: The main question in this research is making comparison between CAM effectiveness and that of CFM. This comparison has been made by patients and some terms such as; satisfaction, being optimistic or pessimistic, especial treatments, successful treatments, role of government, CAM's reputation in the public and people basic knowledge level about CAM; have been considered as key variables. According to the available information it is obvious that because of inconsiderable government's notice, poor propagandas, low public knowledge, few published books and lots of other unmanaged problems CAM has been somehow restricted to show itself off among other medical aspects. But despite the abovementioned troubles because of CAM `s power in preventing and curing a large number of serious diseases which CFM is incompetent to cure them , patients' disappointing from CFM and crowded CAM institutes , they , all encouraged us to perform this research and to be optimistic to the conclusions. We believe in this fact that CAM is an extremely dominant Standpoint of medicine in both preventive and curative prospects. Patients' satisfaction is our main dependent variable in this research and independent variables' changing effects will be investigated on dependent variables.
II. METHOD
We have to mention that there are many obstacles that you have to overcome in order to research in this field. For example finding a CAM hospital which is supervised by both government and university was a great job. We got to "S.Mostafa.Khomeini" hospital after two weeks of looking for it about four hours each day. Because there was no similar research in CAM we had no template and our methodology was a mixture of our observations and CAM articles in US and UK. Our research procedure can be divided into two steps: 1-study course: such as books, magazines, web pages, articles, or even old and young herbal sellers which we needed them to increase our basic knowledge in CAM field. 2-Visual course: in this step we have used both cohort and cross sectional studies to take patients' history. We have three tools here: First the questionnaire Second the interviews with patients and their physicians Third patients' documents which after a long bargain we've been allowed to access them.
III. RESULT
According to the protocol for collecting CAM customers' attitudes and based on the methods which we follow to get to patients information, we worked on 500 patients and collected their information from Tir to Aban of the year 1384. The information gathered in four categories: 1- Private information 2- CAM examination from patients point of view 3- Patients memory and past experience in CAM 4- Patients memory and past experience in CFM These information are exhibited in descriptive statistical charts. 1-in the first item (personal information) age, gender, education, occupation, and marriage condition have been asked. 2-in the second item we have converged variables such as "ways of getting to know CAM", "amount of basic CAM knowledge, satisfaction from CAM, CAM's optimistic making effects, therapeutic methods, logical diagnosis, CAM preventive ability, and public and governments attention. 3, 4- For collecting this category of patients' information we searched into their documents and discovered about side effects, visiting periods, therapeutic methods, and number of physicians in both CAM and CFM.
IV. DISCUSSION In this part it was decided to have good analysis in data and then suitable interpretation based on comparing our finding with other centers in other countries like US and UK. If our comparison had any significant result, it was suggested at last. Part1: Gender and marriage distribution in our sample: Patients were mostly married housewives and single businessmen. Part2: This chart is witness of growing rate of herbal drugs customers which shows its reputation in public, but 67% of patients think that governments' efforts and also medical education organizing are extremely inappropriate and sometimes their procedures of tackling problems are completely wrong . In one sentence: "Authorities aren't aware of public necessities"
Also people need to suitable places for medical services, and we've found that most patients prefer governmental hospitals which are supervised by universities because of satisfactory and cut-price services. Right now 60% of CAM services are in clinics and 30% are in hospitals and 10% in form of private places.
State of referring to CAM in our country is extraordinary odd because in comparison with WHO criteria it is not well-proportioned at all. Based on our interviews with patients we've found that 67% of patients visit CAM centers based on recommendation of those whom were pleased with CAM services, whereas only 0.95% are recommended by other physicians. We've found two major justifications for this brain-teaser: 1- Being ignorant about CAM centers and their ability of curing compound disorders. 2- Boredom of some physicians to recommend patients to others, and most probably to lose them. Whereas in US more than 25.8% of CAM customers have been suggested to CAM by their family physicians. Public comprehension of CAM is unfortunately despairing because based on our findings about 70% of citizens don't have any information at all. Among others about 30% owe their knowledge to magazines and 5% owe to elderly people. These statistics are signs of poor propagandas and inaccurate informing. Despite this pessimistic news of our country, in US most of medical centers are working on CAM and their number has pushed passed the 10-20 % frontier in 1995 to 50-60% in 1997, and only during two years. In preventive and diagnostic portion of CAM we've found extraordinary strange realities: About 80% of CAM patients have found it effective for their current diseases and also confessed that CAM tips provide patients with such lifestyle which prevent them from getting a large spectrum of prolonged diseases.
CAM prescriptions are based on everyone's prints and taste so it is absolutely based on human nature, whereas CFM is unconfirmed. Based on patients' comments, we've found that more that 70% of patients have found CAM diagnosis and its questions while history taking is completely logical and you can see their wisdom, and in some cases even they get shocked by physician's prediction about them.68% of our samples have said that CAM therapeutic methods are easy to do. 40% of our sample has said that CAM is owner of the most effective remedies.52% of our sample believes that CAM has made them optimistic during their medications.
Also we've discovered that among patients with low level of education, mostly experience is important and they trust to CAM experts by trade, but the more level of education becomes the less they trust to experience and instead of it they believe in academic education, they conjecture to blessing as well. We've found that among women, experience is the most important characteristic of CAM physicians, whereas for men academic education is on focus. The most effective medications as patients' point of view are; prayed, fasting, pilgrimage, reflexology, phlebotomize, and massage. Patients' history taking results have revealed that most problems are skeletal and joints, psychotic problems such as depression, stress and anxiety, GI disorders and metabolism maladies. We've made comparison among Iran, US, and UK. In UK seven treatments have many followers such as homeopathy, acupuncture, manipulation, hypnotherapy, aromatherapy, reflexology, and herbal medicine. But in US chiropractic, pray, and herbal are the most commons. Also we've discovered that most of Americans visit CAM based on integrative concept, and 55% believe that CAM and CFM are completing each other. Either 55% have expressed that they just wanted to have a taste of CAM. 16.8% of Americans visit CAM because of cold and 6.6%due to neck ache. This means that Americans put CAM in primitive stages of medication. But Iranians put CAM as their last shot, which cause their condition more complicated. Part3 In third and fourth category of information, period of visiting patients has reported 5 to 6(Chart 11) weeks at average and based on patients attitudes it has three major reasons: 1- Impatience of patients 2- CAM's effects appears in long time 3- Not feeling comfortable with CAM methods and having a habit of CFM In our sample (500 individuals) about 98% of patients have had CFM experiences for 4 to 5 years and they have visited by10 physicians.
This simple information on one hand proves CFM incapability for curing most of diseases and on the other hand inadequate public information of CAM. Patients' history taking in CFM shows that in about thirty percent, the reason was unknown for physicians, in 16% the reason was related to nervous system, and in 15% reason was joints and skeletal disorders, and in 7%psychotic problems were the reason of visiting. But patients' history taking in CAM shows that more than 80% of the diseases have three aspects: 1. Psychotic 2. Spiritual 3. Physical And no disease is just physical and this reality is the reason of complexity of most diseases which don't respond to treatments.
V. Conclusion It is obvious from this discussion that complementary medicine is a heterogeneous subject. It is unlikely that all complementary disciplines will have an equal impact on Iran health practices. The individual complementary therapies with the most immediate relevance to the medical profession are reviewed in detail in later articles, but some disciplines are inevitably beyond the scope of this series--most notably those related to healing--and interested readers should consult texts listed in the boxes.
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