Patient Decision-Making about Complementary and Alternative Medicine (CAM) in Cancer Management: The Context and Process

[摘要] Objective : The purpose of this paper was to describe the personal and social contexts of cancer patients' treatment decisions related to CAM as well as the process through which cancer patients reach CAM decisions throughout the cancer trajectory.Data Sources and Study Selection : A variety of CAM decision-making models published in the past ten years within the Canadian health literature were selected and reviewed.Results : The CAM decision-making process is influenced by a variety of sociodemographic, disease-related, psychological, and social factors. Four main phases of the CAM decision-making process were reviewed: Taking stock of treatment options; Gathering and evaluating CAM information; Making CAM decisions; and, Revisiting the CAM decision. Immediately following diagnosis, cancer patients become interested in taking stock of the full spectrum of conventional and CAM treatment options that may enhance the effectiveness of their treatment and mediate potential side effects. CAM information is then gathered and evaluated from numerous information sources that vary in terms of credibility and scientific legitimacy. When making a decision regarding CAM options, patients attempt to make sense of the diverse information obtained while acknowledging their beliefs and values. The CAM decision is often revisited at key milestones, such as end of conventional treatment, and when additional information about disease, prognosis and treatment is obtained.Conclusions : The CAM decision-making process is a dynamic and iterative process that is influenced by complex array of personal and social factors. Oncology health professionals need to be prepared to offer decision support related to CAM throughout the cancer trajectory.   Keywords:   Complementary therapies, decision-making process, oncology, health professionals, communication.

[学科分类] 肿瘤学