醫療專業者對於癌症患者使用非西醫補充與另類醫療的看法

Use of Complementary and Alternative Medicine among Cancer Patients: Views of Health Professionals

郭淑珍

《人文社會與醫療學刊》 5期 (2018/05) Pp. 53-77

摘要

雖然癌症病患會使用各種樣式的非西醫的補充與另類療法((complementary and alternative medicine,CAM)，然而臨床上病患大多不會主動告知醫療專業人員，醫療專業人員也很少主動向病患提起CAM使用的議題，顯示CAM使用在癌症病患與醫療專業人員之間的溝通障礙是值得重視的議題，過去的研究大多著重於探究癌症病患對另類與輔助療法的態度、或使用的樣式等，但針對照顧病患的醫療專業人員對CAM、以及病患使用CAM之態度為何則研究不多。本研究採用深度訪談，針對有照顧過癌症病患的醫師、護理師與營養師，收集其對於CAM和癌症病患使用CAM的看法，並輔以病患就醫時的參與觀察記錄，以探討醫療專業人員對病患使用CAM行為的觀點。研究發現醫療專業人員對於CAM態度，受到工作組織脈絡、生活經驗、世代、與教育等影響;對於癌症病人使用CAM，有以下因素會影響醫療專業人員的反應，首先，這些另類療法是否排擠了正規療法，其次，這個療法是否侵擾正規療法，第三，病人西醫療法的治療結果；醫療專業者和病患互動時，對於CAM的討論，大多採取被動或是原則性的指導，較少主動與病患深入討論。醫療專業者之所以有這些反應，可能是醫院實質上很少將CAM療法用在癌症治療，另外，臨床專業者對CAM了解有限，而目前衛生政府單位也沒有相關指引，提供給醫療專業者參考，因此不知該如何具體回應病患的需求。

關鍵字

補充與另類療法 ； 癌症 ； 醫師 ； 護理師 ； 營養師

並列摘要

Cancer patients often withhold disclosing information concerning their use of complementary and alternative medicine (CAM) to oncology healthcare providers, while oncology healthcare providers rarely discuss issues on CAM use with their patients. Therefore, the barrier in patient-oncology healthcare provider communication of CAM use is a topic warranting attention. Previous studies largely focus on investigating cancer patients' attitude toward CAM or the types of CAM used. However, few studies have examined the attitudes of oncology healthcare providers toward CAM and patients' use of CAM. This study conducted an in-depth interview and participant observation to collect the views of physicians, nurses, and dietitians on CAM and on cancer patients' use of CAM. This study found that health professionals' attitude toward CAM was influenced by their work organization context, life experience, cohort, and education. The following factors influenced health professionals' response to cancer patients' use of CAM: First, whether CAM has replaced conventional therapy; second, whether CAM affects the use of conventional therapy; and third, the therapeutic effects of western medicine on patients. When interacting with patients, health professionals generally take a passive step to discuss CAM issues with patients or discuss these issues on principle; they seldom take a proactive stance to engage in in-depth discussions with patients. Health professionals respond as such possibly because hospitals rarely incorporate CAM therapy in cancer treatments. In addition, clinicians' understanding of CAM is limited, and without CAM guidelines from health authorities, these clinicians do not know how to respond to patients' requests.

並列關鍵字

Complementary and alternative medicine ； cancer ； physicians ； nurses ； dietitians