- 期刊
Characteristics of Patients Using Complementary Alternative Medicine Combined with Conventional Medicine in Primary Care
併用輔助與替代療法之基層醫療病患特質
摘要
目的：輔助與替代療法(complementary and alter-native medicine, CAM)是一群目前不被認為是正統醫學範疇的各種醫療照護體系、實務及產品，輔助療法是與正統醫學一起使用的療法，替代療法是用於取代正統醫學。CAM療法包括五大類：傳統醫療（如中醫、針灸）、身心療法（如靜坐）、生物學基礎療法（如草藥、飲食補充劑、高劑量維生素）、手部操作及身體基礎療法（如按摩）和能量療法（如氣功）。在美國，使用CAM已日趨普及，百分之七十五的成人過去曾經使用CAM，百分之六十二的成人過去一年內使用CAM。在台灣，使用CAM也是普遍的事情，百分之七十五點五的成人過去一年內使用CAM，但是某些CAM不列入醫療管理之行為，不屬於全民健康保險給付的範圍，所以較少關於病患使用CAM合併正統醫學的研究。本研究的目的在瞭解台北市北投區基層醫療病患使用CAM合併正統醫學的盛行率，並且分析其病患的特性及相關影響因素。方法：本研究在台北市立聯合醫院附設北投門診部進行，北投門診部是位於台北市北投區的公立基層醫療門診，我們隨機選擇二○○四年九月間北投門診部就診病患作為研究對象。病患的基本資料及特性都被收集，病患並接受訪談有關其使用CAM的問題（目前使用CAM合併正統醫學、過去曾經使用CAM）。結果：共有一二九名病患納入研究，其中百分之二十五點六的病患目前使用CAM合併正統醫學。病患目前使用CAM合併正統醫學與其年齡、教育程度、慢性病、醫療觀念、和使用CAM病史等因素有關，使用CAM病史是最重要的決定因素。一般而言，年齡老的病患、教育程度低的病患、患有慢性病的病患、相信使用CAM合併正統醫學會有幫助的病患、和過去曾經使用CAM的病患，比較傾向於目前使用CAM台併正統醫學。百分之六十七點四的病患過去曾經使用CAM。結論：台灣社區內存在有三種不同的醫療體系，即西醫、中醫和民俗療法，民眾求診常採用多重就醫的方式。從本研究可知，台北市北投區基層醫療病患使用CAM台併正統醫學是件普通的事。曾有報告指出，某些CAM療法會干擾正統醫學的療效，病患使用CAM合併正統醫學卻不見得熟悉這類資訊。面對民眾廣泛的使用CAM，基層醫療醫師最好充實這類療法的相關知識，以促進醫師與病患之溝通，提供有效的醫療照護。
並列摘要
Objective: Complementary and alternative medicine (CAM) is a group of diverse medical care systems, practices, and products that are not presently considered to be part of conventional medicine. The purpose of this study was to understand the prevalence and factors associated with patients who use CAM combined with conventional medicine in primary care in Beitou District of Taipei City. Methods: We conducted the study at Beitou Outpatient Clinic of Taipei City Hospital, Yangming Branch. Adult patients who visited Beitou Outpatient Clinic in September 2004 were randomly selected to participate in this project. Subjects were interviewed and asked about their use of CAM (use CAM combined with conventional medicine, and ever used CAM). A frequency distribution was used to describe the patient characteristics and prevalence of patients who use CAM combined with conventional medicine. The chi-square test and logistic regression analysis were performed to identify factors associated with patients who use CAM combined with conventional medicine. Results: A total of 129 patients were recruited in this study, 25.6% of the patients use CAM combined with conventional medicine. Factors associated with patients who use CAM combined with conventional medicine were noted as following: age, educational level, chronic diseases, medical belief, and use of CAM history. Patients who use CAM combined with conventional medicine were greater by: older patients, patients with lower educational level, patients with known chronic diseases, patients who believe that CAM combined with conventional medicine will help, and patients who ever used CAM. Conclusion: CAM used in conjunction with conventional medicine was a commonplace practice in primary care in Beitou District of Taipei City. To maintain effective physician-patient communication and ensure responsible clinical practice, it is important that primary care physicians enrich the knowledge associated with these therapies.