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      Professionals’ experiences and attitudes toward use of Traditional Chinese Medicine in hospice palliative inpatient care units: A multicenter survey in Taiwan

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          Abstract

          Background

          Medical staff may have difficulties in using conventional medicine to manage symptoms among terminally ill patients, including adverse effects of the treatment. Traditional Chinese medicine (TCM) is regarded as a complementary or alternative medicine, and has been increasingly used in the field of palliative medicine in recent years. This study aimed to investigate the experiences of and attitudes toward using TCM among palliative care professionals, and to provide preliminary information about its use in palliative care.

          Methods

          This was a cross-sectional survey study conducted in eight inpatient hospice wards in Taiwan between December 2014 and February 2016. The questionnaire was self-administered, and was analyzed with descriptive statistics including Pearson’s Chi-square test and Fisher’s exact test.

          Results

          A total of 251 palliative care professionals responded to the questionnaire, of whom 89.7% and 88.9% believed that the use of TCM could improve the physical symptoms and quality of life in terminally ill patients, respectively. Overall, 59.8%, of respondents suggested that TCM had rare side effects, and 58.2% were worried that TCM could affect the liver and kidney function of patients. In total, 89.7% and 88.0% of professionals agreed there were no suitable clinical practice guidelines and educational programs, respectively, for TCM use in palliative care.

          Conclusions

          Most of the respondents agreed there was insufficient knowledge, skills-training, and continuing education on the use of TCM in terminally ill patients in Taiwan. These results show that to address patient safety considerations, guidelines about use of TCM in palliative care should be established.

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          Most cited references52

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          Traditional Chinese medicine.

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            Use and acceptance of complementary and alternative medicine among the general population and medical personnel: a systematic review.

            The interest in complementary and alternative medicine (CAM) has increased during the past decade and the attitude of the general public is mainly positive, but the debate about the clinical effectiveness of these therapies remains controversial among many medical professionals. We conducted a systematic search of the existing literature utilizing different databases, including PubMed/Medline, PSYNDEX, and PsycLit, to research the use and acceptance of CAM among the general population and medical personnel. A special focus on CAM-referring literature was set by limiting the PubMed search to "Complementary Medicine" and adding two other search engines: CAMbase (www.cambase.de) and CAMRESEARCH (www.camresearch.net). These engines were used to reveal publications that at the time of the review were not indexed in PubMed. A total of 16 papers met the scope criteria. Prevalence rates of CAM in each of the included studies were between 5% and 74.8%. We found a higher utilization of homeopathy and acupuncture in German-speaking countries. Excluding any form of spiritual prayer, the data demonstrate that chiropractic manipulation, herbal medicine, massage, and homeopathy were the therapies most commonly used by the general population. We identified sex, age, and education as predictors of CAM utilization: More users were women, middle aged, and more educated. The ailments most often associated with CAM utilization included back pain or pathology, depression, insomnia, severe headache or migraine, and stomach or intestinal illnesses. Medical students were the most critical toward CAM. Compared to students of other professions (ie, nursing students: 44.7%, pharmacy students: 18.2%), medical students reported the least consultation with a CAM practitioner (10%). The present data demonstrate an increase of CAM usage from 1990 through 2006 in all countries investigated. We found geographical differences, as well as differences between the general population and medical personnel.
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              Trends in the use of complementary health approaches among adults: United States, 2002-2012.

              This report presents national estimates of the use of complementary health approaches among adults in the United States across three time points. Trends in the use of selected complementary health approaches are compared for 2002, 2007, and 2012, and differences by selected demographic characteristics are also examined.
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                Author and article information

                Contributors
                Journal
                Integr Med Res
                Integr Med Res
                Integrative Medicine Research
                Elsevier
                2213-4220
                2213-4239
                12 August 2020
                June 2021
                12 August 2020
                : 10
                : 2
                : 100642
                Affiliations
                [a ]Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
                [b ]Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
                [c ]Department of Family Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
                [d ]Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
                [e ]Department of Family Medicine, Hualien Tzu Chi Hospital, Hualien, Taiwan
                [f ]Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
                [g ]Department of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan
                [h ]Department of Family Medicine, Taipei Veterans General Hospital Taoyuan Branch, Taoyuan, Taiwan
                [i ]Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
                Author notes
                [* ]Corresponding author at: Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Road, Beitou District, Taipei 112, Taiwan. sjhwang@ 123456vghtpe.gov.tw
                Article
                S2213-4220(20)30274-2 100642
                10.1016/j.imr.2020.100642
                7607421
                110f236c-3101-4416-af05-f44272db9ac2
                © 2020 Korea Institute of Oriental Medicine. Publishing services by Elsevier B.V.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 28 May 2020
                : 3 August 2020
                : 6 August 2020
                Categories
                Original Article

                chinese herbal medicine,clinical practice guidelines,educational programs,palliative care professionals,traditional chinese medicine

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