• 셀메드
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• 제6권3호
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• pp.15.1-15.4
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• 2016

Evidence based practice (EBP) is a system of applying the most current and valid high quality evidence to support clinical decision making in a healthcare setting. In the twenty five years since its inception, EBP has become the accepted benchmark for excellence in healthcare. Although the system emerged within the biomedical sciences, in the years since EBP has become normative across all healthcare modalities from dentistry, allied health to complementary and alternative medicine (CAM). Practicing evidence based medicine within any modality potentially offers the patient the best available care based on high quality evidence. Yet it is the nature of the evidence that provokes some questions about the suitability of EBP across all modalities of healthcare. The meta analysis of randomized controlled trial (RCT) stands at the pinnacle of the hierarchy of evidence in EBP. This forms a challenge to CAM due to the difficulty in reducing the elementals of a holistic naturopathic assessment of a patient into an answerable question to be tested within a RCT. On one level this makes EBP paradigmatically incompatible with CAM, yet on another level it presents the opportunity to redefine the parameters of what is considered high level evidence. EBP has become a tool, and at times a weapon wielded by governments and health insurance companies to direct healthcare funding and policy. The implications of the nature of accepted evidence are becoming far reaching. The pursuit of the best available healthcare for each individual is the focus of EBP. However, the injudicious use of this system to direct health policy is fraught with biomedical bias and dominance. This issue raises the challenge to CAM to present high level evidence according to the rules of evidence, or face the annihilation of centuries of empirical knowledge.

• 대한예방한의학회지
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• 제21권3호
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• pp.29-42
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• 2017

Background : Efforts towards increasing insurance coverage for traditional Korean medicine (TKM) are being continued. However, various difficulties are faced in generating evidence for TKM due to limited financial support and the low quality of research methodology. Objectives : The objectives of this study were to review the Swiss evaluation program for complementary and alternative medicine (CAM) and assess the expansion in public health insurance coverage of complementary medicine as approved by referendum in Switzerland. Methods : The regulations of CAM in the European Union were assessed. Research articles, reports, government publications and websites which deal with the 'Programm Evaluation $Komplement{\ddot{a}}rmedizin$ (PEK)' and the referendum in Switzerland were searched for and analyzed. Results : The PEK was conducted from 1998 to 2005. The PEK evaluated the efficacy, utilization and cost-effectiveness of anthroposophical medicine, homeopathy, neural therapy, phytotherapy and traditional Chinese medicine. However, clear conclusions could not be drawn from the evaluation according to the PEK Report. Later, a referendum was implemented in which 5 therapies would be added to the Switzerland Constitution with the support of the public. The coverage of CAM was approved by Swiss a plebiscite with an approval rate of 67.0%. Conclusions : The reason for the successful referendum is suggested to be public support and the solidarity with CAM experts and politicians. It may be surmised that recognition of the political efforts and scientific aspects required to expand insurance coverage of TKM, and towards obtaining public support, is necessary.

• 성인간호학회지
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• 제27권6호
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• pp.728-741
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• 2015

Purpose: The purpose of the study was to explore and describe the experience of pursuing complementary and alternative medicine (CAM) in breast cancer patients. Methods: Ten women with breast cancer participated in the study. Data were collected through individual in-depth unstructured and individualized interviews with each participant from February to July, 2015. Theoretical sampling was used upto the point of theoretical saturation. Data were analyzed using Corbin & Strauss's grounded theory methodology. Results: Through open coding, 22 sub-categories, and 13 categories were identified. Analysis revealed that the core category was 'endless management of mind and body for healing', which consisted of four phases; exploring, applying, grasping, and integrating. Through this process, the participants utilized various action/interactional strategies such as 'dealing with information', 'trying out blindly', 'enduring volitionally', 'experiencing effects on mind and body,' and 'grasping one's own way.' The consequences of these strategies were integrating the habit of health remedy into one's life, becoming a main agent for change, and tolerating one's weak body. Conclusion: In-depth understanding of the CAM pursuing experiences of patients with breast cancer would guide clinical nurses and policy makers to develop effective interventions and policies for better supporting them with regard to the usage of CAM.

• 근관절건강학회지
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• 제23권3호
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• pp.187-196
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• 2016

Purpose: The purpose of this study was to investigate the perception and utilization patterns of complementary and alternative medicines (CAM) in patients with fibromyalgia syndrome. Methods: A total of 92 fibromyalgia syndrome patients participated in this study. Data were collected using a structured questionnaire and were analyzed with SPSS/WIN 23.0 program. Results: As a result, 59.8% of subjects had an experience of CAM and 33.7% of subjects have used until now. There were significant differences of the use of CAM between the group of CAM users and non-CAM users by education ($x^2$=4.04, p=.044), period of illness ($x^2$=15.03, p=.001), and period of treatment ($x^2$=12.10, p=.002). Relatively large numbers of patients understanded as that CAM was effective (58.7%) and fibromyalgia syndrome was controllable (75.0%). Moreover, there were significant differences of the use of CAM by the perception of CAM effects ($x^2$=4.15, p=.042), fibromyalgia syndrome ($x^2$=6.55, p=.038), and best treatment for fibromyalgia ($x^2$=11.03, p=.001). Conclusion: These results could be utilized as a basic data for developing nursing intervention for fibromyalgia syndrome.

• 지역사회간호학회지
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• 제25권1호
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• pp.1-11
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• 2014

Purpose: The purpose of this study is to obtain information of use of complementary and alternative medicines (CAMs) and any reported adverse effects of them on vulnerable elders in a community. Methods: 1,837 elderly subjects aged 65 or higher with health problems were selected from those who were enrolled in a public health care center and received visiting health management services. A proportional stratified sampling method was used. Data collection was completed by face to face interviews using a structured questionnaire. The descriptive statistics and ${\chi}^2$-test were used to analyze the data. Results: The prevalence of CAM use last year was 57.5%, and 10.4% of the subjects reported adverse effects of the therapies. The mean score of the subjects' attitudes towards CAM was $4.1{\pm}3.44$ (range 1~10). The major sources of advice and exposure to CAM therapies were most likely to be from family and friends (72.5%). The primary reason for choosing CAM was to manage symptoms and relieve pain (86.6%). Conclusion: These findings suggest the need to develop nursing strategies for reducing and preventing adverse effects of CAM use by promoting awareness of using safe and appropriate CAM therapies.

• 셀메드
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• 제3권4호
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• pp.31.1-31.8
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• 2013

This study has been geared to document primary information on common complementary and alternative medicines (CAM) used to treat and/or manage common dermatological disorders in Mauritius, a tropical multicultural island in the Indian Ocean. Data from 355 key informants was collected via a semi-structured questionnaire. Pearson correlation and Chi-squared test were performed to delineate any association. Quantitative indexes including the Importance Value (IV) and fidelity value were calculated. Results tend to indicate that cultural reasons were behind the use of CAM among Mauritians and traditional knowledge was mainly acquired either from parents/relatives or from self-experience. Among the medicinal plants mentioned, Aziadiracta indica (IV = 0.78) and Paederia tomentosa (IV = 0.70) were found to be most used plants. Calendula officinalis (IV = 0.15), Centella asiatica (IV = 0.22) and Agauria salicifolia (IV = 0.11) were also recorded to be used for common dermatological disorders though greatly under-utilised. Animal products were mentioned by 38.0% respondents and cow ghee was found to be commonly used in the management of measles (IV = 0.88). Spiritual healing was found to be used mainly for measles and warts. Given the plethora of novel information documented from the present survey, it can be suggested that the Mauritian population still relies to a great extent on CAM which needs to be preserved and used sustainably. Nonetheless, further investigation is required to probe the possible active constituents that could be the basis of an evidence based investigation to discover new drugs.

• 대한한의학회지
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• 제29권4호
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• pp.47-54
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• 2008

Objective: The purpose of this study was to investigate the disease burden of cancer, to investigate how many cancer patients use CAM (complementary and alternative medicine) therapies with or without conventional medicine, to know reasons for use of cancer CAM therapies, and finally to discuss viewpoints on treating cancer with traditional Korean medicine (TKM). Method: In order to know the disease burden of cancer, the prevalence and mortality of cancer patients of Korean, American, and WHO reports were investigated, and the usage of cancer CAM therapies was investigated in several reports. The viewpoints about cancer treatment with TKM were suggested with the characteristics of TKM. Results: One hundred thousand Korean people were diagnosed [in time period] as new cancer patients, and cancer patients are gradually increasing every year. Cancer is a leading cause of deaths in Korea and worldwide. From 21% to 63% of Korean cancer patients, 80% of American cancer patients, and 35.9% of European cancer patients used CAM therapies, and the most common therapy was an herbal therapy. Conclusions: TKM has been used to treat cancer since initial use of acupuncture and herbs with basic viewpoints on human health and disease. First, TKM regards occurrence of cancer as an environmental problem of the whole human being. Second, the pathologic concept centered on antipathogenic Qi (Zheong Qi) can reinforce the functioning of the patient's own natural vitality to overcome cancer. Third, TKM deals with cancer patients through mind, body, and spirit based on the monoism of mind and body.

• Biomolecules & Therapeutics
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• 제19권3호
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• pp.274-281
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• 2011

Pharmacological approaches have been included in conventional medical treatment for insomnia or sleep disorders. However, long-term use of frequently prescribed medications can often lead to habituation, critical withdrawal symptoms and/or side effects. Some individuals with insomnia or trouble sleeping have used complementary and alternative medicine (CAM) therapies to treat their conditions. Recently, CAMs or herbs have been attractive alternative medications to many patients with sleep disorders who may be averse to using conventional drugs. We reviewed the most widely available sleep-promoting herbs commonly used in the western and oriental countries.

• 대한한방내과학회지
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• 제36권3호
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• pp.252-264
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• 2015

Complementary and alternative medicine (CAM) is becoming a popular health care means in most countries, and more than 70% of the developing world's population is depending on CAM, including traditional Chinese medicine and ayurvedic medicine. Islamic medicine, another CAM, has shown remarkable success in healing acute and chronic diseases and has been utilized by people in Mediterranean countries. This paper aims to throw light on Islamic medicine through Ibn Sina, known as Avicenna in the West; Ibn Sina was a celebrated Persian thinker, philosopher, and physician who is remembered for his masterpiece, The Canon of Medicine. The paper also discusses the relationship between Islamic medicine and Korean medicine.

• 한국한의학연구원논문집
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• 제17권3호
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• pp.35-42
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• 2011

Objectives : The terms, CAM and Integrative Medicine, have been often used to conceptualize relation between TKM and western medicine in Korea. But both terms often lead to confusion since the backgrounds of those were not being properly discussed. Methods : We researched the concepts of CAM and Integrative Medicine through the changes in definitions and research methods. Results : Although modern medical verification of CAM showed some results through scientific researches, there existed certain limitations. The term Integrative Medicine newly emerged for this reason. The rise of the new term came to criticize existing research methodologies such as RCTs or SRs. However in Korea, Integrative Medicine has often been misunderstood as a unification of two different medical systems. Conclusions : Thus, in future research of relationship between TKM and western medicine, debates on plausibility & philosophical background of TKM, and research methodology are indispensable.