Search

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ctim.2006.08.001 Byline: Alex Broom (a), Jon Adams (b) Abstract: This paper examines the topics discussed over the course of the Complementary Therapies in Medicine (CAM) research methods series and looks ahead at research methods that either have not been discussed so far in the series or are currently emerging as potentially useful research tools. It is emphasised that an in-depth knowledge of methodological advances (and existing tools) is vital if researchers are to design and implement appropriate programs with the ability to adequately address the vast range of research questions pertinent to CAM. Author Affiliation: (a) School of Social Science, University of Queensland, St. Lucia, Qld, Australia (b) Division of Epidemiology and Social Medicine, School of Population Health, University of Queensland, Qld, Australia

High levels of use of complementary and alternative medicine (CAM) have been consistently reported amongst cancer patients over recent years. This is occurring in the context of an apparent increase in sources of information on therapeutic alternatives and a growth in the range of those claiming professional expertise in the field. To date there has been little research on patient experience of discussions about CAM with biomedical cancer specialists in this increasingly complex social environment. This paper addresses three issues: patient experience with cancer specialists: the significance of that experience for patient engagement with CAM; and the nature and significance of inter-professional dynamics. It draws on the results of a qualitative study with cancer patients in the UK. In-depth interviews with 80 purposively sampled patients, incorporating a range of disease types and stages, were conducted. Patients reported three main types of approach by oncologists: explicit or implicit negativity: supportive ambivalence: and, pragmatic acceptance. Crucially, patients' accounts suggest that the type of approach adopted influences (though does not determine) patient action. Specialist cancer nurses emerged as potentially powerful mediators between oncologists and patients. Despite the apparent potential for influence from multiple information sources and 'experts', on the basis of this study we would argue that oncologists remain crucial to patient engagement with CAM. However, this is not to argue that the influence is a simplistic one. Where patient and medical perspectives diverge, strategic alignment with specialist nurses may help patients make choices which conflict with perceived advice. Keywords: Cancer; Complementary and alternative medicine (CAM); UK; Oncologists; Specialist cancer nurses

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-9566.2007.01002.x Byline: Alex Broom (1), Philip Tovey (2) Keywords: cancer; complementary medicine; evidence-based medicine; integrative care Abstract: Abstract The integration of complementary and alternative medicine (CAM) into cancer services is increasingly discussed as a potential part of UK health policy but as yet there has been little sociological research examining this process. This paper examines the results of a study on the provision of CAM to cancer patients in two distinct organisational contexts: the hospice and the hospital. It is based on interviews with medical specialists, nursing staff and CAM therapists. This paper focuses on how integration is managed in each organisation, examining professional boundary disputes and inter-professional dynamics. Discussion focuses on the rhetorical and practical strategies that are employed by a variety of differently positioned interviewees to negotiate the complexities of the interface of CAM and biomedicine. The results show significant differentiation in how differently positioned cancer clinicians view and utilise the biomedical hierarchy of evidence. We argue that the integration of CAM should not be conceptualised as a mere challenge to biomedicine, or, as resulting in a linear process of deprofessionalisation. Rather, it should be seen as producing a complex array of processes, including strategic adaptation on the part of medical specialists and NHS organisations. Author Affiliation: (1)School of Social Science, University of Queensland (2)School of Healthcare, University of Leeds Article note: Address for correspondence: Alex Broom, School of Social Science, University of Queensland, St Lucia, QLD 4072 Australia, e-mail: a.broom@vq.edu.av

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ctim.2005.11.002 Byline: Alex Broom Keywords: Ethics; Social research; Complementary medicine; Research methods Abstract: There are numerous ethical issues that one must consider when developing a research project; however, much discussion about ethics in health research has focused on experimental studies such as clinical trials. As a result, there remains some ambiguity as to the ethical issues that need to be considered in health-related social research. This paper outlines a number of important ethical issues that CAM researchers should be aware of when developing, running and writing up social research. Maintaining high ethical standards is extremely important in social research as it protects participants and researchers, improves the quality of the data retrieved and ensures that future researchers will have access to participants within the community. Author Affiliation: School of Social Sciences, The University of Queensland, St. Lucia, Qld 4072, Australia

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ctim.2005.01.001 Byline: Alex Broom Abstract: Qualitative methods, such as the in-depth interview, offer a potentially powerful means of uncovering the complex experiences of patients, carers and clinicians within treatment and decision-making processes. In the context of complementary and alternative medicine (CAM), qualitative interview-based projects allow for subjectivity and complexity within human experience, making them a powerful tool for increasing our knowledge of important processes within CAM. However, qualitative interview-based projects are often poorly designed, carried out and analysed. This article provides a guide for CAM researchers on how to use qualitative interviews to produce meaningful, and methodologically sound, research findings. Author Affiliation: School of Healthcare, University of Leeds, Leeds LS2 9UT, UK

This article argues that experiences of, and attitudes towards, online communities are deeply embedded in understandings of masculinity, the perceived character of the Internet, and changes in the roles of the patient and the expert within decision-making processes. Drawing on the accounts of a group of Australian men with prostate cancer and prostate cancer specialists, this qualitative study explores experiences of online support groups. Results point to three unexplored and important factors influencing how both patients and clinicians perceive and experience online support. First, online support groups provide some men with a method of managing constraints posed by dominant constructions of masculinity within their experiences of prostate cancer, allowing for increased sharing and intimacy by limiting inhibitions associated with face-to-face encounters. However, other men view online support groups as havens for deception and misinformation, and computer-mediated communication as a highly problematic form of social interaction. Finally, this article shows how some medical specialists experience online support groups as a threat to their expert status and control over decision-making processes, outlining the nature and possible implications of their responses to this threat. Keywords: Internet, masculinity, online support, prostate cancer, Online communities are developing around particular health problems, with people 'chatting' to others about their health problems, treatment programmes and encounters with medical professionals (Hardey, 1999; Lamberg, 1997b; Rainie and [...]

This article examines the relationship between cultural constructions of masculinity and men's experiences of prostate cancer in Australian society. Drawing on the results of a qualitative study involving in-depth interviews [...]

There is increasing awareness of a need for rigorous research into complementary and alternative medicine, but as yet, limited guidance has been given to researchers, practitioners and students as to the range and scope of the various methodologies available and how existing methods can be modified for CAM research. This research methods series provides an outline of the main methods for researching CAM-related issues, including clinical trials, cross-sectional studies and qualitative methodologies. Drawing on the experiences of a range of experts in CAM research, each article in this series addresses the scope and strengths of a particular methodological approach. This series aims to convey the basis and objectives of particular methodologies within the context of CAM research, and thus, each paper will draw on actual examples of CAM research. It is intended to be of value both to inexperienced researchers and to those who are more experienced but are looking to broaden their range of knowledge. In this introduction, we outline some of the fundamental concepts for researching CAM, providing an overall sense of where each methodological approach outlined in this series fits in the 'order of things'. We outline different design strategies, the philosophical differences underpinning particular approaches to collecting data, and the issue of bias in research design and analysis.