Search

Byline: Marja J. Verhoef, PhD (Departments of Community Health Sciences and Medicine, University of Calgary, Calgary, AB, mverhoef@ucalgary.ca); Andrea Mulkins, MSc (Tzu Chi Research Group, Vancouver, BC); Linda E. Carlson, [...]

Introduction: The literature identifies significant inequalities in the health status of rural and Aboriginal populations, compared with the general population. Providing rural primary care physicians with public health skills could [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ctim.2005.04.002 Byline: Andrea L. Mulkins (a), Joanna Eng (a), Marja J. Verhoef (b) Abstract: The objective of this study was to assess what factors the Tzu Chi Institute (TCI) practitioners identified as supports and barriers to providing care within an integrative health care setting. Author Affiliation: (a) Tzu Chi Research Group, Vancouver, BC (b) Department of Community Health Sciences, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, Canada T2N 4N1 Article Note: (footnote) [star] Sources of Support: Funding was provided through grants from both the Samueli Institute for Information Biology and the Tzu Chi Foundation.

Abstract Background Integrative health care (IHC) is an interdisciplinary blending of conventional medicine and complementary and alternative medicine (CAM) with the purpose of enhancing patients' health. In 2006, we designed a study to assess outcomes that are relevant to people using such care. However, we faced major challenges in conducting this study and hypothesized that this might be due to the lack of a research climate in these clinics. To investigate these challenges, we initiated a further study in 2008, to explore the reasons why IHC clinics are not conducting outcomes research and to identify strategies for conducting successful in-house outcomes research programs. The results of the latter study are reported here. Methods A total of 25 qualitative interviews were conducted with key participants from 19 IHC clinics across Canada. Basic content analysis was used to identify key themes from the transcribed interviews. Results Barriers identified by participants fell into four categories: organizational culture, organizational resources, organizational environment and logistical challenges. Cultural challenges relate to the philosophy of IHC, organizational leadership and practitioner attitudes and beliefs. Participants also identified significant issues relating to their organization's lack of resources such as funding, compensation, infrastructure and partnerships/linkages. Environmental challenges such as the nature of a clinic's patient population and logistical issues such as the actual implementation of a research program and the applicability of research data also posed challenges to the conduct of research. Embedded research leadership, integration of personal and professional values about research, alignment of research activities and clinical workflow processes are some of the factors identified by participants that support IHC clinics' ability to conduct outcomes research. Conclusions Assessing and enhancing the broader evaluation culture of IHC clinics prior to implementing outcomes research may be a critical step towards ensuring productive and cost-effective research programs. However, as IHC clinics are often complex systems, a whole systems approach to research should be used taking into account the multidimensional and complex nature of such treatment systems so that the results are useful and reflect real life.

The article examines the use of complementary and alternative medicine used by cancer patients for their treatment and mentions the decision making pathway of the treatment course for their illness. It mentions the five pathways identified in the research as well as the factors that impact these pathways. It also mentions the use of mixed-methods pilot study for the research.

Religious beliefs and practices are thought to help people confront problems that push the limits of human life. Integrating the life course perspective, we assess whether the accumulation of religiosity ("spiritual capital") between childhood and adulthood had any bearing on its ability to cushion the mental health insults of a cancer diagnosis, factoring in age‐at‐diagnosis. Using two waves of data from National Survey of Midlife Development in the United States (N = 1431), results suggest that stable high religious importance between childhood and adulthood weakened the deleterious mental health consequences of a cancer diagnosis. For individuals under the age of 45, the relationship between a cancer diagnosis and psychological distress was considerably weaker for those reporting stably high or increasing religious importance between childhood and adulthood. We discuss the implications of our results for research at the intersection religion and the life course perspective. [ABSTRACT FROM AUTHOR]

The standard notion of autonomy in medical ethics does not require that autonomous choices not be irrational. The paper gives three examples of seemingly irrational patient choices and discusses how a rational autonomy analysis differs from the standard view. It then considers whether a switch to the rational autonomy view would lead to overriding more patient decisions but concludes that this should not be the case. Rather, a determination of whether individual patient decisions are autonomous is much less relevant than usually considered in determining whether health care providers must abide by these decisions. Furthermore, respect for rational autonomy entails strong positive requirements of respect for the autonomy of the person as a rational decision maker. The rationality view of autonomy is conceptually stronger than the standard view, allows for a more nuanced understanding of the practical moral calculus involved in respecting patient autonomy, and promotes positive respect for patient autonomy. [ABSTRACT FROM AUTHOR]

A list of authors who have contributed in writing the articles published in the December 2, 2005 issue of "The Journal of Alternative and Complementary Medicine," is presented.

Abstract This article will demonstrate that Traditional Chinese Medicine (TCM) is well established within Canada. This is seen in the trends that include it and in its widespread institutionalization. Canadians [...]