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| Mike Saks and Judith Allsop |
Chapter 17 - Researching Orthodox and Complementary and Alternative Medicine
Janet Richardson and Mike Saks |
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| Contributor
biography |
| Janet Richardson is Reader in Nursing
and Health Studies in the Faculty of Health and Social
Work at the University of Plymouth, UK. She is a psychologist
and registered nurse with a PhD in Health Services Research.
She has research and development experience in the NHS
where she spent some ten years evaluating health services
and establishing clinical audit and clinical/research
governance systems. She is particularly interested in
the interface of research, clinical practice and education
in health care settings. She secured funding for, and
established a complementary therapy outpatient service
within, an acute hospital and implemented a systematic
approach to evaluating this new service. She was Chair
of the Research Council for Complementary Medicine (RCCM)
from 1997 to 2003. |
| Mike Saks is Professor and Pro Vice
Chancellor (Research and Academic Affairs) at the University
of Lincoln, UK. He was previously Dean of Health and Community
Studies at De Montfort University. He has published extensively
on health research in books such as Developing Research
in Primary Care (Radcliffe Medical Press, 2000), Complementary
and Alternative Medicine: Challenge and Change (Routledge,
2003) and Orthodox and Alternative Medicine: Professionalization,
Politics and Health Care (Sage, 2003). He has been
a member/chair of many NHS committees at all levels, including
on research and development – as well as being Chair
of the RCCM from 2003 to 2007. He has also acted as an
adviser to the UK Department of Health, most recently
on health support workers and the Shipman Inquiry. He
has been a central participant in a number of funded international
health projects and is President-elect of the Executive
of the International Sociological Association Research
Committee on Professional Groups. |
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| Chapter overview |
| This chapter addresses the challenges
in researching health across the boundaries of orthodox
medicine and complementary and alternative medicine (CAM).
It discusses the evidence base in orthodox medicine and
CAM, as well as some of the specific issues raised by
researching the latter. |
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| Chapter links |
Chapter
2 - Competing Paradigms and Health Research
Chapter 13 - Experimental
Methods in Health Research
Chapter 16 - Mixed Methods
and Multidisciplinary Research in Health Care
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| Suggested
Online Readings |
| Caspi,
O., Koithan, M. and Criddle, M.W. (2004) ‘Alternative
Medicine or "Alternative" Patients: A Qualitative
Study of Patient-Oriented Decision-Making Processes with
Respect to Complementary and Alternative Medicine’,
Medical Decision Making, 24 (1): 64-79. |
| The paper reports on research to examine
patient-oriented decision-making processes in the use
of CAM therapies. Using exploratory research, adults with
chronic rheumatological disorders who utilize allopathic
medicine only, CAM only, or both were recruited to the
study. Three distinct decision paths were identified,
differing substantially on the importance given to: provider
trust, disease severity/prognosis, willingness to experiment,
intuitive/spiritual factors, and evidence on outcomes.
The paper concludes that the divergent decision paths
indicate the possibility of "alternative patients,"
not just "alternative therapies." Since informed
decisions, tailored to the patient, are likely lead to
more sustainable outcomes for patients, the findings may
help providers to advise patients about treatment alternatives. |
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| Steinsbekk,
A. and Launso, L. (2005) ‘Empowering the Cancer
Patient or Controlling the Tumor? A Qualitative Study
of How Cancer Patients Experience Consultations With Complementary
and Alternative Medicine Practitioners and Physicians,
Respectively’, Integrative Cancer Therapies,
4 (2): 195-200. |
| The paper explores how patients with
cancer, who have had consultations with both a conventional
physician and a complementary and alternative medicine
(CAM) practitioner, experience these consultations. It
draws on semi-structured, in-depth interviews with 17
Norwegian cancer patients who had visited both a CAM practitioner
and a physician. The cancer patients reported two different
modes of consultation: in one, the focus was on the patient
in the other, the focus was on controlling the tumour
in the other, Patients' accounts of the two modes of consultation
differed in terms of the issues discussed; who controlled
the agenda; how the practitioner understood the disease;
communication skills and the extent to which the patient
felt empowered during the consultation. |
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| Turner,
P.K. (2004) ‘Mainstreaming Alternative Medicine:
Doing Midwifery at the Intersection’, Qualitative
Health Research, 14 (5): 644-62. |
| This paper explores how operating
within the dominant socio-political system challenges
alternative health care providers' definitions of themselves,
their practices, and their systems of beliefs. The case
study describes the experiences of one group of birth
care providers (both certified nurse and non-licensed,
apprentice-trained midwives) ‘as a web of paradox’
that simultaneously marginalizes parts of their occupational
identity while allowing them to operate within the dominant
socio-political system. |
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| Further Reading |
| Ernst, E. (ed) (2006) The Desktop
Guide to Complementary and Alternative Medicine: An Evidence-based
Approach. 2nd edition. London: Mosby. |
| This is a good general overview which
draws together some of the current international research
evidence for CAM. |
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| Richardson, J. (2004) ‘Developing
Complementary Therapy Services: A Systematic Approach’,
Health Psychology Update, 13 (3): 23-33. |
| This article discusses further the
establishment and evaluation of the CAM service established
within an NHS setting in Britain that is considered as
a case study in this chapter. |
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| Saks, M. (2003) Orthodox and Alternative
Medicine: Politics, Professionalization and Health Care,
London: Sage. |
| This is an important book for understanding
the context within which orthodox and alternative medicine
have developed in Britain and the United States and the
significance of politics in the struggle for legitimacy
in research and other areas. |
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