Wu, IX, Lam, VC, Ho, RS, Cheung, WK, Sit, RW, Chou, L-W, Zhang, Y, Leung, T-H & Chung, VC 2020, 'Acupuncture and related interventions for carpal tunnel syndrome: systematic review.', Clinical rehabilitation, vol. 34, no. 1, pp. 34-44.View/Download from: Publisher's site
OBJECTIVE:To synthesize evidence on the effectiveness of acupuncture and related therapies for primary carpal tunnel syndrome (CTS) by conducting a systematic review of randomized controlled trials (RCTs). DATA SOURCES:Nine databases were searched for potential RCTs from their inception till July 2019. REVIEW METHODS:RCTs which reported at least one of the three outcomes were included: symptom severity, functional status and pain. Included RCTs were appraised using the Cochrane Risk of Bias Tool. RESULTS:A total of 10 RCTs (728 participants) were included. Majority were at high risk of bias for blinding of participants, personnel and outcome assessors. When compared to conventional medications, manual acupuncture showed significant superior effect in reducing symptom than ibuprofen (mean difference (MD) on Symptom Severity Scale (SSS)) = -5.80, 95% confidence interval (CI): -7.95 to -3.65) and prednisolone (MD = -6.50, 95% CI: -10.1, -2.86). Electroacupuncture plus splinting was more effective in reducing symptom severity than splinting alone (SSS score: MD = -0.20, 95% CI: -0.36 to -0.03). Manual acupuncture showed significantly superior effect than ibuprofen in improving functional status (Functional Status Scale (FSS): MD = -1.84, 95% CI: -2.66 to -1.02). The combination of electroacupuncture and splinting showed more improvement in functional status compared to splinting alone (FSS: MD = -6.22, 95%CI: -10.7 to -1.71). Triple treatment of acupuncture, magnetic spectrum heat lamp and splinting showed stronger pain relief than splinting alone. CONCLUSION:For both symptom relief and function improvement, manual acupuncture is superior to ibuprofen while electroacupuncture plus splinting outperforms splinting alone. Limited evidence showed electroacupuncture's potential role in pain reduction.
Wong, CHL, Wu, IXY, Cheung, WKW, Ho, RST, Leach, MJ, Peng, W, Zhang, Y, Wu, JCY & Chung, VCH 2019, 'Impact of evidence-based healthcare education for Chinese medicine practitioners: A pre-post evaluation.', Complementary therapies in medicine, vol. 45, pp. 38-44.View/Download from: Publisher's site
WHO Traditional Medicine Strategy 2014-23 recommended evidence-based healthcare (EBHC) education for traditional and complementary medicine (T&CM) professionals, including Chinese medicine practitioners (CMPs). We evaluated the impact of a customized educational workshop on Hong Kong CMPs' knowledge, attitude and practice of EBHC. Two validated instruments, Evidence-based Practice Questionnaire (EPQ) and Evidence-based Practice Inventory (EPI), were used to assess the impact of EBHC education. Paired t-tests were used to compare scores before and after the workshop. Multiple linear regression was performed to explore the associations between changes in EPQ/EPI scores and CMPs' characteristics. CMPs who completed the workshop (n = 59) demonstrated significant improvements in the attitude (p = 0.013) and knowledge domains of the EPQ (p = 0.005). Significant improvements were also observed in the attitude, perceived behavioural control, decision making, and intention and behaviour domains of the EPI. CMPs who had never received prior EBHC training showed a larger magnitude of improvement in the EPI attitude (p = 0.032), decision making (p = 0.015), and intention and behaviour (p = 0.015) domains post-workshop. Our findings suggest that tailored workshop is effective in strengthening knowledge and in improving attitudes towards EBHC. Future RCTs should be conducted to affirm our findings. Future initiatives may consider incorporating this education approach into CMP curricula, as well as facilitating implementation of EBHC in routine Chinese medicine practice.
Grönblom Lundström, L, Aasa, U, Zhang, Y & Sundberg, T 2019, 'Health care in light of different theories of health-A proposed framework for integrating a social humanistic perspective into health care.', Journal of integrative medicine, vol. 17, no. 5, pp. 321-327.View/Download from: Publisher's site
The objective of this paper is to provide an overview of the biomedical, the biopsychosocial, and the social humanistic theories of health and to propose a framework for integrating the latter into health care. In summary, the definitions of health, illness and disease are essential to the practice of health care and play fundamental roles in how patients' experiences of being ill are valued and assessed within health care systems. Principally, the biomedical perspective proceeds from pathoanatomical deficiencies defining disease and malfunction; the addition of psychosocial components forms a biopsychosocial perspective. In addition, the social humanistic perspective extends from a person's will, their ability to act, and the possibility to fulfill wanted actions. Thus, health care that does not address the social humanistic perspective may lack the power to describe how these entities are related to the patient on a personal level; thus, the will of the patient is not always fully addressed. Importantly, by targeting the will of the patient and the patient's ability to act, the proposed framework of integrating a social humanistic perspective into health care may further emphasize and strengthen the interrelatedness of medical perspectives. A framework for integrating a social humanistic perspective into health care is proposed and its potential impact on health care is discussed.
Bishop, FL, Lauche, R, Cramer, H, Pinto, JW, Leung, B, Hall, H, Leach, M, Chung, VC, Sundberg, T, Zhang, Y, Steel, A, Ward, L, Sibbritt, D & Adams, J 2019, 'Health Behavior Change and Complementary Medicine Use: National Health Interview Survey 2012.', Medicina (Kaunas, Lithuania), vol. 55, no. 10.View/Download from: Publisher's site
Background and objectives: Complementary and alternative medicine (CAM) use has been associated with preventive health behaviors. However, the role of CAM use in patients' health behaviors remains unclear. This study aimed to determine the extent to which patients report that CAM use motivates them to make changes to their health behaviors. Materials and Methods: This secondary analysis of 2012 National Health Interview Survey data involved 10,201 CAM users living in the United States who identified up to three CAM therapies most important to their health. Analyses assessed the extent to which participants reported that their CAM use motivated positive health behavior changes, specifically: eating healthier, eating more organic foods, cutting back/stopping drinking alcohol, cutting back/quitting smoking cigarettes, and/or exercising more regularly. Results: Overall, 45.4% of CAM users reported being motivated by CAM to make positive health behavior changes, including exercising more regularly (34.9%), eating healthier (31.4%), eating more organic foods (17.2%), reducing/stopping smoking (16.6% of smokers), or reducing/stopping drinking alcohol (8.7% of drinkers). Individual CAM therapies motivated positive health behavior changes in 22% (massage) to 81% (special diets) of users. People were more likely to report being motivated to change health behaviors if they were: aged 18-64 compared to those aged over 65 years; of female gender; not in a relationship; of Hispanic or Black ethnicity, compared to White; reporting at least college education, compared to people with less than high school education; without health insurance. Conclusions: A sizeable proportion of respondents were motivated by their CAM use to undertake health behavior changes. CAM practices and practitioners could help improve patients' health behavior and have potentially significant implications for public health and preventive medicine initiatives; this warrants further research attention.
Zhang, Y, Dennis, JA, Bishop, FL, Cramer, H, Leach, M, Lauche, R, Sundberg, T, Leung, B, Zhang, AL, Bacon, L, Sibbritt, D & Adams, J 2019, 'Complementary and Alternative Medicine Use by U.S. Adults with Self-Reported Doctor-Diagnosed Arthritis: Results from the 2012 National Health Interview Survey.', PM&R, vol. 11, no. 10, pp. 1059-1069.View/Download from: Publisher's site
BACKGROUND:The use of complementary and alternative medicine (CAM) therapies have been reported for the management of arthritis. However, little is known about CAM use among adults with self-reported doctor-diagnosed arthritis. OBJECTIVES:To determine (1) the prevalence and type of CAM use, (2) the difference in characteristics between CAM users and non-CAM users, and (3) the factors related to CAM use, among U.S. adults with self-reported doctor-diagnosed arthritis. DESIGN:Secondary analysis of the 2012 National Health Interview Survey (NHIS) data. SETTING:The NHIS is a cross-sectional survey that gathers health-related data on the civilian, noninstitutionalized U.S. POPULATION: PARTICIPANTS:The NHIS 2012 uses a complex, multistage sampling design and oversamples minorities to achieve population representation; it included 34 525 adults, with 7179 adults having arthritis. METHODS:Data were analyzed using Stata 15.1 survey syntax. The potential factors related to CAM use included sociodemographics and health-related characteristics. MAIN OUTCOME MEASUREMENTS:CAM modalities were categorized into six groups: natural products, manipulative therapies, mind-body therapies, special diets, movement therapies, and other practitioner-based CAM modalities. RESULTS:Of the adults with arthritis, 2428 (weighted estimate of 36.2% of U.S. adult population) had used CAM within the last year. Adults with arthritis reported greater use of CAM than those without, particularly the use of natural products, manipulative therapies and other practitioner-based CAM modalities. Factors associated with higher CAM use included being female, residing in regions other than the U.S. South, having a college degree or higher, reporting very good/excellent self-rated health status, and having current symptoms of joint stiffness/pain. CONCLUSION:As more than one-third of U.S. adults with arthritis seek CAM therapies, open and nonjudgmental conversations between conventional medicine providers, CAM...
Chu, MHK, Wu, IXY, Ho, RST, Wong, CHL, Zhang, AL, Zhang, Y, Wu, JCY & Chung, VCH 2018, 'Chinese herbal medicine for functional dyspepsia: systematic review of systematic reviews', Therapeutic Advances in Gastroenterology, vol. 11.View/Download from: Publisher's site
© The Author(s), 2018. Background: Pharmacotherapy, including prokinetics and proton pump inhibitors for functional dyspepsia (FD) have limited effectiveness, and their safety has been recently questioned. Chinese herbal medicine (CHM) could be considered as an alternative. A systematic review (SR) of SRs was performed to evaluate the potential effectiveness and safety of CHM. Method: We conducted a comprehensive literature search for SRs with meta-analyses in eight international and Chinese databases. Pooled effect estimation from each meta-analysis was extracted. The AMSTAR instrument was used to assess the methodological quality of the included SRs. Results: A total of 14 SRs of mediocre quality assessing various CHMs, alone or in combination with conventional pharmacotherapy, were included. Meta-analyses showed that CHM was more effective than prokinetic agents for the alleviation of global dyspeptic symptoms. Three specific CHM formulae appeared to show superior results in the alleviation of global dyspeptic symptoms, including Si Ni San, modified Xiao Yao San and Xiang Sha Liu Jun Zi decoction. No significant difference in the occurrence of adverse events in using CHM or pharmacotherapy was reported. Conclusion: CHM can be considered as an alternative for the treatment of FD symptoms when prokinetic agents and proton pump inhibitors are contraindicated. Future trial design should focus on measuring changes in individual dyspeptic symptoms and differentiate the effectiveness of different CHM for postprandial distress syndrome and epigastric pain syndrome. A network meta-analysis approach should be used to explore the most promising CHM formula for FD treatment in the future.
Leung, B, Lauche, R, Leach, M, Zhang, Y, Cramer, H & Sibbritt, D 2018, 'Special diets in modern America: Analysis of the 2012 National Health Interview Survey data', Nutrition and Health, vol. 24, no. 1, pp. 11-18.View/Download from: Publisher's site
Special diets are frequently used by the public but reasons for use and characteristics of users remain unclear.
To determine prevalence of the use of special diets, the individual characteristics associated with their use and reasons for use.
The secondary analysis used data from the 2012 National Health Interview Survey (NHIS), a cross-sectional household interview survey of a nationally representative sample of non-hospitalized US adult populations (n = 34,525). The dependent variables in this secondary analysis were the use of a special diet (vegetarian, macrobiotic, Atkins, Pritikin, and Ornish) ever and during the past 12 months. Independent variables included sociodemographic, clinical and behavioral variables. Prevalence of special diet use and reasons for use were analyzed descriptively. Associations between independent and dependent variables were analyzed using Chi-square tests and logistic regression. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.
Lifetime and 12-month prevalence of using special diets were 7.5% (weighted n = 17.7 million) and 2.9% (weighted n = 6.9 million), respectively. Individuals using special diets in the past 12 months were more likely female (OR = 1.45; 95% CI = 1.21–1.74), not married (OR = 0.76; 95% CI = 0.63–0.91), college-educated (OR = 1.98; 95% CI = 1.25–3.11) and depressed (OR = 1.50; 95% CI = 1.14–1.98). They more likely also used herbal products (OR = 2.35; 95%CI = 1.84–2.99), non-vitamin (OR = 1.82; 95% CI = 1.45–2.27) and vitamin supplements (OR = 1.57; 95% CI = 1.24–1.99). Diets were mainly used to improve overall health (76.7%) or for general wellness/prevention (70.4%).
Special diets are mainly used for unspecific health reasons by those who are females, have a college degree or with depression, and commonly used in conjunction with herbs and dietary supplements.
Zhang, Y, Phy, J, Scott-Johnson, C, Garos, S, Orlando, J, Prien, S & Huang, J-C 2017, 'Effects of a Delphi consensus acupuncture treatment protocol on the levels of stress and vascular tone in women undergoing in-vitro fertilization: a randomized clinical trial protocol', BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE, vol. 17.View/Download from: Publisher's site
Zhang, Y, Dennis, JA, Leach, MJ, Bishop, FL, Cramer, H, Chung, VCH, Moore, C, Lauche, R, Cook, R, Sibbritt, D & Adams, J 2017, 'Complementary and Alternative Medicine Use Among US Adults With Headache or Migraine: Results from the 2012 National Health Interview Survey', HEADACHE, vol. 57, no. 8, pp. 1228-1242.View/Download from: Publisher's site
Zhang, Y, Lauche, R, Sibbritt, D, Olaniran, B, Cook, R & Adams, J 2017, 'Comparison of Health Information Technology Use Between American Adults With and Without Chronic Health Conditions: Findings From The National Health Interview Survey 2012', Journal of Medical Internet Research, vol. 17, no. 10.View/Download from: Publisher's site
Background: Health information technology (HIT) is utilized by people with different chronic conditions such as diabetes and hypertension. However, there has been no comparison of HIT use between persons without a chronic condition, with one chronic condition, and multiple (≥2) chronic conditions (MCCs).
Objective: The aim of the study was to assess the difference in HIT use between persons without a chronic condition, with one chronic condition, and with MCCs, to describe the characteristics of HIT use among those with chronic conditions and to identify the predictors of HIT use of the persons with one chronic condition and MCCs.
Methods: A secondary data analysis was conducted in spring 2017 using the National Health Interview Survey (NHIS) 2012 Family Core and Sample Adult Core datasets that yielded 34,525 respondents aged 18 years and older. Measures included overall HIT use (ie, any use of the following five HIT on the Internet: seeking health information, ordering prescription, making appointment, emailing health provider, and using health chat groups), as well as sociodemographic and health-related characteristics. Sociodemographic and health characteristics were compared between HIT users and nonusers among those who reported having at least one chronic condition using chi-square tests. Independent predictors of HIT use were identified using multiple logistic regression analyses for those with one chronic condition, with MCCs, and without a chronic condition. Analyses were weighted and performed at significance level of .005.
Results: In 2012, adults with one health chronic condition (raw count 4147/8551, weighted percentage 48.54%) was significantly higher than among those with MCCs (3816/9637, 39.55%) and those with none of chronic condition (7254/16,337, 44.40%, P<.001). Seeking health information was the most prevalent HIT use. Chi-square tests revealed that among adults with chronic conditions, those who used HIT were significantly different from ...
Chung, VCH, Wu, X, Lu, P, Hui, EP, Zhang, Y, Zhang, AL, Lau, AYL, Zhao, J, Fan, M, Ziea, ETC, Ng, BFL, Wong, SYS & Wu, JCY 2016, 'Chinese Herbal Medicine for Symptom Management in Cancer Palliative Care: Systematic Review And Meta-analysis', MEDICINE, vol. 95, no. 7.View/Download from: Publisher's site
Zhang, Y, Leach, MJ, Bishop, FL & Leung, B 2016, 'A Comparison of the Characteristics of Acupuncture- and Non-Acupuncture-Preferred Consumers: A Secondary Analysis of NHIS 2012 Data', JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE, vol. 22, no. 4, pp. 315-322.View/Download from: Publisher's site
Cramer, H, Ward, L, Steel, A, Lauche, R, Dobos, G & Zhang, Y 2016, 'Prevalence, Patterns, and Predictors of Yoga Use Results of a US Nationally Representative Survey', AMERICAN JOURNAL OF PREVENTIVE MEDICINE, vol. 50, no. 2, pp. 230-235.View/Download from: Publisher's site
Frawley, J, Peng, W, Sibbritt, D, Ward, L, Lauche, R, Zhang, Y & Adams, J 2016, 'Is there an association between women's consultations with a massage therapist and health-related quality of life? Analyses of 1800 women aged 56-61 years', JOURNAL OF BODYWORK AND MOVEMENT THERAPIES, vol. 20, no. 4, pp. 734-739.View/Download from: Publisher's site
Cramer, H, Hall, H, Leach, M, Frawley, J, Zhang, Y, Leung, B, Adams, J & Lauche, R 2016, 'Prevalence, patterns, and predictors of meditation use among US adults: A nationally representative survey', SCIENTIFIC REPORTS, vol. 6.View/Download from: Publisher's site
Cramer, H, Chung, VCH, Lauche, R, Zhang, Y, Zhang, A, Langhorst, J & Dobos, G 2015, 'Characteristics of acupuncture users among internal medicine patients in Germany', COMPLEMENTARY THERAPIES IN MEDICINE, vol. 23, no. 3, pp. 423-429.View/Download from: Publisher's site
Zhang, Y, Leach, MJ, Hall, H, Sundberg, T, Ward, L, Sibbritt, D & Adams, J 2015, 'Differences between Male and Female Consumers of Complementary and Alternative Medicine in a National US Population: A Secondary Analysis of 2012 NIHS Data', Evidence-Based Complementary and Alternative Medicine.View/Download from: Publisher's site
Gobler, CJ, Lobanov, AV, Tang, Y, Turanov, AA, Zhang, Y, Doblin, MA, Taylor, GT, Sanudo-Wilhelm, SA, Grigoriev, IV & Gladyshev, VN 2013, 'The central role of selenium in the biochemistry and ecology of the harmful pelagophyte, Aureococcus anophagefferens', The ISME Journal, vol. 7, no. 7, pp. 1333-1343.View/Download from: Publisher's site
The trace element selenium (Se) is required for the biosynthesis of selenocysteine (Sec), the 21st amino acid in the genetic code, but its role in the ecology of harmful algal blooms (HABs) is unknown. Here, we examined the role of Se in the biology and ecology of the harmful pelagophyte, Aureococcus anophagefferens, through cell culture, genomic analyses and ecosystem studies. This organism has the largest and the most diverse selenoproteome identified to date that consisted of at least 59 selenoproteins, including known eukaryotic selenoproteins, selenoproteins previously only detected in bacteria, and novel selenoproteins. The A. anophagefferens selenoproteome was dominated by the thioredoxin fold proteins and oxidoreductase functions were assigned to the majority of detected selenoproteins. Insertion of Sec in these proteins was supported by a unique Sec insertion sequence. Se was required for the growth of A. anophagefferens as cultures grew maximally at nanomolar Se concentrations. In a coastal ecosystem, dissolved Se concentrations were elevated before and after A. anophagefferens blooms, but were reduced by 495% during the peak of blooms to 0.05 nM. Consistent with this pattern, enrichment of seawater with selenite before and after a bloom did not affect the growth of A. anophagefferens, but enrichment during the peak of the bloom significantly increased population growth rates. These findings demonstrate that Se inventories, which can be anthropogenically enriched, can support proliferation of HABs, such as A. anophagefferens through its synthesis of a large arsenal of Se-dependent oxidoreductases that fine-tune cellular redox homeostasis.
Zhang, Y, Peck, K, Spalding, M, Jones, BG & Cook, RL 2012, 'Discrepancy between patients' use of and health providers' familiarity with CAM', Patient Education and Counseling, vol. 89, no. 3, pp. 399-404.View/Download from: Publisher's site
Objective: To compare patients' complementary and alternative medicine (CAM) use and physicians' familiarity with certain CAM modalities in the same setting and to assess patient-provider dialogue about patients' CAM use. Methods: An observational survey study with convenience sampling at ambulatory family medicine clinics in two Texas cities. A total of 69 healthcare providers and 468 patients completed the surveys. Patients' surveys assessed use of 27 CAM therapies, perception of CAM use and interaction with providers. Providers' survey assessed perception and attitude toward CAM use. Results: CAM modalities most used by the patients are not those modalities that providers best understood. Of the 330 patients (70%) who responded to the relevant questions about discussing CAM, 44.5% reported never having discussed CAM use with their providers. Binomial logistic regression revealed no link between age, gender or ethnicity for discussing CAM with providers. College-educated patients (adjust OR = 2.8, 95%CI = 1.3-6.0) and US citizens were both about three times more likely to discuss CAM than their counterparts. Conclusion: Lack of knowledge and unfamiliarity with CAM modalities might prevent important patient-provider discussions. Practice implications: Providers should use existing resources and encourage a bilateral dialogue that involves transferring of information and assisting patients in decisions making about CAM use and health care. © 2012 Elsevier Ireland Ltd.
Zhang, Y, Peck, K, Spalding, M, Xu, T & Ragain, M 2010, 'A study to examine the attitudes, knowledge, and utilization of CAM by primary care professional in West Texas', Complementary Therapies in Medicine, vol. 18, no. 6, pp. 227-232.View/Download from: Publisher's site
Objective: This study examined the attitudes, knowledge, and utilization of CAM among primary care providers at two campuses of the Texas Tech University Health Sciences Center (TTUHSC). Design and setting: A cross-sectional study design and a convenient sampling method were used. This study employed the questionnaire adapted from the Wahner-Roedler's study to survey participants in TTUHSC. Primary survey collection was conducted at the two campuses where all Family Medicine healthcare professionals were recruited. Main outcome measures: We measured participants' knowledge of, their familiarity and experience with, their attitudes towards and utilization of CAM. Results: Of the 69 respondents, more than half (56.5%) were female and younger than 36 years. Overall, our study revealed a positive attitude towards CAM. More than 60% of the providers would like to refer a patient to a CAM practitioner and about 75% of them believed that incorporation of CAM therapies into the practice would have a positive impact. Providers were most familiar with and felt most comfortable counseling their patients about massage therapy and St. John's Wort among all CAM modalities. About 70% of the participants believed that the institution should offer proven CAM therapies to patients. Conclusions: This study provides some preliminary findings that may lead to further exploration of healthcare professional's attitudes towards CAM. © 2010.
Zhang, Y, Jones, B, Spalding, M, Young, R & Ragain, M 2009, 'Use of the internet for health information among primary care patients in rural West Texas', Southern Medical Journal, vol. 102, no. 6, pp. 595-601.View/Download from: Publisher's site
Background: Little is known about how primary care patients in rural, remote or border areas use the internet for their health information. This study examined the factors related to internet use for medical information among primary care clinic patients in such areas of West Texas. Methods: A convenience sample was drawn from nine clinics that serve low-income rural area populations. Surveys were distributed to the patients during a 6-week period in the winter of 2006. The analytical sample included 1890 participants. Logistic regressions were conducted. Results: Of 1890 subjects, 699 (37%) reported having used the internet for medical information. Among those who reported using the internet for health information, respondents' primary usage pattern was to request more health information (29.9%), followed by the purchase of health supplies (13.4%). Most internet users (78.8%) agreed that the online medical/health information had improved their understanding of a specific condition, disease, or treatment. Almost 60% of the internet users thought the information was reliable. The correlates of internet use included health insurance, self-rated health, health confidence, and number of worried days as well as age, education level, ethnicity, and language. Conclusions: Our findings showed a much lower rate of internet use for medical/health information compared with a 2006 nationwide survey. This finding suggests that promoting health/medical information through websites or other on-line resources might not be the most effective way to reach a majority of patients in remote, rural or border areas. Copyright © 2009 by The Southern Medical Association.
Zhang, Y, Jones, B, Ragain, M, Spalding, M, Mannschreck, D & Young, R 2008, 'Complementary and alternative medicine use among primary care patients in west texas', Southern Medical Journal, vol. 101, no. 12, pp. 1232-1237.View/Download from: Publisher's site
BACKGROUND:: This study explored factors related to practitioner-based complementary and alternative medicine (CAM) usage among primary care clinic patients in rural West Texas areas, including physiciansĝ€™ awareness of their patients CAM use. METHODS:: A convenience sample was drawn from nine clinics that served low-income populations. Surveys were distributed to patients during a 6-week period in the winter of 2006. The analytical sample included 1731 participants. Logistic regressions were conducted to explore the factors related to CAM use. RESULTS:: Of 1731 subjects, 52.0% (900) reported that they were currently using or had used CAM. The main types of CAM practitioners were chiropractor (42.7%) followed by massage therapist (33.3%) and herbalist (8.3%). Those who had discussed the use of alternative medicine with their physicians and those who had more days where they felt worried in the past 30 days were more likely to use CAM than their counterparts. Patients whose healthcare was covered by nonprivate insurance, those who rated their healthcare providers more highly, and those who agreed that their doctor visits were obtainable were less likely to use CAM. CONCLUSIONS:: CAM use is clearly not uncommon among primary care patients in rural areas, with more than half of patients reporting some type of use. This study suggests that further research should elicit opinions on CAM among people who do not regularly access a conventional primary care provider, as well as assess the relationship between CAM and conventional medical treatment in terms of cost and health benefits. © 2008 by The Southern Medical Association.
Zhang, Y, Borders, TF & Rohrer, JE 2007, 'Correlates of Intent to Seek Unnecessary Pap Tests Among Elderly Women', Women's Health Issues, vol. 17, no. 6, pp. 351-359.View/Download from: Publisher's site
Purpose: Cervical cancer screening may be over-used by elderly women who might not benefit from the test. The purpose of this study was to examine the relative importance of objective factors (e.g. intact cervix) and subjective factors (e.g. patients' Pap-smear related beliefs/attitudes) as correlates of elderly women's intention to have a Pap smear. Methods: This study was a secondary data analysis using a subset sample of the elderly women (≥65 years) who participated in the Texas Tech 5000 Survey Wave 4, a cross-sectional phone interview study conducted in 2002. Intent to have a Pap test, previous gynecologic history, and beliefs/attitudes related to Pap tests were measured. χ2 tests and logistic regression were conducted. Results: Among the 1,044 women in the analytical sample, 70.2% (733) reported intending to have a Pap smear test within the next 2 years. About 77% (449/582) of the women who had not undergone a hysterectomy reported the intend to have a Pap smear, whereas 62% (284/462) of the women who had undergone a hysterectomy reported the same intent (χ 2 = 30.26; df = 1; p = .000). Among women who had undergone a hysterectomy, having received a Pap smear within the past 2 years (odds ratio [OR], 21.32; 95% confidence interval [CI], 11.52-39.47), perceiving that their doctors might feel having the test is a good idea (OR, 7.14; 95% CI, 3.15-16.19), and insurance covering the test (OR, 2.21; 95% CI, 1.18-4.15) were positive correlates of intent to have a Pap test. Among women who had not undergone a hysterectomy, previous Pap smear history (OR, 19.28; 95% CI, 10.15-37.10), perceived doctor's opinion (OR, 5.39; 95% CI, 2.38-12.19), perceived pain of the test (OR, 0.52; 95% CI, .28-.99), perceived importance (OR, 4.00; 95% CI, 1.32-12.10), and perceived risk of developing cervical cancer (OR, 4.27; 95% CI, 1.27-14.33) were correlates. Conclusions: Public health educational messages intended to increase appropriate use of Pap screening should include factu...
Zhang, Y, Rohrer, J, Borders, T & Farrell, T 2007, 'Patient satisfaction, self-rated health status, and health confidence: An assessment of the utility of single-item questions', American Journal of Medical Quality, vol. 22, no. 1, pp. 42-49.View/Download from: Publisher's site
This study examined if known predictors of patient satisfaction would still be significant when single items are used. Approximately 5000 elderly persons were randomly sampled from 65 000 households in West Texas. Single-item questions about patient satisfaction, self-rated overall health status, self-rated mental health, and health confidence were analyzed by chi-square tests and logistic regressions. Slightly more than 12% of the participants were not satisfied or barely satisfied with health care received. Those who reported higher health confidence, lower self-rated overall health, having emotional problems, or who were men were less likely to be satisfied with health care. A simple survey tool based on single-item questions identified by the current study might be useful for monitoring patient satisfaction, self-rated health, and health confidence in primary care settings and hence might assist management in capturing the basic picture for improving health care quality. Copyright © 2007 by the American College of Medical Quality.