- Discuss the impact of science on the rise of conventional medicine. Briefly contrast alternative modern and alternative traditional approaches in CAM.
Alternative modern approaches include homeopathy and naturopathy while alternative traditional approaches include ayurveda, traditional healing, and acupuncture. Homeopathy is the treatment using substances from plants, animals, or minerals. Homeopathic remedies can be purchased as over the counter products. Naturopathy operates on the principle that “nature has a healing power” and promotes treatments that are most natural and non-invasive. This include herbal supplements. Both homeopathy and naturopathy originated in Germany in the 18th century. In comparison, the traditional approaches like ayurveda and acupuncture originated from Asia. Ayurveda is the oldest medical system in India and is still practiced there as well as in its neighboring countries of Nepal and Bangladesh. Acupuncture comes from China and is a medical system that has been practice for over 2,000 years. It involves the use of metallic needles inserted in the skin at strategic energy points in the body. Both ayurveda and acupuncture require supervision by qualified practitioners as these are more invasive compared to the over-the-counter products.
- Discuss historical and socio-demographic trends in the utilization of various forms of CAM. What insights do models of health self-management offer into age and ethnic differences in CAM use?
The various forms of CAM can be grouped into five categories. These are (a) alternative medical systems; (b) mind-body interventions; (c) biologically-based therapies; (d) manipulative and body-based methods; and (e) energy therapies (NCCAM, n.d.). In the category of mind-body interventions, the Health Belief Model was used by the Adams et al. (2011) in determining the role of the parents’ medication beliefs in the treatment of children’s asthma. Their study showed that the “parents’ strong positive beliefs about conventional and alternative medications were associated with greater self-directed problem solving and with more risks for non-adherence” (p.11). Health self-management through mind-body interventions espouse the idea of maintaining a balance in once life and technique for this includes prayer, meditation, mental healing and outlets through music, arts and dance are used as therapies. Health self-management also promote the idea of patient participation in the healing process as well as the concept that the body has natural healing capabilities.
- How is the concept of wellness different from the WHO definition of health?
The concept of wellness differs from the WHO definition because of the idea of self-perception. According to Schuster et al., (2004), “wellness is the generalized self-perception of health” (p.351). WHO’s definition of health in 1948 was being “a a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. In 1986, WHO added to be healthy “an individual or a group must be able to realize aspirations and satisfy needs, and to change or cope with the environment” (Schuster 2004, p. 350). From the wellness perspective, the health of a person goes beyond the state of the person’s biological processes. It is the ability to “function and deal with life’s stressors” (Kick, 2000 as ited in Schuster et al., 2004, p.351). However, Adams et al (1997 as cited in Schuster, 2004) noted that there is still a lack of tools to measure positive health or wellness.
- What four questions summarize the tasks of alternative medicine research?
- What are the valuing patterns of researchers and their study populations? According to Kaplan (1984 as cited in Cassidy, 1995) researchers “need to make these valuations conscious, specific, and explicit” (p.52). The reason is to prevent bias when conducting research.
- What terminologies are used in the field of alternative medicine and how are these defined? Health concepts are defined depending on certain paradigms. For example reductionists would refer to persons who seek healthcare as patients while the relational paradigm would refer to them also as clients or persons. Illness is considered a problem by reductionist while relational looks at it as a challenge. The healthcare practitioner is an expert according to reductionist but the relational paradigm would refer to them as partners.
- What methods are most appropriate in gathering information?
Cassidy enumerated several anthropologic methods which include (a) examination of existing records, (b) participant observations, (c) interviewing. (d) projective instruments; (d) unobtrusive observation, and (e) survey questionnaires.
- Does the research employ scientific approaches?
If the study is quantitative then it is expected that the research is valid and reliable. If the approach is qualitative then it must be satisfy the criteria of validity and transferability.
- Under what conditions is outcome research in CAM considered an appropriate alternative to RCTs?
Despite randomized clinical trials (RCTs) being the gold standard in research, there are specific conditions in CAM interventions that limit or pose a challenge to effectiveness of RCTs. Verhoef (2002) enumerates six challenges and these are (a) multiple modalities are used by CAM interventions and often are rather complex; (b) CAM treatments are varied as it is individualized and treatment is adjusted depending on the needs of individual patient; (c) chronic conditions of patients which often requires restoring balance instead of treating specific symptoms; (d) beliefs and preference of participants; (e) difficulty in identifying the placebo effect; and (f) patient-provider relationship is a key element in CAM treatments. Therefore, qualitative research is an appropriate alternative to RCTs because it can provide details on why the treatment is effective among the individuals. The participants perspective on why the treatments are effective and how they went through the experience are likewise documented and analyzed.
6. Describe the five approaches within a sociological perspective for understanding CAM use.
Stratton (2008) enumerated the five approaches by distinguishing the specific focus of each approach. These approaches focus on the following:
- Examining spirituality, religion, health effort, and personal openness
- Investigation of attitudes and subjective norms
- Inductive, qualitative approach; Meanings associated with CAM use
- Macro-structural approach – CAM is categorized as a social movement
The first three are considered micro-approaches while the last two are macro-approaches.
7. Discuss at least one theme (research finding and critique) in the sociological investigations of Users of CAM, Practitioners of CAM, and Physician Orthodoxy.
One of the themes that Siahpush (2000) focused on in his critiques is the lack or limited samples. In the discussion about why people use alternative medicine the author says the “sample used in most existing studies are often too small to yield generalizable results” (p.162). Due to this lack in the samples, the reasons why alternative medicine is popular is considered by the author as just speculations. There were no existing empirical studies that have researched on four reasons he has noted. As regards the process that lead to someone to take alternative medicine, the researcher identified only two studies, those by Sharma (1990) and Semmes (1990). In the discussion about the physician’s using alternative theraphies, Shiapush (2000) found out that studies about this topic are most often limited to the “extent of use of alternative modalities and do not go beyond descriptive statistics” (p.170).
References
Adams, S.K., Murdock, K.K., McQuaid, E.L., & Lima, L. (2011). The Role of Parents’ Medication Beliefs, Religious Problem-Solving, and Risks for Treatment Nonadherence in Urban Families with Asthma. Health Services Insights 2011:4 11–21. doi: 10.4137/HSI.S6464.
Siahpush, M. (2000). A Critical Review of the Sociology of Alternative Medicine: Research on users, practitioners and the orthodoxy. Health (London), 4 (159). doi: 10.1177/136345930000400201.
Stratton, T. & McGivern-Snofsky, J.L. (2008).Toward a Sociological Understanding of Complementary
and Alternative Medicine Use. The Journal of Alternative and Complementary Medicine, 14(6), pp.777-783. doi 10.1089/acm.2007.7006.
