The Association of the Health Management Strategy with Subjective Health and Well-being Outcomes in General Population

Background@#People face many obstacles to overcoming crisis in life and proactively manage life crises. This study aimed to evaluate the association of self-management strategy with subjective health and well-being for the general South Korean population. @*Methods@#We recruited 1,200 respondents using an equal-probability sampling method from March to May 2018. A questionnaire including life version of the Smart Management Strategy for Health Assessment Tool (SAT-Life), the five Health Status Questionnaire, Short Form-12, McGill Quality of Life Questionnaire (MQOL), Patient Health Questionnaire-9 (PHQ-9), and Satisfaction With Life Scale (SWLS) was administered to participants. @*Results@#In multiple stepwise logistic regression model adjusted with basic demographic variables (age, sex, region, education and monthly income level), core strategy was independently associated with physical, mental, social, spiritual, and general health status (adjusted odds ratios [aORs], 1.97–2.92). Preparation strategy was independently associated with physical, mental, spiritual, and general health status (aORs, 2.36–3.31). Implementation strategy was independently associated with physical, social, spiritual, and general health status (aORs, 2.22–2.42). Core strategy and implementation strategy were independently associated with higher Physical Component Score (aORs, 2.21–2.29) and higher Mental Component Score (aORs, 1.68–1.76). Core strategy and preparation strategy were independently associated with lower PHQ-9 (aORs, 2.63–3.74). Pearson's correlation coefficients between scores on SAT-Life and the other factors (MQOL social support, MQOL spiritual well-being, and SWLS) explain having significant correlations ranging from 0.41–0.43. @*Conclusion@#Self-management strategies of health might be encouraged to manage subjective health and well-being outcomes.

Comparison of eating habits and inappropriate weight control efforts of secondary school students enrolled in a weight control program

BACKGROUND/OBJECTIVES@#Numerous school-based weight control programs have been initiated for weight loss among adolescents. However, the relationship between these programs and inappropriate weight control efforts, dietary habits and behavior of students, have not been investigated sufficiently. This study was undertaken to investigate the association between body mass index (BMI) of adolescents, and their health status and inappropriate weight-control efforts. We further examined the relationship between attendance to school-based weight-control programs and attempting inappropriate weightcontrol efforts, dietary habits, and behavior. @*SUBJECTS/METHODS@#A survey of 1,742 students was conducted in Korea. Logistic regression was used to assess differences in the health status (grouped by BMI and improper weight control) and dietary habits, based on attendance to the weight-control programs. @*RESULTS@#Obese students were significantly more dissatisfied with physical, mental and spiritual health. Students who attended weight-control programs were likely to be underweight (P < 0.001), whereas those who did not attend weight-control programs were likely to attempt weight control improperly (P < 0.001). Students who participated in the program also had relatively healthy dietary habits (P < 0.001–0.027), and students who did not attend had comparatively unhealthy dietary habits (P < 0.001–0.008). Students who attended weight-control programs were likely to be underweight (P < 0.001) with relatively healthy dietary habits (P < 0.001–0.027), whereas students who did not attend the programs were likely to attempt weight control improperly (P < 0.001) and had comparatively unhealthy dietary habits (P < 0.001–0.008). @*CONCLUSIONS@#Attending school-based weight-control programs was significantly associated with not attempting inappropriate weight-control efforts, as well as following healthy dietary habits. Our data indicates that offering school-based weight-control programs is valuable to student health, and is anticipated to reducing the public health burden.

Comparison of eating habits and inappropriate weight control efforts of secondary school students enrolled in a weight control program

BACKGROUND/OBJECTIVES@#Numerous school-based weight control programs have been initiated for weight loss among adolescents. However, the relationship between these programs and inappropriate weight control efforts, dietary habits and behavior of students, have not been investigated sufficiently. This study was undertaken to investigate the association between body mass index (BMI) of adolescents, and their health status and inappropriate weight-control efforts. We further examined the relationship between attendance to school-based weight-control programs and attempting inappropriate weightcontrol efforts, dietary habits, and behavior. @*SUBJECTS/METHODS@#A survey of 1,742 students was conducted in Korea. Logistic regression was used to assess differences in the health status (grouped by BMI and improper weight control) and dietary habits, based on attendance to the weight-control programs. @*RESULTS@#Obese students were significantly more dissatisfied with physical, mental and spiritual health. Students who attended weight-control programs were likely to be underweight (P < 0.001), whereas those who did not attend weight-control programs were likely to attempt weight control improperly (P < 0.001). Students who participated in the program also had relatively healthy dietary habits (P < 0.001–0.027), and students who did not attend had comparatively unhealthy dietary habits (P < 0.001–0.008). Students who attended weight-control programs were likely to be underweight (P < 0.001) with relatively healthy dietary habits (P < 0.001–0.027), whereas students who did not attend the programs were likely to attempt weight control improperly (P < 0.001) and had comparatively unhealthy dietary habits (P < 0.001–0.008). @*CONCLUSIONS@#Attending school-based weight-control programs was significantly associated with not attempting inappropriate weight-control efforts, as well as following healthy dietary habits. Our data indicates that offering school-based weight-control programs is valuable to student health, and is anticipated to reducing the public health burden.

Erratum: Correction of the Text in the Article “Table”: Discordance between Physician and the General Public Perceptions of Prognostic Disclosure to Children with Serious Illness: a Korean Nationwide Study

While recently extending that research, however, the authors discovered that 236 members of the general population were mistakenly to be duplicated by the investigating agency (Word Research) and 1,241 were reported rather than 1,005. The authors present corrections and discuss the relevant data. The authors wish to apologize to the publisher and readers of Journal of Korean Medical Science for these errors.

Erratum: Correction of the Text in the Article “Table”: Discordance between Physician and the General Public Perceptions of Prognostic Disclosure to Children with Serious Illness: a Korean Nationwide Study

While recently extending that research, however, the authors discovered that 236 members of the general population were mistakenly to be duplicated by the investigating agency (Word Research) and 1,241 were reported rather than 1,005. The authors present corrections and discuss the relevant data. The authors wish to apologize to the publisher and readers of Journal of Korean Medical Science for these errors.

The Attitudes of Physicians and the General Public toward Prognostic Disclosure of Different Serious Illnesses: a Korean Nationwide Study

Background@#Although international guidelines recommend palliative care approaches for many serious illnesses, the palliative needs of patients with serious illnesses other than cancer are often unmet, mainly due to insufficient prognosis-related discussion. We investigated physicians' and the general public's respective attitudes toward prognostic disclosure for several serious illnesses. @*Methods@#We conducted a cross-sectional survey of 928 physicians, sourced from 12 hospitals and the Korean Medical Association, and 1,005 members of the general public, sourced from all 17 administrative divisions in Korea. @*Results@#For most illnesses, most physicians (adjusted proportions – end-organ failure, 99.0%; incurable genetic or neurologic disease, 98.5%; acquired immune deficiency syndrome [AIDS], 98.4%; stroke or Parkinson's disease, 96.0%; and dementia, 89.6%) and members of the general public (end-organ failure, 92.0%; incurable genetic or neurologic disease, 92.5%; AIDS, 91.5%; stroke or Parkinson's disease, 92.1%; and dementia, 86.9%) wanted to be informed if they had a terminal prognosis. For physicians and the general public, the primary factor to consider when disclosing terminal status was “the patient's right to know his/her condition” (31.0%). Yet, the general public was less likely to prefer prognostic disclosure than physicians. Particularly, when their family members were patients, more than 10% of the general public did not want patients to be informed of their terminal prognosis. For the general public, the main reason for not disclosing prognosis was “psychological burden such as anxiety and depression” (35.8%), while for the physicians it was “disclosure would have no beneficial effect” (42.4%). @*Conclusion@#Most Physicians and the general public agreed that disclosure of a terminal prognosis respects patient autonomy for several serious illnesses. The low response rate of physicians might limit the generalizability of the results.

Erratum: Correction of the Text in the Article “Table”: Discordance between Physician and the General Public Perceptions of Prognostic Disclosure to Children with Serious Illness: a Korean Nationwide Study

While recently extending that research, however, the authors discovered that 236 members of the general population were mistakenly to be duplicated by the investigating agency (Word Research) and 1,241 were reported rather than 1,005. The authors present corrections and discuss the relevant data. The authors wish to apologize to the publisher and readers of Journal of Korean Medical Science for these errors.

The Attitudes of Physicians and the General Public toward Prognostic Disclosure of Different Serious Illnesses: a Korean Nationwide Study

Background@#Although international guidelines recommend palliative care approaches for many serious illnesses, the palliative needs of patients with serious illnesses other than cancer are often unmet, mainly due to insufficient prognosis-related discussion. We investigated physicians' and the general public's respective attitudes toward prognostic disclosure for several serious illnesses. @*Methods@#We conducted a cross-sectional survey of 928 physicians, sourced from 12 hospitals and the Korean Medical Association, and 1,005 members of the general public, sourced from all 17 administrative divisions in Korea. @*Results@#For most illnesses, most physicians (adjusted proportions – end-organ failure, 99.0%; incurable genetic or neurologic disease, 98.5%; acquired immune deficiency syndrome [AIDS], 98.4%; stroke or Parkinson's disease, 96.0%; and dementia, 89.6%) and members of the general public (end-organ failure, 92.0%; incurable genetic or neurologic disease, 92.5%; AIDS, 91.5%; stroke or Parkinson's disease, 92.1%; and dementia, 86.9%) wanted to be informed if they had a terminal prognosis. For physicians and the general public, the primary factor to consider when disclosing terminal status was “the patient's right to know his/her condition” (31.0%). Yet, the general public was less likely to prefer prognostic disclosure than physicians. Particularly, when their family members were patients, more than 10% of the general public did not want patients to be informed of their terminal prognosis. For the general public, the main reason for not disclosing prognosis was “psychological burden such as anxiety and depression” (35.8%), while for the physicians it was “disclosure would have no beneficial effect” (42.4%). @*Conclusion@#Most Physicians and the general public agreed that disclosure of a terminal prognosis respects patient autonomy for several serious illnesses. The low response rate of physicians might limit the generalizability of the results.

Erratum: Correction of Ethics Statement: Discordance between Physician and the General Public Perceptions of Prognostic Disclosure to Children with Serious Illness: a Korean Nationwide Study

The approval number of Institutional Review Board (IRB) was wrong in the article.

Quantity over Quality? Perception of Designating Long-Term Care Hospitals as Providers of Hospice and Palliative Care / 한국호스피스완화의료학회지

PURPOSE: Amendment to the Act on Decisions on Life-sustaining Treatment was recently enacted to designate long-term care hospitals as providers of hospice and palliative care. Despite its benefit of providing improved accessibility to end-of-life care, the amendment has raised concerns about its effect on quality of service. This study aimed to use information obtained from an expert group interview and previous studies to compare how cancer patients, family caregivers, physicians, and the general Korean population perceive the potential benefits and risks of this amendment.METHODS: We conducted a multicenter cross-sectional study from July to October 2016. The included participants answered a structured questionnaire regarding the extent to which they agree or disagree with the questionnaire items indicating the potential benefits and risks of the amendment. Chi-square tests and univariate and multivariate logistic regression analyses were performed.RESULTS: Compared with the general population, physicians agreed more that long-term care hospitals are currently not adequately equipped to provide quality hospice and palliative care. Family caregivers found improved access to long-term care hospitals more favorable but were more likely to agree that these hospitals might prioritize profits, thereby threatening the philosophy of hospice care, and that families might cease to fulfill filial responsibilities. Compared with the general population, cancer patients were more concerned about the potentially decreased service quality in this setting.CONCLUSION: Although potential service beneficiaries and providers expected improved accessibility of hospice and palliative care services, they were also concerned whether the system can provide adequate quality of end-of-life care.

Establishment of Normative Self-Rated Health Status Data and Association between Ideal Life Expectancy and Social Wellness of General Population in Korea

PURPOSE: The purpose of this study was to establish normative data for holistic health parameters in the general Korean population and to investigate the factor associated with ideal life expectancy (ILE) among these holistic health parameters and sociodemographic variables. METHODS: This study used a questionnaire to obtain self-reported physical, mental, social, spiritual, and general health status and then evaluated their association with ILE. A total of 1,241 individuals responded to the questionnaire, from which we established a multidimensional health status reference data set representing the Korean population. To explain factors associated with ILE, we stratified results by age and gender and performed multiple logistic regression of sociodemographic variables and multidimensional health status. RESULTS: Women reported poor health status more frequently for all five health categories. The average ILE was 87.46 years versus 84.42 years of life expectancy in the general Korean population. Single marital status, higher income, and better social health were significantly associated with higher ILE. CONCLUSION: ILE could be a good indicator reflecting social wellness in a certain society. Comprehensive social health promotion programs can improve individuals' attitudes toward life expectancy, especially for vulnerable groups.

Discordance between Physician and the General Public Perceptions of Prognostic Disclosure to Children with Serious Illness: a Korean Nationwide Study

BACKGROUND: It is difficult to decide whether to inform the child of the incurable illness. We investigated attitudes of the general population and physicians toward prognosis disclosure to children and associated factors in Korea. METHODS: Physicians working in one of 13 university hospitals or the National Cancer Center and members of the general public responded to the questionnaire. The questionnaire consisted of the age appropriate for informing children about the prognosis and the reason why children should not be informed. This survey was conducted as part of research to identify perceptions of physicians and general public on the end-of-life care in Korea. RESULTS: A total of 928 physicians and 1,241 members of the general public in Korea completed the questionnaire. Whereas 92.7% of physicians said that children should be informed of their incurable illness, only 50.7% of the general population agreed. Physicians were also more likely to think that younger children should know about their poor prognosis compared with the general population. Physicians who opposed incurable illness disclosure suggested that children might not understand the situation, whereas the general public was primarily concerned that disclosure would exacerbate the disease. Physicians who were women or religious were more likely to want to inform children of their poor prognosis. In the general population, gender, education, comorbidity, and caregiver experience were related to attitude toward poor prognosis disclosure to children. CONCLUSION: Our findings indicate that physicians and the general public in Korea differ in their perceptions about informing children of poor prognosis.

Public Perception and Acceptance of the National Strategy for Well-Dying / 한국호스피스완화의료학회지

PURPOSE: Ten years have passed since the Korean government announced its plan to institutionally support hospice and palliative care in 2002. In line with that, this study aims to suggest future directions for Korea's hospice and palliative care policy. METHODS: We conducted a survey on people's perception and acceptance of well-dying. Data were collected from 1,000 participants aged 19~69 years between June 1 and June 11, 2012 via computer-assisted telephone interviews. RESULTS: The most important factor for well-dying was placing no burden of care on others (36.7%) and the second most important factor was staying with their family and loved ones (19.1%). Among nine suggestions of policy support for well-dying, the most popular was the promotion of voluntary care sharing (88.3%), followed by the palliative care training support for healthcare providers (83.7%) and the support for palliative care facilities instead of funeral halls (81.7%). The idea of formulating a five-year national plan for end-of-life care drew strong support (91%). According to the survey, the plan should be implemented by the central government (47.5%), the National Assembly (20.2%) or civic groups (10%). CONCLUSION: This study demonstrated the public consensus and their consistent direction toward policy support for well-dying. Results of this study may serve as a foundation for the establishment of policy support for people's well-dying and palliative care at the national-level.

Cross-Cultural Adaptation of the Korean Version of the Minneapolis-Manchester Quality of Life Instrument-Adolescent Form

We verified the reliability and validity of the Korean version of the Minneapolis-Manchester Quality of Life Instrument-Adolescent Form (KMMQL-AF) among Korean childhood cancer survivors. A total of 107 childhood cancer patients undergoing cancer treatment and 98 childhood cancer survivors who completed cancer treatment were recruited. To assess the internal structure of the KMMQL-AF, we performed multi-trait scaling analyses and exploratory factor analysis. Additionally, we compared each domains of the KMMQL-AF with those of the Karnofsky Performance Status Scale and the Revised Children's Manifest Anxiety Scale (RCMAS). Internal consistency of the KMMQL-AF was sufficient (Cronbach's alpha: 0.78-0.92). In multi-trait scaling analyses, the KMMQL-AF showed sufficient construct validity. The "physical functioning" domain showed moderate correlation with Karnofsky scores and the "psychological functioning" domain showed moderate-to-high correlation with the RCMAS. The KMMQL-AF discriminated between subgroups of different adolescent cancer survivors depending on treatment completion. The KMMQL-AF is a sufficiently reliable and valid instrument for measuring quality of life among Korean childhood cancer survivors.

The correlates of unemployment and its association with quality of life in cervical cancer survivors / 부인종양

OBJECTIVE: Little is known regarding cervical cancer survivors' employment status, which represents social integration of cancer survivors as a pivotal domain of long-term quality of life. The goal of this study was to assess the correlates of unemployment and evaluate the impact on the comprehensive quality of life in cervical cancer survivors. METHODS: We enrolled 858 cervical cancer survivors from the gynecologic oncology departments of multi-centers in Korea. Factors associated with unemployment were identified using multivariate logistic regression analyses. We assessed different health-related quality of life domains with multivariate-adjusted least-square means between cervical cancer survivors who currently work and do not. RESULTS: After diagnosis and treatment, the percentage of unemployed survivors increased from 50.6% to 72.8%. Lower income (adjusted odds ratio [aOR], 1.97; 95% confidence interval [CI], 1.38 to 2.81), medical aid (aOR, 1.58; 95% CI, 1.05 to 2.38), two or more comorbidities (aOR, 1.80; 95% CI, 1.12 to 2.90), current alcohol drinkers (aOR, 2.33; 95% CI, 1.54 to 3.52), and employed at the time of diagnosis (aOR, 10.72; 95% CI, 7.10 to 16.16) were significantly associated with unemployment. Non-working groups showed significant differences with respect to physical functioning, role functioning, depression, and existential well-being. CONCLUSION: The proportion of unemployed cervical cancer survivors seems to increase, with low-income status and the presence of medical aid negatively being associated with employment, in addition to other comorbidities and previous working status. Effort should be made to secure the financial status of cervical cancer survivors.

Associations between Health Behaviors and Health-Related Quality of Life among Breast Cancer Survivors

PURPOSE: To examine the levels of physical activity (PA) and diet quality, socio-demographic and clinical correlates, and identify associations with health-related quality of life (HRQOL) among breast cancer survivors. METHODS: The study used a cross-sectional study design. A total of 74 breast cancer survivors who had completed their primary cancer therapy were recruited from a comprehensive cancer center in Korea. Measurements used included the International Physical Activity Questionnaire, the Diet Quality Index, and the EORTC QLQ-C30. RESULTS: Only twenty-six women (35.1%) met the American Cancer Society criteria of weekly PA, while most participants (93.2%) displayed good or excellent diet quality. Those less likely to meet the PA criteria were older women, women who had a lower economic level, and women not receiving anti-hormone therapy. However, there was no significant factor associated with diet quality. Women who met the criteria for PA displayed significantly better global QOL than women who did not meet the criteria. No significant differences were found in HRQOL between women who did and did not meet the diet quality criteria. CONCLUSION: Nurses should be aware of breast cancer survivors who are older and who have a low economic status when assessing and screening the level of PA to improve HRQOL.

Public Attitudes toward Development of National Program for Cancer Survivorship / 한국호스피스완화의료학회지

PURPOSE: This study aimed to explore the public attitude toward the development of national health program for cancer survivorship. Based on the results of this survey suggest the necessity of national health program for cancer survivorship. METHODS: We surveyed 1,015 adults who were over 20 years of age from the sixteen cities and local districts of Korea. We conducted a telephone survey with a structured questionnaire on the post-treatment care at the nation and on the permission as the handicapped for cancer. RESULTS: Fifty-six percent of respondents answered that post-treatment program at the national level is very necessary and twenty-seven percent replied that it is necessary. Respondents emphasized 'Expanding insurance coverage for post-treatment care' (29.8%) and 'Systematic education and rehabilitation programs after treatment' (25.6%). This study found that a lower educational level [adjusted odds ratio (aOR)=1.36; 95% confidence interval (CI)=1.04~1.77], earning under 300 per month [aOR=1.36; 95% CI=1.04~1.77], being married (60.2%) [aOR=1.79; 95% CI=1.34~2.37] and thought higher level of cancer treatment in Korea than the advanced (64.4%) [aOR=1.56; 95% CI=1.15~2.12] influenced the positive attitude toward a national health program. Sixty-eight percent of respondents answered 'Strongly agree' or 'agree' to permission for cancer survivors as the handicapped. People who have been married (72.4%) [aOR=1.89; 95% CI=1.41~2.53] and who have had a lower educational level [aOR=1.35; 95% CI=1.03~1.78] responded that they agree more to permission for cancer survivors as the handicapped. CONCLUSION: This study shows the positive public attitude of the public toward the national health program for the cancer survivors.

Charactersitics and issues of guideline to withdrawal of a life-sustaining therapy

Agenerally accepted consensus of end-of-life (EOL) care decision-making did not appear in Korean medical society until the year 2009. To enhance physician's ethical perception of EOL care, consensus guidelines to withdrawing life-sustaining therapies endorsed by Korean Medical Association, Korean Academy of Medical Science, and Korean Hospital Association, were published on October 13, 2009. In this article, the characteristics and issues with the guidelines are presented to improve understanding by physicians who interact with EOL patients. According to the guidelines, physicians should identify, document, respect, and act on hospitals inpatients' needs, priorities, and preferences for EOL care. The guidelines advocate that competent patients express their right of self-determination in EOL care decisions through advance directives. However, there are barriers to adopting advance directives as a legitimate tool of EOL decision-making in our current society. The guidelines stressed the importance of open communication between care-givers and patients or their surrogates. Through communication, physicians can create a plan regarding how to manage EOL until the patients' last day of life. Concerted actions among the general public, professionals, other stake-holders for EOL care, and governmental organizations to improve EOL care in our society are also stipulated. Physicians, who know the clinical meaning of the treatments available to EOL patients, should play a central role based on the consensus guidelines to help patients and their families make informed decisions about EOL care.

A Comparison of Clinical Oncologists and Family Physicians toward Complementary and Alternative Medicine in South Korea: Perceptions, Attitudes and Physician-Patient Communication / 가정의학회지

BACKGROUND: Although, its efficacy is unclear, the application of complementary and alternative medicine (CAM) is increasing among patients worldwide. The physician's role is very important to help patients understand and use CAM properly. The aim of this study is to examine the perceptions, attitudes and physician-patient communication of about CAM in two distinguished specialty physicians. METHODS: A web-based survey was performed to list oncologists and family physicians in Korea between May 2007 and July 2007. E-mails were sent to total of 5,429 physicians and 547 physicians replied on survey (response rate: 10.1%). Of them, 500 participants comprising 174 clinical oncologists and 326 family physicians were involved in this study. The study questionnaire consisted of 26 questions including questions about general characteristics of CAM and intentions of introduction and education to their patients. RESULTS: Of 500 physicians, males were 73.4%, and 82.0% were middle-aged 30-49. Family physicians had more interest than oncologists about CAM (79.5% and 57.5%, respectively). In addition to, family physicians preferred introducing CAM to their patients than oncologists (34.1% and 18.4%, respectively). Almost 85% of the oncologists and family physicians thought that it was necessary to introduce CAM to their patients. However, 60.2% of them had hesitated their practice because 70.3% of them did not have sufficient knowledge in CAM. Both specialty physicians responded that usefulness of CAM information when regarding practice, should contain evidence-based evaluation (59.2%) and consensus guideline (37.0%). CONCLUSION: The results of this study showed that most physicians did not have sufficient information regarding CAM (87.2%). The result implies that evidence based information on complementaryand alternative medicine should be offered in the national level to improve communication between physicians and patients.

A Comparison of Clinical Oncologists and Family Physicians toward Complementary and Alternative Medicine in South Korea: Perceptions, Attitudes and Physician-Patient Communication / 가정의학회지

BACKGROUND: Although, its efficacy is unclear, the application of complementary and alternative medicine (CAM) is increasing among patients worldwide. The physician's role is very important to help patients understand and use CAM properly. The aim of this study is to examine the perceptions, attitudes and physician-patient communication of about CAM in two distinguished specialty physicians. METHODS: A web-based survey was performed to list oncologists and family physicians in Korea between May 2007 and July 2007. E-mails were sent to total of 5,429 physicians and 547 physicians replied on survey (response rate: 10.1%). Of them, 500 participants comprising 174 clinical oncologists and 326 family physicians were involved in this study. The study questionnaire consisted of 26 questions including questions about general characteristics of CAM and intentions of introduction and education to their patients. RESULTS: Of 500 physicians, males were 73.4%, and 82.0% were middle-aged 30-49. Family physicians had more interest than oncologists about CAM (79.5% and 57.5%, respectively). In addition to, family physicians preferred introducing CAM to their patients than oncologists (34.1% and 18.4%, respectively). Almost 85% of the oncologists and family physicians thought that it was necessary to introduce CAM to their patients. However, 60.2% of them had hesitated their practice because 70.3% of them did not have sufficient knowledge in CAM. Both specialty physicians responded that usefulness of CAM information when regarding practice, should contain evidence-based evaluation (59.2%) and consensus guideline (37.0%). CONCLUSION: The results of this study showed that most physicians did not have sufficient information regarding CAM (87.2%). The result implies that evidence based information on complementaryand alternative medicine should be offered in the national level to improve communication between physicians and patients.