Why do chronic illness patients decide to use complementary and alternative medicine? A qualitative study.

BACKGROUND AND PURPOSE: A substantial proportion of European and American people now use healthcare options known as complementary and alternative medicine (CAM). This study aimed to understand the processes and decisional pathways through which chronic illness patients choose treatments outside of regular allopathic medicine. MATERIALS AND METHODS: This qualitative study used Charmaz's constructivist grounded theory methods to collect and analyze data. Using theoretical sampling, 21 individuals suffering from chronic illness and who had used CAM treatment participated in face-to-face in-depth interviews conducted in Miami/USA. RESULTS: Seven overarching themes emerged from the data to describe how and why people with chronic illness choose CAM treatments. These themes included 1) influences, 2) desperation, 3) being averse to allopathic medicine and allopathic medical practice, 4) curiosity and chance, 5) ease of access, 6) institutional help, and 7) trial and error. CONCLUSION: In selecting treatment options that include CAM, individuals draw on their social, economic, and biographical situations. Though exploratory, this study sheds light on some of the less examined reasons for CAM use.

Healthworlds, Cultural Health Toolkits, and Choice: How Acculturation Affects Patients' Views of Prescription Drugs and Prescription Drug Advertising.

How do minorities differ from Whites in their interactions with the broader consumeristic health culture in the United States? We explore this question by investigating the role that acculturation plays in minority and White patients' views of prescription drugs and the direct-to-consumer advertising (DTCA) of prescription drugs. Drawing on data from six race-based focus groups, we find that patients' views of prescription drugs affect their responses to DTCA. While both minorities and Whites value the information they receive from DTCA, level of acculturation predicts how minorities use the information they receive from DTCA. Less acculturated minorities have healthworlds and cultural health toolkits that are not narrowly focused on prescription drugs. This results in skepticism on the part of less acculturated minorities toward pharmaceuticals as treatment options. In this article, we argue that researchers must consider the role acculturation plays in explaining patients' health dispositions and their consumeristic health orientations.

A qualitative analysis of the naming process of complementary and alternative medicine by chronically ill patients.

OBJECTIVES: A chronic illness/condition typically generates some disturbance in people. In the context of this turmoil, some individuals might make a choice to use healing options outside of regular allopathic medicine. This study is an attempt to understand the processes through which health practices/healing options get named as Complementary and Alternative Medicine (CAM) by chronic illness patients. DESIGN AND SETTING: This study used a grounded theory methodology to collect and analyze data. Following the principles of theoretical sampling, in-depth face to face interviews were conducted with a total of 21 individuals with varied chronic illnesses/conditions residing in Miami. The study sample constituted of 16 women and 5 men, belonging to different ethnicities and using varied health practices and healing options. FINDINGS: Through the findings it is suggested, that there is nothing definite about the definition of CAM. Individuals name and rename activities and health practices as CAM based on their perceptions and the way they approach such health practices/healing options. The naming process of CAM is contextual and even food and activities or pastimes can get named as CAM if they hold meaning for a person. CONCLUSION: Research in the US continually shows that CAM is widely used, but what actually constitutes CAM differs based on whom you ask. Whether what can be named as CAM should be circumscribed or left open is a debate that has policy implications and needs to be explored by future researchers.

Beyond unequal access: Acculturation, race, and resistance to pharmaceuticalization in the United States.

Trends toward pharmaceuticalization in Western countries have led to increased research and theorizing about the roles macro-level institutions, structures, and collective actors play in contributing to patients' reliance on prescription drugs. Relatively less work has focused on the degree to which patients resist pharmaceuticalization pressures, and even less research has explored the factors contributing to patients' resistance to pharmaceuticalization. Drawing on focus groups with patients who had been recently prescribed a prescription drug, this paper investigates how marginalization in the mainstream US society, as measured by acculturation and race, contributes to differences in patients' subjective experiences and responses to prescription drugs. We find that racial minorities report a greater skepticism of prescription drugs compared to whites and express that they turn to prescription drugs as a last resort. While highly acculturated participants rarely discuss alternatives to prescription drugs, less acculturated racial minorities indicate a preference for complementary and alternative remedies. We draw on the literatures on the pharmaceuticalization of society and the social nature of medicine to examine the role marginalization plays in patients' views of prescription drugs. Public health research conceives of racial minorities' lower rates of prescription drug usage compared to whites as primarily a problem of lack of access. Our results suggest another piece to the puzzle: minorities resist pharmaceuticalization pressures to express their cultural and racial identities.