Araştırma Makalesi
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Traditional and complementary medicine perspectives of family physicians in Istanbul

Yıl 2023, Cilt: 8 Sayı: 1, 16 - 23, 07.02.2023
https://doi.org/10.22391/fppc.1192917

Öz

Introduction: The World Health Organization, within the scope of the Traditional Medicine Strategy for 2014-2023, recommends the development of integrated health policies, particularly in the area of primary healthcare. However, family physicians often report feeling insufficiently trained to effectively integrate these practices into patient care. This study aims to assess the views, understanding, and experiences of family physicians regarding the utilization of Traditional & Complementary Medicine (T&CM).

Methods: The family physicians employed by the Istanbul Health Directorate Public Health Services were solicited to participate in an 18-question online survey to assess their level of education in T&CM methods, their views on integration of T&CM into family medicine, and the impact of these practices on patient care.

Results: A total of 324 family physicians took part in the survey; 12.0% were specialists, 64.5% had worked in primary care for over 10 years, and 59.6% were in the age range of 31-50 years. Among the physicians, the majority (70.1%) reported a preference for integrating T&CM practices with conventional medicine (ConvM). The majority of the participants (71.6%) had no formal T&CM training, and 66.4% reported inquiring about T&CM in their patient consultations. Over half of the physicians (56.79%) believed that T&CM methods should be used in preventive medicine. The most widely recognized T&CM technique was cupping therapy (18.5%), which was also the most frequently recommended method by physicians.

Conclusion: Most of the family physicians who participated in the study expressed a desire for integrative medicine, despite acknowledging limited formal education in this field. Offering physicians training in evidence-based complementary medicine therapies could provide them with additional non-invasive treatment options. However, patients' diffidence to inform their family physicians about T&CM practices they undergo may pose significant risks. As a result, incorporating education on integrative medicine into formal medical education and residency training may be necessary.

Keywords: Family physician, complementary medicine, integrative medicine, traditional medicine

Teşekkür

The authors are thankful to the Istanbul Provincial Health Directorate for providing support for carrying out this research, and all the family physicians for their participation in the study. They are also grateful to Assoc. Prof. Onur Ozturk from Samsun Education and Research Hospital, Turkiye, and Dr. Hammad Khan from the University of California Davis, Department of Psychiatry & Behavioral Sciences, California, USA for their valuable feedback regarding the research paper. The authors would like to express their gratitude to Prof. Mustafa Tozun from the Department of Public Health and Prof. Ferhan Elmali from the Department of Biostatistics in Izmir Katip Celebi University for their insightful comments and consultancy in statistical methods.

Kaynakça

  • 1. Frass M, Strassl RP, Friehs H, Mullner M, Kundi M, Kaye AD. Use and acceptance of complementary and alternative medicine among the general population and medical personnel: A systematic review. Ochsner J. 2012;12(1):45-56. https://pubmed.ncbi.nlm.nih.gov/22438782/
  • 2. Harris PE, Cooper KL, Relton C, Thomas KJ. Prevalence of complementary and alternative medicine (CAM) use by the general population: A systematic review and update. Int J Clin Pract. 2012;66(10):924-39. https://doi.org/10.1111/j.1742-1241.2012.02945.x
  • 3. World Health Organization. Programme on Traditional Medicine. WHO traditional medicine strategy 2002-2005. World Health Organization; 2002. https://apps.who.int/iris/handle/10665/67163 (Access Date: October 24, 2022)
  • 4. Ock SM, Choi JY, Cha YS, Lee JB, Chun MS, Huh CH, et al. The use of complementary and alternative medicine in a general population in South Korea: Results from a national survey in 2006. J Korean Med Sci. 2009;24(1):1-6. https://doi.org/10.3346/jkms.2009.24.1.1
  • 5. Peltzer K, Pengpid S. Prevalence and determinants of traditional, complementary and alternative medicine provider use among adults from 32 countries. Chin J Integr Med. 2018;24(8):584-90. https://doi.org/10.1007/s11655-016-2748-y
  • 6. Posadzki P, Watson LK, Alotaibi A, Ernst E. Prevalence of use of complementary and alternative medicine (cam) by patients/consumers in the UK: Systematic review of surveys. Clin Med J Royal College Physicians London. 2013;13(2):126-31. https://doi.org/10.7861/clinmedicine.13-2-126
  • 7. Fjær EL, Landet ER, McNamara CL, Eikemo TA. The use of complementary and alternative medicine (CAM) in Europe. BMC Complement Med Ther. 2020;20(1):108. https://doi.org/10.1186/s12906-020-02903-w
  • 8. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States. 2007. Natl Health Stat Report. 2009;(12):1-23. https://doi.org/10.1037/e623942009-001
  • 9. Ng JY, Garber A, Luong M, Cooley K, Busse JW. No improvement in disclosure of natural health product use to primary care medical doctors in the last 15 years: A survey of naturopathic patients. Complement Ther Clin Pract. 2020;39:101106. https://doi.org/10.1016/j.ctcp.2020.101106
  • 10. Trail-Mahan T, Mao CL, Bawel-Brinkley K. Complementary and alternative medicine: Nurses’ attitudes and knowledge. Pain Management Nursing. 2013;14(4):277-86. https://doi.org/10.1016/j.pmn.2011.06.001
  • 11. Hall H, Brosnan C, Cant R, Collins M, Leach M. Nurses’ attitudes and behaviour towards patients’ use of complementary therapies: A mixed methods study. J Adv Nurs. 2018;74(7):1649-58. https://doi.org/10.1111/jan.13554
  • 12. Ben-Arye E, Frenkel M, Klein A, Scharf M. Attitudes toward integration of complementary and alternative medicine in primary care: Perspectives of patients. physicians and complementary practitioners. Patient Educ Couns. 2008;70(3):395-402. https://doi.org/10.1016/j.pec.2007.11.019
  • 13. Karahanci ON, Oztoprak UY, Ersoy M, Zeybek Unsal C, Hayirlidag M, Ornek Buken N. Comparison of traditional, complementary medicine draft regulations and regulations. Turk J Bioethics. 2015;2(2):117-26. https://doi.org/10.5505/tjob.2015.85856
  • 14. World Health Assembly. WHO Traditional Medicine Strategy: 2014-2023. World Health Organization; 2013. http://www.who.int/medicines/publications/traditional/trm_strategy14_23/en/ (Access Date: October 24, 2022)
  • 15. Joos S, Musselmann B, Szecsenyi J. Integration of complementary and alternative medicine into family practices in Germany: Results of a national survey. Evid Based Complement Alternat Med. 2011;2011:495813. https://doi.org/10.1093/ecam/nep019
  • 16. Berretta M, Rinaldi L, Taibi R, Tralongo P, Fulvi A, Montesarchio V, et al. Physician Attitudes and Perceptions of Complementary and Alternative Medicine (CAM): A Multicentre Italian Study. Front Oncol. 2020;10:594. https://doi.org/10.3389/fonc.2020.00594
  • 17. Furlow ML, Patel DA, Sen A, Liu JR. Physician and patient attitudes towards complementary and alternative medicine in obstetrics and gynecology. BMC Complement Altern Med. 2008;8:35. https://doi.org/10.1186/1472-6882-8-35
  • 18. Lipman L, Dale J, MacPherson H. Attitudes of GPs towards the provision of acupuncture on the NHS. Complement Ther Med. 2003;11(2):110-4. https://doi.org/10.1016/S0965-2299(03)00042-6
  • 19. Perkin MR, Pearcy RM, Fraser JS. A comparison of the attitudes shown by general practitioners. hospital doctors and medical students towards alternative medicine. J R Soc Med. 1994;87(9):523-5. https://doi.org/10.1177/014107689408700914
  • 20. White AR, Resch KL, Ernst E. Complementary medicine: Use and attitudes among GPs. Fam Pract. 1997;14(4):302-6. https://doi.org/10.1093/fampra/14.4.302
  • 21. Berman BM, Bausell RB, Lee WL. Use and referral patterns for 22 complementary and alternative medical therapies by members of the American College of Rheumatology: Results of a national survey. Arch Intern Med. 2002;162(7):766-70. https://doi.org/10.1001/archinte.162.7.766
  • 22. Fountain-Polley S, Kawai G, Goldstein A, Ninan T. Knowledge and exposure to complementary and alternative medicine in paediatric doctors: A questionnaire survey. BMC Complement Altern Med. 2007;7:38. https://doi.org/10.1186/1472-6882-7-38
  • 23. Tozun M, Kucukkefe Bag H, Pektas M, Soyacikgoz E, Tekindal MA. Knowledge. Attitudes. and Opinions of Health Professionals and Students on Traditional and Complementary Medicine Practices in Turkey: A Systematic Review and Meta-Analysis. EUR J ENV PUBLIC HLT. 2022;6(2):em0115. https://doi.org/10.21601/ejeph/12186

İstanbul’daki aile hekimlerinin geleneksel ve tamamlayıcı tıp bakış açıları

Yıl 2023, Cilt: 8 Sayı: 1, 16 - 23, 07.02.2023
https://doi.org/10.22391/fppc.1192917

Öz

Giriş: Dünya Sağlık Örgütü, 2014-2023 Geleneksel Tıp Stratejisi kapsamında, özellikle birinci basamak sağlık hizmetleri alanında entegre sağlık politikaları geliştirilmesini tavsiye etmektedir. Öte yandan, aile hekimleri genellikle bu uygulamaları hasta bakımına etkili bir şekilde entegre etmek için yetersiz eğitim aldıklarını hissettiklerini bildirmektedir. Bu çalışma, aile hekimlerinin Geleneksel ve Tamamlayıcı Tıp (GETAT) kullanımına ilişkin görüş, anlayış ve deneyimlerini değerlendirmeyi amaçlamaktadır.

Yöntem: İstanbul Sağlık Müdürlüğü Halk Sağlığı Hizmetleri’ne bağlı görev yapan aile hekimlerine 18 soruluk çevrimiçi bir anket uygulanarak GETAT yöntemleri konusundaki eğitim düzeyleri, GETAT uygulamalarının aile hekimliğine entegrasyonu ve hasta bakımı üzerine etkileri gibi konularla ilgili görüşleri değerlendirilmiştir.

Bulgular: Ankete toplam 324 aile hekimi katılmıştır; bunların %12,0'si uzman, %64,5'i 10 yıldan fazla birinci basamakta çalışmış ve %59,6'sı 31-50 yaş aralığındaydı. Hekimlerin %70,1'i GETAT uygulamalarının konvansiyonel tıp ile entegre edilmesini tercih ettiğini bildirdi. Katılımcıların büyük çoğunluğu (%71,6) formal bir GETAT eğitimi almamıştı ve %66,4'ü hasta konsültasyonlarında GETAT hakkında sorular sorduğunu bildirmiştir. Hekimlerin yarısından fazlası (%56,79) koruyucu hekimlikte GETAT yöntemlerinin kullanılması gerektiğine inanmaktadır. En çok tanınan T&CM tekniği, hekimler tarafından da en sık önerilen yöntem olan kupa tedavisi (%18,5) idi.

Sonuç: Çalışmaya katılan aile hekimlerinin çoğu, bu alandaki örgün eğitimlerinin sınırlı olduğunu kabul etmelerine rağmen, entegratif tıbba ilgi duyduklarını belirtmişlerdir. Kanıta dayalı tamamlayıcı tıp terapileri konusunda doktorlara eğitim vermek, onlara invaziv olmayan ek tedavi seçenekleri sağlayabilir. Öte yandan, hastaların başvurdukları GETAT uygulamaları hakkında aile hekimlerine bilgi verme konusundaki çekinceleri önemli riskler oluşturabilir. Sonuç olarak, tamamlayıcı tıp eğitimini resmi tıp eğitimi ve uzmanlık eğitimi ile birleştirmek gerekli olabilir.

Anahtar kelimeler: Aile hekimliği, tamamlayıcı tıp, entegratif tıp, geleneksel tıp

Kaynakça

  • 1. Frass M, Strassl RP, Friehs H, Mullner M, Kundi M, Kaye AD. Use and acceptance of complementary and alternative medicine among the general population and medical personnel: A systematic review. Ochsner J. 2012;12(1):45-56. https://pubmed.ncbi.nlm.nih.gov/22438782/
  • 2. Harris PE, Cooper KL, Relton C, Thomas KJ. Prevalence of complementary and alternative medicine (CAM) use by the general population: A systematic review and update. Int J Clin Pract. 2012;66(10):924-39. https://doi.org/10.1111/j.1742-1241.2012.02945.x
  • 3. World Health Organization. Programme on Traditional Medicine. WHO traditional medicine strategy 2002-2005. World Health Organization; 2002. https://apps.who.int/iris/handle/10665/67163 (Access Date: October 24, 2022)
  • 4. Ock SM, Choi JY, Cha YS, Lee JB, Chun MS, Huh CH, et al. The use of complementary and alternative medicine in a general population in South Korea: Results from a national survey in 2006. J Korean Med Sci. 2009;24(1):1-6. https://doi.org/10.3346/jkms.2009.24.1.1
  • 5. Peltzer K, Pengpid S. Prevalence and determinants of traditional, complementary and alternative medicine provider use among adults from 32 countries. Chin J Integr Med. 2018;24(8):584-90. https://doi.org/10.1007/s11655-016-2748-y
  • 6. Posadzki P, Watson LK, Alotaibi A, Ernst E. Prevalence of use of complementary and alternative medicine (cam) by patients/consumers in the UK: Systematic review of surveys. Clin Med J Royal College Physicians London. 2013;13(2):126-31. https://doi.org/10.7861/clinmedicine.13-2-126
  • 7. Fjær EL, Landet ER, McNamara CL, Eikemo TA. The use of complementary and alternative medicine (CAM) in Europe. BMC Complement Med Ther. 2020;20(1):108. https://doi.org/10.1186/s12906-020-02903-w
  • 8. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States. 2007. Natl Health Stat Report. 2009;(12):1-23. https://doi.org/10.1037/e623942009-001
  • 9. Ng JY, Garber A, Luong M, Cooley K, Busse JW. No improvement in disclosure of natural health product use to primary care medical doctors in the last 15 years: A survey of naturopathic patients. Complement Ther Clin Pract. 2020;39:101106. https://doi.org/10.1016/j.ctcp.2020.101106
  • 10. Trail-Mahan T, Mao CL, Bawel-Brinkley K. Complementary and alternative medicine: Nurses’ attitudes and knowledge. Pain Management Nursing. 2013;14(4):277-86. https://doi.org/10.1016/j.pmn.2011.06.001
  • 11. Hall H, Brosnan C, Cant R, Collins M, Leach M. Nurses’ attitudes and behaviour towards patients’ use of complementary therapies: A mixed methods study. J Adv Nurs. 2018;74(7):1649-58. https://doi.org/10.1111/jan.13554
  • 12. Ben-Arye E, Frenkel M, Klein A, Scharf M. Attitudes toward integration of complementary and alternative medicine in primary care: Perspectives of patients. physicians and complementary practitioners. Patient Educ Couns. 2008;70(3):395-402. https://doi.org/10.1016/j.pec.2007.11.019
  • 13. Karahanci ON, Oztoprak UY, Ersoy M, Zeybek Unsal C, Hayirlidag M, Ornek Buken N. Comparison of traditional, complementary medicine draft regulations and regulations. Turk J Bioethics. 2015;2(2):117-26. https://doi.org/10.5505/tjob.2015.85856
  • 14. World Health Assembly. WHO Traditional Medicine Strategy: 2014-2023. World Health Organization; 2013. http://www.who.int/medicines/publications/traditional/trm_strategy14_23/en/ (Access Date: October 24, 2022)
  • 15. Joos S, Musselmann B, Szecsenyi J. Integration of complementary and alternative medicine into family practices in Germany: Results of a national survey. Evid Based Complement Alternat Med. 2011;2011:495813. https://doi.org/10.1093/ecam/nep019
  • 16. Berretta M, Rinaldi L, Taibi R, Tralongo P, Fulvi A, Montesarchio V, et al. Physician Attitudes and Perceptions of Complementary and Alternative Medicine (CAM): A Multicentre Italian Study. Front Oncol. 2020;10:594. https://doi.org/10.3389/fonc.2020.00594
  • 17. Furlow ML, Patel DA, Sen A, Liu JR. Physician and patient attitudes towards complementary and alternative medicine in obstetrics and gynecology. BMC Complement Altern Med. 2008;8:35. https://doi.org/10.1186/1472-6882-8-35
  • 18. Lipman L, Dale J, MacPherson H. Attitudes of GPs towards the provision of acupuncture on the NHS. Complement Ther Med. 2003;11(2):110-4. https://doi.org/10.1016/S0965-2299(03)00042-6
  • 19. Perkin MR, Pearcy RM, Fraser JS. A comparison of the attitudes shown by general practitioners. hospital doctors and medical students towards alternative medicine. J R Soc Med. 1994;87(9):523-5. https://doi.org/10.1177/014107689408700914
  • 20. White AR, Resch KL, Ernst E. Complementary medicine: Use and attitudes among GPs. Fam Pract. 1997;14(4):302-6. https://doi.org/10.1093/fampra/14.4.302
  • 21. Berman BM, Bausell RB, Lee WL. Use and referral patterns for 22 complementary and alternative medical therapies by members of the American College of Rheumatology: Results of a national survey. Arch Intern Med. 2002;162(7):766-70. https://doi.org/10.1001/archinte.162.7.766
  • 22. Fountain-Polley S, Kawai G, Goldstein A, Ninan T. Knowledge and exposure to complementary and alternative medicine in paediatric doctors: A questionnaire survey. BMC Complement Altern Med. 2007;7:38. https://doi.org/10.1186/1472-6882-7-38
  • 23. Tozun M, Kucukkefe Bag H, Pektas M, Soyacikgoz E, Tekindal MA. Knowledge. Attitudes. and Opinions of Health Professionals and Students on Traditional and Complementary Medicine Practices in Turkey: A Systematic Review and Meta-Analysis. EUR J ENV PUBLIC HLT. 2022;6(2):em0115. https://doi.org/10.21601/ejeph/12186
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi (Original Article)
Yazarlar

Ali Timucin Atayoglu 0000-0003-4568-4234

Mahmut Tokaç 0000-0002-3051-0074

Sibel Doğan 0000-0003-4026-1419

Abdullah Güner 0000-0001-8624-4468

Erdoğan Kocayiğit 0000-0001-7197-9410

Muharrem Güner 0000-0002-4468-5254

Yayımlanma Tarihi 7 Şubat 2023
Gönderilme Tarihi 21 Ekim 2022
Kabul Tarihi 27 Aralık 2022
Yayımlandığı Sayı Yıl 2023Cilt: 8 Sayı: 1

Kaynak Göster

APA Atayoglu, A. T., Tokaç, M., Doğan, S., Güner, A., vd. (2023). Traditional and complementary medicine perspectives of family physicians in Istanbul. Family Practice and Palliative Care, 8(1), 16-23. https://doi.org/10.22391/fppc.1192917
AMA Atayoglu AT, Tokaç M, Doğan S, Güner A, Kocayiğit E, Güner M. Traditional and complementary medicine perspectives of family physicians in Istanbul. Fam Pract Palliat Care. Şubat 2023;8(1):16-23. doi:10.22391/fppc.1192917
Chicago Atayoglu, Ali Timucin, Mahmut Tokaç, Sibel Doğan, Abdullah Güner, Erdoğan Kocayiğit, ve Muharrem Güner. “Traditional and Complementary Medicine Perspectives of Family Physicians in Istanbul”. Family Practice and Palliative Care 8, sy. 1 (Şubat 2023): 16-23. https://doi.org/10.22391/fppc.1192917.
EndNote Atayoglu AT, Tokaç M, Doğan S, Güner A, Kocayiğit E, Güner M (01 Şubat 2023) Traditional and complementary medicine perspectives of family physicians in Istanbul. Family Practice and Palliative Care 8 1 16–23.
IEEE A. T. Atayoglu, M. Tokaç, S. Doğan, A. Güner, E. Kocayiğit, ve M. Güner, “Traditional and complementary medicine perspectives of family physicians in Istanbul”, Fam Pract Palliat Care, c. 8, sy. 1, ss. 16–23, 2023, doi: 10.22391/fppc.1192917.
ISNAD Atayoglu, Ali Timucin vd. “Traditional and Complementary Medicine Perspectives of Family Physicians in Istanbul”. Family Practice and Palliative Care 8/1 (Şubat 2023), 16-23. https://doi.org/10.22391/fppc.1192917.
JAMA Atayoglu AT, Tokaç M, Doğan S, Güner A, Kocayiğit E, Güner M. Traditional and complementary medicine perspectives of family physicians in Istanbul. Fam Pract Palliat Care. 2023;8:16–23.
MLA Atayoglu, Ali Timucin vd. “Traditional and Complementary Medicine Perspectives of Family Physicians in Istanbul”. Family Practice and Palliative Care, c. 8, sy. 1, 2023, ss. 16-23, doi:10.22391/fppc.1192917.
Vancouver Atayoglu AT, Tokaç M, Doğan S, Güner A, Kocayiğit E, Güner M. Traditional and complementary medicine perspectives of family physicians in Istanbul. Fam Pract Palliat Care. 2023;8(1):16-23.

Family Practice and Palliative Care      ISSN 2458-8865       E-ISSN 2459-1505