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Factors Involved in Decision Making

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Title: Factors Involved in Decision Making


1
Factors Involved in Decision Making
  • Complementary Therapies and Rheumatoid Arthritis

Merilee Brockway
2
Background
3
Rheumatoid Arthritis (RA)
  • A chronic, systemic illness
  • Treated symptomatically
  • Affects 0.3 - 1.5 of population
  • Affects all aspects of bio-psycho-social
    wellness spectrum
  • Patients are often experts in their illness and
    are very active in their health care regimen
  • Many pursue CAM

4
Complementary Therapy
  • 20-30 of Canadians use CAM (17 of which
    are people with RA)
  • lt40 inform their primary physician
  • Very few studies on WHY people choose to use
    CAM

5
Complementary / Alternative Medicine
(CAM)
Medical practice that does not conform to the
standards of the medical community, that is not
taught widely at North American medical schools
and that is generally unavailable at North
American hospitals (Verhoef Sutherland, 1995)
6
Research Questions
  • What leads RA sufferers to pursue or
    not to pursue alternative therapies?
  • What factors contribute to their decision?
  • What information sources do these individuals
    use in their decision making process?

7
Purpose
  • To examine which factors patients with RA take
    into account when making decisions about whether
    or not to use alternative therapies and their
    reasons for choice.

8
Method
9
Design
  • A qualitative descriptive study, based on
    participants experiences with decision making
    regarding use of alternative or complementary
    therapies.

10
Participant Recruitment
  • Placement of posters in the office of the
    Arthritis Society
  • Attendance at support group meetings for
    arthritis sufferers
  • Word of mouth through the
  • arthritis community

11
Sample
  • Eleven participants - 10 female, 1male
  • Caucasian
  • Mid 30s to late 60s
  • High school - University degree
  • RA diagnoses for 4 - 37 years

12
Data Collection
Semi-structured face-to-face interviews, 30
minutes - 1 hour in duration, were conducted
using open questioning with direct probes used as
necessary. Interviews were tape recorded and
transcribed.
13
Data Analysis
  • Transcribed text was
  • Submitted to standard
  • content analysis
  • Divided into units of meaning
  • Categorized
  • Grouped into thematic descriptions

14
Findings
15
Themes
  • Desperation
  • Empowerment
  • Legitimization / Integration

16
Desperation
  • Somebody do anything for me, please. Just stop
    the pain.

You get to a point where youll try anything
cause it might be the one that might work
I was pretty desperate, I was looking for
anything - any sort of relief from the pain
17
Empowerment
I would prefer to treat my body with respect
It really appeals to me to keep treating my
system in a natural way.
Im enjoying the fact that Im involving my own
self and using discovery in my own wellness
journey
  • Were too dependent sometimes on ...
    conventional medicine which doesnt work in all
    cases

18
Integration / Legitimization
  • I wish that the healthcare system would
    incorporate alternative approaches as well as
    mainstream together

The other issue is of course money. My Enbrel
is 100 covered and homeopathy is 0.
19
Resources Accessed
20
Implications
21
Significance to Nursing
  • Improved understanding of patient perspectives
    experience
  • Facilitate more effective patient teaching
  • Guide practice in primary,secondary and
    tertiary care settings

22
Thank You
  • Questions?

23
References
  • Allen, M., Oberle, K., Grace, M. Russell, A.
    (2002). Elk velvet antler in rheumatoid
    arthritis Phase II trial. Biological Research
    for Nursing. 3(3), 111-118.
  • Astin, J. A. (1998). Holistic health Alternative
    methods and patient choice. American Journal of
    Nursing. 98(9), 9
  • Burns, N. and Grove, S.K. (2001). The practice
    of nursing research Conduct, critique and
    utilization. 4th ed. Saunders, Philadelphia.
  • Chan, H. K. (2002). The utilization and reasons
    of choice for Chinese or western medicine among
    rheumatoid arthritis patients in Hong Kong. Hong
    Kong Nursing Journal. 3(3), 7-16
  • Eisenburg, D.M. et al (1998) Trends in
    alternative medicine use in the United States
    1990-1997. JAMA 290 1596-1575.
  • Kanning, M. (1999). Why would I want to use
    complementary and alternative therapy A
    patients perspective. Rheumatic Disease Clinics
    of North America. 25(4), 823-831
  • Mason, J. (2002). Qualitative Researching (2nd
    ed.). Sage. London
  • Millar, W. J. (1997). Use of alternative health
    care practitioners by Canadians. Canadian
    Journal of Public Health. 88(3), 154-158.
  • Porth, C.M. (2002). Pathophysiology Concepts of
    Altered Disease States. Philadelphia Lippincott
  • Sandelowski, M. (2000). Focus on research
    methods Whatever happened to qualitative
    description. Research in Nursing Health. 23,
    334-340
  • Verhoef, M.J. and Sutherland, L.R. (1995).
    General practitioners assessment of and
    interest in alternative medicine in Canada.
    Social Science Medicine. 41(4), 511-515.
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