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Complementary and Alternative Medicine Use in Gynecologic Cancer Patients. Amornrat Supoken, MD Thitima Chaisrisawadsuk, MD Bandit Chumworathayi, MD Department of Obstetrics and Gynecology Faculty of Medicine, Khon Kaen University. Introduction. In Thailand
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Complementary and Alternative Medicine Use in Gynecologic Cancer Patients Amornrat Supoken, MD Thitima Chaisrisawadsuk, MD Bandit Chumworathayi, MD Department of Obstetrics and Gynecology Faculty of Medicine, Khon Kaen University
Introduction • In Thailand • Cancer is the third highest cause of death.1 • Gynecologic cancer is the most commoncancer in women.2 1.Ministry of Public Health, 1996; Hangsubcharoen, 1996 2.National Cancer Institute of Thailand, 1994
Introduction • Gynecologic cancer is associated with • a high morbidity & mortality rate • a significant decrease in quality of life Ronald. New Jersey:Parthenose Publishing Group; 1990
Introduction • Complementary and alternative medicine (CAM) • a group of diverse medical and health care systems, practices, and products that are notgenerally considered part of conventional medicine. The National Center for Complementary and Alternative Medicine, 2009.
Introduction The use of CAM is widespread all over the world. Adams M, Jewell AP. Int Semin Surg Oncol; 2007
Introduction • There is emerging evidence to support that quality of life and general well-being is improved in gynecologic cancer patients who use CAM. Adams M, Jewell AP. Int Semin Surg Oncol; 2007
Introduction • In the Northeast of Thailand where many features of population are different from other parts .
Introduction • There is no study regarding CAM use in Northeastern part of Thailand.
Design and Objective • Design • Descriptive analytical study • Objective • To determine the proportion, types and associated factors of CAM use in gynecologic cancerpatients who attend Srinagarind Hospital.
Subjects and Methods • Inclusion criteria • Gynecologic cancer patients • > 20 year-old • Able to give their informed consent • >1-month of diagnosis • Exclusion criteria • Use CAM for other reasons
Subjects and Methods After IRB approval in September, 2008 Cross-sectional survey between October to December, 2008 Inclusion criteria gynecologic cancer patients > 1-month of diagnosis >20 year-old able to give their informed consent Exclusion criteria Use CAM for other reasons 50 admitted and 50 walk-in gynecologic cancer Collect data by one-by-one interview Demographic data, Type of CAM
Operational definition Acupuncture Aromatherapy Biofeedback Homeopathy Hypnotherapy Yoga Massage Naturopathy Nutritional supplements Relaxation therapy Spiritual healing Subjects and Methods
Statistical analysis • Descriptive data • Mean + SD • Percentage • Comparative statistics • t-test for continuous data • Fisher’s exact test for categorical data • Z-test for difference for proportions
Results Characteristics of the included participants
Results Characteristics of the included participants
Results • The proportion of CAM use was 67% (57.8-76.2%) • The types of CAM were (N=67)
Results • The associated factors
Results • The associated factors
Discussion • CAM use in our study is very common up to 67%. • The most common type of CAM use is Buddhist praying. • The associated factors were stages and chemotherapy.
Discussion • Vasuratna et al., 2008 • The most popular CAMs used were foods and dietary supplements (45.1%) followed by herbs (37.8%). Vasuratna et al. Poster presented in IGCS;2008
Discussion • The associated factors from other studies • Western country1 • Lower age • Higher education level • Regular exercise • Social class • Asian country2 • Age • Advanced stage • Higher educationlevel Lee MM, et al. American Journal of Public Health; 2006.1 Kay S, et al. The Journal of Alternative and Complementary Medicine; 2008.2
Discussion • Vasuratna et al., 2008 • The statistically significant factors associated with CAM • Education (p=0.014) • Financial status (p=0.027) • Occupation (p=0.003) • * Stage of diseases (p<0.001) • * Chemotherapy treatment (p<0.001) • The last two factors were also found in our study. Vasuratna et al. Poster presented in IGCS;2008
Discussion • The possible explanation is the difference in race, religion and cultural context.
Discussion • This is the first study regarding proportion and type of CAM use in gynecologic cancer patients in Northeastern, Thailand.
Discussion • The primary objective was to determine the proportion of CAM use. • The sample size calculation was based on the primary objective. • This may result in inadequate sample size to give accurate assessment of the associated factors.
Discussion • Our results show a high proportion of CAM use. • The effect of CAM use is needed for further research with regard to the benefits and risks.
Acknowledgement • Thitima Chaisrisawadsuk, MD • Assoc.Prof. Bandit Chumworathayi, MD • Assoc.Prof. Woraluk Somboonporn, MD
Thank you for your attention