Heather Eastwood

Use of complementary and alternative medicine and quality of life: changes at the end of life.

The purpose of this study was to compare the physical, psychological and social dimensions associated with quality-of-life outcomes over the last year of life, between advanced cancer users and nonusers of complementary and alternative medicine. One hundred and eleven patients were identified through Queensland Cancer Registry records, and followed up every four to six weeks until close to death using standardized protocols. Outcome measures were symptom burden, psychological distress, subjective wellbeing, satisfaction with conventional medicine and need for control over treatment decisions. At the initial interview, 36 (32%) participants had used complementary/alternative medicine the previous week; mainly vitamins, minerals and tonics and herbal remedies. Among all participants, 53 (48%) used at least one form of complementary/alternative medicine over the study period. Only six (11%) visited alternative practitioners on a regular basis. Overall, complementary/alternative medicine users reported higher levels of anxiety and pain, less satisfaction with conventional medicine and lower need for control over treatment decisions compared with nonusers. These differences tend to change as death approaches. A more rigorous assessment of complementary/alternative medicine use, psychological distress, pain and subjective wellbeing among patients with advanced cancer is needed in the clinical setting.

Why are Australian GPs using alternative medicine? Postmodernisation, consumerism and the shift towards holistic health

This paper examines a comprehensive, sociological explanation of the increasing recognition and use of alternative therapies-such as acupuncture—by Australian GPs. Noting the pragmatic motives of clinical legitimacy and market demand, this paper goes on to explore the deeper roots of this phenomenon in a widespread cultural shift often termed postmodernisation. In this instance, this development involves a return to and commodification of nature, spirituality, tradition and pre-modern, often non-Western values and practices. These postmodernising trends are compatible with the holistic health values that underpin alternative therapies. The analytic inductive methodology employed involved the collection of data from 60 health care providers from the Brisbane metropolitan region. This paper, however, draws on only part of the data collected to provide empirical evidence of clinical postmodern encounters of biomedically trained GPs (n=17) who employ alternative medicine in their daily practice.

A comparison of the psychosocial aspects of aids and cancer-related bereavement

Objective: This study compares the psychological symptoms and bereavement distress of individuals bereaved by AIDS with a group bereaved by a cancer death, and addresses the question of whether an AIDS death is associated with a higher rate of adverse psychosocial factors that may increase risk of psychological morbidity in the bereaved individuals. Method: AIDS (n = 28) and cancer (n = 30) bereaved individuals (all within 3 months of the bereavement) completed measures of psychological morbidity and measures addressing a range of other adverse factors, e.g., number of losses, levels of social support and stigma. Results: The cancer and AIDS bereaved were essentially similar on all psychological symptom measures. The AIDS group reported lower levels of social support in response to the bereavement than cancer bereaved individuals; a greater number of bereavements, were more likely to conceal the cause of death from significant others including their own family and perceived, in some instances, a greater level of rejection from others. The AIDS group reported higher levels of social support from friends than from family. Conclusions: At three months following bereavement, AIDS and cancer bereaved were similar in levels of distress. While this may change with the progress of grief over time, it suggests essentially similar early bereavement responses. Those bereaved by AIDS reported a range of other adverse factors such as a greater number of losses, lower social support, stigma, and less open disclosure of the cause of death.

Attitudes and practices of general practitioners in the diagnosis and management of attention-deficit/hyperactivity disorder

Objective:u2003 To assess understanding of, and actual and potential roles in management of attention‐deficit/hyperactivity disorder (ADHD) among GPs.