Jenny-Ann Brodin Danell

Publication activity in complementary and alternative medicine

In this article we analyse how research on complementary and alternative medicine (CAM) break through into one established scientific arena, namely academic journals. With help from bibliometric methods we analyse publication of CAM articles, in the Medline database, during the period 1966–2007. We also analyse the general content of the articles and in what journals they get published. We conclude that the publication activity of CAM articles increases rapidly, especially in the late 1990s, and that the changing growth rate is not due to the general expansion of Medline. The character of CAM articles has changed towards more clinical oriented research, especially in subfields such as acupuncture and musculoskeletal manipulations. CAM articles are found both in core clinical journals and in specialized CAM journals. Even though a substantial part of the articles are published in CAM journals, we conclude that the increasing publication activity is not restricted to the expansion of these specialized journals.

Reception of integrative and complementary medicine (ICM) in scientific journals: a citation and co-word analysis

Even if integrative and complementary medicine (ICM) is a growing scientific field, it is also a highly contested area in terms of scientific legitimacy. The aim of this article is to analyze the reception of ICM research in scientific journals. Is this kind of research acknowledged outside the ICM context, for example, in general or specialized medicine? What is the impact of ICM research? and Is it possible to identify any shift in content, from the original ICM research to the documents where it is acknowledged? The material consisted of two sets: documents published in 12 ICM journals in 2007; and all documents citing these documents during the years 2007–2012. These sets were analyzed with help from citation and co-word analysis. When analyzing the citation pattern, it was clear that a majority of the cited documents were acknowledged in journals and documents that could be related to research areas outside the ICM context, such as pharmacology & pharmacy and plant science—even if the most frequent singular journals and subject categories were connected to ICM. However, after analyzing the content of cited and citing documents, it was striking how similar the content was. It was also evident that much of this research was related to basic preclinical research, in fields such as cell biology, plant pharmacology, and animal experiments.

Representation and Negotiation of Complementary and Alternative Medicine: A Citation Context Analysis

Complementary and alternative medicine (CAM) is not only increasingly popular and frequently used in Western societies, it is also a growing scientific field. But how are results from clinical CAM studies received and represented by other researchers? This article discusses the migration and representation of three clinical CAM studies, published in high-impact medical journals, analyzed with help from quantitative and qualitative citation context analysis. The results indicate a great variety concerning the migration of results and that this kind of research is subject to different kinds of boundary work, especially concerning biomedical standards and design of the studies.

From disappointment to holistic ideals: a qualitative study on motives and experiences of using complementary and alternative medicine in Sweden

Background Recent studies indicate increased use of complementary and alternative medicine (CAM) in western societies, to ameliorate health problems. Even if there is substantial research on general patterns of use, there is limited knowledge on individual motives. This study contributes to a qualitative understanding of experiences of choosing and using CAM. Design and methods This study consists of in-depth interviews with 10 CAM users in Sweden. The participants represent different backgrounds and experiences of using CAM. The interviews have been analysed in accordance with content analysis. Results In analysing experiences of choosing and using CAM four main themes were identified: frustration and critique, values and ideology, individual responsibility, and combining treatments. In general, the participants were highly reflexive on issues concerning their health. They highlighted their own role and responsibility, combined a variety of treatments, and continuously dealt with questions on risks, even if they had relatively different approaches to if and when to use CAM. The results also show that motives may change over time. Even if initial choices were closely related to frustration and critique of conventional treatments (for example, by perceiving conventional health care as limited, not receiving proper diagnoses, or being critical to conventional drugs) was long-term use motivated by ideological characteristics of CAM (such as holistic and individualized treatments, and extensive interaction with practitioners). Conclusions Four main themes, concerning experiences of choosing and using CAM were identified. This study also supports the idea that initial motives for choosing CAM may differ from those explaining long-term use. Significance for public health Recent studies indicate increased use of complementary and alternative medicine (CAM), both in general western populations and specific patient groups. Well-documented motives for choosing CAM are related to disappointment and failure of conventional health care. In addition, there are findings that demonstrate that certain basic values (such as individualism and holistic orientations) are related to the use of CAM. A better understanding of individual motives behind people’s choice of CAM, and how this is related to their perception of the health care system, is important for policy makers and health care professionals alike. This study contributes to a qualitative understanding of experiences of choosing and using CAM and how motives may change over time. It also contributes with knowledge on how users combine CAM with conventional health care and deal with risks.

Development of scientific publications on acupunctur

During the last couple of decades, the use of acupuncture, in order to treat and relieve different kinds of symptoms and disorders, has increased dramatically in Western societies (e.g., Eisenberg et al., 1993; Harris & Rees 2000; Thomas et al. 2001; Vincent & Furnham, 1996). Together with some other integrative and complementary therapies1, such as osteopathy and chiropractic, acupuncture has evolved from being a rather unusual treatment to a relatively accepted one, and has been integrated in public health sectors. Today, it is often possible to get acupuncture from biomedical professionals, such as doctors and midwives, or visit trained acupuncturists as part of conventional health care, which is covered by general social security systems. Previous studies indicate a rapid increase in research of integrative and complementary medicine in general (Danell & Danell, 2009; Fu et al., 2011) and on acupuncture (Han & Ho, 2011). There are also indications of a growth in evidence-based research, in the form of clinical trials, in sub-fields such as acupuncture and musculoskeletal manipulations (Danell & Danell, 2009), and increased publications in mainstream biomedical journals (Barnes et al., 1996; Fontantarosa, 2001). There has also been notable institutional and financial support for research on integrative and complementary medicine through, for example, the establishment of the National Center for Complementary and Alternative Medicine (a branch of the US National Institute of Health) and associations such as the International Society for Complementary Medicine Research. However, the establishment of integrative and complementary medicine in biomedical contexts is far from uncontroversial. In most Western countries there are both symbolic and institutional divisions between biomedicine on one hand, and alternative/complementary/integrative medicine on the other (e.g., Jutte, 2001). One crucial

Introduction: Reconceptualising Complementary and Alternative Medicine as Knowledge Production and Social Transformation

This introduction proposes new directions for the social science of complementary and alternative medicine (CAM). It firstly reviews trends and gaps in the sociology of CAM, which has largely focussed on issues related to motivations for use, professionalisation struggles, and CAM’s relationship to biomedicine. CAM is more often treated as a signifier of social change than as a set of practices shaped by, and implicated in, epistemic and social transformations. By drawing on approaches from Science and Technology Studies (STS)—including actor-network theory and theories of boundary work, social worlds, co-production, and epistemic cultures—the chapter calls attention to CAM’s contingency, situatedness, materiality, and co-production within various spheres of governance and knowledge production. Such perspectives, it is argued, offer fruitful ways of comprehending what CAM is and how and why it is evolving.

Translation of Complementary and Alternative Medicine in Swedish Politics

In this chapter, the political understanding—or translation—of complementary and alternative medicine (CAM) is analysed within the context of the Swedish parliament. This is achieved with help from an actor network approach, using motions written by parliamentary politicians during the time period 1980–2015. The main findings suggest that there are two types of translations. The first is focused on public health issues in which CAM is presented as a potential contribution to problems such as long-term sick leaves. The second is focused on more specific CAM issues, such as legal constraints and lack of knowledge, which might delimit the use and practice of CAM. In general, the debate is in favour of CAM and is dominated by liberal and conservative parties. It is also dominated by ideals of freedom of choice and free markets, although ideals of social justice also are recurrent. Another finding is that the political understanding of CAM follows scientific and medical norms.