The aim of this doctoral research was to explore CAM use in pregnancy from the perspectives of pregnant women and health professionals. The research was conducted in four phases: a systematic review of the published literature from 2008-2012; cross sectional surveys of two cohorts of women during the first and last trimester; and a cross sectional survey of health professionals (midwives, obstetricians, anaesthetists) at Aberdeen Maternity Hospital. The systematic review reported a significant proportion of women used CAM during pregnancy with prevalence rates ranging from 5.8% to 74.2%. The study of health professionals identified that more than 30% of respondents have prescribed, referred or advised the use of CAM to pregnant women. The main associated factor for CAM use was, 'personal use of CAM', with an odds ratio of 8.26 (95% CI 3.09–22.05; P < 0.001). Two thirds of women (63%) reported using CAM, excluding vitamins and minerals, during early pregnancy. The independent predictors of CAM use identified were: use by family and friends (OR 4.1, 95% CI 2.3–7.3, p < 0.001); ethnicity (non-white British) (OR 3.4, 95% CI 1.8–6.8, p < 0.001); and use prior to pregnancy (OR 2.4, 95% CI 1.2–4.8, p = 0.014). Two thirds of women (61.4%) reported using CAM, excluding vitamins and minerals, during the third trimester. The independent associated factors for CAM medicine use identified were: CAM use before pregnancy (odds ratio [OR] 4.36, 95% confidence interval [CI] 2.39–7.95, P<0.001); a university education (OR 2.41, 95% CI 1.46–4.0, P<0.001), and CAM use by family or friends (OR 2.36, 95% CI 1.61–3.47,P<0.001). The lack of an evidence based approach together with the reliance on the advice of family and friends is of concern given the lack of robust data of efficacy and safety. To date, four peer reviewed papers from this doctoral research have been published.

<p> This paper explores trauma as a continuum and how various forms of trauma can be treated with mindfulness and somatic psychotherapy modalities. Ten modalities are discussed through hermeneutic, heuristic, and intuitive inquiry research methods: mindful breathing; mindfulness-based stress reduction (MBSR); emotional freedom techniques (EFT) and energy psychology; eye movement desensitization and reprocessing (EMDR) and attachment focused EMDR; Hakomi mindfulness-centered psychotherapy; sensorimotor psychotherapy; somatic experiencing; acupuncture, Soma Neuromuscular Integration&reg; bodywork, and authentic movement. Unique to this thesis is the approach to somatically releasing trauma using an acronym framework created by the author, conceptualized as Safety, Trust, Acceptance, Belonging, Love, Earth, and Ecopsychology (STABLE&copy;). Adding a depth psychotherapy perspective, the myth of Inanna is offered as an allegory to enrich the practice of co-regulating patients as they work through their trauma narratives. Recognizing nature as an essential component to healing the wounds of the soul adds an ecopsychological and wilderness therapy perspective.</p>

In American society, where the biomedical profession is institutionalized and its therapies dominate health care, a decision to deviate from prevailing norms can be considered remarkable. Yet research done by Eisenberg et al. (1993) found that unconventional or alternative medicine had an "enormous presence" in U.S. health care and that one in three persons had utilized an unconventional therapy in 1990. The objective of this thesis was to explore this phenomenon. Individuals who had used alternative and biomedical intervention to treat a disorder were recruited through practitioners of alternative therapies. Through semi-structured interviews, case histories focusing on the illness trajectory and treatment choices were obtained. These were analyzed following a method outlined by Glaser and Strauss (1967) for generating grounded theory. The specific purpose of this study was to examine the case histories for a basic social process and to identify key variables which influenced the utilization of both a biomedical and alternative intervention. It was the position of this thesis that treatment responses involved more than the decision to accept or decline a specific therapy. Rather, choices were made by social actors embedded within unique social worlds which were differentiated by social variables (e.g., culture, ethnicity, social class) particular to the individual (see, among others, Brown 1989, Fitzpatrick 1989, Freund and McGuire 1991, Gerhardt 1989, Kleinman 1988, Mumford 1983). Treatment decisions were made within a framework of internalized patterns of interpretation and meaning, dynamically influenced by ongoing interactional and relational patterns; an individual's treatment response could be conceptualized as an emergent, multi-phased process (Pescosolido 1992). Analysis of respondents' case histories supported the notion of a dynamic response process. Individuals described an evolving illness trajectory directed at achieving a desired state of wellness. Disparities between treatment outcomes and the desired goal prompted an evaluation and choice-making process. All respondents had developed a health care conceptualization in which biomedical and alternative therapies were either categorized as effective for specific conditions or occupied a particular place on a health care continuum, thereby perceiving a scope of treatment options beyond those available within biomedicine.

This thesis investigates the moral content of illness ontologies in different healing systems, in particular biomedicine and homeopathy. It was motivated by the wish to gain a greater understanding of the possible meaning and ethical significance underlying the increasing popularity of complementary and alternative medicine (CAM) in Western countries. CAM is an umbrella term for a diverse group of therapeutic approaches, indicating their marginalized status in relation to conventional, scientific medicine. However, despite their diversity most CAM share a common bond by subscribing to a holistic perspective on life, health and illness. It is for this reason that this thesis concentrates on the conceptual level. The subject is approached by making use of interview material from five homeopathic doctors from Austria. Their perspective on different aspects of non-conventional, as well as biomedical, practice and underlying theory provides the springboard for theoretical investigations. The demand for scientific evidence of CAM is critically examined. The issue of increasing pluralism in health care is explored, along with its challenge of finding appropriate epistemological approaches for therapeutic systems that are based on different illness ontologies. The favored approach in this thesis is based on the recognition by medical historians that there are four basic illness axioms: "illness as loss of balance", "illness as disruption of interpersonal communication", "illness as a physical defect" and "illness as pathic creation". These axioms are matched respectively with four different epistemic pathways: the dialectical, the hermeneutical, the analytical and the phenomenological. The interviewees considered the more humane quality of the doctor/patient relationship in their homeopathic practices to be due to the holistic premises of homeopathy, which place the subjective dimension of patients at their center. The difficulty of achieving informed consent in the commonly used sense in homeopathic practice was solved by engaging in a shared decision-making process. Life was explained by the interviewees in vitalistic terms. Although rejected by science, the notion of vitalism appears to hold significance for the public. Illness was always perceived as a multidimensional process and not as a purely physico-chemical dysfunction. It became evident that the holistic perspective takes account of the many dimensions of human illness, of which neither the conventional reductionist conception nor the dualistic mind/body approach are capable. However, the unmanageable complexity of holism poses a problem for therapeutic practice. A conceptual approach providing some structure for the holistic multidimensionality is found in the four illness axioms and in analogous observations by Aristotle. It is concluded that there could be a connection between the increased popularity of CAM and their underlying holistic perspective, since this theoretical foundation allows the practitioner to address the patient in a whole-person way. At the same time the holistic perspective provides a much broader scope than biomedicine for patients to influence their health. The recognition that human multidimensionality needs to be appreciated at the level of illness ontology may also provide an impetus for bioethics to approach contemporary ethical challenges from a perspective of an ethics of the good life, instead of concerning itself predominantly with setting limits in the arena of technological medicine.

Clearly, the wide range of health information sources on the World Wide Web has the potential to lead to distribution of inaccurate medical information from unqualified sources bringing a great risk. Given the growing number of Internet users that access health-related information, the need for a more standard means to validate web site content is apparent. This paper examines how source, information, timeliness, accessibility, and design factors impact web document credibility on a narrower health topic - Alternative Medicine. It also examines the contrasts of different levels of credibility with metadata usage as well as the relationships between metadata usage measures. These preliminary results and examinations give an overview of how metadata is currently being used in this subject area.

In the 1970s and 1980s, Sweden held about 15-20 certified health resorts that wanted to improve peoples’ health with vegetarian food and alternative medicine. This essay aims to explore the popularity of health resorts through a patient’s perspective. What did the patients look for at the resort, which they could not find in the official health care? A basis for the analysis is Bonnie Blair O´Connor’s theory of Health Belief Systems. In short, it claims that all medical systems are equal, from a patient’s point of view. A patient in the 1970s and 1980s could turn to the Health Belief System of conventional medicine, or chose an alternative – for example the Health Belief System constituted by Swedish health resorts. The material for this survey comes from one of the most famous health resorts in Sweden, Föllingegården in the north of Jämtland. From 1976 to 1990 Mrs Lilly Johansson, who advocated a very strictly vegetarian diet to people with various health problems, ran the resort. The archives of Föllingegården have recently been discovered, and this is the first time someone looks at the patients’ bookings, journals and letters. The survey reveals that about three quarters of the patients were women, that the average patient was about 50 years old, and that he or she was most likely to be a white-collar worker. About half of the patients were explicitly ill, and suffered from different kinds of aches, rheumatism, allergies, eczema, bowel problems or other chronic disease. In their anamnesis, and in evaluation forms concerning their stay at Föllingegården, the patients reveal their motifs for coming to the health resort. Many of them had been let down by conventional health care. They were tired of heavy medication and/or careless doctors. At the health resort, they searched for a more personal contact with their healer and a more natural way of curing diseases and improve health. This essay shows that patients in the 1970s and 1980s contributed to the popularity of health resorts by trusting the health resorts with a wide range of health problems, by persuading doctors of the official health care to refer to and finance their stay at the health resort, and by taking responsibility for their own health in an era when official health care started to prove insufficient.

Complementary and alternative medicine (CAM) is distinct from orthodox western medicine. In the modern time¡Adue to chronic disease increase year by year and the consumer¡¦s concept of health is not merely without disease. These had changed the people¡¦s seeking medical help behavior. Western medicine in controlling and treating of acute disease had achieved remarkable results, but of chronic disease is disappointed due to chemical drugs long tern side effects. Complementary and alternative medicine relative to western medicine is more nature and modest without severe side effect. In many studies , people utilization of CAM as medical treatment increase year by year. In this study , I will explore the using conditions and degrees of CAM of patients in chronic psychiatric ward. We purposely select the patients and under the informed consensus of patient we apply questionnaires to them. After collecting the questionnaires, we perform statistic analysis. According to statistic results, we discuss the clinical meaning and hope to offer some valuable informations to mental heath providers.

<p> The purpose of this mixed methods study was to examine the benefits of art as a therapeutic modality for identifying stress in Gulf War to active duty veterans suffering from Post-Traumatic Stress Disorders (PTSD). This is a mixed methodology study. The case and control sampling approach was a systematic random sample with a paired treatment control design. The questions where chosen to the specificity of the Gulf War veteran. The qualitative data was scrutinized using a mixed methods design utilizing the tool known as the 17 Point Questionnaire. The quantitative data was obtained using the tool known as the PSS 14 Stress Scale. Both qualitative data and quantitative data were tested for validity and reliability using various tools including Spearman&rsquo;s Rho, or (Spearman's Rank Correlation Coefficient), Cluster Analysis, Pearson&rsquo;s Coefficient, Dendorgrams, paired and independent T-tests, and summary statistics to determine data. Convergent validity was evaluated by comparing positive and negative PSS-14 factors and by examining relationships with the number of actual to perceived benefits of stress reduction using Likert Scale results over thirty days between two Gulf War veteran groups identified with PTSD. Findings have shown a significant reductions in stress in the treatment group. Findings have also shown significant correlations between the studies perceived benefits for specific modalities and the use of ceramic or clay work as a preferred method of choice were also identified within the research. Due to the ability of art to reduce stress in Gulf War victims suffering from PTSD, longitudinal studies have been recommended to provide art treatment therapies with conclusive evidence based research status. With this change in status it is anticipated that art therapy will have greater accessibility within the Veterans Administration (VA) system for those seeking alternative methods of treatment.</p>

<p> Wellness is enough of a vital concern in the United States that as of 2014, the Patient Protection and Affordable Care Act was enacted to encourage employers to adopt evidence-based workplace wellness programs. Although it is believed that these wellness programs will decrease both chronic disease and healthcare costs, participation has been minimal. Existing research has identified the positive impact of both the individual&rsquo;s role and the use of technology in wellness planning. This inquiry used an action research case study design to explore how theory-driven web-based wellness planning impacted study participants&rsquo; decisions, actions, and perceptions about wellness. The researcher created a free, open access, proprietary web-based wellness planning tool based on stages of change and integral theory. Over the 4-month period of this study, the web site had 307 visitors and 29 registered users, 12 of whom also were employees of technology companies and were recruited to take part in the case study. Web site observation, the wellness-planning tool, and individual interviews served as the primary sources of data. Analysed using thematic analysis and descriptive statistics, the findings demonstrated that this web-based planning tool increased the users&rsquo; wellness awareness and may impact their intention to make improvements. Although the tool had a positive impact on users&rsquo; wellness planning skills and enhanced their understanding of wellness, most users continued to overemphasize physical wellness and underemphasize spirit and community, as represented by the lower quadrants of integral theory. Interviews further revealed that there may be an interest for employers to expand workplace wellness (WPW) program offerings, involve employees in program design, and expand WPW activities, with the intention of increasing self-care of both employees and their family members. These findings are limited to the participants and conditions of this research but warrant further study with more participants spanning a longer time period to determine whether changes may be generalizable and sustainable.</p>

<p>The sociological literature on pain and the body largely emphasizes the social and cultural dynamics of suffering. Within this realm, the medical institution is often paramount in regulating how pain is understood and the responses that are appropriate in managing pain. Less is known about other forms of healthcare that treat pain, namely Complementary and Alternative Medicine (CAM). While most research explains the overall &ldquo;who&rdquo; of the population of CAM users, few studies address the &ldquo;why&rdquo; and the overall effects of using a nonconventional system of medicine. </p><p> This research is aimed at discerning health beliefs and behaviors that are associated with engaging with a nonconventional system of healthcare and how treatment-seeking differs between patients choosing (CAM) and those choosing conventional medicine. Additionally, this study traces the trajectory of patients&rsquo; treatment-seeking behavior and explores whether nonconventional treatment changes outlooks on medicine and other health-related beliefs and behaviors. </p><p> A mixed method design was used to explore whether CAM users (compared with conventional medicine users) are more likely to possess beliefs associated with CAM. A survey-questionnaire was first distributed to pain patients (n=98) in two health office locations: pain management and acupuncture. Since little is known about CAM users&rsquo; decision-making processes, qualitative interviews (n=20) were conducted with people using acupuncture to elaborate on the survey results. </p><p> Statistically significant differences were found among pain management and acupuncture users on measures of proactivity, medication use, and patient-centered care. Additionally, qualitative findings showed that most acupuncture users were initially skeptical of this nonconventional treatment and gradually grew to use it for ailments beyond pain. At the same time, they grew to value the time and intimacy that was shared with their acupuncturist, who often engaged them in holistic approaches to health. The findings suggest strong discontent and resistance to conventional forms of treatment, which were found to be non-validating of pain experiences of patients and their desires to find non-pharmaceutical solutions for pain. This research proposes that CAM patients are demonstrating their ability to make choices on their own behalf without the approval of traditional medical experts and suggests implications for this new autonomy. </p>