Table 4.
Attitudes and knowledge about indirect risk situations (n = 466)a
| Total | Medical doctor (n = 142) | Nurse (n = 69) | Provider with dual training (n = 32) | Complementary therapist (n = 223) | p-value | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | ||
| Whether complementary modalities should be subjected to more scientific testing^^ | |||||||||||
| Yes | 302 | 71.6 | 119 | 88.8 | 54 | 88.5 | 15 | 55.6 | 114 | 57 | < 0.001* |
| Most important factor for recommending a complementary modality | < 0.001^ | ||||||||||
| Evidence for safety | 209 | 49.1 | 52 | 38.2 | 37 | 59.7 | 12 | 44.4 | 108 | 53.7 | |
| Evidence for efficacy | 169 | 39.7 | 55 | 40.4 | 25 | 40.3 | 14 | 51.9 | 75 | 37.3 | |
| Evidence does not matter | 22 | 5.2 | 5 | 3.7 | 0 | 0 | 0 | 0 | 17 | 8.5 | |
| Double responses | 26 | 6.1 | 24 | 17.6 | 0 | 0 | 1 | 3.7 | 1 | 0.5 | |
| Sufficient efficacy evidence to recommend a complementary modality | < 0.001^ | ||||||||||
| No or weak evidence for efficacy | 39 | 9.3 | 9 | 6.6 | 3 | 4.9 | 2 | 7.4 | 25 | 12.9 | |
| Moderate evidence for efficacy | 151 | 36.1 | 37 | 27.2 | 11 | 18 | 17 | 63 | 86 | 44.3 | |
| Strong evidence for efficacy | 168 | 40.2 | 66 | 48.5 | 39 | 63.9 | 7 | 25.9 | 56 | 28.9 | |
| Would never recommend | 60 | 14.4 | 24 | 17.6 | 8 | 13.1 | 1 | 3.7 | 27 | 13.9 | |
| Sufficient evidece for safety | < 0.001^ | ||||||||||
| No or weak evidence for safety | 12 | 2.9 | 3 | 2.2 | 0 | 0 | 1 | 3.7 | 8 | 4.1 | |
| Moderate evidence for safety | 57 | 13.6 | 4 | 3 | 3 | 4.8 | 7 | 25.9 | 43 | 22.1 | |
| Strong evidence for safety | 309 | 73.7 | 108 | 80 | 52 | 83.9 | 18 | 66.7 | 131 | 67.2 | |
| Would never recommend | 41 | 9.8 | 20 | 14.8 | 7 | 11.3 | 1 | 3.7 | 13 | 6.7 | |
| Number of complementary modality care patients who delayed or declined conventional treatment | < 0.001* | ||||||||||
| No patients | 337 | 80 | 95 | 70.4 | 30 | 49.2 | 25 | 96.2 | 187 | 94 | |
| One or more patients | 84 | 20 | 40 | 29.6 | 31 | 50.8 | 1 | 3.8 | 12 | 6 | |
| How the providers would address a complementary modality patient who delayed or declined conventional treatment | |||||||||||
| Have not experienced | 206 | 44.2 | 52 | 36.6 | 15 | 21.7 | 12 | 38.7 | 127 | 58.8 | < 0.001* |
| Respect the patient’s choice | 157 | 33.7 | 57 | 40.1 | 35 | 50.7 | 11 | 35.5 | 54 | 25.0 | < 0.001* |
| Try to convince patient | 127 | 27.3 | 65 | 45.8 | 13 | 18.8 | 7 | 22.6 | 42 | 19.4 | < 0.001* |
| Encourage patient soliciting a second opinion | 150 | 32.2 | 34 | 23.9 | 24 | 34.8 | 12 | 38.7 | 80 | 37.0 | 0.122* |
| Ask family members to intervene | 9 | 1.9 | 7 | 4.9 | 2 | 2.9 | 0 | 0.0 | 0 | 0.0 | 0.003^ |
| Inform patient of consequences of not receiving conventional treatment | 203 | 43.6 | 91 | 64.1 | 42 | 60.9 | 10 | 32.3 | 60 | 27.8 | < 0.001* |
| Approve of patient combining complementary and conventional treatments | < 0.001^ | ||||||||||
| Never | 23 | 5.9 | 12 | 9 | 3 | 5.8 | 0 | 0 | 8 | 4.5 | |
| Sometimes | 147 | 37.8 | 84 | 63.2 | 31 | 59.6 | 6 | 24 | 26 | 14.5 | |
| Often | 107 | 27.5 | 27 | 20.3 | 9 | 17.3 | 8 | 32 | 63 | 35.2 | |
| Always | 112 | 28.8 | 10 | 7.5 | 9 | 17.3 | 11 | 44 | 82 | 45.8 | |
| Asking patients if they consider risks of combining complementary and conventional treatments | < 0.001* | ||||||||||
| Never | 153 | 39.2 | 54 | 40.3 | 17 | 30.4 | 11 | 44 | 71 | 40.6 | |
| Sometimes | 147 | 37.7 | 59 | 44 | 31 | 55.4 | 11 | 44 | 46 | 26.3 | |
| Often/always | 90 | 23.1 | 21 | 15.7 | 8 | 14.3 | 3 | 12 | 58 | 33.1 | |
| Advice given to patients who ask about complementary modalities | < 0.001^ | ||||||||||
| Discourage use | 14 | 3.6 | 10 | 7.5 | 2 | 3.6 | 0 | 0 | 2 | 1.1 | |
| Encourage use | 100 | 25.8 | 3 | 2.3 | 4 | 7.3 | 11 | 42.3 | 82 | 47.1 | |
| Neither | 177 | 45.6 | 81 | 60.9 | 30 | 54.5 | 10 | 38.5 | 56 | 32.2 | |
| Other | 97 | 25 | 39 | 29.3 | 19 | 34.5 | 5 | 19.2 | 34 | 19.5 | |
| Advice given to patients who ask about conventional treatment | |||||||||||
| Discourage use | 2 | 0.5 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 1.1 | 0.005^ |
| Encourage use | 308 | 78.2 | 116 | 86.6 | 42 | 77.8 | 21 | 84 | 129 | 71.3 | |
| Neither discourage nor encourage | 46 | 11.7 | 5 | 3.7 | 6 | 11.1 | 4 | 16 | 31 | 17.1 | |
| Other | 38 | 9.6 | 13 | 9.7 | 6 | 11.1 | 0 | 0 | 19 | 10.5 | |
| Complementary modalities are dangerous because they delay conventional treatments | < 0.001* | ||||||||||
| Yes | 178 | 47.6 | 100 | 78.1 | 35 | 71.4 | 6 | 24 | 37 | 21.5 | |
*Pearson’s chi-square test; ^Fisher’s exact test; aDue to multiple and missing responses, the analyzed numbers do not always add up to the total number;^^The missing response variated between (n = 8 and n = 84)