title: Psychological and behavioral mechanisms influencing the use of complementary and alternative medicine (CAM) in cancer patients.
abstract: BACKGROUND
  This study explored the psychological and behavioral mechanisms of complementary and alternative medicine (CAM) use in Japanese cancer patients using two applied behavioral models, the transtheoretical model (TTM), and theory of planned behavior (TPB).
  
  
  METHODS
  Questionnaires were distributed to 1100 patients at three cancer treatment facilities in Japan and data on 521 cancer patients were used in the final analysis. The questionnaire included items based on TTM and TPB variables, as well as three psychological batteries.
  
  
  RESULTS
  According to the TTM, 88 patients (17%) were in precontemplation, 226 (43%) in contemplation, 33 (6%) in preparation, 71 (14%) in action, and 103 (20%) in maintenance. The model derived from structural equation modeling revealed that the stage of CAM use was significantly affected by the pros, cons, expectation from family, norms of medical staff, use of chemotherapy, period from diagnosis, and place of treatment. The primary factor for the stage of CAM use was the expectation from family.
  
  
  CONCLUSIONS
  The findings revealed the existence of a number of psychologically induced potential CAM users, and psychological variables including positive attitude for CAM use and perceived family expectation greatly influence CAM use in cancer patients.
authors.affiliation: Graduate School of Human Sciences, Osaka University, 1-2 Yamadaoka, Suita Osaka 565-0871, Japan. khirai@grappo.jp
authors.forename: K
authors.initials: K
authors.lastname: Hirai
authors.forename: K
authors.initials: K
authors.lastname: Komura
authors.forename: A
authors.initials: A
authors.lastname: Tokoro
authors.forename: T
authors.initials: T
authors.lastname: Kuromaru
authors.forename: A
authors.initials: A
authors.lastname: Ohshima
authors.forename: T
authors.initials: T
authors.lastname: Ito
authors.forename: Y
authors.initials: Y
authors.lastname: Sumiyoshi
authors.forename: I
authors.initials: I
authors.lastname: Hyodo
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003131:Combined Modality Therapy / Q000523:psychology; D000529:Complementary Therapies / Q000523:psychology* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005195:Family Relations; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011369:Professional-Patient Relations; D011581:Psychological Tests; D011795:Surveys and Questionnaires