title: Push or pull? Relationships between lung cancer patients' perceptions of quality of care and use of complementary and alternative medicine.
abstract: Little is known about relationships between quality of care (QoC) and use of complementary and alternative medicine (CAM) among patients with lung cancer (LC).
  
  
  OBJECTIVE
  This study examines CAM-use among patients with LC in Sweden, associations between QoC and CAM-use among these patients, and reported aspects of LC-care perceived as particularly positive and negative by patients, as well as suggestions for improving QoC.
  
  
  METHODS
  Survey data from 94 patient members of the Swedish LC patient organization about CAM-use and QoC as measured by the instrument "Quality from the patient's perspective" were analyzed.
  
  
  RESULTS
  Fifty (53%) LC-patients used CAM, with 40 of the CAM-users reporting that CAM helped them. The most common CAMs used were dietary supplements and natural remedies, followed by prayer. Significantly more patients reported using prayer and meditation for cure than was the case for other types of CAM used. Less than half the CAM-users reported having spoken with staff from the biomedical health care system about their CAM-use. Patients provided numerous suggestions for improving LC-care in a variety of areas, aiming at a more effective and cohesive care trajectory. No differences in QoC were found between CAM-users and non-CAM-users, but differences in CAM-use i.e. type of CAM, reasons for using CAM, and CAM-provider consulted could be associated with different experiences of care.
  
  
  CONCLUSIONS
  It is important to recognize that CAM-users are not a homogeneous group but might seek different types of CAMs and CAM-providers in different situations depending on experiences of care.
authors.affiliation: Dept. of Learning, Informatics, Management and Ethics, Medical Management Center, Karolinska Institutet, Stockholm, Sweden. mlv@du.se
authors.forename: M
authors.initials: M
authors.lastname: Lövgren
authors.forename: B
authors.initials: B
authors.lastname: Wilde-Larsson
authors.forename: J
authors.initials: J
authors.lastname: Hök
authors.forename: H
authors.initials: H
authors.lastname: Leveälahti
authors.forename: C
authors.initials: C
authors.lastname: Tishelman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000529:Complementary Therapies / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000451:nursing* / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009736:Nursing Process; D010342:Patient Acceptance of Health Care; D011795:Surveys and Questionnaires; D013548:Sweden