title: Patient expectations of 'effectiveness' in health care: an example from medical herbalism.
abstract: OBJECTIVE
  The study explored people's experiences of medical herbalism, with the aim of enhancing understanding about the use of herbalism in the context of contemporary UK health care.
  
  
  BACKGROUND
  The popularity and use of complementary and alternative medicine in westernised societies is now well documented, and medical herbalism, in particular, is enjoying a particularly strong revival of interest. Despite this, the reasons for its sustained popularity remain unclear.
  
  
  METHODS
  The study was underpinned by Gadamerian hermeneutic phenomenology.
  
  
  METHODS
  Nineteen adult clients of medical herbalists were interviewed about their experiences. The processes of data collection and data analysis were informed predominantly by van Manen's phenomenological framework and by Kvale's framework for interview-based studies.
  
  
  RESULTS
  Herbalism more closely met participants' expectations of effective health care. The themes 'dealing with illness causation', 'patient-practitioner collaboration' and 'provision of authentic evidence' were fundamental to achieving effectiveness but were perceived as more easily attainable in the context of medical herbalism.
  
  
  CONCLUSIONS
  Health care is more likely to meet the expectations of patients when its purposes, methods and goals are negotiated and made explicit, from the perspectives of both patient and health care professional. Medical herbalism has the potential to contribute usefully to participants' healthcare, especially when used selectively and in conjunction with conventional health care.
  
  
  CONCLUSIONS
  The continued popularity of complementary and alternative medicine amongst the general public makes its acknowledgement in conventional health care more important than ever. In the context of the integrative health movement, it is therefore essential that health care professionals develop their understanding about patient practices and preferences, if a responsive health care system is to be maintained. Nurses are in a prime position to influence the knowledge base and future direction of integrative health care, especially in relation to the patient perspective.
authors: School of Health & Social Care, Bournemouth University, Bournemouth, Dorset, UK. clittle@bournemouth.ac.uk
authors: Christine V
authors: CV
authors: Little
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000529:Complementary Therapies / Q000451:nursing / Q000706:statistics & numerical data*; D019033:Delivery of Health Care, Integrated / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D029001:Herbal Medicine / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D008517:Phytotherapy / Q000451:nursing / Q000706:statistics & numerical data; D011787:Quality of Health Care; D012737:Sex Factors; D016896:Treatment Outcome; D006113:United Kingdom; D055815:Young Adult