title: Complementary and alternative medicine use of women with breast cancer: self-help CAM attracts other women than guided CAM therapies.
abstract: OBJECTIVE
  Examine stability of use of complementary and alternative medicine (CAM) of breast cancer patients, reasons for CAM use, and sociodemographic, clinical, and psychological predictors of CAM use.
  
  
  METHODS
  CAM use was assessed after adjuvant therapy and six months later. Following the CAM Healthcare Model, CAM use was divided into use of provider-directed (guided) and self-directed (self-help) CAM. Stability and reasons for CAM use were examined with McNemar's tests and descriptive statistics. Cross-sectional and longitudinal associations between predictors and CAM use were examined with univariate and multivariate logistical analyses.
  
  
  RESULTS
  Use of provider-directed and self-directed CAM was stable over time (N=176). Self-directed CAM was more often used to influence the course of cancer than provider-directed CAM. Both were used to influence well-being. Openness to experience predicted use of provider-directed CAM, while clinical distress predicted use of self-directed CAM, after adjusting for other predictors. Perceived control did not predict CAM use.
  
  
  CONCLUSIONS
  CAM use is stable over time. It is meaningful to distinguish provider-directed from self-directed CAM.
  
  
  CONCLUSIONS
  Providers are advised to plan a 'CAM-talk' before adjuvant therapy, and discuss patients' expectations about influence of CAM on the course of cancer. Distressed patients most likely need information about self-directed CAM.
authors.affiliation: Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands. d.n.lo-fo-wong@amc.uva.nl
authors.forename: Deborah N N
authors.initials: DN
authors.lastname: Lo-Fo-Wong
authors.forename: Adelita V
authors.initials: AV
authors.lastname: Ranchor
authors.forename: Hanneke C J M
authors.initials: HC
authors.lastname: de Haes
authors.forename: Mirjam A G
authors.initials: MA
authors.lastname: Sprangers
authors.forename: Inge
authors.initials: I
authors.lastname: Henselmans
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D000529:Complementary Therapies / Q000523:psychology / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D015995:Prevalence; D012648:Self Care; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires