Predictors of use of complementary and alternative medicine by non-hodgkin lymphoma survivors and relationship to quality of life.
OBJECTIVE
This study hypothesized that non-Hodgkin lymphoma (NHL) patients who used complementary and alternative medicine (CAM) would have higher health-related quality of life (HRQOL) and a greater perceived sense of control than nonusers. However, since CAM may predict HRQOL, and perceived control may be both associated with CAM use as well as being an independent predictor of HRQOL, the authors also sought to test whether perceived control mediated the relationship between CAM use and HRQOL.


METHODS
This was a cross-sectional study design. NHL survivors diagnosed between June 1, 1998 and August 31, 2001 were selected from the population-based SEER (Surveillance, Epidemiology, and End Results) cancer registry for Los Angeles County and were mailed a survey in 2003 that assessed CAM use and predictors of CAM use. The response rate was 54.8%; 319 provided complete data for analysis.


METHODS
Categories of CAM were defined according to the National Center for Complementary and Alternative Medicine guidelines. The authors measured survivors' cancer-related control using the Perceived Personal Control scale, a 4-question scale that was adapted from previously validated scales. HRQOL was measured using the mental component summary and physical component summary scores from the SF-36 v2.0. Bivariate and multivariable logistic and linear regression models were used to assess factors associated with CAM use and the association of CAM use with psychosocial health outcomes, respectively.


RESULTS
Sixty-one percent of respondents reported using at least one CAM modality within the past 4 weeks, and 40% did so after excluding personal prayer and support groups. Younger age and higher education were significantly associated with greater CAM use as were higher perception of cancer-related control (P = .004) and more positive mental functioning (P = .016). Perception of control significantly mediated the association between CAM use and mental functioning (P < .001).


CONCLUSIONS
CAM use may be related to more positive mental health-related quality of life by increasing patients' perception of perceived control over their health; however, cause and effect cannot be determined. Physicians should be aware that cancer survivors have a need to take an active role in improving their health.
University of Southern California, Los Angeles, CA, USA. ahamilt@med.usc.edu
Ann S
AS
Hamilton
Melissa F
MF
Miller
Neeraj K
NK
Arora
Keith M
KM
Bellizzi
Julia H
JH
Rowland
D000368:Aged; D000529:Complementary Therapies / Q000379:methods*; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006801:Humans; D015141:Los Angeles; D008228:Lymphoma, Non-Hodgkin / Q000523:psychology*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D017741:Survivors / Q000523:psychology*