title: Using a mixed methods research design to investigate complementary alternative medicine (CAM) use among women with breast cancer in Ireland.
abstract: OBJECTIVE
  To investigate complementary and alternative medicine (CAM) use among women with breast cancer in Ireland using a mixed methods modified sequential explanatory design.
  
  
  METHODS
  Semi-structured interviews were conducted with oncology professionals (n = 20) and CAM practitioners (n = 20) and this was followed by a survey of 406 women with breast cancer using the 'Use of Complementary and Alternative Therapies Survey' questionnaire (UCATS) (Lengacher et al., 2003). Follow up interviews were subsequently undertaken with a subset of this survey sample (n = 31).
  
  
  RESULTS
  Over half of those surveyed (55.7%, n = 226) used some form of CAM since diagnosis. The most frequently used therapies were massage, herbal supplements (including herbs with oestrogenic properties), antioxidants, relaxation, counselling, health supplements, reflexology, reiki and support groups. Dietary interventions were used primarily to reduce symptoms and/or side effects while reduction of psychological stress was the primary reason for use of stress-reducing therapies. Most respondents reported that the CAM therapies they had used were helpful. The qualitative data elaborated on and provided clarification of the survey results.
  
  
  CONCLUSIONS
  Similar to international studies, CAM is popular among women with breast cancer in Ireland. As such, the challenge for Irish oncology professionals is to identify low risk CAM therapies that are likely to benefit patients while educating patients and themselves on therapies which may be of concern. This study clearly illustrates the benefits of using a mixed methods approach to enhance our understanding of a complex clinical issue and thus we recommend that this method should be the method of choice when planning health services research.
authors.affiliation: UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Belfield, Dublin, Ireland. patricia.fox@ucd.ie
authors.forename: Patricia
authors.initials: P
authors.lastname: Fox
authors.forename: Michelle
authors.initials: M
authors.lastname: Butler
authors.forename: Barbara
authors.initials: B
authors.lastname: Coughlan
authors.forename: Mary
authors.initials: M
authors.lastname: Murray
authors.forename: Noreen
authors.initials: N
authors.lastname: Boland
authors.forename: Terry
authors.initials: T
authors.lastname: Hanan
authors.forename: Hilary
authors.initials: H
authors.lastname: Murphy
authors.forename: Pauline
authors.initials: P
authors.lastname: Forrester
authors.forename: Marie
authors.initials: M
authors.lastname: O' Brien
authors.forename: Nollaig
authors.initials: N
authors.lastname: O' Sullivan
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000628:therapy*; D000529:Complementary Therapies / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007494:Ireland; D016015:Logistic Models; D008875:Middle Aged; D036301:Qualitative Research; D012657:Self-Help Groups / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires