title: Experiences of complementary and alternative medicine in patients with inflammatory bowel disease - a qualitative study.
abstract: BACKGROUND
  The use of Complementary and Alternative Medicine (CAM) in Inflammatory Bowel Disease (IBD) is increasing. Although CAM often improves patients' well-being, it can also lead to side-effects and interactions with conventional medications. Research on patients with IBD in Sweden who have experiences of CAM is sparse. More studies are needed to enhance awareness of and improve communication about CAM. The aim of this study was to describe experiences of CAM in the healthcare context reported by patients with IBD.
  
  
  METHODS
  Fifteen patients with IBD, eight with Crohn's disease (CD) and seven with ulcerative colitis (UC), were recruited. Semi-structured qualitative interviews were conducted and qualitative content analysis was performed.
  
  
  RESULTS
  The analysis revealed the theme Knowledge and communication lead to participation in the area of CAM based on three categories; CAM use, Communication and Self-care. Patients with IBD wanted to be asked about CAM to be able to start a dialogue, as some perceived being treated in a disparaging manner and not taken seriously when raising the subject. Healthcare professionals (HCPs) need to be aware of this in order to meet and understand patient needs. Patients with IBD found it easier to communicate about CAM with the IBD nurses than physicians and dietary changes was one important CAM treatment.
  
  
  CONCLUSIONS
  The finding that it was easier to discuss CAM with nurses than physicians emphasizes the important role of the IBD nurse in communication and monitoring patients' CAM use. Patients wanted to be asked about CAM to be able to start a dialogue, as some perceived not taken seriously when raising the subject. Furthermore, HCPs need to understand that many patients with IBD regard dietary changes as an important part of CAM treatment. Further research in these areas is needed.
authors.affiliation: Division of Gastroenterology, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, SE-18288 Stockholm, Sweden. annelie.lindberg@ds.se.
authors.forename: Annelie
authors.initials: A
authors.lastname: Lindberg
authors.forename: Bjöörn
authors.initials: B
authors.lastname: Fossum
authors.forename: Per
authors.initials: P
authors.lastname: Karlen
authors.forename: Lena
authors.initials: L
authors.lastname: Oxelmark
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003093:Colitis, Ulcerative / Q000523:psychology / Q000628:therapy*; D003142:Communication; D000529:Complementary Therapies; D003424:Crohn Disease / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012648:Self Care; D013548:Sweden; D055815:Young Adult