title: Compared perspectives of Arab patients in Palestine and Israel on the role of complementary medicine in cancer care.
abstract: BACKGROUND
  Complementary medicine (CM) is extensively used by patients with cancer across the Middle East.
  
  
  OBJECTIVE
  We aimed to compare the perspectives of two Arab populations residing in diverse socioeconomic-cultural settings in Palestine and Israel regarding the role of CM in supportive cancer care.
  
  
  METHODS
  A 27-item questionnaire was constructed and administered to a convenience sample of Arab patients receiving cancer care in four oncology centers in northern Israel and Palestine.
  
  
  RESULTS
  Each of the two groups had 324 respondents and was equally distributed by age and marital status. Compared with the Israeli-Arab group, Palestinian participants reported significantly higher CM use for cancer-related outcomes (63.5% vs. 39.6%, P < 0.001), which included more herbal use (97.6% vs. 87.9%, P = 0.001) and significantly lower use of dietary supplements, acupuncture, mind-body and manual therapies, and homeopathy. Most respondents in both groups stated that they would consult CM providers if CM was integrated in oncology departments. Related to this theoretical integrative scenario, Palestinian respondents expressed fewer expectations from their oncologists to actively participate in building their CM treatment plan. Treatment expectations in both groups focused on improving quality of life (QOL), whereas Palestinian respondents had fewer expectations for CM to improve fatigue, emotional concerns, sleep, and daily functioning.
  
  
  CONCLUSIONS
  Arab patients with cancer from Palestine and Israel highly support CM integration within their oncology institutions aiming to improve QOL. Nevertheless, respondents differed in their perceived model of CM integration, its treatment objectives, and their oncologists' role in CM integration.
authors.affiliation: Clalit Health Services, Haifa and Western Galilee District, Israel; Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Eran
authors.initials: E
authors.lastname: Ben-Arye
authors.affiliation: Biodiversity and Environmental Research Centre, Til, Nablus, Palestine.
authors.forename: Amneh M A
authors.initials: AM
authors.lastname: Hamadeh
authors.affiliation: Department of Internal Medicine, Bnai-Zion Hospital, Haifa, Israel.
authors.forename: Elad
authors.initials: E
authors.lastname: Schiff
authors.affiliation: Biodiversity and Environmental Research Centre, Til, Nablus, Palestine.
authors.forename: Rana M
authors.initials: RM
authors.lastname: Jamous
authors.affiliation: Clalit Health Services, Haifa and Western Galilee District, Israel.
authors.forename: Jamal
authors.initials: J
authors.lastname: Dagash
authors.affiliation: Biodiversity and Environmental Research Centre, Til, Nablus, Palestine.
authors.forename: Rania M
authors.initials: RM
authors.lastname: Jamous
authors.affiliation: Department of Oncology and Radiation Therapy, Rambam Health Care Campus, Haifa, Israel; The Community Oncology Unit, Nazareth, Clalit Health Services, Northern District, Israel.
authors.forename: Abed
authors.initials: A
authors.lastname: Agbarya
authors.affiliation: Department of Oncology and Radiation Therapy, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Gil
authors.initials: G
authors.lastname: Bar-Sela
authors.affiliation: Clalit Health Services, Haifa and Western Galilee District, Israel.
authors.forename: Eyas
authors.initials: E
authors.lastname: Massalha
authors.affiliation: The Middle East Cancer Consortium, Haifa, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Silbermann
authors.affiliation: Biodiversity and Environmental Research Centre, Til, Nablus, Palestine. Electronic address: msshtayeh@yahoo.com.
authors.forename: Mohammed Saleem
authors.initials: MS
authors.lastname: Ali-Shtayeh
mesh_terms: D018912:Arabs / Q000208:ethnology / Q000706:statistics & numerical data*; D001294:Attitude to Health / Q000208:ethnology; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003431:Cross-Cultural Comparison; D065246:Culturally Competent Care; D005260:Female; D006801:Humans; D007557:Israel / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology* / Q000628:therapy*; D010166:Palliative Care / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000706:statistics & numerical data*; D018511:Systems Integration
keywords: Islamic medicine; Oncology; complementary and alternative medicine; doctor-patient communication; integrative medicine; palliative care; quality of life