title: Perception of cancer patients of their disease, self-efficacy and locus of control and usage of complementary and alternative medicine.
abstract: OBJECTIVE
  A high percentage of cancer patients use complementary and alternative medicine (CAM). The aim of our study was to learn more about the association of CAM usage, information needs, perceived impact of disease, locus of control and self-efficacy of cancer patients.
  
  
  METHODS
  We asked patients attending a series of lectures on CAM using a standardized questionnaire which integrated questions on information needs, CAM and validated short questionnaires on self-efficacy, perception of the disease and locus of control of reinforcement.
  
  
  RESULTS
  One hundred and eighty-five patients answered the questionnaire, from whom 45 % used CAM. Sixty percentage disclosed using CAM to the general practitioner and 57 % to the oncologist. Physicians and nurses, print media and the Internet are the most important source of information on CAM (used by 20-25 % each). Impact on neither daily life, perceived personal control nor coherence was associated with CAM usage, disclosure to physicians or sources of information. There also was no association between CAM usage and self-efficacy. In contrast, there was a significant association between CAM user rate and a high external locus of control.
  
  
  CONCLUSIONS
  While CAM usage is agreed upon by many physicians due to the idea that it helps patients to become active and feel more in control of the disease, our data are in favor of the contrary. A strong perception of external locus of control seems to be a driver of CAM usage. Physicians should be aware of this association when counseling on CAM.
authors.affiliation: Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
authors.forename: Marie-Desirée
authors.initials: MD
authors.lastname: Ebel
authors.forename: Ivonne
authors.initials: I
authors.lastname: Rudolph
authors.forename: Christian
authors.initials: C
authors.lastname: Keinki
authors.forename: Andrea
authors.initials: A
authors.lastname: Hoppe
authors.forename: Ralph
authors.initials: R
authors.lastname: Muecke
authors.forename: Oliver
authors.initials: O
authors.lastname: Micke
authors.forename: Karsten
authors.initials: K
authors.lastname: Muenstedt
authors.forename: Jutta
authors.initials: J
authors.lastname: Huebner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D010465:Perception; D020377:Self Efficacy; D011795:Surveys and Questionnaires