title: Perceptions of complementary and alternative medicine among cardiac patients in South Trinidad: a qualitative study.
abstract: BACKGROUND
  Complementary and alternative medicine (CAM) has been practiced for centuries owing to the absence or limited availability of conventional medicine. CAM has persisted globally with over USD34 billion spent annually, despite modernization, globalization, technological advancement, and limited supportive evidence. The present qualitative study explores the perception of CAM among cardiac patients with respect to rationale, perceived outcomes, influences, and public health concerns.
  
  
  METHODS
  This study used a qualitative, interpretative approach. Twelve cardiac disease patients were recruited from private clinics in South Trinidad and interviewed. The study obtained ethical approval, and all participants provided written consent. The semi-structured interviews were digitally recorded, transcribed, and thematically analyzed. Participants with poor cognitive function, difficulty speaking, and those not understandable owing to language barriers were excluded.
  
  
  RESULTS
  CAM use was based largely on patient perception regardless of the clinical reality. The perceived mode of action and its natural character was responsible for the therapeutic outcomes and uses. Participants reported that CAM provided holistic care, improved the quality of life, overcame the limitations of conventional medicine, satisfied their increased expectation for comprehensive care, and prevented or counteracted adverse effects caused by conventional medicine. Participants reported a lack of scientific information on CAM and stated that policy makers should assist patients through increased research, public health education, and improved integration of CAM and conventional medicine.
  
  
  CONCLUSIONS
  The participants' use of CAM was largely based on perception. CAM was thought to improve therapeutic outcomes, provide holistic care, decrease or prevent complications from conventional medicine, and improve quality of life. Participants acknowledged that they may be ill-informed about the basic concepts or actions of CAM. They urged policymakers to create an environment that assists the public and health care providers in promoting safe and effective CAM practice.
authors.affiliation: Arthur Lok Jack Graduate School of Business, Max Richards Drive, Champ Fleurs, Mount Hope, Trinidad. vmandrakes@hotmail.com.|Faculty of Medicine, University of the West Indies, St. Augustine, Trinidad and Tobago. vmandrakes@hotmail.com.
authors.forename: Mandreker
authors.initials: M
authors.lastname: Bahall
authors.affiliation: University of Liverpool, London, UK. mark.edwards@my.ohecampus.com.|University of Roehampton, London, UK. mark.edwards@my.ohecampus.com.
authors.forename: Mark
authors.initials: M
authors.lastname: Edwards
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D001294:Attitude to Health; D000529:Complementary Therapies; D003695:Delivery of Health Care / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006331:Heart Diseases / Q000628:therapy*; D006694:Holistic Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010465:Perception; D036301:Qualitative Research; D011788:Quality of Life; D014300:Trinidad and Tobago