Original Research PapersPatient perceptions of patient-centred care, empathy and empowerment in complementary medicine clinical practice: A cross-sectional study
Introduction
Psychosocial elements of clinical care play an important role in patient experiences and can impact on health outcomes [1]. Factors such as practitioner empathy [2]; patient-practitioner communication and partnership [3]; individualised, holistic approaches to consultation [4]; and patient experiences of empowerment [5] may promote more favourable clinical outcomes. An increasing understanding of the importance of these psychosocial factors has led to a contemporary movement within the health and medical community toward more person-focussed models of clinical care, such as patient-centred care (PCC) [6], [7], [8].
Paradigms of care found within complementary medicine (CM) philosophies, such as holism [9], [10], promote a whole-person approach analogous with the person-focussed ideals espoused by PCC [11]. Both holism and PCC seek to comprehensively address the patient's health and well-being beyond immediate physical concerns by exploring and acknowledging each patient's individual needs and facilitating sustainable health promotion that accounts for social and environmental factors [11], [12]. CM approaches to treatment can vary in the level of participation required by the patient; treatment can be either patient-enacted (remedies prescribed for self-administration, dietary/lifestyle advice) [13] or practitioner-enacted (acupuncture, manual therapies) [14]. However, in regards to the nature of clinical care provided, patients who seek to consult with CM practitioners do so because they expect to participate in a patient-centred, holistic process [15], [16], [17]. In light of the global prevalence and increasing use of CM [18], [19], [20], it is of interest to note that perceptions of clinical care contribute to reasons for CM use.
Clinical care expectations as drivers of use are particularly applicable to patients seeking care from CM practitioners for chronic health conditions [21], [22], [23]. This is interesting to note due to the high representation of individuals with chronic health conditions amongst CM users [20], [24], the increasing contribution of chronic health conditions to the global burden of disease [25], and emerging assertions that PCC is a particularly effective approach to managing chronic health conditions [26], [27], [28]. If CM practitioners are indeed providing a consultation characterised by PCC, it follows that CM may proffer an overlooked resource of PCC with value to contribute by way of addressing patients’ psychosocial needs, particularly those of patients with chronic health conditions.
While there is a substantial body of qualitative literature supporting the predication that the practice of CM clinical care is indeed aligned with the principles of PCC, there has been little attempt to verify this correlation through quantitative methods [29]. The present study aims to provide a preliminary examination of patient perceptions of the degree to which CM practitioners from a variety of professions employ a patient-centred approach during clinical consultation.
Section snippets
Study design
A cross-sectional survey design was used in order to capture data on prevailing patient experiences. As this study was the first to use quantitative measures to assess PCC and its components across a variety of CM professions in Australia, a preliminary study approach was employed.
Setting
In order to readily access a cross-section of the general population of CM users, the study recruited participants from the setting of the Endeavour College of Natural Health's Wellnation student clinics in Brisbane,
Results
In total, 252 participants were recruited across the five clinics (myotherapy n = 77; naturopathy n = 55; nutrition n = 52; acupuncture n = 44; homeopathy n = 21) during the five weeks of data collection. Excluding follow-up patients who had already participated, the average response rate was 81.5% of those patients who were invited to take part. While efforts were made to invite every patient who attended the clinic when recruitment was taking place in order to limit sampling bias, this was not possible
Discussion
This study is the first to provide a quantitative report of patient perceptions of patient-centred clinical care across a variety of CM professions. The findings of this study draw attention to three key insights regarding: the characteristic nature of the patient's experience of CM clinical care; variations in perceptions of clinical care between different CM professions; and the nuances within CM clinical care as perceived by patients seeking treatment for chronic health conditions.
Conclusion
Findings from this study offer novel insights into the nature of the CM consultation as it is experienced by CM patients and as it relates to psychosocial aspects of health-care provision. These insights carry implications for the potential role of CM within the wider field of health-care, particularly in regards to the growing issue of chronic disease management. While the findings discussed here offer a promising preliminary view of CM clinical care and its potential applications, moreover
Conflicts of interest
None.
Source of funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Acknowledgements
The authors wish to thanks Liz Iaccarino, Clinic Manager of Brisbane's Wellnation clinics, for her ongoing support throughout the project. The authors also wish to thank Brisbane's Wellnation clinic staff, supervisors and student practitioners for their support and contributions during data collection.
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2021, Complementary Therapies in Clinical PracticeCitation Excerpt :The increasing popularity of health and fitness worldwide may also contribute to the increases in CAM use [12,15–18]. Furthermore, considering the importance of the therapeutic relationship of healer and patient, there is an assertion that CAM which provides an opportunity for patients to contribute to the restoration of their health actively, perhaps has the edge over allopathic medicine [19–22]. The widespread international use of CAM may also stem from its anticipated safety [23–25].
Perceptions of person-centred care amongst individuals with chronic conditions who consult complementary medicine practitioners
2020, Complementary Therapies in MedicineCitation Excerpt :Naturopaths, however, rely largely on patient-enacted treatments (e.g. remedies or dietary/lifestyle advice that patients must self-administer outside of the consultation) – an approach requiring the naturopath to engage the patient in the treatment process, which typically involves provision of patient education and detailed discussion of the patient’s individual circumstances.28 Previous studies show such patient education by naturopaths may improve the patient’s self-efficacy and sense of empowerment, while time spent discussing the patient’s needs may result in the patient feeling heard and supported,17,23 leading to a particularly high degree of perceived PCC during consultation with naturopaths. While care provided by CM practitioners was typically rated more highly than care provided by MDs, patients of different CM professions differed slightly in the domains and items for which they gave lower ratings to their MDs.