Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-28T18:57:38.107Z Has data issue: false hasContentIssue false
  • English
  • Français

Senior and Health-Professionals' Perceptions and Communication about Prescriptions and Alternative Therapies*

Published online by Cambridge University Press:  29 November 2010

Muriel J. Montbriand
Muriel J. Montbriand
Affiliation:
University of Saskatchewan
Get access Rights & Permissions [Opens in a new window]

Abstract

Patients and professionals have difficulty communicating with one another about prescriptions and alternative therapies. The aim of this research was to investigate and contrast 714 seniors and health-professionals' perceptions and communication about the above mentioned health products. First, intensive face-to-face, ethnographic interviews with health professionals and seniors were conducted to elicit relevant issues of concern. Second, focus groups were used to evaluate the issues and wording of question probes developed initially. Third, a survey established associations and predictive validity of variables found in the first two phases. Highlights from the emergent themes include different perceptions of (a) the value and usage of alternative therapies, (b) information adequacy about prescriptions and alternative therapies, and (c) communication about prescription misuses and alternative therapy use. Seniors and professionals suggested insights for improving clinical practice.

Résumé

Les patients et les professionnels éprouvent de la difficulté à communiquer entre eux en ce qui concerne les ordonnances et les médecines parallèles. Cette recherche visait à étudier et à rapprocher les perceptions et les échanges de 714 aîné(e)s et professionnels de la santé sur ces produits de santé. D'abord, on a effectué des entretiens personnels et ethnographiques avec des professionnels de la santé et des aîné(e)s pour déceler les questions de préoccupation pertinentes. Ensuite, on a utilisé des groupes de discussion pour évaluer les questions et la formulation des éléments initialement développées. Troisièmement, une étude a permis d'établir des associations et la validité prédictive des variables des deux premières étapes. Parmi les grandes lignes des thèmes, on note des perceptions différentes sur (a) la valeur et l'utilisation des médecines parallèles, (b) la précision de l'information sur les ordonnances et les médecines parallèles et (c) la communication sur la mauvaise utilisation des ordonnances et l'utilisation des médecines parallèles. Les aîné(e)set les professionnels ont présenté des recommandations d'amélioration de la pratique clinique.

Keywords

MedicationsAlternate TherapiesHealth-ProfessionalsPerceptionsCommunicationMédicamentsmédecines parallélesprofessionels de la santéperceptionscommunication
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 19 , Issue 1 , Spring/Printemps 2000 , pp. 35 - 56
Copyright
Copyright © Canadian Association on Gerontology 2000

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aoki, F.Y., Hildahl, V.K., Large, G.W., Mitenko, P.A., & Sitar, D.S. (1983). Aging and heavy drug use: A prescription survey in Manitoba. Journal of Chronic Diseases, 36, 75–84.CrossRefGoogle Scholar
Becker, M.H. (1974) The health belief model and personal health behavior. Thorofare, NJ: Stack Press.Google Scholar
Becker, M.H., & Maiman, L.A. (1983). Models of health-related behavior. In D., Mechanic (Ed.), Handbook of health, health care and the health professions (pp. 539–568) London: Free Press.Google Scholar
Beisecker, A.E., & Beisecker, T.D. (1990). Patient information-seeking behaviors when communicating with doctors. Medical Care, 28,19–28.CrossRefGoogle Scholar
Block, G., Cox, C, Madans, J., Schreiber, G.B., Licitra, L., & Melia, N. (1988).Vitamin supplement use, by demographic characteristics. American Journal of Epidemiology, 127, 297–309.Google Scholar
Bogdan, R.C., & Biklen, S.K. (1982). Qualitative research for education: An introduction to theory and methods. Toronto: Allyn & Bacon.Google Scholar
Brigden, M.L. (1987). Unorthodox therapy and your cancer patient. Postgraduate Medicine, 81, 271–280.CrossRefGoogle Scholar
Brigden, M.L. (1995). Unproven (questionable) cancer therapies. Western Journal of Medicine, 163, 463–469.Google Scholar
Brock, D.W., & Wartman, S.A. (1990). When competent patients make irrational choices. The New England Journal of Medicine, 322,1595–1599.CrossRefGoogle Scholar
Bush, P.J., & Osterweis, M. (1978). Pathways to medicine use. Journal of Health and Social Behavior, 19, 179–189.CrossRefGoogle Scholar
Butler, K. (1992). A consumer's guide to “alternative medicine”. New York: Prometheus Books.Google Scholar
Calnan, M. (1988). Lay evaluation of medicine and medical practice: Report of a pilot study. International Journal of Health Services, 18, 311–322.CrossRefGoogle Scholar
Campbell, S. M., & Roland, M.O. (1996). Why do people consult the doctor? Family Practice, 13,75–83.CrossRefGoogle Scholar
Cassileth, B.R., & Chapman, C.C. (1995). Alternative and complementary cancer therapies. Cancer, 77, 1026–1034.3.0.CO;2-F>CrossRefGoogle Scholar
Cassileth, B.R., Lusk, E.J., Strouse, T.G., & Bodenheimer, B.J. (1984). Contemporary unorthodox treatments in cancer medicine. Annals of Internal Medicine, 101,105–112.CrossRefGoogle Scholar
Chaiton, A., Spitzer, W.O., Roberts, R.S., & Delamore, T. (1976). Patterns of medical drug use: A community focus. Canadian Medical Association Journal, 114,33–37.Google Scholar
Chappell, N.L., Maclure, M., Brunt, H., Hopkins, J., & Mullett, J. (1997). Seniors' view of medication reimbursement policies: Bridging research and policy at the point of policy impact. Canadian Journal on Aging, Supplement 1997, 114–131.Google Scholar
Chrischilles, E.A., Foley, D.J., Wallace, R.B., Lemke, J.H., Semla, T.P., Hanlon, J.T., Glynn, R.J., Ostfeld, A.M., & Guralnik, J.M. (1992). Use of medications by persons 65 and over: Data from the established populations for epidemiologic studies of the elderly. Journal of Gerontology, 47, M137-M144.Google Scholar
Clark, N.M., Nothwehr, F., Gong, M., Evans, D., Maiman, L.A., Hurwitz, M.E., Roloff, D., & Mellins, R.B. (1995). Physician-patient partnership in managing chronic illness. Academic Medicine, 70, 957–959.CrossRefGoogle Scholar
Cochran, B.J.M. (1992). Consumer counseling. In P., Carruthers-Czyzewski (Ed.), Self-medication: Reference for health professionals: Vol. 1 (4th ed). Ottawa: Canadian Pharmaceutical Association.Google Scholar
Cook, C, & Baisden, D. (1986). Ancillary use of folk medicine by patients in primary care clinics in Southwestern West Virginia. Southern Medical Journal, 79, 1098–1101.CrossRefGoogle Scholar
Cook, T.D., & Campbell, D.T. (1979). Quasi-experimentation: Design and analysis issues for field settings. Boston: Houghton Mifflin.Google Scholar
Eisenberg, D.M., Kessler, E.C., Foster, C, Norlock, F.E., Calkins, D.R., & Delbanco, T.L. (1993). Unconventional medicine in the United States: prevalence, cost, and patterns of use. The New England Journal of Medicine, 328, 246–252.CrossRefGoogle Scholar
Fabrega, H. (1975). The position of psychiatry in the understanding of human disease. Archives of General Psychiatry, 32, 1500–1512.CrossRefGoogle Scholar
Facts and Comparisons. (2000). The Lawrence review of natural products* monograph system. St. Louis, Missouri: Facts and Comparisons. (1999 date given to indicate the current package.)Google Scholar
Ferguson, J.A. (1990). Patient age as a factor in drug prescribing practices. Canadian Journal on Aging, 9, 270–295.CrossRefGoogle Scholar
Fillenbaum, G.G., Hanlon, J.T., Corden, E.H., Thandi, Z.P, Wall, Jr., , W.E., & Brock, D. (1993). Prescription and nonprescription drug use among Black and White community-residing elderly. American Journal of Public Health, 83, 1577–1582.CrossRefGoogle Scholar
Fowler, F.J., & Mangione, T.W. (1990). Standardized survey interviewing: Minimizing interviewer-related error. London: Sage.Google Scholar
Friedlander, E.R. (1989). Dream your cancer away: the Simontons. In D., Stalker & C., Glymour (Eds.), Examining holistic medicine (pp. 273–285). New York: Prometheus.Google Scholar
Garro, L. (1986). Decision-making models of treatment choice. In McHugh, S. & Vallis, T. M. (Eds.), Illness behavior: A multidisciplinary model (pp. 173–188). New York: Plenum Press.CrossRefGoogle Scholar
Ghiselli, E.E., Campbell, J.P., & Zedeck, S. (1981). Measurement theory and analysis issues for field settings. Boston: Houghton Mifflin.Google Scholar
Gilbert, E.S. (1968). On discrimination using qualitative variables. Journal of American Statistical Association, 63, 1399–1412.Google Scholar
Gortz, J.P., & LeCompte, M.D. (1984). Ethnography and qualitative design in educational research. New York: Academic Press.Google Scholar
Government of Saskatchewan. (1992). Who uses prescription drugs? Results from a population-wide study in Saskatchewan. Drug Plan and Extended Benefits Branch, Saskatchewan Health, Regina, Saskatchewan.Google Scholar
Government of Saskatchewan. (1997). Annual statistical report 1996–97. Drug Plan and Extended Benefits Branch, Saskatchewan Health, Regina, Saskatchewan.Google Scholar
Greene, M.G., Adelman, R.D., & Rizzo, C. (1996). Problems in communication between physicians and older patients. Journal of Geriatric Psychiatry, 24, 13–32.Google Scholar
Guba, E.G., & Lincoln, Y.S. (1982). Epistemological and methodological basis of naturalistic inquiry. Educational Communication and Technology, 30, 233–252.CrossRefGoogle Scholar
Hadlow, J., & Pitts, M. (1991). The understanding of common health terms by doctors, nurses and patients. Social Science and Medicine, 32, 193–196.CrossRefGoogle Scholar
Health and Welfare Canada (1990). Nutrition recommendations. Ottawa: Canadian Government Publishing Centre.Google Scholar
Herbert, V. (1987). Health claims in food labeling and advertising: literal truths but false messages; deceptions by omission of adverse facts. Nutrition Today, 22, 25–30.CrossRefGoogle Scholar
Hughes, D. (1982). Control in the medical consultation: organizing talk in a situation where co-participants have different competence. Sociology, 15, 360–376.Google Scholar
Kerlinger, F.N. (1986). Foundations of behavioral research (3rd ed.). Toronto: Holt, Rinehart & Winston.Google Scholar
Kim, I., Williamson, D.F., Byers, T., & Koplan, J.P. (1993). Vitamin and mineral supplement use and mortality in a US cohort. American Journal of Public Health, 83, 546–550.CrossRefGoogle Scholar
Kleinman, A. (1980). Patients and healers in the context of culture. Berkeley: University of California Press.Google Scholar
Kleinman, A. (1988). The illness narratives: Suffering, healing, and the human condition. New York: Basic Books.Google Scholar
Kronenfeld, J.J., & Wasner, C. (1982). The use of unorthodox therapies and marginal practitioners. Social Science Medicine, 16, 1119–1125.CrossRefGoogle Scholar
Krueger, R.A. (1988). Focus groups: Apractical guide for applied research. Newbury Park, CA: Sage.Google Scholar
Lerner, I.J., & Kennedy, B.J. (1992). The prevalence of questionable methods of cancer treatment in the United States. Ca-A Cancer Journal for Clinicians, 42, 181–191.CrossRefGoogle Scholar
Lexchin, J. (1992). Prescribing and drug costs in the province of Ontario. International Journal of Health Services, 22, 471–487.CrossRefGoogle Scholar
Lofland, J., & Lofland, L.H. (1984). Analyzing social settings: A guide to qualitative observation and analysis (2nd ed.). Belmont, CA: Wadsworth.Google Scholar
McGinnis, L.S. (1991). Alternative therapies, 1990: an overview. Cancer, 67, 1788–1792.CrossRefGoogle Scholar
McHugh, S., & Vallis, T.M. (Eds.) (1985). Illness behavior: A multidisciplinary model. New York: Plenum.Google Scholar
McKim, W.A., & Mishara, B.L. (1987). Drugs and aging. Toronto: Butterworths.Google Scholar
McKim, W.A., Stones, M.J., Kozma, A. (1990). Factors predicting medicine use in institutionalized and non-institutionalized elderly. Canadian Journal on Aging, 9, 23–34.CrossRefGoogle Scholar
Miles, M.B., & Huberman, A.M. (1994). An expanded sourcebook: qualitative data analysis (2nd ed.). London: SageGoogle Scholar
Millar, W.J. (1997). Use of alternative health care practitioners by Canadians. Canadian Journal of Public Health, 88, 154–158.CrossRefGoogle Scholar
Montbriand, M.J. (1989). Alternate health care beliefs of Saskatchewan residents of European descent in a biomedical setting (Master's Thesis). Saskatoon: College of Nursing, University of Saskatchewan.Google Scholar
Montbriand, M.J. (1993). Freedom of choice: an issue concerning alternate therapies chosen by cancer patients. Oncology Nursing Forum, 20, 1195–1201.Google Scholar
Montbriand, M.J. (1994a). Decision heuristics of patients with cancer: alternate and biomedical choices. (Ph.D. Dissertation). Saskatoon: College of Medicine, University of Saskatchewan.Google Scholar
Montbriand, M.J. (1994b). An overview of alternate therapies chosen by cancer patients. Oncology Nursing Forum, 20, 1547–1554.Google Scholar
Montbriand, M.J. (1995) A decision tree model describing alternate health care choices made by oncology patients. Cancer Nursing, 18, 104–117.CrossRefGoogle Scholar
Montbriand, M.J. (1997). An inquiry into the experience of oncology patients who leave biomedicine to use alternate therapies. Canadian Oncology Nursing Journal 7, 6–9.CrossRefGoogle Scholar
Montbriand, M.J. (1998) Abandoning biomedicine for alternate therapies: oncology patients' stories. Cancer Nursing, 21, 36–45.CrossRefGoogle Scholar
Morgan, D.L. (1988). Focus groups as qualitative research. Newbury Park, CA: Sage.Google Scholar
Ong, L.M.L., deHaes, J.C.J.M., Hoos, A.M., & Lammes, F.B. (1995). Doctor-patient communication: A review of the literature. Social Science and Medicine, 40, 903–918.CrossRefGoogle Scholar
Quinn, K., Baker, M.J., & Evans, B. (1992). A population-wide profile of prescription drug use in Saskatchewan, 1989. Journal of Canadian Medical Association, 146, 2177–2186.Google Scholar
Rose, M.A. (1996). Effect of an AIDS education program for older adults. Journal of Community Health Nursing, 13, 141–148.CrossRefGoogle Scholar
Rossman, G.B., & Wilson, B.L. (1985). Numbers and words: Combining quantitative and qualitative methods in a single large-scale evaluation study. Evaluation Review, 9, 627–643.CrossRefGoogle Scholar
Ryan, A.S., Craig, L.D., & Ginn, S.C. (1992). Nutrient intakes and dietary patterns of older Americans: A national study. Journal of Gerontology, 47, M145–M150.CrossRefGoogle Scholar
Salant, P., & Dillman, D.A. (1994). How to conduct your own survey. Toronto: Wiley.Google Scholar
Sampson, W. (1997). Why a new alternative medicine journal? The Scientific Review of Alternative Medicine, 1, 4–6.Google Scholar
Sharpe, T.R., Smith, M.C., & Barbre, A.R. (1985). Medicine use among the rural elderly. Journal of Health and Social Behavior, 26, 113–127.CrossRefGoogle Scholar
Skoll, S.L., August, R.J., & Johnson, G.E. (1979). Drug prescribing for the elderly in Saskatchewan during 1976. Canadian Medical Association Journal, 121, 1074–1081.Google Scholar
Spradley, J.P. (1979). The ethnographic interview. Toronto: Holt, Rinehart and Winston.Google Scholar
Statistics Canada (1994). Income distributions by size in Canada, 1994. Cat. No. 13–207.Google Scholar
Stevens, R.E., Lawrence, L.W., & Loudon, D. (1991). The public's image of doctors, dentists, and pharmacists. Health Marketing Quarterly, 9, 97–105.Google Scholar
Stewart, M., & Roter, D. (Eds.). (1989). Communicating with medical patients. Newbury Park: Sage.Google Scholar
Stewart, R.B., Moore, M.T., Franklin, E.M., Marks, R.G., & Hale, W.E. (1991). A longitudinal evaluation of drug use in an ambulatory elderly population. Journal of Clinical Epidemiology, 44, 1353–1359.Google Scholar
Stoehr, G.P., Ganguli, M., Seaberg, E.C., Echement, D.A., & Belle, S. (1997). Over-the-counter medication use in older rural community: The MoVIES Project. Journal of the American Geriatrics Society, 45, 158–165.CrossRefGoogle Scholar
Street, R. (1992). Communicative styles and adaptations in physician-patient consultations. Social Science and Medicine, 34, 1155–1163.CrossRefGoogle Scholar
Tuominen, J.D. (1988). Prescription drugs and the elderly in BC. Canadian Journal on Aging, 7, 174–182.CrossRefGoogle Scholar
Verhoef, M.J., & Sutherland, L.R. (1995). Alternative medicine and general practitioners. Canadian Family Physician, 41, 1005–1011.Google Scholar
Waitzkin, H. (1989). A critical theory of medical discourse: Ideology, social control, and the processing of social context in medical encounters. Journal of Health and Social Behavior, 30, 220–239.CrossRefGoogle Scholar
Wilcox, S.M., Himmelstein, D.U., & Woodlhandler, S. (1994). Inappropriate drug prescribing for the community-dwelling elderly. Journal of the American Medical Association, 272, 292–296.CrossRefGoogle Scholar
Wilson, H.S. (1985). Research in nursing. Don Mills, ON: Addison-Wesley.Google Scholar