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Using Alternative Therapies to Manage Chronic Illness Among Older Adults: An Examination of the Health Context, Predisposing and Enabling Processes

Published online by Cambridge University Press:  31 March 2010

Andrew V. Wister ,
Minda Chittenden ,
Bonnie McCoy ,
Kelly Wilson ,
Trasey Allen  and
Melanie Wong
Andrew V. Wister
Affiliation:
Simon Fraser University at Harbour Center
Minda Chittenden
Affiliation:
Simon Fraser University at Harbour Center
Bonnie McCoy
Affiliation:
Simon Fraser University at Harbour Center
Kelly Wilson
Affiliation:
Simon Fraser University at Harbour Center
Trasey Allen
Affiliation:
Simon Fraser University at Harbour Center
Melanie Wong
Affiliation:
Simon Fraser University at Harbour Center
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Abstract

This paper examines use of alternative therapies to manage a chronic illness among older adults with at least one of three major conditions: arthritis, heart disease, and hypertension. Drawing from developments in the health utilization literature, a focus is placed on the illness context, predisposing factors, and several factors deemed to enable persons to use complementary medicine. The baseline data (n = 879) from the 1995–96 North Shore Self-Care Study conducted in Vancouver, Canada were used for this study. Two dependent variables were analysed using logistic regression techniques – the first is based on a comprehensive question about using alternative therapies (such as herbal remedies, acupuncture, massage therapy, etc.) to manage a chronic condition; and the second uses a more specific question pertaining to meditation or praying. The results from the first analysis show that being younger, suffering from arthritis compared to hypertension, comorbidity, taking fewer medications, lower income, reading on the chronic condition, and the interaction between reading and illness self-efficacy are associated with trying alternative therapies. The findings for the second analysis show that being female, being younger, and not married, as well as reporting a more serious condition, illness duration and the interaction between having moderate levels of mutual aid and number of confidants result in a greater likelihood of trying meditation/prayer. Implications of these results are discussed in terms of their theoretical import, and their relevance for the degree to which unconventional and conventional medicine are complementary.

Résumé

Cet article traite de l'utilisation de médecines douces pour gérer une maladie chronique chez les adultes âgés qui souffrent d'au moins une des trois affections suivantes: arthrite, maladie du œeur et hypertension. En tirant des conclusions de la littérature reliée à la santé, l'accent est mis sur le contexte de la maladie, les facteurs prédisposants et plusieurs facteurs qui semblent inciter certaines personnes à utiliser des médecines douces. Des données de départ (n = 87) tirées d'une étude effectuée en 1995–96 à Vancouver, Canada (North Shore Self-Care Study) ont été utilisées. On a analysé deux variables dépendantes en utilisant des techniques de régression logistique – la première se fonde sur une question globale concernant l'utilisation des médecines douces (les herbes médicinales, l'acupuncture, les massages thérapeutiques, etc.) pour gérer un état chronique et la deuxième porte sur une question plus spécifique relative à la méditation ou la prière. Les résultats de la première analyse montrent que le fait d'être plus jeune, de souffrir d'arthrite par rapport à l'hypertension, de comorbidité, de consommer moins de médicaments, d'avoir des revenus plus bas, de lire sur son état chronique et d'agir sur soi à partir de ses lectures sont associés à l'essai des médecines douces. Les conclusions de la deuxième analyse montrent que le fait d'être une femme, plus jeune, célibataire, d'avoir un état plus grave et une maladie plus longue, le lien entre des niveaux modérés d'entraide et le nombre de confidents, incitent vraisemblablement à avoir recours à la méditation et à la prière. Les répercussions de ces résultats sont abordés sous l'angle de leur signification théorique et du degré de pertinence de la complémentarité de la médecine conventionnelle et non conventionnelle.

Keywords

Alternative TherapiesIllness ManagementComplementarymédicines doucesgestion de la maladiecomplémentaire
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 21 , Issue 1 , Spring/Printemps 2002 , pp. 47 - 62
Copyright
Copyright © Canadian Association on Gerontology 2002

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References

Andersen, R., (1995). Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36(March),1–10.CrossRefGoogle ScholarPubMed
Andersen, R., & Newman, J. (1973). Societal and individual determinants of medical care use in the United States. Milbank Memorial Fund Quarterly, 51, 91–124.Google ScholarPubMed
Astin, J.A. (1996). Why patients use alternative medicine: Results of a national study. Journal of the American Medical Association 279(19), 1548–1553.CrossRefGoogle Scholar
Bandura, A. (1986). Social foundations of thought and action. NJ: Prentice Hall.Google Scholar
Boisset, M., & Fitzcharles, M-A. (1994). Alternative medicine use by rheumatology patients in a universal health care setting. Journal of Rheumatology, 21, 148–152.Google Scholar
Chappell, N., & Blandford, A., (1987). Health service utilization by elderly persons. Canadian Journal of Sociology 12, 195–215.CrossRefGoogle Scholar
Clark, N., Becker, M., Janz, N., Lorig, K., Rakowski, W., & Anderson, L. (1991). Self-management of chronic disease by older adults: A review and questions for research. Journal of Aging and Health, 3(1), 3–27.CrossRefGoogle Scholar
Clark, N., Janz, N., Dodge, J., Schork, M., Fingerlin, T., Wheeler, J., Liang, J., Keteyian, S., & Santinga, J. (2000). Changes in functional health status of older women with heart disease: Evaluation of a program based on self-regulation. Journal of Gerontology: Social Sciences, 55B(2), S117–S126.CrossRefGoogle Scholar
CMAJ. (1991). One in five Canadians is using alternative therapies, survey finds. Canadian Medical Association Journal, 144(4), 469.Google Scholar
CMAJ. (1997). Higher earners seek more alternative care. Canadian Medical Association Journal, 157(7), 996.Google Scholar
Cohen, S., & Syme, L. (1985). Social support and health. New York: Academic Press.Google Scholar
Dean, K., & Kickbusch, I. (1995). Health related behaviour in health promotion: utilizing the concept of self-care. Health Promotion International, 10(1), 35–40.CrossRefGoogle Scholar
DeMaris, A. (1995). A tutorial in logistic regression. Journal of Marriage and the Family, 57, 956–968.CrossRefGoogle Scholar
Eisenberg, D.M., Kessler, R.C., Foster, C., Norlock, F.E., Calkins, D.R., & Delbanco, T.L. (1993). Unconventional medicine in the United States: Prevalence, costs, and patterns of use. New England Journal of Medicine, 328(4), 246–252.CrossRefGoogle ScholarPubMed
Fisher, P., & Ward, A. (1994). Complementary medicine in Europe. British Medical Journal, 309, 107–111.CrossRefGoogle ScholarPubMed
Fleming, G., Giachello, A., Anderson, A., & Andrade, P. (1984). Substitute, supplement or stimulus for formal medical care services? Medical Care, 22, 950–966.CrossRefGoogle ScholarPubMed
Furnham, A., & Forey, J. (1994). The attitudes, behaviours and beliefs of patients of conventional vs. complementary (alternative) medicine. Journal of Clinical Psychology, 50(3), 458–469.3.0.CO;2-V>CrossRefGoogle ScholarPubMed
Gray, D. (1985). The treatment strategies of arthritis sufferers. Social Science and Medicine, 12, 507–515CrossRefGoogle Scholar
Kart, C.S., & Engler, C.A. (1994). Predisposition to self-health care: Who does what for themselves and why? Journal of Gerontology: Social Sciences, 49(6), S301–S308.CrossRefGoogle ScholarPubMed
Kelner, & Wellman, (1997). Health care and consumer choice: Medical and alternative therapies. Social Science and Medicine, 45(2), 201–212.CrossRefGoogle ScholarPubMed
Kestin, M., Miller, L., Littlejohn, G., & Wahlqvist, M. (1985). Medical Journal of Australia, 143, 516–519.CrossRefGoogle Scholar
Kronenfeld, J.J., & Wasner, C. (1982). The use of unorthodox therapies and marginal practitioners. Social Science and Medicine, 16, 1119–1125.CrossRefGoogle ScholarPubMed
Lewith, G. (1997). A measure of success. British Journal of General Practice, 47, 47–49.Google ScholarPubMed
Longino, (1997). Beyond the body: An emerging medical paradigm. American Demographics, Dec., 14–19.Google ScholarPubMed
Lorig, K., Brown, B.W., Ung, E., Chastain, R. Shoor, S., & Holman, H.R. (1989). Development and evaluation of a scale to measure the perceived self-efficacy of people with arthritis. Arthritis and Rheumatism, 32, 37–44.CrossRefGoogle ScholarPubMed
Lorig, K., & Holman, H.R. (1989). Long-term outcomes of the Arthritis Self-Management Study: Effects of reinforcement efforts. Social Science and Medicine, 29, 221–224.CrossRefGoogle ScholarPubMed
McDonald-Miszczak., L., Wister, A.V., & Gutman, G.M. (2001). Self-care among older adults: An analysis of the objective and subjective illness context. Journal of Aging & Health, 13 (1), 120–145.CrossRefGoogle Scholar
MacLennan, A.H., Wilson, D.H., & Taylor, A. (1996). Prevalence and cost of alternative medicine in Australia. The Lancet, 347, 569–573.CrossRefGoogle ScholarPubMed
Marshall, R., Gee, R., Israel, D., Edwards, F., Dumble, J., Wong, S., Chan, C., Patel, R., Poon, P. & Tam, G. (1990). The use of alternative therapies by Auckland general practitioners. New Zealand Medical Journal, 103, 213–215.Google ScholarPubMed
Menard, S. (1995). Applied Logistic Regression Analysis. Quantitative Applications in the Social Sciences. London: Sage.Google Scholar
Millar, W.J. (1997). Use of alternative health care practitioners by Canadians. Canadian Journal of Public Health, 88(3), 154–158.CrossRefGoogle ScholarPubMed
Moore, J., Phipps, K., & Marcer, D. (1985). Why do people seek treatment by alternative medicine? British Medical Journal 290, 28–29.CrossRefGoogle ScholarPubMed
Montbriand, M., & Laing, G. (1991). Alternative health care as a control strategy. Advanced Journal of Nursing, 16, 325–332.CrossRefGoogle ScholarPubMed
Morgan, S.P., & Teachman, J.D. (1988). Logistic regression: Description, examples, and comparisons. Journal of Marriage and the Family, 50; 929–936.CrossRefGoogle Scholar
Murray, J., & Shepherd, S. (1993). Alternative or additional medicine? An exploratory study in general practice. Social Science and Medicine, 37(8), 983–988.CrossRefGoogle ScholarPubMed
Murry, R.H., & Rubel, A.J. (1992). Sounding board: Physicians and healers - unwitting patterns in health care. The New England Journal of Medicine, 326(1), 61–64.CrossRefGoogle Scholar
Northcott, H.C., & Bachynsky, J. (1993). Research Note: Concurrent utilization of chiropractic, prescription medicines, nonprescription medicines and alternative health care. Social Science and Medicine, 37(3), 431–435.CrossRefGoogle Scholar
OAM-NIH Classification of Alternative Medicine Practices. (1999). Office of Alternative Medicine. Webpage.Google Scholar
Ory, M., & Defriese, G. (Eds.) (1998). Self-Care in later life: Research, program & policy Perspectives. New York: Sage.Google Scholar
Richmond, C. (1991). As their health improves, British broaden quest for alternative health care. Canadian Medical Association Journal, 144(7), 912–914.Google ScholarPubMed
Romeder, J.M. (1990). The self-help way: Mutual aid and health. Ottawa: Canada Council on Social Development.Google Scholar
Schepers, R.M., & Hermans, H.E. (1999). The medical profession and alternative medicine in the Netherlands: Its history and recent developments. Social Science & Medicine, 48, 343–351.CrossRefGoogle Scholar
Sutherland, L., & Verhoef, M. (1994). Why do patients seek a second opinion or seek alternative medicine? Journal of Clinical Gastroenterology, 19(3), 194–197.CrossRefGoogle Scholar
Verhoef, M., Sutherland, L., & Brkich, L. (1990). Use of alternative medicine by patients attending a gastoenterology clinic. Canadian Medical Assocaition Journal, 142(2), 121–125.Google Scholar
Vincent, C., & Furnham, A. (1996). Why do patients turn to complementary medicine? British Journal of Clinical Psychology, 35, 37–48.CrossRefGoogle ScholarPubMed
Wardell, W.I. (1994). Alternative medicine in the United States. Social Science & Medicine, 38(8), 1061–1068.CrossRefGoogle Scholar
Wister, A.V. (1992). Residential attitudes and knowledge, use, and future use of home support agencies. Journal of Applied Gerontology, 11(1), 84–100.CrossRefGoogle ScholarPubMed
Wister, A.V. (1995). The relationship between self-help group participation and other health behaviours among older adults. Canadian Journal of Community Mental Health, 14(2), 23–38.CrossRefGoogle Scholar
Wister, A.V., & Dean, K. (1998) A comparative analysis of graphical interaction and logistic regression modelling: Self-care and coping with a chronic illness in later life. Paper presented at the 14th World Congress of Sociology, Montreal, Quebec, July 26-Aug. 1, 1998.Google Scholar
Wolinsky, F.D. (1978). Assessing the effects of predisposing, enabling and illness-morbidity characteristics on health service use. Journal of Health and Social Behaviour, 19, 384–396.CrossRefGoogle Scholar
Wolinsky, F.D., & Johnson, R.J. (1991). The use of health services by older adults. Journal of Gerontology: Social Sciences, 46(6), S345–S357.CrossRefGoogle ScholarPubMed
Zimmer, Z., & Chappell, N. (1994). Mobility restriction and the use of devices among seniors. Journal of Aging and Health, 6(2), 185–208.CrossRefGoogle Scholar