摘要：Objectives. Complementary and alternative therapies have become popular with patients in Western countries. Studies have suggested motivations for patients’ choosing a wide range of complementary therapies. Data on the expectations of patients who use complementary therapy are limited. We assessed the expectations of patients who use complementary therapy. Methods. Patients attending a British National Health Service (NHS) outpatient department that provided acupuncture, osteopathy, and homoeopathy were asked to complete a qualitative survey. Results. Patients expected symptom relief, information, a holistic approach, improved quality of life, self-help advice, and wide availability of such therapies on the NHS. Conclusions. Physicians’ understanding of patients’ expectations of complementary therapies will help patients make appropriate and realistic treatment choices. The use of complementary therapies has been reported in a number of studies. 1– 6 Thomas et al. 7 estimated that patients made 22 million visits to practitioners of at least 1 of 6 established therapies in 1998 in the United Kingdom. Reasons for patients’ choosing complementary therapies are diverse 8 and include ineffectiveness of orthodox medicine, concern about the adverse effects of orthodox medicine, poor patient–physician communication, and the increasing availability of complementary therapy. 9, 10 Although attempts have been made through surveys to examine the extent of, use of, and reasons for referral to complementary therapy, few surveys have elicited the expectations of patients. In 1 small, unpublished study, researchers found that although most patients sought a cure or improvement in their condition, they also were looking for hope, reassurance, explanations, advice, and understanding. 11 Because expectations of both practitioner and patient influence the outcome of an intervention, understanding the expectations of patients and clarifying the limitations of treatment are important. 11 Patients who are dissatisfied with conventional treatment may have high expectations of complementary therapies. Such expectations, particularly in the context of chronic illness, may be unreasonable, thus leading to dissatisfaction with the complementary therapy. Conversely, dissatisfaction with conventional treatment might lead to low expectations for any other form of intervention and, therefore, a patient’s inflation of the outcome of treatment of the complementary therapy. An understanding of patient expectations is particularly relevant in regard to non-Western therapies grounded in different theories. These therapies, which are often based on a long and detailed patient assessment aimed at addressing health problems at a deep level, can involve lifestyle changes. For patients expecting a quick fix, the complementary therapy approach could present a challenge that may have an adverse effect on compliance or follow-up. Alternatively, patients may find conventional treatments to be limited and may desire a “holistic” approach that enables them to search for meaning in their illness. 12 Qualitative research methods are appropriate for new fields of study or for settings in which the experiences of individuals are of concern to policymakers. 13 These methods provide rich descriptions of what it is like to experience illness or suffering 14 and should be an essential component of health services research. 15 I used a qualitative survey approach to examine the expectations of patients who were treated at a British National Health Service (NHS) complementary therapy outpatient center.
