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Annals of Oncology Advance Access originally published online on October 26, 2007
Annals of Oncology 2008 19(1):49-55; doi:10.1093/annonc/mdm494
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© 2007 European Society for Medical Oncology. For Permissions, please email: journals.permissions@oxfordjournals.org

quality of life

Psychological and behavioral mechanisms influencing the use of complementary and alternative medicine (CAM) in cancer patients

K. Hirai1,*, K. Komura2, A. Tokoro3, T. Kuromaru4, A. Ohshima5, T. Ito6, Y. Sumiyoshi7 and I. Hyodo8

1 Department of Psychology and Behavioral Sciences, Graduate School of Human Sciences, Center for the Study of Communication Design, and Department of Complementary and Alternative Medicine, Graduate School of Medicine
2 Graduate School of Human Sciences, Osaka University, Osaka
3 Department of Psychosomatic Medicine, National Hospital Organization, Kinki-chuo Chest Medical Center, Osaka
4 Department of Palliative Care, Hikone Hospital, Hikone
5 Department of Psycho-Oncology, National Kyushu Cancer Center, Kyushu
6 Department of Complementary and Alternative Medicine, Graduate School of Medicine, Osaka University, Osaka
7 Department of Urology, Shikoku Cancer Center, Matsuyama
8 Division of Gastroenterology, University of Tsukuba, Tsukuba, Ibaraki, Japan

* Correspondence to: Dr K. Hirai, Graduate School of Human Sciences, Osaka University, 1-2 Yamadaoka, Suita Osaka 565-0871, Japan. Tel: +81-6-6879-8060; Fax: +81-6-6879-8060; E-mail: khirai{at}grappo.jp

Background: This study explored the psychological and behavioral mechanisms of complementary and alternative medicine (CAM) use in Japanese cancer patients using two applied behavioral models, the transtheoretical model (TTM), and theory of planned behavior (TPB).

Patients and methods: Questionnaires were distributed to 1100 patients at three cancer treatment facilities in Japan and data on 521 cancer patients were used in the final analysis. The questionnaire included items based on TTM and TPB variables, as well as three psychological batteries.

Results: According to the TTM, 88 patients (17%) were in precontemplation, 226 (43%) in contemplation, 33 (6%) in preparation, 71 (14%) in action, and 103 (20%) in maintenance. The model derived from structural equation modeling revealed that the stage of CAM use was significantly affected by the pros, cons, expectation from family, norms of medical staff, use of chemotherapy, period from diagnosis, and place of treatment. The primary factor for the stage of CAM use was the expectation from family.

Conclusions: The findings revealed the existence of a number of psychologically induced potential CAM users, and psychological variables including positive attitude for CAM use and perceived family expectation greatly influence CAM use in cancer patients.

Key words: CAM, cancer patients, psychological adjustment, theory of planned behavior, transtheoretical model

Received for publication May 8, 2007. Revision received September 6, 2007. Accepted for publication September 14, 2007.


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