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Pamphlet Collection Library of Congress. Darling Charles Hial. William J. Guthrie Frederick Bickell. Meade - Scholar's Choice Edition. Humphrey Henry H Henry Hollingsworth. Allen Charles William. David - Scholar's Choice Edition. George Washington - Scholar's Choice Edition. William Roscoe Thayer. Hystaspes King of Persia, B. Pike G Holden Godfrey Holden. In order to identify men who potentially held a range of views about CAM, they were recruited from three contrasting settings: an NHS oncology centre where CAM users were identified in outpatient clinics using a short screening questionnaire , the outpatients clinics at a NHS homeopathic hospital and a cancer charity providing CAM therapies paid for privately.
A small sub-sample of patients who had never used CAM was also recruited.
Semi-structured interviews were carried out with participants in their own homes, covering a range of topics relating to their use of CAM. The topics reported here include: how information on CAM was obtained; which sources of information were most useful; how this information was used in decisions about using CAM.
Interviews were recorded and fully transcribed and the data were analysed thematically, drawing on the principles of constant comparison [ 15 ]. ME took the lead in coding and analysing the data, aided by the qualitative analysis software Atlas. AS read and coded a sub-set of the interview transcripts from each recruitment setting, and met with ME to discuss the developing coding framework and agree on broad themes. Members of the steering group also read sections of some transcripts and commented on the coding framework.
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The study comprised thirty-four male cancer patients who were using CAM, evenly distributed across the treatment sites: eleven from the oncology unit, twelve from the homeopathic hospital and eleven from the cancer charity. A broad spectrum was achieved across the sampling criteria. The age of participants ranged from 31 to 83 years, with a mean of 57 years. The spread across cancer type and stage of illness is shown in Tables 1 and 2. Participants were white and came from a range of manual, non-manual and professional occupational backgrounds. Over half were professional.
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Twenty-two participants had used CAM before their cancer diagnosis, for other health problems or for health maintenance, while for twelve participants, cancer had been the trigger to CAM use. Seven 'non-users of CAM' were also interviewed and they cited lack of knowledge and information about CAM as major reasons for non-use.
This paper will focus on those men who were using CAM. The types of CAM used by the men are shown in Appendix 1. All participants used CAM alongside their conventional treatment, except for one man who had refused orthodox treatment in favour of CAM therapies. The ways in which CAM was used and the perceived benefits are reported elsewhere [ 16 ].
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The focus of this paper is how the men sought, evaluated and used CAM information. Data illustrating each theme are mostly provided in tables 4 to 9, with some quotes illustrating key points interspersed within the text.
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Men talked about the lack of CAM information available from the NHS and the difficulty in engaging in discussion about CAM with professionals they encountered during their conventional care see Appendix 2. One man, who went on to access support from the CAM charity, described his frustration and sadness. I chose not to probe Another participant talked about the possibility of empowering patients by making CAM information accessible. The main resource for these men was the 'lay referral network' [ 17 ]: personal stories and recommendations passed on by family, friends, work colleagues and other acquaintances, often provoked by a cancer diagnosis.