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Using a mixed methods research design to investigate complementary alternative medicine (CAM) use among women with breast cancer in Ireland

Authors: Fox Patricia, Butler Michelle, Coughlan Barbara, Murray Mary, Boland Noreen, Hanan Terry, Murphy Hilary, Forrester Pauline, O' Brien Marie, O' Sullivan NollaigJournal: European journal of oncology nursing : the official journal of European Oncology Nursing SocietyPublished: August 1, 2013DOI: 10.1016/j.ejon.2012.10.008
Q1 JournalSJR: 0.85h-index: 73SCImago
Limited EvidenceObservationaln=477 participants

In Plain Language: cancer pain, explained

To investigate complementary and alternative medicine (CAM) use among women with breast cancer in Ireland using a mixed methods modified sequential explanatory design. Semi-structured interviews were conducted with oncology professionals (n = 20) and CAM practitioners (n = 20) and this was followed by a survey of 406 women with breast cancer using the 'Use of Complementary and Alternative Therapies Survey' questionnaire (UCATS) (Lengacher et al., 2003). Follow up interviews were subsequently undertaken with a subset of this survey sample (n = 31). Over half of those surveyed (55.7%, n = 226) used some form of CAM since diagnosis. The most frequently used therapies were massage, herbal supplements (including herbs with oestrogenic properties), antioxidants, relaxation, counselling, health supplements, reflexology, reiki and support groups. Dietary interventions were used primarily to reduce symptoms and/or side effects while reduction of psychological stress was the primary reason for use of stress-reducing therapies. Most respondents reported that the CAM therapies they had used were helpful. The qualitative data elaborated on and provided clarification of the survey results. Similar to international studies, CAM is popular among women with breast cancer in Ireland. As such, the challenge for Irish oncology professionals is to identify low risk CAM therapies that are likely to benefit patients while educating patients and themselves on therapies which may be of concern. This study clearly illustrates the benefits of using a mixed methods approach to enhance our understanding of a complex clinical issue and thus we recommend that this method should be the method of choice when planning health services research.

Key Findings: what this observational study found about cancer pain

  • ✓Over half of women with breast cancer in Ireland (55.7%) used some form of complementary and alternative medicine since their diagnosis.
  • ✓The most frequently used CAM therapies among breast cancer patients were massage, herbal supplements, antioxidants, relaxation, counselling, health supplements, reflexology, reiki, and support groups.
  • ✓Dietary interventions were primarily used by breast cancer patients to reduce symptoms and side effects of their condition or treatment.

What This Means for You

While this study shows reflexology is used by breast cancer patients and considered helpful, the evidence is observational rather than from rigorous controlled trials, so discuss any complementary therapies with your oncology team.

What This Means for Practitioners

Reflexology ranks among commonly used complementary therapies for breast cancer patients in Ireland, positioning it as a relevant supportive care option to discuss with oncology professionals for patient referral.

Study Design: how this observational study was run

Sample Size
477 participants
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Cancer pain: common questions

What does this study say about cancer pain?

While this study shows reflexology is used by breast cancer patients and considered helpful, the evidence is observational rather than from rigorous controlled trials, so discuss any complementary therapies with your oncology team.

What did this study find?

Over half of women with breast cancer in Ireland (55.7%) used some form of complementary and alternative medicine since their diagnosis. The most frequently used CAM therapies among breast cancer patients were massage, herbal supplements, antioxidants, relaxation, counselling, health supplements, reflexology, reiki, and support groups. Dietary interventions were primarily used by breast cancer patients to reduce symptoms and side effects of their condition or treatment.

How strong is this evidence?

This is a observational study and we rate its evidence limited. It covers 477 participants. It was published in European journal of oncology nursing : the official journal of European Oncology Nursing Society, a Q1 journal. This study is indexed here for context; it did not test reflexology itself.

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