A cross-sectional study of socio-cultural and health determinants of complementary and alternative medicine use by Chinese patients with mental health needs in an urban primary care setting.

摘要

Background. The use of complementary and alternative medicine (CAM) is widespread and growing. Scientific interest in understanding the demographics, prevalence and patterns of CAM use have increased during recent years. However, understanding of CAM use by Asian-American populations remains limited. Based on a conceptual framework derived from the socio-behavioral model and Traditional Chinese Medicine, this dissertation aims to explore the prevalence of CAM use and socio-cultural and health determinants of CAM use.;Method. A cross-sectional survey was used to explore CAM use in a community sample consisting of 153 Chinese American adults with DSM-IV diagnosis. Path analysis was employed to assess the effects of predisposing, enabling, needs, and cultural factors on CAM use. In addition, predisposing, enabling, and cultural factors were hypothesized to directly influence both physical and mental health status. A directional relationship from physical health status to mental health status was also assessed.;Results. The study sample was predominately foreign-born with low SES. Over 90% of the study participants had used CAM during their lifetime, and over 80% reported current use. The most used CAM therapies were herbal medicine, megavitamin, and acupuncture. Based on the path analysis results, predisposing factors, including age and religiosity exerted the strongest effects on CAM use, followed by education and physical health status. A directional, positive relationship from physical health status to mental health status was also observed. All cultural factors did affect CAM use indirectly. However, acculturation and stigma toward mental health were negatively associated with physical health status. A significant relationship was noted between strong traditional beliefs about mental illness and poor mental health status.;Conclusion. Findings suggest that a majority of Chinese immigrants with mental health needs are using CAM, and that a culturally relevant conceptual model can be used to explain CAM use of this population. To ensure its sustainability and applicability, this model needs be further tested with different populations. Implications for practice, policy and research are addressed.