Referral to yoga therapists in rural primary health care: A survey of general practitioners in rural and regional New South Wales, Australia.

BACKGROUND: Yoga is an increasingly accepted complementary treatment modality for referral in Australian general practice, yet this practitioner group has largely escaped research attention in Australia. Complementary medicine use is highest in rural and regional areas, where a number of primary health care challenges are also more pronounced. Despite the significant role of complementary therapists in rural and regional Australia, and the increasing acceptance of yoga therapy in general practice, there has been little exploration of the interface between yoga therapists and conventional primary health care practitioners in this area. MATERIALS AND METHODS: A 27-item questionnaire was sent to all 1486 general practitioners (GPs) currently practising in rural and regional Divisions of General Practice in New South Wales, Australia. RESULTS: Completed questionnaires were returned by 585 GPs, with 49 returned as 'no longer at this address' (response rate 40.7%). One-in-eight GPs (12.1%) advised their patients of specific yoga therapies and protocols, and 7.2% advised specific meditation techniques. Three-quarters of GPs (76.6%) referred to a yoga therapist at least a few times per year, with 12.5% of GPs referring at least once per week. GPs being in a remote location (OR = 10.95; CI: 1.55, 77.31), being female (OR = 1.85; 95% CI: 1.16, 2.94), GPs graduating from an Australian medical school (OR = 4.52; 95% CI: 2.61, 7.80), perceiving lack of other treatment options (OR = 3.29; 95% CI: 1.61, 6.74), GPs reporting good or very good knowledge of yoga therapies (OR = 18.2; 95% CI: 9.19, 36.19), and GPs using CAM for their own personal health (OR = 4.53; 95% CI: 2.60, 7.87) were all independently predictive of increased referral to yoga therapists amongst the rural GPs in this study. CONCLUSIONS: There is a significant interface between yoga therapists in Australian rural and regional general practice. There is generally high support for yoga therapies among Australian GPs, with low levels of opposition to the incorporation of these therapies in patient care. There is a need for increased research into yoga therapies practice, policy and regulation in these areas

The urban-rural divide in complementary and alternative medicine use: A longitudinal study of 10,638 women

Background: Research has identified women in rural and remote areas as higher users of complementary and alternative medicine (CAM) practitioners than their urban counterparts. However, we currently know little about what influences women's CAM consumption across the urban/rural divide. This paper analyses 10,638 women's CAM use across urban and rural Australia.Methods: Data for this research comes from Survey 5 of the Australian Longitudinal Study on Women's Health conducted in 2007. The participants were aged 56-61years. The health status and health service use of CAM users and non-users were compared using chi-square tests for categorical variables and t-tests for continuous variables.Results: Women who consulted a CAM practitioner varied significantly by place of residence: 28%, 32% and 30% for urban, rural and remote areas respectively (P < .005). CAM users tended to be more dissatisfied with conventional care than CAM non-users, but this was consistent across the 3 areas of residence. CAM users have higher percentages of most symptoms but the only rural/urban differences were for severe tiredness, night sweats, depression and anxiety. For diagnosed diseases, CAM users have higher percentages of most diagnoses but only hypertension and skin cancer were statistically significantly higher for rural and remote but not urban women (P < .005).Conclusions: In contrast to some recent claims, our analysis suggests the lack of access to and/or patient dissatisfaction with conventional health practitioners may not play a central role in explaining higher use of CAM by women in rural and remote areas when compared to women in urban areas. © 2011 Adams et al; licensee BioMed Central Ltd

Prevalence and characteristics of Australian women who use prayer or spiritual healing: A nationally representative cross-sectional study

© 2016 Elsevier Ltd. Objectives: To determine the prevalence and characteristics of users of prayer or spiritual healing among Australian women aged 31-36 years. Design and setting: This cross-sectional study was conducted as a part of the Australian Longitudinal Study on Women's Health (ALSWH). The sample used in the current sub-study were participants from the 'young' cohort (1973-78) (n = 8180) aged between 31 and 36 years. Main outcome measure: Use of prayer or spiritual healing. Results: Prayer or spiritual healing was used on a regular basis by 20% of women aged between 31 and 36 years in 2009. Women who had symptoms of chronic illnesses (p = 0.001), women who had never smoked (p = 0.001) and women who used other forms of CAM (p < 0.001) were significantly more likely to use prayer or spiritual healing. Conclusion: A signifibasis. Further research is required to better understand their rationale for using prayer or spiritual healing and its perceived impact on health related outcomes and general well-being.cant proportion of women use prayer or spiritual healing on a regular basis. Further research is required to better understand their rationale for using prayer or spiritual healing and its perceived impact on health related outcomes and general well-being

Complementary and alternative medicine for victims of intimate partner abuse: A systematic review of use and efficacy

Objectives. To examine: (i) the extent to which victims of intimate partner abuse (IPA) use complementary and alternative medicine (CAM) and (ii) the effects of CAM on their mental health. Methods. Medline, Scopus, and Web of Science were searched for studies measuring the extent of CAM use amongst victims of IPA and trials assessing the impact of CAM on mental health amongst this population. Risk of bias was assessed using the Cochrane collaboration tool. Results. No studies measuring the level of CAM use amongst IPA victims, and only three studies assessing the effect of CAM on the mental health of this population were identified. Two studies looked at yogic breathing, while one assessed the effect of music therapy. All three studies showed some beneficial effects; however, each had a small sample, brief intervention period, and no follow-up measurement and were considered to be at high risk of bias. Conclusions. The review found little evidence for the benefits of CAM for IPA victims. Findings suggest positive effects of music therapy and yogic breathing; however, methodological limitations mean that these results should be interpreted with caution. It is important that more research into the use and effects of CAM amongst this population are undertaken. © 2014 Luke Duffy et al

Is Health Practitioner Regulation Keeping Pace with the Changing Practitioner and Health-Care Landscape? An Australian Perspective

Health-care delivery is undergoing significant evolution and change. Task substitution has resulted in some practitioner groups expanding their scope of practice by assuming more complex clinical roles, new practitioner groups have emerged, and consumer-driven demand has changed the way the public engage with health practitioners and the way many health-care services are delivered. Using Australia as a case study, this paper explores the issue of the hesitancy to include new professions in health professions regulation schemes. Despite the significant changes in the health-care delivery landscape, policy development in this area has remained relatively static, with active resistance to extending formal registration to new practitioner groups. Ignoring the issue of new practitioner groups in regulatory schemes is unacceptable from a public health perspective and runs against the key public protection objectives of health practitioner regulation. Development of pathways for the entry of new health practitioner groups into regulatory schemes must be developed as a matter of priority

The outcomes of complementary and alternative medicine use among pregnant and birthing women: Current trends and future directions

© 2015 Future Medicine Ltd. Complementary and alternative medicine is used by a substantial number of pregnant women and maternity care providers are often faced with the task of ensuring women are using safe and effective treatments while respecting a woman's right to autonomous decision-making. In the era of evidence-based medicine maternity health professionals are expected to draw upon the best available evidence when making clinical decisions and providing health advice. This review will outline the current trends in research evidence associated with the outcomes of complementary and alternative medicine use amongst pregnant and birthing women as well as highlight some potential directions for future development in this important yet largely unknown topic in contemporary maternity care

The Association between women’s choice of birth setting and their use of CAM during labor and birth.

Purpose: Contemporary maternity care often means women are able to choose a number of settings for their birth including hospitals, birth centers, and community settings. There is also evidence that many women utilised complementary and alternative medicine (CAM) during pregnancy and birth. The purpose of this study is to examine the association between women’s choice of birth setting and their use of CAM during labor and birth. Methods: Longitudinal data from a sub-study of women (n = 2445) from the nationally-representative Australian Longitudinal Study of Women’s Health (ALSWH) was analyzed for relationships between women’s birth setting (hospital, birth center, or community) and their demographics, attitudes towards maternity care (including CAM), and use of CAM during pregnancy and birth. Results: The characteristics associated with women’s choice of birth setting include some demographic features such as employment status, health care subsidy, and level of education. Women’s birth setting choice was also linked to a preference for CAM practitioner by women birthing in birth centers and community settings. In contrast, women birthing in hospitals held more positive views towards obstetric care. There was a higher use of CAM during pregnancy by women birthing in birth centers and community but this was not consistent across all CAMs investigated. Naturopaths, herbal medicines, homeopathy and flower essences were more commonly used by women birthing in community compared with those in a birth center. There was also a higher rate of CAM use for intrapartum pain management for women birthing outside of a hospital setting, although women attending a birth center were more likely than those birthing in community to use pharmacological pain management techniques. Conclusion: There are characteristic differences between women birthing in different birth settings which seems to be influenced as much by preference for maternity care and interest in CAM use as it is by demographics

Characteristics of women who practice yoga in different locations during pregnancy

Objectives: Yoga practice during pregnancy is gaining increasing popularity. This study examined the characteristics of pregnant women who practiced yoga in regard to the different locations (at home, in yoga classes, or both). Design: The study sample was drawn from the Australian Longitudinal Study on Women's Health (ALSWH), a national longitudinal study of women to investigate multiple factors affecting health and wellbeing of women over a 20-year period. Setting: Postal survey. Participants: Women born between 1973 and 1978, who were randomly selected from the national Medicare database and identified as being pregnant or having recently given birth (n=2316). Outcome measures: Relationships between yoga use (attending yoga classes and/or practising yoga at home) and women's characteristics (demographic measures, pregnancy-related health concerns, health service utilisation, attitudes to complementary and alternative medicine). Results: Practising yoga both at home and in classes was associated with perceiving complementary and alternative medicine (CAM) as preventative (odds ratio (OR)=1.62); perceiving CAM as affording health control (OR=1.50); experiencing sadness (OR=1.72); preparing for labour (OR=2.31); birthing in a birth centre (OR=7.97); and experiencing less vomiting (OR=0.38). Practising at home only was associated with perceiving CAM as affording health control (OR=1.76); perceiving CAM as promoting a holistic health approach (OR=1.65); and birthing in a birth centre (OR=3.54). Practising in classes only was associated with experiencing stress (OR=1.97); and birthing in a birth centre (OR=4.85) (all p<0.05). Conclusions: The findings suggest that the location in which a woman practices yoga is associated with attitudinal, health-related and birth environmental factors

The characteristics, experiences and perceptions of naturopathic and herbal medicine practitioners: Results from a national survey in New Zealand

© Cottingham et al.; licensee BioMed Central. Background: Despite the popularity of naturopathic and herbal medicine in New Zealand there remains limited data on New Zealand-based naturopathic and herbal medicine practice. Methods: An online survey (covering 6 domains: demographics; practice characteristics; research; integrative practice; regulation and funding; contribution to national health objectives) was administered to naturopaths and herbal medicine practitioners. From a total of 338 naturopaths and herbal medicine practitioners, 107 responded providing a response rate of 32%. Data were statistically analysed using STATA. Results: A majority of the naturopaths and herbal medicine practitioners surveyed were female (91%), and aged between 45 and 54 years. Most practiced part-time (64%), with practitioner caseloads averaging 8 new clients and over 20 follow-up clients per month. Conclusions: There is a need for greater understanding and communication between practitioners of conventional care and naturopathic and herbal medicine which could support informed, coordinated and effective health provision within the New Zealand health care system. There is a need for further in-depth research examining naturopaths and herbal medicine practitioners' perceptions and practices, to provide insights of benefit to all those practising and managing health services as well as those directing health policy in New Zealand

Severity of back pain may influence choice and order of practitioner consultations across conventional, allied and complementary health care: A cross-sectional study of 1851 mid-age Australian women

© 2016 The Author(s). Background: Back pain is a common, disabling and costly disorder for which patients often consult with a wide range of health practitioners. Unfortunately, no research to date has directly examined the association between the severity of back pain and back pain sufferers' choice of whom and in what order to consult different health practitioners. Methods: This is a sub-study of the large nationally representative Australian Longitudinal Study on Women's Health (ALSWH). The mid-age cohort women (born 1946-51, n = 13,715) of the ALSWH were recruited from the Australian national Medicare database in 1996. These women have been surveyed six time, with survey 6 being conducted in 2010 (n = 10,011). Mid-age women (n = 1851) who in 2010 had sought help from a health care practitioner for their back pain were mailed a self-report questionnaire targeting their previous 12 months of health services utilisation, health status and their levels of back pain intensity. Results: A total of 1620 women were deemed eligible and 1310 (80.9 %) returned completed questionnaires. Mid-age women with back pain visited various conventional, allied health and CAM practitioners for care: 75.6 % consulted a CAM practitioner; 58.4 % consulted a medical doctor; and 54.2 % consulted an allied health practitioner. Women with the most severe back pain sought conventional care from a general practitioner, and those who consulted a general practitioner first had more severe back pain than those who consulted another practitioner first. Following the general practitioner visit, the women with more severe back pain were more likely to be referred to a conventional specialist, and those with less severe back pain were more likely to be referred to a physiotherapist. Conclusions: Our findings suggest that women with more severe back pain are likely to visit a conventional practitioner first, whereas women with less severe back pain are likely to explore a range of treatment options including CAM practitioners. The improvement of back pain over time following the various possible sequencing of consultations with different types of health practitioners is a topic with implications for ensuring safe and effective back pain care and worthy of further detailed investigation