This new edition of Ann Bowling's well-known and highly respected text has been thoroughly revised and updated to reflect key methodological developments in health research. It is a comprehensive, easy to read, guide to the range of methods used to study and evaluate health and health services. It describes the concepts and methods used by the main disciplines involved in health research, including: demography, epidemiology, health economics, psychology and sociology.The research methods described cover the assessment of health needs, morbidity and mortality trends and rates, costing health services, sampling for survey research, cross-sectional and longitudinal survey design, experimental methods and techniques of group assignment, questionnaire design, interviewing techniques, coding and analysis of quantitative data, methods and analysis of qualitative observational studies, and types of unstructured interviewing. With new material on topics such as cluster randomization, utility analyses, patients' preferences, and perception of risk, the text is aimed at students and researchers of health and health services. It has also been designed for health professionals and policy makers who have responsibility for applying research findings in practice, and who need to know how to judge the value of that research.

Research Methods in Health. Investigating health and health services

The Psychology of Religion and Coping: Theory, Research, Practice

Introduction: Primary care has a central role in integrating care within a health system. However, conceptual ambiguity regarding integrated care hampers a systematic understanding. This paper proposes a conceptual framework that combines the concepts of primary care and integrated care, in order to understand the complexity of integrated care. Methods: The search method involved a combination of electronic database searches, hand searches of reference lists (snowball method) and contacting researchers in the field. The process of synthesizing the literature was iterative, to relate the concepts of primary care and integrated care. First, we identified the general principles of primary care and integrated care. Second, we connected the dimensions of integrated care and the principles of primary care. Finally, to improve content validity we held several meetings with researchers in the field to develop and refine our conceptual framework. Results: The conceptual framework combines the functions of primary care with the dimensions of integrated care. Person-focused and population-based care serve as guiding principles for achieving integration across the care continuum. Integration plays complementary roles on the micro (clinical integration), meso (professional and organisational integration) and macro (system integration) level. Functional and normative integration ensure connectivity between the levels. Discussion: The presented conceptual framework is a first step to achieve a better understanding of the inter-relationships among the dimensions of integrated care from a primary care perspective.

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Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care.

Objective: To investigate the use of and expenditure on 17 of the most popular forms of complementary and alternative medicine (CAM) by adult Australians, sociodemographic characteristics of CAM users, and communication between CAM users and their doctors. Methods: In May–June 2005, a sample of 1067 adults, 18 years and older, from all Australian states and territories, was recruited by random-digit telephone dialing and interviewed about their CAM use in the previous 12 months. Results: In the 12-month period, 68.9% (95% CI: 66.1%–71.7%) of those interviewed used at least one of the 17 forms of CAM and 44.1% (95% confidence interval: 41.1%–47.1%) visited a CAM practitioner. The estimated number of visits to CAM practitioners by adult Australians in the 12-month period (69.2 million) was almost identical to the estimated number of visits to medical practitioners (69.3 million). The annual “out of pocket” expenditure on CAM, nationally, was estimated as 4.13 billion Australian dollars (US $3.12 billion). L...

Complementary and Alternative Medicine Use in Australia: A National Population-Based Survey

Background. No comprehensive systematic review has been published since 1998 about the frequency with which cancer patients use complementary and alternative medicine (CAM). Methods. MEDLINE, AMED, and Embase databases were searched for surveys published until January 2009. Surveys conducted in Australia, Canada, Europe, New Zealand, and the United States with at least 100 adult cancer patients were included. Detailed information on methods and results was independently extracted by 2 reviewers. Methodological quality was assessed using a criteria list developed according to the STROBE guideline. Exploratory random effects metaanalysis and metaregression were applied. Results. Studies from 18 countries (152; >65 000 cancer patients) were included. Heterogeneity of CAM use was high and to some extent explained by differences in survey methods. The combined prevalence for “current use” of CAM across all studies was 40%. The highest was in the United States and the lowest in Italy and the Netherlands. Metaanalysis suggested an increase in CAM use from an estimated 25% in the 1970s and 1980s to more than 32% in the 1990s and to 49% after 2000. Conclusions. The overall prevalence of CAM use found was lower than often claimed. However, there was some evidence that the use has increased considerably over the past years. Therefore, the health care systems ought to implement clear strategies of how to deal with this. To improve the validity and reporting of future surveys, the authors suggest criteria for methodological quality that should be fulfilled and reporting standards that should be required.

https://journals.sagepub.com/doi/pdf/10.1177/1534735411423920

How Many Cancer Patients Use Complementary and Alternative Medicine: A Systematic Review and Metaanalysis

Neuropsychiatric problems, and how they interact to impact on quality of life (QOL) in brain tumor patients, are generally poorly understood The objectives of this study were: (1) to document the prevalence of depression, fatigue, emotional distress, and existential issues in a sample of brain tumor patients (2) to examine the interconnectedness of these problems, and (3) to explore their relationship with disease-related variables and QOL This is a cross-sectional, questionnaire-based survey of 73 patients with primary brain tumors who presented to a neurological clinic at a tertiary cancer centre for ongoing care Data for 60 participants (29 women, 31 men) who completed validated questionnaires were retained for analysis Results showed that there was a high burden of depressive symptoms as measured by the Beck Depression Inventory-II (mean score 111, SD 74), with 38% of the sample scoring in the clinically depressed range Overall QOL scores for this sample were similar to a reference sample of brain tumor patients The scores on the existential subscale of the McGill Quality of Life questionnaire were comparable to those of a reference sample of cancer patients receiving ongoing care (mean score 72; SD 17) Fifty per cent of the sample could be classified as struggling with existential issues Although scores reflecting depression, fatigue, emotional distress, and existential problems were interrelated, the presence of depressive symptoms was the single most important independent predictor of QOL in this cohort of brain tumor patients Implications for treatment are discussed

Quality of life in brain tumor patients: the relative contributions of depression, fatigue, emotional distress, and existential issues.

Background: "Integrative health care" has become a common term to describe teams of health care providers working together to provide patient care. However this term has not been welldefined and likely means many different things to different people. The purpose of this paper is to develop a conceptual framework for describing, comparing and evaluating different forms of teamoriented health care practices that have evolved in Western health care systems. Discussion: Seven different models of team-oriented health care practice are illustrated in this paper: parallel, consultative, collaborative, coordinated, multidisciplinary, interdisciplinary and integrative. Each of these models occupies a position along the proposed continuum from the nonintegrative to fully integrative approach they take to patient care. The framework is developed around four key components of integrative health care practice: philosophy/values; structure, process and outcomes. Summary: This framework can be used by patients and health care practitioners to determine what styles of practice meet their needs and by policy makers, healthcare managers and researchers to document the evolution of team practices over time. This framework may also facilitate exploration of the relationship between different practice models and health outcomes.

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From parallel practice to integrative health care: a conceptual framework

Purpose:To conduct a systematic review of reasons for and sociodemographic and disease characteristics associated with complementary and alternative medicine (CAM) use in cancer patients.Methods:Eligible studies were identified by searching the following databases: Alt Health Watch, AMED, CINAHL, CancerLit, PremMEDLINE, MEDLINE, Pub-Med, Ingenta, EMBASE, and Health Star, as well as reference lists in review articles. Only English-language articles published between 1994 and 2004 were included. Search terms includedCAM and oncology/cancer, decision making and CAM and oncology/cancer, treatment decision making and CAM and oncology/cancer, andhealth care choices and CAM and oncology/cancer.Results:Fifty-two eligible studies were identified and summarized. These studies were conducted in 14 different countries, with the largest number of studies being completed in the United States (34.6%). A therapeutic response, wanting control, a strong belief in CAM, CAM as a last resort, and finding hope were the most co...

https://journals.sagepub.com/doi/pdf/10.1177/1534735405282361

Reasons for and characteristics associated with complementary and alternative medicine use among adult cancer patients: a systematic review.

Complementary and alternative medicine whole systems research: Beyond identification of inadequacies of the RCT

Randomized controlled trials (RCTs) have an important place in the assessment of the efficacy of complementary and alternative medicine (CAM). However, they address only one, limited, question, namely whether an intervention has-statistically-an effect. They do not address why the intervention works, how participants are experiencing the intervention, and/or how they give meaning to these experiences. Therefore, we argue that the addition of qualitative research methods to RCTs can greatly enhance understanding of CAM interventions. Qualitative research can assist in understanding the meaning of an intervention to patients as well as patients' beliefs about the treatment and expectations of the outcome. Qualitative research also assists in understanding the impact of the context and the process of the intervention. Finally, qualitative research is helpful in developing appropriate outcome measures for CAM interventions. Greater understanding of CAM interventions has the potential to improve health care delivery.

Marja J. Verhoef

Papers

Quality of life in brain tumor patients: the relative contributions of depression, fatigue, emotional distress, and existential issues.

From parallel practice to integrative health care: a conceptual framework

Reasons for and characteristics associated with complementary and alternative medicine use among adult cancer patients: a systematic review.

Complementary and alternative medicine whole systems research: Beyond identification of inadequacies of the RCT

Assessing Efficacy of Complementary Medicine: Adding Qualitative Research Methods to the "Gold Standard"