INTRODUCTIONBeing healthy has become a main concern with people all over the United States. With this desire to become healthier and live longer, the use of alternative medicine is becoming a popular choice when choosing health care options. Dyer(1996) refers to alternative medicine as "treatments and practices that have not gained wide acceptance or have not yet had adequate scientific research to be considered standard medical treatment." As Evans(1998) reports, during the past ten years, alternative treatments such as chiropractic, massage therapy, acupuncture, Tai Chi, Qigong, nutritional supplements and other modalities have been receiving tremendous scientific support as well as the acceptance that goes with it. Today people are tending to seek safer, more natural approaches to health care. As alternative medicine continues to grow, we will more likely begin to see more allopathic practitioners take on a more Holistic approach to healing, more hospitals offering alternative therapies, and more insurance companies covering them(Evans,1998). Researchers have found that in a given year about a third of all American adults use unconventional(alternative) medical treatments, such as relaxation techniques, chiropractic, therapeutic massage, special diets, and megavitamins. Unconventional techniques are most often used for back problems, headache, arthritis, musculoskeletal pain, insomnia, depression and anxiety. The most frequent users are educated, upper-income white Americans in the 25-49 year age group, and they are more likely to live in the West(Eisenberg, D.M; Kessler, R.C; Foster, C; Norlock, F.E; Calkins, D.R; & Delbanco, T.L. 1993). The survey conducted by Eisenberg et al. estimated that 34% of a random group of patients studied had used alternative medical treatments, and 72% did not inform their physicians of the therapies used. Researchers have tested three main hypotheses that explain why people use alternative medicine. Patients are dissatisfied with conventional treatment, patients want more control over their health care decisions, and patients see alternative therapies as more compatible with their values, worldview, and beliefs. The following variables were found as predictors of alternative health care use: more education, poorer health status, a holistic orientation to health and any of the following health problems: anxiety, back problems, chronic pain and urinary tract problems(Astin,1998). Alternative treatments in some cases have become so popular and effective that some people no longer need the aid of an alternative therapist to practice the use alternative treatments, they are using them on their own. Krauss(1997) found that alternative treatments seemed to be the choice for those with insomnia, depression, anxiety, severe headaches, and chronic pain; however not all that used alternative treatments saw alternative therapists. Many studies have been done to examine why people use alternative medicine and their views on it in the United States as a whole. I wanted to examine the views of healthcare and alternative medicine in St. Joseph, Missouri. I wanted to find out how college students in St. Joseph feel about alternative medicine and what factors influence their likelihood to use alternative treatments.
My participants for this study consisted of 85 psychology 101 students from Missouri Western State College in St. Joseph, Missouri. The participants were not paid for their participation, but received extra credit from the instructor of the course for participating.
I administered pencil and paper surveys consisting of 25 questions to each participant. The survey consisted mostly of straightforward yes and no questions, including a few demographic questions, and some brief information on their medical history (see appendix).
I was the only researcher who collected the data. Dr. Chuck Hughes D.C. assisted me with the formulation of the survey. All participants received a copy of the same survey, which took approximately ten minutes to complete.
RESULTS Two chi square tests of independence were conducted. First, a chi square test of independence was calculated comparing whether the sex of the subject had an effect on their likelihood of having used alternative treatments. I had expected to find that women would be more likely to use alternative treatments than men. No significant relationship was found (chi square(1)=1.097,p>.05). There appears to be no significant dependence of the subjects` sex on their likelihood of using alternative treatments. A second chi square test of independence was calculated comparing the income of the subject with their likelihood of using alternative treatments. I had expected to find that subjects with higher income would be more likely to use alternative treatments than those with lower income. No significant relationship was found (chi square(1)=2.165,p>.05). About half of the participants(53 percent) rated their general health as being good, while 32 percent said their general health was excellent. The three most bothersome health conditions reported, with participants responding that they presently have or have had in the past, were headaches(62 percent), allergies(52 percent), followed by back problems(42 percent). One fourth of the participants reported seeing an alternative provider for any of their three most bothersome conditions. The three most commonly used alternative treatments were chiropractic(27 percent), physical therapy(20 percent), followed by massage therapy(9 percent). Forty-four percent of the participants reported that their insurance has paid for their alternative treatments. The majority of participants (71 percent) said they would discuss alternative therapies with their medical provider and would tell their medical provider if they went to an alternative provider. Also, 29 percent reported that their medical provider has referred them to an alternative provider.
DISCUSSION My initial hypothesis was that women would be more likely to use alternative treatments than men and that subjects with higher income would be more likely to use alternative treatments. The data did not support my hypothesis. Out of all alternative treatments listed in the survey, subjects were most likely to have used chiropractic, physical therapy, and massage therapy. I myself being a massage therapist was surprised to see that only 9.4 percent had reported ever seeing a massage therapist. With massage therapy being an excellent way to relieve stress, and attending college and studying being very stressful events, I had expected more subjects to use this therapy. I was not surprised that chiropractic was the most commonly used alternative therapy, considering that 42 percent of participants reported currently having or having had back problems. Overall, prevalence of alternative medicine among college students was not as high as I originally expected to find. This could most likely be due to the lack of money of most college students, and the lack of information on alternative therapies available. A lot of people are unaware of what alternative treatments are available and what they can do for you. Being an alternative provider myself and also working for a chiropractor, I see what great results alternative medicine can provide and was pleased to see that more insurance companies (44 percent in this study) are paying for alternative treatments. It is also nice to know that more and more patients are discussing alternative treatments with their medical providers, and that some medical providers are beginning to refer patients to alternative providers. According to recent literature, the use of alternative medicine is on the rise and it is becoming more important that medical providers and alternative providers work together with the patients` best interest in mind(Evans,1998). After completing this study I think we are slowly on our way to reaching this goal. A limitation of this study might be my sample of subjects. Sixty-four percent of the subjects were female and the vast majority of subjects were between the ages of 18 and 21, with very few being non-traditional students. I expected this though, since I used students from an introductory level course. In doing future research it would be better to include a more even number of non-traditional and traditional college, and a more even number of males and females. Using a more representative sample from the general population instead of using college students would have most likely given me better data to work with, since a lot of college students lack the funds or are unaware of what alternative treatments are available. In doing future research in this area it might be interesting to compare the views and use of alternative treatments between nursing majors and psychology majors. Taking all these things into consideration might make for better research and more accurate data. Alternative medicine is an area that definitely deserves more research, and the use of it will hopefully continue to grow therefore offering the public more choices regarding what`s most important in life, your health.
REFERENCES Astin, J.A.(1998). Why patients use alternative medicine: Results of a national study. JAMA, 279, 1548-1553. Dyer, K.A.(1996). Recognizing the potential of alternative medical treatments. JAMA, 275, 578. Eisenberg, D.M.; Kessler,R.C.; Foster,C.; et al. (1993). Unconventional medicine in the United States: prevalence, costs, and patterns of use. New England Journal of Medicine, 328, 245-252. Evans, R.S.(1998, October 9). Breaking the mold: The integration of conventional and alternative medicine. [online: available at http://altmedicine.miningco.com]. Krauss, H.H.; Godfrey,C.; Kirk,J.; Eisenberg,D.M.(1997). Use of alternative treatments for emotional dysphoria by individuals with physically disabling conditions. Perceptual and Motor Skills, 85, 1450.
APPENDIXPlease take a few minutes and answer each of the following questions, please give honest answers. All answers will be kept confidential. Thank you for participating in this study.
1. Your age?_________
2. Have you been to a health care provider in the last 12 months? Y (77.6%) N (22.4%)
3. Sex? M (36.5%) F (63.5%)
5. Do you work in the health care field? Y (1.2%) N (97.6%)
6. Is your household income, <12,500 (17.6%) 12,500 - 24,999 (10.6%) 25,000 - 39,999 (23.5%) 40,000 - 59,999 (30.6%) >60,000 (12.9%)
7. Would you say that your general health has beenů.. Excellent (31.8%) Good (52.9%) Fair (14.1%) Poor (1.2%)
8. Have you been generally satisfied with health care in St. Joseph? Y (70.6%) N (21.2%)
9. Are you from St. Joseph? Y (36.5%) N (62.4)
10. I am going to list some of the more common conditions and I would like for you to answer if you have the condition presently, if you have ever had this condition in the past or have never had the condition. Have you been Treated for this?Anxiety Presently Past Never Y N (10.6%) (16.5%) (68.2%) (2.4%) (50.6%)Allergies Presently Past Never Y N (34.1%) (17.6%) (44.7%) (36.5%) (31.8%)Arthritis Presently Past Never Y N (8.2%) (1.2%) (84.7%) (5.9%) (43.5%)Back Problems Presently Past Never Y N (25.9%) (16.5%) (54.1%) (22.4%) (43.5%)Cancer Presently Past Never Y N (92.9%) (45.9%)Chronic Pain Presently Past Never Y N (8.2%) (3.5%) (84.7%) (10.6%) (40.0%)Depression Presently Past Never Y N (7.1%) (15.3%) (74.1%) (5.9%) (50.6%)Diabetes Presently Past Never Y N (95.3%) (45.9%)Digestive Problems Presently Past Never Y N (8.2%) (4.7%) (84.7%) (7.1%) (44.7%)Dizziness Presently Past Never Y N (4.7%) (20.0%) (70.6%) (10.6%) (47.1%)Female Problems Presently Past Never Y N (11.8%) (22.4%) (62.4%) (25.9%) (35.3%)Headaches Presently Past Never Y N (27.1%) (35.3%) (35.3%) (22.4%) (55.3%) High Blood Pressure Presently Past Never Y N (1.2%) (4.7%) (88.2%) (2.4%) (45.9%)Insomnia Presently Past Never Y N (5.9%) (11.8%) (76.5%) (1.2%) (50.6%)Lung Problems Presently Past Never Y N (3.5%) (2.4%) (88.2%) (4.7%) (44.7%)Obesity Presently Past Never Y N (7.1%) (3.5%) (83.5%) (2.4%) (49.4%)Skin Problems Presently Past Never Y N (11.8%) (12.9%) (71.8%) (18.8%) (36.5%)Sprains/Strains Presently Past Never Y N (3.5%) (55.3%) (38.8%) (48.2%) (24.7%)Urinary Problems Presently Past Never Y N (4.7%) (21.2%) (71.8%) (23.5%) (35.3%)11. Which three conditions would you say are your most bothersome?_________________________________________________________
12. Do you have one health care provider that you would call "your" doctor? Y (69.4%) N (30.6%)
13. Is your health care provider located in St. Joseph? Y (43.5%) N (55.3%)
14. Do you trust your health care provider? Y (85.9%) N (11.8%)
15. Do you believe that your health care provider has your best interest in mind when he/she recommends a treatment? Y (91.8%) N (8.2%)
16. Do you believe that St. Joseph has an adequate number of quality health care providers to choose from? Y (55.3%) N (35.3%)
17. Do you feel that St. Joseph has adequate hospital facilities? Y (71.8%) N (22.4%)
18. Have you been treated at a hospital in St. Joseph in the last 12 months? Y (21.2%) N (78.8%)
19. Have you been inside a St. Joseph hospital (even to visit someone else) in the last 12 months?Y (63.5%) N (36.5%)20. I am going to list some alternative treatments and I would like you to indicate if you have ever used the technique, if you have been to a provider of that technique in the past 12 months.
EVER USED LAST 12 MONTHS Relaxation Technique Y N Y N (3.5%) (94.1%) (2.4%) (94.1%)Chiropractic Y N Y N (27.1%) (71.8%) (15.3%) (82.4%)Massage Therapy Y N Y N (9.4%) (88.2%) (7.1%) (90.6%)Hypnosis Y N Y N (1.2%) (95.3%) (1.2%) (95.3%)Weight Loss Program Y N Y N (5.9%) (91.8%) (3.5%) (94.1%)Spiritual Healing Y N Y N (4.7%) (91.8%) (2.4%) (92.9%)Herbal Medicine Y N Y N (7.1%) (89.4%) (4.7%) (91.8%)Biofeedback Y N Y N (2.4%) (95.3%) (97.6%)Acupuncture Y N Y N (1.2%) (96.5%) (97.6%) Homeopathy Y N Y N (96.5%) (95.3%)Megavitamin Therapy Y N Y N (1.2%) (96.5%) (96.5%)Exercise Y N Y N (51.8%) (47.1%) (49.4%) (48.2%)Prayer/Spiritual Healing Y N Y N (15.3%) (82.4%) (12.9%) (83.5%)Physical Therapy Y N Y N (20.0%) (75.3%) (9.4%) (87.1%)
21. Did you see an alternative provider for any of your three most bothersome conditions? Y (24.7%) N (74.1%)
22. Were any of these services paid for by insurance? Y (43.5%) N (50.6%)
23. Have you or would you discuss alternative therapies with your medical provider? Y (70.6%) N (29.4%)
24. Did you or would you tell your medical provider that you went to an alternative provider? Y (71.8%) N (28.2%)
25. Has your medical provider ever referred you to an alternative provider? Y (29.4%) N (70.6%)