Attitude toward alternative therapy, compliance with standard treatment, and need for emotional support in patients with melanoma
W. Sollner, M. Zingg-Schir, G. Rumpold and P. Fritsch
Department of Medical Psychology and Psychotherapy, Leopold Franzens University, Innsbruck, Austria. wolfgang.soellner@uibk.ac.at
OBJECTIVE: To examine the attitude of patients with melanoma toward
alternative therapies, their compliance with standard treatment, social
support received by them, and their ways of coping with illness. DESIGN:
Survey in a representative sample. SETTING: University hospital; central
melanoma clinic serving Tyrol region in Austria. PATIENTS: Two hundred
thirty-six consecutive patients with melanoma were approached in a
3-month-period, and 215 of them participated in the study. OUTCOME
MEASURES: Results of a self-developed questionnaire to record patients'
interest in alternative therapies, the Hornheide Questionnaire to assess
patients' distress and social support, and the Freiburg Questionnaire of
Coping With Illness. RESULTS: One hundred seventeen patients (54.4%)
reported interest in nonconventional therapy. Thirty (14%) patients
admitted actual use of such methods. The latter group more often suffered
from advanced cancer (P < .001). Compared with uninterested patients,
subjects interested in alternative therapy were younger (95% confidence
intervals [CI] = 41.3-46.5 vs 48.7-56.7; P < .001), showed a more active
coping style (95% CIs = 3.45-3.75 vs 2.91-3.50; P = .001) and a tendency
toward religiousness and search for personal meaning in the disease (95%
CIs = 2.56-2.85 vs 2.17-2.64; P < or = .08). Their faith in conventional
medicine and ready compliance with physicians' suggestions were not less
than those of uninterested patients (95% CIs = 4.26-4.46 vs 4.35- 4.64; P =
.25). However, they believed that they were receiving less emotional
support from their physicians (95% CIs = 0.95-1.74 vs 0.21-0.93; P = .04)
and expressed interest in getting more such support (P = .04). CONCLUSIONS:
Patients with melanoma consider non-conventional therapies as supplementary
to standard medical methods and as a way of avoiding passivity and coping
with feelings of hopelessness. This does not lessen the need to educate
patients about the lack of efficacy of unorthodox methods but stresses the
importance of offering them adequate emotional support.
