Complementary and alternative medicine use of women with breast cancer: Self-help CAM attracts other women than guided CAM therapies

Objective: Examine stability of use of complementary and alternative medicine (CAM) of breast cancer patients, reasons for CAM use, and sociodemographic, clinical, and psychological predictors of CAM use. Methods: CAM use was assessed after adjuvant therapy and six months later. Following the CAM Healthcare Model, CAM use was divided into use of provider-directed (guided) and self-directed (self-help) CAM. Stability and reasons for CAM use were examined with McNemar's tests and descriptive statistics. Cross-sectional and longitudinal associations between predictors and CAM use were examined with univariate and multivariate logistical analyses. Results: Use of provider-directed and self-directed CAM was stable over time (N = 176). Self-directed CAM was more often used to influence the course of cancer than provider-directed CAM. Both were used to influence well-being. Openness to experience predicted use of provider-directed CAM, while clinical distress predicted use of self-directed CAM, after adjusting for other predictors. Perceived control did not predict CAM use. Conclusion: CAM use is stable over time. It is meaningful to distinguish provider-directed from self-directed CAM. Practice implications: Providers are advised to plan a 'CAM-talk' before adjuvant therapy, and discuss patients' expectations about influence of CAM on the course of cancer. Distressed patients most likely need information about self-directed CAM. (C) 2012 Elsevier Ireland Ltd. All rights reserved