PropertyValue
is nif:broaderContext of
nif:broaderContext
is schema:hasPart of
schema:isPartOf
nif:isString
  • The study was carried out in collaboration with the Swiss Childhood Cancer Registry (SCCR, www.childhoodcancerregistry.ch), which, since 1976, has included all children and adolescents in Switzerland diagnosed with leukemia, lymphoma, central nervous system (CNS) tumors, malignant solid tumors and Langerhans cell histiocytosis (LCH) before they were 21 [17]. This study included all patients registered at the SCCR who were diagnosed between January 1st 2002 and December 31st 2011, were aged 0 to 18 years, and were treated at the Division of Pediatric Hematology/Oncology at the University Children’s Hospital Bern, Switzerland. Exclusion criteria were death within 2 months of diagnosis, and the parents’ refusal to participate in a questionnaire survey. The SCCR was granted ethical approval through the general cancer registry permission (issued by the Swiss Federal Commission of Experts for Professional Secrecy in Medical Research) and a non obstat statement was obtained from the ethics committee of the canton of Bern. For the survey on CAM use, ethical approval was not necessary at the time of the study conduction. Written informed consent was obtained by the participants. A German language questionnaire on CAM use was designed for the parents of children with cancer. It was based on published international studies and specifications of CAM use in Switzerland [1–3,15,16,18,19]. There were a total of 18 questions: six questions about socio-demographic background and conventional cancer treatment, followed by 12 questions about CAM use. The questionnaire was tested for comprehensibility by 12 people (six healthy adults, four physicians and two adolescent patients). On May 29th 2012, the questionnaires were mailed to families with a cover letter, detailed study information and an informed consent form. Patients who did not return the informed consent and questionnaire within 6 weeks received a postal reminder. Along with the reminder, families who lived in the French speaking part of Switzerland received a second questionnaire in French. Definition and Assessment of CAM Use: There is no generally accepted definition of CAM [20], but the one most commonly used was issued by the U. S. National Center for Complementary and Integrative Health (NCCIH). NCCAM defines CAM as a group of diverse medical and health care systems, practices, and products not generally considered part of conventional medicine [21]. CAM practices are grouped into three categories: natural products; mind-body medicine; and, manipulative body-based practices. In our questionnaire, we assessed the way families used CAM before and after the cancer diagnosis, and asked which therapies they had used. Respondents could select from 43 listed CAM therapies and treatments, and could have reported additional methods. CAM methods were grouped into six categories for this analysis: medicaments and remedies (e.g., homeopathy, traditional Chinese medicine, Ayurveda); regulatory therapies (e.g., acupuncture, shiatsu); nutrition (e.g., dietary supplements, juice diet); mind-body therapies (e.g., yoga, music therapy); manual therapies (e.g., massages, chiropractic); and, other therapies (i.e., bioresonance therapy, electromagnetic therapy). We asked who provided these therapies (e.g., physician, non-medical practitioner or therapist or parents), whether CAM was used in a complementary fashion, or as an alternative to conventional treatment, and if CAM users would recommend that therapy to other patients and families. CAM users and non-CAM users were asked why they did or did not use CAM. CAM users were also asked if they had told the treating oncologist, their primary care physician, or pediatrician about the additional therapies they had used, and, if so, what the doctor´s reaction had been. Families were also asked if medical staff had informed them about CAM therapies when they discussed cancer treatment, and if they would have wanted to receive this information from their treating physician. The survey also asked if CAM users thought the therapies they tried were effective (positive or negative effect, or both) and asked them to specify the effects they attributed to CAM therapy. Assessment of Socio-demographic and Cancer-related Data: This study extracted baseline demographic data and prospectively collected medical information on diagnosis and treatment of patients from the SCCR, including age, gender, cancer diagnosis, age at diagnosis, cancer treatment, relapse, and time since diagnosis. The International Classification of Childhood Cancer, 3rd Edition (ICCC-3) was used to classify diagnoses [22]. Treatment was classified as surgical tumor resection (yes/no), chemotherapy (CTX; yes/no), radiotherapy (RTX; none, body and limb irradiation, cranial and spinal irradiation), and bone marrow or peripheral blood stem cell transplantation. Results are presented as descriptive statistics, with percentages and 95% confidence intervals (95% CI). Characteristics of participants included into the analysis and of non-participants were compared with chi-square-tests (gender, deceased at time of study, diagnoses) and t-test (age), accordingly. The Cochran-Armitage test for trend was used to assess if the proportion of patients told about CAM by medical staff had increased over the last decade. Data were analyzed with the Statistical Package for Social Sciences (IBM SPSS, version 21.0, IBM Corp., Armonk, NY).
rdf:type