Original Article

Medical Student Attitudes toward Complementary, Alternative and Integrative Medicine

Table 2

Summary of CAIMAQ items and exploratory factor analysis (n = 1770 all items).

Factor 1. Attitudes toward the desirability of CAIM therapies ( = 0.90)
Item 3: Patients whose doctors know about complementary and alternative medicine, in addition to conventional medicine, benefit more than those whose doctors are only familiar with conventional medicine.
Item 4: When systems of alternative medicine (such as traditional Chinese medicine) are found to be efficacious in treatment of a disease, doctors should recommend them even though these systems may rely on unknown mechanisms.
Item 6: Therapies lacking rigorous support from biomedical research (randomized controlled trials, etc.) may nevertheless be of value to doctors.
Item 8: A system of medicine that integrates therapies of both conventional medicine and complementary and alternative medicine would be more effective than either conventional medicine or complementary and alternative medicine provided independently.
Item 10: The use of herbal products represents a legitimate form of medicine that can treat a wide variety of disease.
Item 15: Complementary and alternative medicine contains beliefs, ideas and therapies from which conventional medicine could benefit.
Item 16: Chiropractic care can be a valuable method for resolving a wide variety of musculoskeletal problems.
Item 18: Massage therapy can lead to objective improvements in long-term outcomes for patients.
Item 25: Doctors should consider referring patients to alternative health care providers such as homeopaths or naturopaths for conditions poorly managed by conventional medicine.
Item 27: It is ethical for doctors to recommend therapies to patients that involve the use of subtle energy fields in and around the body for medical purposes.
Item 28: Therapeutic Touch is credible as a form of treatment.
Item 30: Treatments of complementary and alternative medicine tend to be less invasive that those of conventional medicine, and may help to reduce the risk of side effects and iatrogenesis.

Factor 2. Attitudes toward progressive patient/physician health care roles ( = 0.79)
Item 13: Patients who express themselves through creative outlets such as art, music or dance may achieve significant health benefits through these activities.
Item 14: Doctors who lead a balanced lifestyle (i.e., attending to their own health, social, family and spiritual needs, as well as interests beyond medicine) generate improved patient satisfaction.
Item 20: A strong relationship between patients and their doctors is a valuable therapeutic intervention that leads to improved outcomes.
Item 21: Doctors who model a healthy lifestyle (i.e., follow their own advice) generate improved patient outcomes.
Item 22: Whenever reasonable, a physician should provide patients with hope and a positive attitude toward healing.
Item 23: A patient who is an active participant in his or her care is likely to experience improved outcomes compared with a patient who is a passive participant.
Item 24: Nutritional counseling and dietary/food supplements can be effective in the treatment of pathology.

Factor 3. Attitudes toward the mind-body-spirit connection ( = 0.70)
Item 1: A patient’s treatment should take into consideration all aspects of his or her physical, mental and spiritual health.
Item 5: Prayer, for oneself or others, can benefit quality of life and disease outcomes.
Item 7: The spiritual beliefs of patients play an important role in their recovery.
Item 11: A patient’s mental state influences his or her physical health.

Factor 4. Attitudes toward the principles of allostasis ( = 0.50)
Item 2: The focus of a primary care physician should be on promoting health rather than treating disease.
Item 12: Disease occurs when the body’s innate ability to heal itself becomes compromised.
Item 19: The innate self-healing capacity of patients often determines the outcome of illness regardless of treatment interventions.

Factor 5. Attitudes toward a holistic understanding of disease ( = 0.66)
Item 9: End-of-life care should be valued as an opportunity for patients to heal.
Item 17: A patient with a terminal illness can experience mental and spiritual healing in being at peace with himself or herself.
Item 26: Even in the absence of clinically significant disease, a person can experience a vast range in terms of physical health.
Item 29: Disease can be viewed as an opportunity for personal change and growth.