搜索结果：Journal of integrative and complementary medicine

Traditional and complementary medicine (T&CM) is used by many populations for healing purposes. For Muslims, these methods include religiously sourced and spiritually based practices, such as consuming herbs and foods mentioned by Prophet Muhammad and performing specific worship activities believed to hasten healing. This paper examined the use of T&CM among American Muslim women and the associations between sociodemographic and religious characteristics and such use. This was an exploratory, cross-sectional survey among English-speaking, adult Muslim women recruited from Chicago mosques and community centers. Participants completed a self-administered survey with items assessing sociodemographic and religious characteristics, as well as usage of traditional complementary and alternative treatments. Descriptive statistics were tabulated, ANOVA and Pearson's chi-squared tests were used to assess bivariate relationships, and multivariate linear and ordered logistic regression models were used to determine associations between outcome variables-religious and nonreligiously sourced complementary and alternative modalities-and independent variables. A total of 254 participants completed the survey. Approximately 70% of participants employed Prophetic medicine, and 50% consulted an alternative healer when facing a health problem. Several sociodemographic and religious factors were associated with the use of complementary/alternative modalities. Notably, immigrants had higher odds of using treatments sourced in sayings of the Prophet Muhammad than those who were born in the U.S. (odds ratio [OR] = 2.41, p < 0.039), whereas those who had lived longer in the U.S. had lower odds of using complementary/alternative modalities than individuals whose duration of stay was shorter (OR = 0.33, p < 0.031). With regard to religiosity, participants with negative religious coping had lower odds of using folk methods (OR = 1.16, p < 0.001) but had higher odds of using nonreligious T&CM (OR = 1.15, p < 0.002). Many American Muslim women utilize T&CM for healing, with the most prevalent modalities being Prophetic medicine and worship activities. T&CM use appears to be associated with demographic features. Further research to unpack the surrounding behavioral and decisional contexts of T&CM, specifically whether it is used integratively or in lieu of allopathic methods, and by whom, is needed.

Research on complementary, alternative, and integrative medicine (CAIM) continues to grow. Bibliometric analyses (BAs) are valuable to assess research trends, identify gaps, and understand the evolution of a body of literature, yet there are no systematic or scoping reviews on how these BAs are conducted. This scoping review aimed to systematically review and summarize BAs on CAIM literature to inform and guide future bibliometric studies in this field and beyond. A scoping review was conducted in accordance with Joanna Briggs Institute guidelines. A systematic search was conducted in MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, Scopus, and Web of Science from database inception to the date of the search on January 5, 2023. Eligible articles were BAs of the CAIM literature. Screening and data extraction were completed independently and in duplicate by at least two reviewers, with findings summarized descriptively. The review included 286 articles published between 1995 and 2023, with approximately 75% published in the last 5 years. Studies were conducted in 36 countries, with China (50%) leading in contributions. All articles used performance analysis techniques, whereas 80% also used science-mapping techniques. The most commonly used performance analysis metrics were "total publications" (98%) and "total citations" (67%). Co-word (63%) and co-authorship (55%) analysis were the most common science mapping techniques. VOSviewer and CiteSpace were the predominant visualization softwares employed. This review demonstrates large methodological diversity in the conduct of CAIM bibliometrics. As a result of this variability, future research should focus on developing uniform methodologies and incorporating diverse metrics and alternative data sources to enhance the reliability and reproducibility of BAs in the CAIM field.

Disorders of gut-brain interaction (DGBI) are common in children and often persist despite conventional treatments, leading families to seek complementary and alternative medicine (CAM). However, evidence for CAM in pediatric DGBI is scarce. This multicenter survey study assessed parents' and pediatricians' experiences with and attitudes toward CAM for children with gastrointestinal symptoms. Parents and pediatricians of children (0-18&#xa0;years) with gastroesophageal reflux disease (GERD) and DGBI (infant colic (IC), functional abdominal pain, and functional constipation) from six Dutch hospitals were included. GERD diagnosis was based on international guidelines, DGBI on Rome IV criteria. Parental surveys addressed child health, medication, (reasons for) CAM use, and attitudes toward CAM research. Pediatricians' surveys covered experiences and attitudes toward CAM for pediatric DGBI. A total of 677 parents (71%) and 76 pediatricians (79%) responded. Most patients had functional constipation (45%) or abdominal pain (41%), with 8% IC and 6% GERD. Seventy-one percent had symptoms for over a year; 58% used medication, and 49% reported side effects. Overall, 42% of patients used CAM, mainly manual therapies, homeopathy, and natural remedies. Predictors of CAM use included IC, longer symptom duration, higher household income, and positive parental CAM experience. Among pediatricians, 53% recommended CAM. Pediatricians with over 15&#xa0;years' experience were less likely to recommend CAM. Sixty-five percent of parents were willing to participate in CAM research. &#xa0;CAM use is common among children with DGBI or GERD, and over half of pediatricians have recommended CAM, underscoring the need for efficacy studies of frequently used CAM. &#x2022; Complementary and alternative medicine (CAM) is commonly used among pediatric patients with gastrointestinal symptoms but often excluded in evidence-based guidelines due to insufficient evidence. &#x2022; Previous research has examined perspectives of patients and families, with limited insight into pediatricians' recommendations. &#x2022; In Dutch hospitals, 42% of children with infant colic, reflux, abdominal pain, or constipation used CAM. Most pediatricians (52.6%) recommended some CAM to these patients. &#x2022; Predictors for CAM use include infant colic, longer symptom duration, positive parental CAM experience, and higher income; pediatricians with&#x2009;>&#x2009;15&#xa0;years' experience were less likely to recommend CAM. Parental interest in CAM research is high (65%).

Recognizing and prioritizing the factors that influence the selection of treatment options is essential for effective health service planning and an appropriate health care delivery system. This study aimed to identify and prioritize the barriers and facilitators to the use of Traditional, Complementary, and Integrative Medicine (TCIM) in Iran. A two-phase, mixed-methods study was conducted. First, a two-round Delphi survey was conducted with a panel of 32 experts, including specialists in Persian medicine (PM) and health policymakers, to acheive consensus on a list of barriers and facilitators within the Iranian context. Subsequently, the Analytical Hierarchy Process (AHP) was applied with a 12-expert panel to determine the relative weight and priority of the agreed-upon criteria. The Delphi process yielded consensus on 18 facilitators and nine barriers. The facilitators were categorized into two main dimensions (Cultural and social facilitators, and Systemic facilitators) and six sub-dimensions. In comparison, the barriers formed four main dimensions (service delivery barriers, policy challenges, financial barriers, and knowledge and attitudinal barriers). Quantitative AHP results revealed that among facilitators, "effects of health professionals" (Final Weight: 0.29) was the most critical dimension, with "Recommendation and referral by conventional physicians (CPs)" (Final Weight: 0.18) as its top factor. Conversely, among barriers, "Policy Challenges" (Final Weight: 0.50) was the most significant dimension, substantially outweighing others. The findings highlight that the recommendation of TCIM by CPs are the strongest facilitator; yet, overarching policy challenges critically hamper its implementation. Addressing this disconnect requires integrated policy reforms and interdisciplinary collaboration to leverage TCIM within Iran's health care system effectively.

Traditional, Complementary, and Integrative Medicine (TCIM) has been established in the academic context of universities. In recent years, strategies have been developed worldwide to strengthen the role of TCIM in supporting the health of the population. Online databases are a common way for obtaining evidence-based information. This article is an update of a former systematic review from 2010 on published databases resources for TCIM. The databases CINAHL, CAMbase, Web of Science, MEDLINE/PubMed, and Google Scholar search engine were searched for databases related to TCIM published in peer-reviewed journals between 2010 and November 2024. All included databases were visited online, and information on the origin, content, and scope of the database was extracted. A total of 6579 articles were identified through the literature search. After exclusion of irrelevant articles, full-text screening of 127 articles yielded 37 new databases. Together with 16 still available old databases, these mainly contained information on herbal therapies (n = 15) and Traditional Chinese Medicine (n = 11) from 18 different countries. Newly identified medicinal plant databases offer various scientific resources such as crude drugs, indigenous plants, and structures for natural and phytochemical components with molecular biological content. This literature review illustrates the dynamic development in the database landscape over the last 15 years. While the number of bibliographic databases is shrinking, databases in the field of medical plants/herbal therapy content are on the rise, which might be due to advances in plant genomics and molecular biology.

There is a need to better understand traditional, complementary, and integrative medicine (TCIM) and health literacy (HL) as intersecting fields of research, and to identify the impact of HL on TCIM use and practices. This is best achieved through validated instruments that measure TCIM-specific HL. This critical, systematic review aimed to identify the use and features of validated instruments for measuring HL in the general adult population using TCIM, and the degree to which those elements measure TCIM-specific HL. Evaluation of the methodological rigor of instrument testing and grade determination was undertaken using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist and an adapted version of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-COSMIN manual for the systematic review of patient-reported outcome measures. A total of 21 validated HL instruments, identified from 29 studies, were included in the review. Ten instruments were specific or partially specific to TCIM. Most instruments assessed two or more HL domains (n = 14), including five that assessed all four domains of the integrated conceptual model of HL. Approximately one quarter of all instruments received an overall assessment rating of "very good" quality (n = 5), with majority of instruments rating as either "doubtful" (n = 9) or "inadequate" (n = 7) quality. The examination of HL in relation to TCIM use and users will clearly benefit the TCIM research field and the wider health research community. Focused efforts to develop validated TCIM-specific HL instruments will ensure TCIM use and users are not excluded from HL scholarship and advancements.

Traditional and alternative medicine (TAM) remains a cornerstone of health care in Tanzania, particularly in rural and underserved communities. Despite its cultural significance and widespread use, TAM occupies a largely underregulated space within the national health system. This review critically examines the historical evolution, policy frameworks, and institutional roles shaping TAM's integration in Tanzania. A systematic literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement and Joanna Briggs Institute protocols. Searches were undertaken in PubMed, Scopus, and Google Scholar, and supplemented by gray literature from government and international organizations. Studies published between January 2010 and May 2025 were included, alongside selected pre-2010 sources providing essential historical or legislative context. Data were extracted and synthesized thematically to evaluate policy development, regulatory mechanisms, and institutional mandates. The PRISMA flow diagram summarizes the screening process, with 34 studies forming the core evidence base for thematic analysis. Analysis of the 34 included studies indicates progress through instruments such as the Traditional and Alternative Medicine Act (2002), the Traditional Medicine Policy (2009), and the Medicines and Medical Devices Act (2019). Key institutions including the Ministry of Health, the Tanzania Medicines and Medical Devices Authority, and the Tanzania Commission for Science and Technology have advanced regulation, accreditation, and research. However, persistent challenges remain, notably fragmented institutional coordination, limited professional recognition, and inadequate protection of intellectual property. Comparative insights from the World Health Organization and the African Union frameworks highlight opportunities for policy alignment, innovation, and regional collaboration. TAM continues to play a critical role in Tanzania's health care landscape by providing culturally congruent and accessible services. Strengthening regulation, enhancing institutional coordination, embedding monitoring and evaluation mechanisms, and safeguarding indigenous knowledge are essential for sustainable integration. Balancing cultural heritage with scientific validation will support health care equity and consolidate TAM's position within national health policy frameworks.

Vitality refers to an organism's inherent energy that supports adaptive functioning and well-being. Both frailty and depressive disorders are characterized by energy depletion and are commonly associated with fatigue, reduced subjective well-being, and impaired quality of life. Assessing vitality may serve as a complementary approach to identify conditions associated with energy depletion, while offering clinically meaningful information beyond that captured by disorder-specific measures alone. The Integrative Vitality Scale (IVS) measures the physical and psychological dimensions of vitality. This study examined the clinical validity of the IVS in frailty and depressive disorders. Data were drawn from two independent South Korean samples: adults aged &#x2265;65&#x202f;years assessed for frailty (Study 1) and adults aged &#x2265;19&#x202f;years assessed for depressive disorders (Study 2). Correlation analysis was used to examine the associations between IVS scores and fatigue, subjective well-being, and quality of life. Receiver operating characteristic (ROC) curve analysis was used to evaluate screening performance against structured clinical interview-based reference standards. Hierarchical regression analyses were used to test the incremental explanatory value of the IVS beyond the established measures of frailty and depression. The IVS total and subscale scores were negatively associated with frailty, depressive symptoms, and fatigue, and positively associated with subjective well-being and quality of life. Physical vitality demonstrated good screening performance, with overall discriminative ability in a similar range to that of a clinician-rated frailty measure. For depressive disorders, the IVS total score showed fair screening performance, with overall discriminative ability in a similar range to that of the widely used self-report depression scale. Hierarchical regression analyses further indicated that the IVS explained additional variance in fatigue, subjective well-being, and quality of life beyond the established measures of frailty and depressive symptom severity, with physical vitality primarily related to fatigue, and psychological vitality being more strongly related to well-being and quality of life. The IVS demonstrated clinical validity as a self-report screening and assessment tool for conditions characterized by energy depletion. Beyond initial screening, the IVS provides patient-centered information on functional status that is not fully captured by disorder-specific measures, supporting its complementary role in clinical screening contexts. Further validation in representative and community-based samples is required before broader public health applications can be considered. https://cris.nih.go.kr/cris/search/detailSearch.do?seq=27011&status=5&seq_group=27011&search_page=M, identifier KCT0009372; https://cris.nih.go.kr/cris/search/detailSearch.do?seq=26780&status=5&seq_group=26780&search_page=M, identifier KCT0009263.

Many depressed patients opt for complementary integrative medicine (CIM). We aim to evaluate whether there is an association between the severity of depressive symptoms and CIM. A cross-sectional study using the Brazilian National Survey (PNS, 2019), a population-based study. A sample of 4,792 participants (15-107 years old) reporting a current treatment of depression was categorized into 3 groups: 1 (N=4,307, Yes Psychotherapy/Medication-No CIM), 2 (N=148, Yes CIM-No Psychotherapy/Medication) and 3 (N=337, Yes Psychotherapy/Medication-Yes CIM). Participants answered a sociodemographic questionnaire and the Patient Health Questionnaire-9. We used three categories of depression: no depression (score &#x2264;9), mild (score 10-14) and moderate/severe (&#x2265;15). Multinomial logistic regression estimated crude/adjusted odds ratios and 95% confidence intervals. Among participants who reported using at least one type of CIM, 3.2% and 7.0% used CIM exclusively or associated with conventional treatments, respectively. The higher the intensity of depressive symptoms, the lower the chance of using CIM exclusively. In Brazil only a minority of depressed people use CIM exclusively.

Patients with breast cancer commonly experience anxiety and sleep disturbance during and after treatment, and these symptoms are closely interrelated, negatively affecting the quality of life. Mindfulness-based interventions (MBIs) have been increasingly used as a nonpharmacological supportive approach. This systematic review and meta-analysis aimed to evaluate the effects of MBIs on anxiety and sleep quality in patients with breast cancer. A systematic search of PubMed, Web of Science, Cochrane Library, CINAHL, and Embase was conducted up to May 15, 2025. Random-effects meta-analysis was used to estimate standardized mean differences (SMDs) with 95% confidence intervals (CIs). Risk of bias was assessed using the Cochrane RoB 2.0, and the certainty of evidence was evaluated with Grading of Recommendations, Assessment, Development, and Evaluation. Twenty-four randomized controlled trials (RCTs) including 3,212 participants were analyzed. MBIs significantly reduced anxiety compared with control groups receiving usual care, no intervention, or wait-list conditions (SMD: -0.47, 95% CI: -0.62 to -0.32), whereas no significant effect was observed for sleep quality. Subgroup analysis indicated that intervention duration accounted for 55.5% of the heterogeneity in anxiety outcomes. All studies were rated as having some concerns regarding risk of bias, primarily due to self-reported outcomes and lack of blinding. Certainty of evidence was moderate for anxiety and low for sleep quality. MBIs appear to be effective in reducing anxiety among patients with breast cancer; however, no significant effect was observed for sleep quality. All included studies were rated as having some concerns regarding risk of bias, and the limited reporting of adverse events represents a limitation of the evidence. In addition, substantial heterogeneity in sleep quality outcomes and the limited number of included RCTs restrict exploration of heterogeneity sources and limit generalizability. Further high-quality well-designed RCTs are needed to strengthen and confirm the evidence.

Evidence-based complementary and integrative health (CIH) therapies are now in clinical practice guidelines for common pain and pain-related conditions. Primary care providers (PCPs) are often the first point of contact for discussing CIH therapies as non-pharmacological health management. Yet, little is known about their decisions to recommend CIH therapies. To understand: (1) which CIH therapies PCPs recommend and for what health conditions, (2) reasons for their recommendations or lack thereof, and (3) possible solutions to improve appropriateness of recommendations. Semi-structured qualitative interviews were conducted with 40 PCPs from eight Veterans Health Administration (VA) hospitals offering eight evidence-based CIH therapies (acupuncture, medical massage therapy, yoga, Tai Chi, meditation/mindfulness, biofeedback, clinical hypnosis, guided imagery). A rapid qualitative analysis was performed using a matrix approach. PCPs recommended patients use acupuncture, medical massage therapy, yoga, Tai Chi, and meditation/mindfulness the most and biofeedback, clinical hypnosis, and guided imagery the least. Pain was the main condition for referrals to all CIH therapies except clinical hypnosis and guided imagery, which were most recommended for smoking cessation and mental health, respectively. Decisions to recommend were largely driven by PCP's knowledge of CIH therapies' effectiveness for particular health conditions. Other factors were PCP's own beliefs about CIH therapies, their perceptions about patients' beliefs, patients' positive experiences, and organizational factors (e.g., understanding what therapies are covered for which conditions and the local referral process). PCPs wanted brief educational information containing many types of content, ranging from therapy descriptions to clinical practice guidelines and information on institutional policies on CIH therapy provision. Although some PCPs are appropriately recommending evidence-based CIH therapies, lack of knowledge is a critical barrier for many others. This could be addressed with the educational information tailored to the content and format that PCPs specifically requested.

Acupuncture is an effective method for alleviating abdominal pain and diarrhea in patients, but the impact of emotional disorders (anxiety or depression) on the efficacy of acupuncture for refractory diarrhea-predominant irritable bowel syndrome (RIBS-D) remains unknown. One hundred seventy patients with RIBS were randomly equally divided into acupuncture and sham acupuncture groups. The primary outcome was the response rate, measured by the change in the IBS-Symptom Severity Score (IBS-SSS) from baseline at week 4. The secondary outcomes included stool frequency, stool consistency, work and social adaptability, and quality of life (QOL). Eighty-five patients with RIBS (80 with RIBS-D) received 4 weeks of acupuncture therapy. According to the psychological state assessment, 27 of the 80 patients were anxiety patients, 53 were nonanxiety patients, 21 were depressive patients, and 59 were nondepressive patients. The IBS-SSS response rate at week 4 was 92.6% in anxiety patients and 88.7% in nonanxiety patients (p = 0.581). In terms of secondary outcomes, there was no significant intergroup difference in stool frequency or stool consistency between the anxiety group and the nonanxiety group (p = 0.730, p = 0.418). After adjusting for baseline covariates, no statistically significant differences were detected between the anxiety and nonanxiety groups in the Work and Social Adjustment Scale (WSAS) scores and IBS-QOL scores at week 4 (p = 0.398, p = 0.207). Similarly, no significant difference was noted in the IBS-SSS response rate at week 4 between depressive and nondepressive patients (p = 0.932). However, regardless of baseline covariate correction, there was no significant intergroup difference between the depression group and the nondepressive group in terms of stool frequency, stool consistency, WSAS score, or IBS-QOL score at the fourth week (p = 0.054, p = 0.491, p = 0.873, p = 0.940). In addition, correlation analysis revealed that depression scores at week 4 were positively correlated with the IBS-SSS subscale scores for frequency of abdominal pain and disruption of QOL (&#x3b2; = 0.254, p = 0.012; &#x3b2; = 0.231, p = 0.028), whereas there was no significant relationship between anxiety and depression and the severity of abdominal pain, bloating, or bowel satisfaction score. No statistically significant differences were detected between patients with and without emotional disorders in terms of IBS-SSS response rate, stool frequency, stool consistency, and work and social adaptability following acupuncture treatment. However, depression had a negative effect on the IBS-related abdominal pain frequency scores and IBS-related QOL, suggesting that acupuncture might be an effective nonpharmacological therapy for IBS with comorbid depression. American Clinical Trial Registry (https://clinicaltrials.gov/) NCT04276961. Registered on February 19, 2020.

Anecdotal reports and preliminary clinical observations suggest potential benefits of homeopathic medicines in hemorrhoids, but high-quality evidence remains limited. To evaluate whether individualized homeopathic medicinal products (IHMPs) are superior to placebo in reducing anorectal symptom severity and improving quality of life over 3 months in adults with hemorrhoids, and to assess their safety and tolerability. Three-month, double-blind, randomized (1:1), placebo-controlled trial. Surgery, PG3, and research outpatients of a tertiary homeopathic medical college hospital in West Bengal, India. One hundred and thirty-four adults with grade I-III hemorrhoids. IHMPs (verum; n = 67) or identical-looking placebos (control; n = 67) both administered alongside standard concomitant care including sitz baths, pelvic floor exercises, and dietary advice. The primary outcome was the change in the Anorectal Symptom Severity and Quality-of-Life (ARSSQoL) total score over 3 months. Secondary outcomes included ARSSQoL subscales, numeric rating scales (NRSs), and EQ-5D-5L questionnaire and visual analog scale. Outcomes were assessed monthly for up to 3 months. The primary analysis compared model-based estimates of change over time between groups using repeated measures analysis of variance; the secondary analyses comprised multivariate linear mixed models, Bayesian hierarchical modeling, and sensitivity analyses under intention-to-treat and per-protocol frameworks. After 3 months, IHMPs demonstrated significantly greater improvement than placebo in ARSSQoL total (mean group difference -6.5, 95% confidence interval -8.7, -4.2; p < 0.001), with large effect sizes. Most ARSSQoL subscales, NRSs, and EQ-5D-5L scores favored IHMPs. Multivariate and Bayesian analyses confirmed consistent intervention-by-time effects, with a high probability of directional superiority for IHMPs in symptom reduction and self-rated health, while sensitivity analyses showed the findings to be robust to protocol deviations. Kent's repertory was the most frequently used in remedy selection. Nitricum acidum emerged as the most effective remedy. No treatment-related serious adverse events were observed. In this randomized, double-blind trial, IHMPs were associated with greater reductions in the ARSSQoL improvements in quality of life compared with placebo over 3 months. Although the magnitude and consistency of effects across multiple analytic approaches suggest potential clinical relevance, the absence of a validated minimal clinically important difference for the ARSSQoL warrants cautious interpretation. Further independent replications and methodological refinement of outcome thresholds are needed.

Complementary and alternative medicine (CAM) is widely used by oncology patients to manage symptoms, reduce stress, and improve quality of life. Unlike conventional treatments, CAM is rarely reimbursed in Germany, resulting in significant out-of-pocket costs. These expenses may contribute to financial burden and financial toxicity, yet this dimension remains understudied. This multicenter, open-label, cross-sectional study was conducted in 2024. A standardized anonymous questionnaire collected demographic, socioeconomic, and medical data, CAM utilization, out-of-pocket expenditures, and distress levels (NCCN Distress Thermometer). Descriptive statistics, Chi-square tests, Pearson correlations, and independent t-tests were applied. A total of 209 patients (median age 62.6 years, 52.6% female) participated; 57.4% reported CAM use. Female patients were more likely than males to use CAM (p&#x2009;<&#x2009;0.001). Among CAM users, 71.7% incurred out-of-pocket expenses, averaging &#x20ac;124/month for women and &#x20ac;153/month for men. Expenditures were highest among patients with hematological malignancies (&#x20ac;229/month). A strong positive correlation was observed between the number of CAM modalities used and monthly costs (p&#x2009;<&#x2009;0.001). No significant difference in distress was found between CAM users and non-users; however, female CAM users reported lower distress than their male counterparts (p&#x2009;<&#x2009;0.05). CAM use is common among German oncology patients and generates substantial out-of-pocket costs, particularly in vulnerable subgroups. When combined with cancer-related income loss, these expenditures increase financial burden and may contribute to financial toxicity. Integrative oncology models, reimbursement strategies, and patient counseling are essential to mitigate economic vulnerability and ensure equitable access to supportive care.

Cancer-related cognitive impairment (CRCI) is a prevalent and clinically significant sequela of cancer and its treatment, markedly reducing quality of life. As a core component of Traditional Chinese Medicine, acupuncture is a potential therapeutic intervention for CRCI; however, conclusive evidence on its efficacy and safety is lacking due to fragmented and methodologically limited studies. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of acupuncture for CRCI. We systematically searched eight databases from inception to February 1, 2025, for randomized controlled trials (RCTs) in adults with CRCI comparing acupuncture with control interventions (e.g., conventional care, sham acupuncture, and other active therapies). Risk of bias was assessed using the Cochrane tool (v1). Meta-analyses used RevMan 5.3. Evidence certainty was evaluated with the GRADE framework. Prespecified subgroup analyses explored heterogeneity by acupuncture modality, treatment duration, cancer treatment phase, and cancer type. Forty-four RCTs (n = 3,783) were included. Versus conventional treatment, acupuncture significantly improved Mini-Mental State Examination (MMSE) scores (mean difference [MD] = 2.34, 95% confidence interval [CI] [1.84, 2.85], P < 0.00001), Montreal Cognitive Assessment (MoCA) scores (MD = 1.48, 95% CI: [1.15, 1.82], P < 0.00001), and reduced postoperative cognitive dysfunction (POCD) incidence (risk ratio [RR] = 0.49, 95% CI: [0.41, 0.60], P < 0.00001). Compared with sham acupuncture, acupuncture improved MMSE (MD = 2.48, 95% CI: [1.55, 3.41], P < 0.00001) and MoCA (MD = 1.52, 95% CI: [0.16, 2.88], P = 0.03) scores, though the latter was imprecise. Acupuncture demonstrated no significant benefit for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 cognitive subscale compared with sham acupuncture (P = 0.11) or other active therapies (P = 0.15). Subgroup analyses identified treatment duration, acupuncture modality, and cancer type as major heterogeneity sources. Safety reporting was often incomplete, yet all documented adverse events were mild and transient. Grading of Recommendations Assessment, Development and Evaluation evidence certainty was low to very low. Acupuncture may improve global cognitive function and reduce POCD incidence in CRCI. However, the safety profile requires further confirmation. Current evidence is limited by methodological weaknesses, substantial heterogeneity, and imprecision, highlighting the need for rigorous, high-quality RCTs with standardized protocols, objective biomarkers, and comprehensive safety monitoring to define acupuncture's role in CRCI management.

Complementary therapies are becoming increasingly popular with patients. Specialized clinics can offer complementary medicine to patients in the German healthcare system, taking into account specific structural requirements. However, little is known about the patients treated in these hospitals. For this purpose, 12,457 hospital stays were analysed from 2007 to 2024 in an approved acute care hospital to obtain more information about the illnesses, comorbidities, length of stay in hospital, age, and chronicity of the patients. Approximately half of the hospital stays examined showed pain-related disorders (49.3%), followed by common internal medical conditions (11.7%) and psychological diagnoses (10.3%). Women showed on mean 14 secondary diagnosis (median 9.0, IQR 6.0), male patients 9.1 (median 9.0, IQR 6.0). 5562 stays showed five or more comorbidities. Considering all hospital stays, the female gender predominated (N&#x202f;=&#x202f;9680, 77.7%, 95% CI 77.0-78.4% vs. male N&#x202f;=&#x202f;2777, 22,3%, 95% CI 21.6-23.0%). The mean age of female patients was 64.6 (median 65.0, IQR25.0) of male patients 64.8 (median 66.0, IQR 24.0). The mean length of stay was 12.2 days (median 14, IQR 7.0). A large number of patients have chronic conditions, with pronounced pain and psychological impairments. A complementary medicine treatment concept focuses on the treatment of chronically ill patients with multiple diseases.

The use of complementary and alternative medicine (CAM) therapies is becoming increasingly popular among patients with cancer; however, referrals to CAM by oncologists remain infrequent. There is limited synthesis of oncologists' perspectives on CAM use and referral practices, despite availability of empirical studies with inconsistent findings. This scoping review aims to map the literature regarding oncologists' attitudes, beliefs, and behaviors toward CAM, with a specific focus on factors influencing referral practices. We conducted a scoping literature review in accordance with the Joanna Briggs Institute guidelines. The protocol was registered with the Open Science Framework. We searched MEDLINE, EMBASE, CINAHL, AMED, PsycINFO, Web of Science, and Scopus databases from January 1, 1990, to February 2026. Eligible studies were peer-reviewed articles examining oncologists' perspectives on CAM use for adults with cancer. Out of 11,853 studies identified, 13 studies were included. Three domains were structured: Commonly referred CAM categories (natural products, mind-body practices, whole medical system, manipulative and body-based therapies, and creative art therapies); views of oncologists on CAM use (presuppositions about CAM integration, information sources and personal use, gender differences, role of workplace in CAM referral, self-reported spirituality and personal beliefs, and facilitators and barriers to CAM referral. While oncologists expressed willingness to integrate CAM for curable cancers, educational, evidence-related, and safety-driven barriers continued to impede their referral decisions. Future research should focus on examining the specific nature of barriers to practitioner collaboration and ways to address the gaps identified in the current evidence base.

Caregivers of patients receiving palliative care frequently experience high levels of stress and anxiety, which may negatively affect their quality of life. This study aimed to investigate the effects of mandala coloring on perceived stress, anxiety, and quality of life (primary outcomes) among caregivers of patients receiving palliative care. This cluster randomized controlled trial included 80 caregivers, allocated to an intervention group (n = 40) or a control group (n = 40). The intervention group participated in mandala coloring sessions 4 days per week for 4 weeks (16 sessions total), while the control group received no intervention. Data were collected using the Perceived Stress Scale (PSS), State Anxiety Scale, and Short Form-36 (SF-36) Health Survey. Postintervention outcomes were analyzed using analysis of covariance, controlling for baseline scores. The study was conducted and reported according to CONSORT cluster extension guidelines. After adjustment for baseline scores, the intervention group showed significantly lower PSS (F = 133.29, p < 0.001, &#x3b7;p2 = 0.634) and state anxiety scores (F = 38.57, p < 0.001, &#x3b7;p2 = 0.334) compared with the control group. Postintervention SF-36 physical (F = 86.31, p < 0.001, &#x3b7;p2 = 0.529) and mental health scores (F = 112.05, p < 0.001, &#x3b7;p2 = 0.593) were significantly higher in the intervention group. In the control group, perceived stress and anxiety increased significantly, and quality of life scores decreased over the study period (p < 0.05). No adverse events, discomfort, or intervention-related withdrawals occurred, indicating that the intervention was safe and well-tolerated. Mandala coloring effectively reduced perceived stress and anxiety and improved the quality of life in caregivers of palliative care patients. Given its noninvasive, low-cost, and safe nature, it may be recommended as a supportive nurse-led intervention in palliative care settings. Mandala coloring can be integrated into routine palliative care as a nurse-led nonpharmacological intervention to support caregiver well-being.

In women who have had a cesarean section, symptoms such as pain, mood swings, and fatigue can negatively impact the postpartum recovery process and make newborn care more difficult. While practical interventions such as classical foot massage (CFM) and kinesio taping (KT) are clinically promising, evidence in the literature regarding the comparative effectiveness of these methods is limited. To compare the effects of KT and CFM on pain (primary outcome), fatigue and mood (secondary outcome). This parallel-group randomized controlled trial was conducted at a university hospital in the Aegean region of T&#xfc;rkiye between December 2024 and April 2025. A total of 105 participants meeting the criteria were randomized into the study (n = 35 in each group); after losses during the follow-up period (KT: 3, CFM: 2, CG: 3), the study was completed and analyzed with 97 participants: KT (n = 32), CFM (n = 33), and CG (n = 32). KT was administered at the 8th hour postoperatively; CFM was administered at 8th and 33rd hours using a standard protocol. Group differences at the 8th and 33rd hours, representing the pre-intervention period, were similar. At 9th hour, lower pain scores were found in the CFM compared to the KT and CG (Cohen's f = 0.34; 95% confidence interval [CI]: [2.90-4.43]; p = 0.009). Similarly, at 34th hour, lower pain scores persisted in the CFM group (Cohen's f = 0.31; 95% CI: [1.77-3.08]; p = 0.014). Regarding subscales, higher "energy" scores were observed in the CFM at 8th hour (Cohen's f = 0.28; 95% CI: [5.08-6.47]; p = 0.026), whereas the KT group showed higher energy at 34th hour (Cohen's f = 0.27; 95% CI:[5.50-6.77]; p = 0.034). In addition, the pleasant mood subscale was significantly higher in favor of CFM at 34th hour (Cohen's f = 0.43; 95% CI: [19.23-23.86]; p = 0.014). No serious side effects were observed during the applications. Mild and transient discomfort was reported in a small number of participants in the CFM group. CFM demonstrated a more pronounced short-term effect in reducing postcesarean pain compared to KT and the CG. Time-varying differences were observed between the CFM and KT groups in terms of energy levels and mood. However, larger-scale studies are needed to confirm the place and effectiveness of these methods in routine clinical use. ClinicalTrials.gov NCT06811285.