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Patient-Reported Experiences with First-Time Naturopathic Care for Type 2 Diabetes
Authors:Erica B Oberg  Ryan Bradley  Clarissa Hsu  Karen J Sherman  Sheryl Catz  Carlo Calabrese  Daniel C Cherkin
Institution:1. School of Naturopathic Medicine, Bastyr University, Kenmore, Washington, United States of America.; 2. Group Health Research Institute, Seattle, Washington, United States of America.; 3. Naturopathic Physicians Research Institute, Portland, Oregon, United States of America.; College of Tropical Agriculture and Human Resources, University of Hawaii, United States of America,
Abstract:Differences in the effectiveness of diverse healthcare providers to promote health behavior change and successful diabetes self-care have received little attention. Because training in naturopathic medicine (NM) emphasizes a patient-centered approach, health promotion, and routine use of clinical counseling on wellness and prevention, naturopathic physicians (NDs) may be particularly well-prepared for promoting behavior change. However, patients’ experiences with NM have not been well studied. This study provides the first report of the perceptions of persons with type 2 diabetes of their first experiences with naturopathic care for their diabetes. Following their participation in a one-year prospective cohort study of adjunctive naturopathic care for diabetes, twenty-two patients were interviewed about their experiences working with a naturopathic physician. Using a content analysis approach, nine dominant themes were identified. Three themes characterized the nature of the ND-patient interaction: 1) patient-centered, 2) holistic health rather than diabetes focused, and 3) collaborative. Five themes characterized the content of the clinical encounter: 1) individualized and detailed health promotion, 2) counseling that promoted self-efficacy, 3) pragmatic and practical self-care recommendations, 4) novel treatment options that fostered hopefulness, and 5) patient education that addressed both diabetes self-care and general health. A ninth theme was cross-cutting: the contrast between ND care and conventional medical care. Results indicate that the routine clinical approach used by NDs is consistent with behavior change theory and clinical strategies found most effective in promoting self-efficacy and improving clinical outcomes.
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