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Holistic pediatrics: a research agenda
K J Kemper1, B Cassileth, T Ferris
1Center for Holistic Pediatric Education and Research, Children's Hospital and Harvard Medical School, Boston, MA, USA.
Insights
Research is needed on the safety and effectiveness of complementary and alternative medicine (CAM) for children, especially those with serious illnesses. Understanding diverse CAM practices and their impact on healthcare is crucial.
Area of Science:
- Pediatrics
- Integrative Medicine
- Health Services Research
Background:
- Growing use of complementary and alternative medicine (CAM) in pediatric care.
- Significant changes in healthcare organization and financing necessitate research.
- Need for evidence-based evaluation of CAM therapies for children.
Purpose of the Study:
- To outline a research agenda for holistic pediatrics.
- To identify research priorities for CAM therapies in children.
- To explore the impact of CAM definitions on healthcare perceptions and funding.
Main Methods:
- Clinical research on safety and effectiveness of CAM for ill children.
- Qualitative ethnographic research on patient-provider communication and adherence.
- Health services research on CAM epidemiology, manpower, and integration.
Main Results:
- Prioritization of clinical research for vulnerable children with serious illnesses.
- Emphasis on understanding the heterogeneity of CAM practices and beliefs.
- Identification of research gaps in understanding CAM's impact on healthcare systems.
Conclusions:
- A comprehensive research agenda is proposed for CAM in pediatrics.
- Further research is essential to ensure the safe and effective integration of CAM.
- Understanding diverse CAM approaches can enhance mainstream pediatric healthcare quality.
Abstract:
Increasing numbers of American families seek complementary and alternative medical care (CAM) for their children; at the same time health care organization and financing are undergoing radical changes. The combination of these factors provides a powerful incentive for research on the effectiveness and safety of CAM therapies and their role in treating children. This article describes a rationale, spectrum, priorities, and methodologies for a research agenda in holistic pediatrics. The top priorities are clinical research projects addressing the safety and effectiveness of alternative therapies used for vulnerable children suffering from serious illnesses. Additionally, major research questions involve the impact of the various definitions such as "alternative," "complementary," "folk," "integrative," and "holistic" medicine on perceptions of health care, professional education, and funding of products and services. Research efforts in alternative therapies need to address explicitly the tremendous heterogeneity between and among the practices, beliefs, and providers of professional and lay services. Qualitative ethnographic research is needed to understand the consequences of diverse explanatory models and meanings of health and illness for patient-provider communication, adherence with professional recommendations, and satisfaction with care. Health services researchers need to address questions related to the epidemiology of CAM practices, health manpower issues, practice characteristics and the process and content of health care and how discoveries about CAM care may enhance the quality of mainstream health services. A rationale is provided for prioritizing certain conditions and therapies within these efforts.