Why Women use Complementary and Alternative Medicine (CAM): A Comparison Across Mid-age and Older Adult Generations

Complementary and Alternative Medicine (CAM) use has been researched widely; however, studies with older adults and Australian populations are limited. While currently there are a range of clinical trials testing the efficacy of different types of CAM, research into the predictors of CAM use is lacking. The profile of Australian CAM users has been explored by researchers, however; the motivations and predictors of CAM use has not. This thesis will test the predictive value of a range of variables previously identified in existing literature that have been linked to CAM use. In addition, the themes surrounding CAM use will be explored across two cohorts of women from both the mid-age and older adult cohorts. A mixed methods design was used to combine both population data and personal experiences of women from a mid-age (born between 1946-51) and older adult (born between 1921-1926) cohort. The profile of Australian women CAM users was mapped using data from the Australian Longitudinal Study of Women’s Health (ALSWH) in the mid-age and older women cohorts at Surveys Two (1998/1999) and Five (2007/2008). There were significantly fewer CAM users but more non-CAM users in 1999 compared to 2007 in the mid-age adult cohort (N = 12338, Age, M = 49.52, SD = 1.46, p < 0.001) and significantly less CAM users and non-CAM users in 1998 compared to 2008 in the older adult cohort (N = 10434, Age, M = 84.20, SD = 1.44, p < 0.016). Logistic regression was used for non-CAM users at Survey Two to predict CAM use at Survey Five in both cohorts of women. In the mid-age cohort, ARIA scores from major cities, p = 0.03, inner regional, p = 0.002 and outer regional cities, p = 0.01 reliably predicted CAM use. Stress was also found to be a significant predictor, p = 0.001. These relationships were all positive, indicating that as remoteness and stress increased, so too did an individual’s likelihood of using CAM in 2007. There were no significant predictors of CAM use found in the older adult cohort. In response to these findings, six focus groups were conducted across two cohorts of women, including mid-age adults (60-65 years old) and older adult cohorts (over 80 years old) until thematic saturation had occurred. Consistent with previous studies it was evident that both mid-age and older adults CAM users consumed a varied and extensive range of CAM products ranging from fish oil through to acupuncture. Older women were less inclined to identify as being CAM users than mid-age women despite using a range of CAM products. Older adults were also more likely to refer to the influence that historical events played in their current health practices. Mid-age adults cited experiencing stress and guilt, the desire for control over their health, a holistic approach and preventative healthcare as the main reasons for commencing CAM use. Attitudes to CAM use varied across the two cohorts. Older adults described hope and optimism as being common in the mindset of a CAM user whereas mid-age adults used terms such as curious and assertive. Availability of services, promotion of CAM and a belief that it had lower risk than conventional medicine were also cited by both cohorts as being motivators to commence CAM use. These findings have important implications for the phrasing of research questions with regard to women’s CAM use. It is perhaps more important to discuss the use of individual CAM products than discuss CAM use in broad terms with older adult cohorts. The importance of direct communication about CAM, control in health decision making and having an open attitude for physicians is also crucial if CAM use is to be managed in conjunction with conventional medicine. Finally, tolerance and experimentation with CAM use is increasing, so guidelines of how to incorporate this into conventional practice should be developed