Attitude Toward Alternative Therapy, Compliance With Standard Treatment, and Need for Emotional Support in Patients With Melanoma

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Abstract
Objective: To examine the attitude of patients with melanoma toward alternative therapies, their compliance with standard treatment, social support received by them, and their ways of coping with illness. Design: Survey in a representative sample. Setting: University hospital; central melanoma clinic serving Tyrol region in Austria. Patients: Two hundred thirty-six consecutive patients with melanoma were approached in a 3-month-period, and 215 of them participated in the study. Outcome Measures: Results of a self-developed questionnaire to record patients' interest in alternative therapies, the Hornheide Questionnaire to assess patients' distress and social support, and the Freiburg Questionnaire of Coping With Illness. Results: One hundred seventeen patients (54.4%) reported interest in nonconventional therapy. Thirty (14%) patients admitted actual use of such methods. The latter group more often suffered from advanced cancer (P<.001). Compared with uninterested patients, subjects interested in alternative therapy were younger (95% confidence intervals [CI]=41.3-46.5 vs 48.7-56.7; P<.001), showed a more active coping style (95% CIs=3.45-3.75 vs 2.91-3.50; P=.001) and a tendency toward religiousness and search for personal meaning in the disease (95% CIs=2.56-2.85 vs 2.17-2.64; P≤.08). Their faith in conventional medicine and ready compliance with physicians' suggestions were not less than those of uninterested patients (95% CIs=4.26-4.46 vs 4.35-4.64; P=.25). However, they believed that they were receiving less emotional support from their physicians (95% CIs=0.95-1.74 vs 0.21-0.93; P=.04) and expressed interest in getting more such support (P=.04). Conclusions: Patients with melanoma consider nonconventional therapies as supplementary to standard medical methods and as a way of avoiding passivity and coping with feelings of hopelessness. This does not lessen the need to educate patients about the lack of efficacy of unorthodox methods but stresses the importance of offering them adequate emotional support. Arch Dermatol. 1997;133:316-321

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