| This study comes from the national "11th Five-Year plan international cooperation projects supporting science and technology issues-an international multi-center study model of integrated traditional Chinese medicine treatment to improve the cure rate of colorectal cancer, including the international multi-center prospective cohort study and qualitative research. It is to be understood that why the colorectal cancer patients seek for traditional Chinese medicine (TCM) after operation, and their experiences, beliefs, and possible problems and obstacles, in order to find the relationship between these factors and the treatment outcome. An important part of the subject is an international multi-center prospective cohort study,310 patients from eight national centers and 160 cases from Norway are enrolled. I served as a monitor of the domestic part of this study.This paper is combined with three parts. The first part is the audit process and the specific implementation results of the domestic part of the cohort research. The second part consists of two research topics, which have the same purpose, and the latter complement the former. The third part includes two reviews. A review of qualitative studies described the concept, characteristics, theoretical foundation, the main method of Chinese medicine in the role of evidence-based status, as well as in clinical research in the application profiles and enlightenment. The other one introduces the qualitative research applications in domestic and international cancer research. Part I Monitoring in Multicenter Prospective Cohort Study on TCM Therapy to Improve Cure Rates of Colorectal after OperationObjective:Monitor to multicenter prospective cohort study to discover the problems in the process and corrected them, so as to promote progress and improve the quality of the research.Methods:Visited the research centers on the domestic regular, Audit focused on the enrolled case and the case report forms. Prepare a study schedule and quality reports to the project leader every 3 months.Conclusions:Patients compliance was the main reason affecting the enroll progress. The next important work was follow-up in time, in order not to lose. Periodic monitor could ensure the progress and quality of the study.Part II Qualitative Research of Colorectal Cancer Patients Seeking For TCM after OperationBackground:Currently, more and more colorectal cancer patients seek for treatment with TCM even those in early and middle stage while they are treated whit western medicine. Especially after the radical surgery and adjuvant chemotherapy and radiotherapy, these western medicine treatments are completed, some patients still insist on long-term treatment with TCM. But no systematic research data is about their specific motive and attitude.Studyâ… A Questionnaire Survey of Colorectal Cancer Patients Seeking For TCM after OperationObjective:To understand purpose of patients with colorectal cancer seeking for TCM after operation, and their attitude and understanding about TCM, prepare for the personal in-depth interviews.Methods:Select the colorectal cancer patients in stageâ…¡orâ…¢from March 1,2009 to June 30,2009 in Xiyuan Hospital, referral consent to be issued from the structured questionnaire, statistic analysis with the SPSS software.Results:In the 128 colorectal cancer patients in stageâ…¡orâ…¢, male 67, female 61,120 patients were surveyed, the participation rate was 93.75%.115 were recovered, the rate was 95.83%,8 questionnaires were deemed to be excluded,107 valid questionnaires were included in the final statistics. In 107 patients,49 ones had taken TCM, only three patients apply that it is not effective. After surgery,70% of patients began the TCM treatment within one year, About 51.40% of patients whose purpose were anti-recurrence and metastasis, and 27.10% of patients wanted to reduce the side effects of radiotherapy or chemotherapy. After a period of the treatment, about 90% of the respondents expressed satisfaction with TCM. 59.81% of respondents considered the effect as the main factor which affected them insisting in TCM.Conclusions:There were some reasons for the patients seeking for TCM, except for the past effective treatment. The purpose of the patients varied with time. Most of them wanted to reduce the side effects of radiotherapy and chemotherapy within lyear after operation. But the others who took TCM a year later wanted to prevent recurrence and metastasis. Most patients evaluated objectively on TCM, they expressed satisfaction with term effect and confidenced on anti-recurrence and metastasis.Studyâ…¡A Qualitative Interview about Colorectal Cancer Patients Seeking For TCM after Radical ResectionObjective:Based on the questionnaire survey, this study was designed in individual in-depth interview, to understood that why the colorectal cancer patients seek for TCM after operation, and their experiences, beliefs, and possible problems and obstacles, in order to find the relationship between these factors and the treatment outcome.Methods:Using purposeful sampling,18 colorectal cancer patients were interviewed. Transcribed the recording information to the scripts, and analyzed with software named ATLAS, ti.Results:Most patients received standard treatment in the general hospital or specialty hospital, some of them began the treatment of TCM and the western medicine at the same time, and others began the treatment of TCM after the western medicine. In the eyes of patients, Chinese medicine and Western medicine were not mutually exclusive, but complementary. The main purposes for TCM were as following aspects:to reduce the side effects of chemotherapy, improve the quality of life and reduce the recurrence and metastasis.Conclusions:Although the patients choose TCM in different ways, but they were full of expectations. At the same time their understanding were changing with continuation of the treatment. The ultimate goal of the Patients seeking for TCM was to prevent recurrence and metastasis. The difficulties and obstacles during the treatment did not affect their confidence of TCM. The efficacies of TCM were embodied not only in the improvement of symptomatic, but also in the improvement of objective indicators. Recent experience gave the patients more confidence to the long-term goal.
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