04. tbl. 96.árg. 2010
Utilization of complimentary and alternative health services in Iceland
Objective: Westerners increasingly use complimentary and alternative (CAM) methods for curing illness and promoting health. The central ideas of CAM appear to resonate with large segments of the general public. Little is known about CAM use in Iceland. The purpose of the study was to assess the scope of utilization of CAM providers and the likely explanatory factors.
Material and methods: The data come from a national postal health survey that took place during the Fall of 2006. A sample of Icelandic adults, age 18-75, was randomly drawn from the National Register. 1532 individuals responded to the survey yielding a 60% response rate.
Results:Almost 32% of the respondents had used a CAM provider in the past 12 months, an estimated increase of 6% since 1998. Women and high income individuals were more likely to use a CAM provider than men and lower income individuals. Physical and mental distress was also related to the likelihood of CAM use. Individuals having negative or positive attitude toward physician services were more likely to use a CAM provider than those expressing a neutral attitude. Finally, repeated physician visits were related to an increased likelihood of CAM use.
Conclusions: Icelanders use CAM providers to a considerable degree, and CAM use has increased in recent years. It appears that some clients regard the care they receive in the general health system as insufficient. Most CAM users appear to use CAM treatments as a supplement to the care received in the general health system.
Table I. Percentage of respondents using different CAM providers in the past 12 months
Provider | % | ni/nk1 |
Massage therapist | 19.3 | 269/1395 |
Reflexolog (Zone therapist) | 4.3 | 59/1389 |
Chiropractor | 4.8 | 67/1392 |
Craniosacral therapist | 5.7 | 79/1386 |
Osteopath | 1.9 | 26/1381 |
Homeopath/Naturopath | 3.8 | 53/1369 |
Yoga teacher/therapist | 6.8 | 94/1379 |
Spiritual healer | 3.2 | 43/1386 |
Acupuncturist | 4.7 | 65/1391 |
1 ni refers to number of individuals visiting a particular CAM provider, and nk refers to number of individuals answering the question.
Table II. Percentage of respondents using a CAM provider by explanatory variables
Variables | % | ni/nk1 | Phi / Cramér's V | |
Gender | ||||
Male | 22.6 | 153/678 | ||
Female | 41.3*** | 272/659 | 0.201 | |
Age | ||||
18-24 | 33.8 | 67/198 | ||
25-34 | 36.2 | 96/265 | ||
35-44 | 33.1 | 96/290 | ||
45-54 | 32.8 | 83/253 | ||
55-64 | 26.2 | 50/191 | ||
65+ | 24.4 | 33/135 | 0.083 | |
Marital status | ||||
Married/Cohabiting | 31.8 | 303/954 | ||
Single | 31.7 | 84/265 | ||
Divorced | 31.3 | 26/83 | ||
Widowed | 26.3 | 5/19 | 0.014 | |
Parent to a child under 18 | ||||
No | 31.5 | 218/693 | ||
Yes | 32.0 | 201/629 | 0.005 | |
Education | ||||
Primary | 28.5 | 59/,207 | ||
Secondary | 30.0 | 221/736 | ||
Tertiary (University level) | 37.2* | 135/363 | 0.073 | |
Employment | ||||
Not employed | 32.7 | 48/147 | ||
Less than 40 hrs pr week | 35.0 | 116/331 | ||
More than 40 hrs pr week | 30.4 | 234/770 | 0.043 | |
Annual individual income (Icelandic Krónur) |
||||
0 - 1699 thousand | 36.4 | 136/374 | ||
1.7 – 3.4 million | 30.5 | 113/370 | ||
3.5 – 5.4 million | 28.0 | 80/286 | ||
5.5 million or more | 29.0 | 53/183 | 0.07391 | |
Residence | ||||
Reykjavik Metropolitan Area | 32.7 | 280/855 | ||
Countryside | 30.1 | 145/482 | -0.027 | |
Belongs to a religious denomination | ||||
No | 31.8 | 34/107 | ||
Yes | 32.3 | 369/1144 | 0.003 | |
I believe in God | ||||
Rather or strongly agree | 33.5 | 324/966 | ||
Rather or strongly disagree | 27.6 | 87/315 | -0.055 | |
Table II. (continued) | ||||
Variables | % | ni/nk1 | Phi / Cramér's V | |
I am a religious person | ||||
Rather or strongly agree | 33.1 | 301/910 | ||
Rather or strongly disagree | 28.5 | 105/369 | -0.045 | |
Disabled | ||||
Yes | 56.0 | 28/50 | ||
No | 31.2*** | 376/1205 | -0.104 | |
Chronic medical condition (confirmed by an MD) | ||||
No chronic condition | 26.4 | 168/637 | ||
1 chronic condition | 33.5 | 94/281 | ||
2 chronic conditions | 39.1 | 66/169 | ||
3 or more chronic conditions | 39.0*** | 97/249 | 0.119 | |
Psychophysiological distress | ||||
Little or moderate | 27.8 | 288/1037 | ||
High | 46.7*** | 119/255 | 0.162 | |
Depression | ||||
Little or moderate | 29.6 | 309/1045 | ||
High | 42.1*** | 102/242 | 0.105 | |
Anger/Aggression | ||||
Little or moderate | 29.3 | 289/987 | ||
High | 39.4*** | 132/335 | 0.095 | |
Anxiety | ||||
Little or moderate | 30.0 | 322/1074 | ||
High | 39.3** | 94/239 | 0.078 | |
Perceived stress | ||||
No, little, or moderate | 29.5 | 297/1008 | ||
High | 40.2*** | 125/311 | 0.098 | |
Negative life events | ||||
No event | 27.8 | 141/507 | ||
1 event | 34.6 | 123/356 | ||
2 or more events | 34.1* | 158/464 | 0.068 | |
Ongoing difficulties | ||||
No difficulties | 23.5 | 12/51 | ||
1-2 difficulties | 23.7 | 22/93 | ||
3 or more difficulties | 32.9 | 309/1185 | 0.062 | |
Number of physician visits in past 12 months | ||||
No visit | 20.7 | 56/271 | ||
1 visit | 23.7 | 68/287 | ||
2-3 visits | 31.8 | 131/412 | ||
4 or more visits | 46.2*** | 157/340 | 0.208 | |
Table II. (continued) | ||||
Variables | % | ni/nk1 | Phi / Cramér's V | |
Number of visits to psychiatrists in past 12 months | ||||
No visit | 31.5 | 405/1285 | ||
1 or more visits | 42.6 | 20/47 | 0.044 | |
Satisfaction with last physician visit | ||||
Rather/very satisfied | 32.4 | 431/1077310/956 | ||
Neither satisfied nor dissatisfied | 32.8 | 66/20184/219 | ||
Rather/very dissatisfied | 34.3 | 37/10845/116 | 0.011 | |
Attitude towards visiting … | ||||
physicians | ||||
Rather or strongly disapprove | 71.4 | 5/7 | ||
Neither approve nor disapprove | 25.2 | 34/135 | ||
Rather or strongly approve | 321.8* | 382/1166 | 0.079 | |
psychiatrists | ||||
Rather or strongly disapprove | 40.9 | 9/22 | ||
Neither approve nor disapprove | 19.4 | 32/165 | ||
Rather or strongly approve | 33.9*** | 380/1120 | 0.106 | |
complimentary or alternative health providers | ||||
Rather or strongly disapprove | 16.3 | 14/86 | ||
Neither approve nor disapprove | 18.0 | 67/372 | ||
Rather or strongly approve | 40.2*** | 339/844 | 0.230 | |
1 ni refers to number of individuals visiting a particular CAM provider, and nk refers to number of individuals answering the question. * p<0.05; ** p<0.01; *** p<0.001 (two-tailed test) |
Tafla III. Logistic regression of CAM use on explanatory variables (N=1110).
Explanatory variables |
B |
se |
OR (Exp B) |
Gender (1=female) | 0.826*** | 0.154 | 2.284 |
Annual individual income | |||
1.7 – 3.4 million | -0.160 | 0.178 | 0.852 |
3.5 – 5.4 million | -0.028 | 0.197 | 0.973 |
5.5 million or more | 0.440 | 0.237 | 1.553 |
Psychophysiological symptoms (score) | 0.042** | 0.014 | 1.043 |
Anger/Aggression (score) | 0,072* | 0.029 | 1.075 |
Attitude towards physician visits | |||
Positive | -0.341 | 0.252 | 0.711 |
Negative | 2.142 | 1.192 | 8.519 |
Attitude towards CAM use | |||
Positive | 1.171*** | 0.187 | 3.226 |
Negative | -0.047 | 0.386 | 0.954 |
Number of physician visits | 0.074*** | 0.022 | 1.077 |
Constant | -2.297*** | 0.297 | 0.101 |
-2 Log Likelihood | 1229.58 | ||
df | 1098 | ||
* p<0.05; ** p<0.01; *** p<0.001 (two-tailed test) |