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ALTERNATIVETHERAPIESsepoct2011VOL.17NO.533AProposedCAMConceptualModelandtheoriestoexplainandpredictCAMuse.11Whiletheoriesandmodelsaresometimesusedinterchangeablythesetermsaredis-tinctinmeaningandpractice.12Theoriesaretypicallyspecictoanotherdisciplineoriginatefromsociologypsychologyetcandfunctiontodescribeexplainorpredictlimitedpropertiesofreali-ty.Thereforeatheoryaddressesanaspectofrealitybystatingwhatsomethingishowsomethinghappensorwhyithappens.Conceptualmodelsontheotherhandtendtoidentifyanddescribespecictypesofbehaviorinspecicsituationsorcon-texts.12Conceptualmodelshavetheabilitytodrawonnumeroustheoriessimultaneouslywhileillustratingthecausallinkagesbetweenelements.BroadlythepreviousapplicationsoftheoriesandmodelsoriginatingfrommedicalsociologypsychologyandmarketingresearchtoCAMcanbeseparatedintoeitherhealthcareutiliza-tionmodelsorhealthbehaviortheories.11Themostcommonthe-oriesandmodelsusedtodateintheCAMliteratureincludetheAndersenSociobehavioralModel13-21HealthLocusofControl1422-24andSelf-regulatoryModel.2526GiventhediversityofCAMprac-ticestheuniqueunderlyingdriversofutilizationandultimateendpointsofCAMuseaconceptualmodelthataddressesthesevariousaspectswouldbevaluabletoCAMeducationandfutureinquiry.InthisarticleweproposeaconceptualmodelthatdescribesthefactorsinvolvedinCAMuse.DEVELOPMENTx0OFx0THEx0CONCEPTUALx0MODELToconstructourconceptualCAMutilizationmodelwebuiltuponprominenttheoriesandhealthutilizationmodelsfromthesociologyandpsychologyliteraturebase.Herewebrief-lydescribethetheoriesandmodelsthatmostinfluencedthedevelopmentofourconceptualmodelwhichincludeParsonx19sSickRoleTheorySuchmanx19sStagesofIllnessTheoryandtheAndersenSociobehavioralModelofhealthcareutilization.Parsonx19sx0Sickx0Rolex0TheoryInourconceptualmodelwedelineatethetransitionfromwell-nessasymptomatictosicknessasadriverofCAMuse.Acentralconstructofhealthserviceutilizationtheoryisthex1csickrolecon-ceptx1drstintroducedbyTalcottParsonsin1951.Thesickrolecon-ceptsuggeststhattheexperienceofbeingsickextendsbeyondphysicalandphysiologicalsymptomstoincludetheimpactofsocio-culturalfactors.Thesickroleconceptoutlinesthetransitionfromthepresenceofsymptomstosicknessandtheinterplaybetweenthecultureandillperson.Parsonx19ssickrolehasfourmajortenets1whenanindividualbecomessicksocietyexcuseshimorhertempo-rarilyfromsocialduties2asickpersonisnotexpectedtohealhimherselfandthusrequiresassistance3thereexistsgeneralagreementthatbecomingsickisanundesirablestateand4togetwellthesickindividualmustseekmedicaltreatment.Thesickroleconceptchannelsthesickintoseekingmedicaltreatmentsothesickindividualrelinquishesself-responsibilitytoenterintoarelationshipofdependencywiththehealthcareprovider.ThoughthesickroleconceptwasinstrumentaltolatermedicalsociologicalworkitfellunderconsiderablescrutinyincludingitsapplicationtoCAM.27Suchmanx19sx0Stagesx0ofx0Illnessx0TheoryAnotherseminalhealthservicesutilizationtheoryisSuchmanx19sStagesofIllness.28Thistheorydetailsalinearrelation-shipbetweenvedifferentpointsintheindividualx19sdecisionprocesstoutilizehealthcare.AccordingtoSuchmanthevestagesofthedecisionprocessare1thesymptomexperiencestage2theassumptionofthesickrolestage3themedicalcarecontactstage4thedependent-patientrolestageand5therecoveryorrehabilitationstage.Duringtheinitialstagetheindividualweighstheseverityofsymptomsincludingpaindis-comfortandemotion.Thisincludestheacknowledgmentthatsomethingiswrong.SimilartoParsonx19sSickRoletheindividualthenassumestheroleofbeingsickandproceedstoseekhealthcareandexplorestheirpersonallayreferralsystem.Duringthefourthstagetheindividualmaytakeonadependentrolehow-evertherearesignicantfactorsthatimpactthistransitionthatrelatetophysicalsocialandpsychologicalfacets.Thisisacriti-calpointinthemodelwherethepatient-practitionerrelationshipmayimpacthealthcareconsumptionandisaparticularlyimpor-tantaspectinCAMutilization.Thefourthstagecanalsobedis-ruptedifthesickindividualx19sbeliefsclashwiththepractitionerx19s.ThistippingpointisalsorelevanttoexplainingthecrossoverbetweenconventionalhealthcareandCAMuseasalignmentwithpersonalbeliefsisanimportantfactorinCAMuse.829Thenalstageinvolvestherelinquishmentofthesickrolebytheindividualexceptwhenaconditionisincurableandentailsongo-ingtreatment.InterestinglyinCAMcontinuoustreatmentmayensueamongasymptomaticindividuals.Thex0Andersenx0Sociobehavioralx0Healthcarex0Utilizationx0ModelThesociobehavioralmodelmostoftenusedtopredicthealthcareutilizationistheAndersenModelinitiallydevelopedin1968.30SinceitsoriginaliterationtheAndersenModelhasbeenrevisedmultipletimes.Therstversionincludedthreeprimarydeterminantsofhealthserviceutilization1predisposingchar-acteristicsdemographicspositionwithinthesocialstructureandhealthbeliefsattitudesknowledgeandvalues2enablingresourcesnancialandphysicalaccesstohealthcareservicesand3needbothself-perceivedandevaluatedhealthstatus.Theperceptionofneedisalargeconstituentoverridingtheutili-zationofhealthservicesinthismodelandisbasedwithinsocialcontext.Inthe1970sthemodelwasexpandedtoincludeaspectsofthehealthcaredeliverysystempolicyavailabilityofresourcesanditsorganizationaswellasacomponentoftheindividualx19ssatisfactionwiththehealthcareservicessuchasconvenienceavailabilityprovidercharacteristicsandquality.Againinthe1980sand1990sthemodelwasmodiedandnowincludestheimpactsofhealthinalinearfashionwithdeterminantsubsetsincluding1primarydeterminantspopulationcharacteristicsthehealthcaresystemandexternalenvironment2healthbehaviorspersonalhealthcharacteristicsandtheuseofhealthservicesand3healthoutcomesperceivedhealthstatusevalu-atedhealthstatusandconsumersatisfaction.TheAndersenSociobehavioralModelhasbeenusedwithtwoslightmodica-