Sunday, 21 January 2018

Refugees in Conflict: Creating a Bridge Between Traditional and Conventional Health Belief Models.

Oncologist. 2017 Dec 28. pii: theoncologist.2017-0490. doi: 10.1634/theoncologist.2017-0490. [Epub ahead of print] Ben-Arye E1,2, Bonucci M3, Daher M4, Kebudi R5, Saad B6,7, Breitkreuz T8, Rassouli M9, Rossi E10,11, Gafer N12, Nimri O13, Hablas M14, Kienle GS15, Samuels N16, Silbermann M17. Author information 1 Integrative Oncology Program, Lin Medical Center, Clalit Health Services, Haifa, Israel 2 Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. 3 Association for Research on Integrative Oncology Therapies, Rome, Italy. 4 St. George Hospital, Balamand University, Beirut, Lebanon. 5 Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey. 6 Al-Qasemi Academy, Baqa El-Gharbia, Israel. 7 Arab American University, Jenin, Palestine. 8 Die Filderklinik, Stuttgart and Paracelsus-Krankenhaus Unterlengenhardt, Bad Liebenzell, Germany. 9 Shahid Beheshti University of Medical Sciences, Teheran, Iran. 10 ASL Tuscany North West Lucca, Italy. 11 Tuscan Network for Integrative Medicine, Lucca, Italy. 12 Radiation & Isotope Centre, Khartoum, Sudan. 13 Ministry of Health, Amman, Jordan. 14 Palliative Care Services, Gharbiya Cancer Society, Tanta, Egypt. 15 University of Witten/Herdecke, and University Medical Center, Freiburg, Germany. 16 Tal Center for Integrative Oncology, Institute of Oncology, Sheba Medical Center, Tel-Hashomer, Israel. 17 Middle East Cancer Consortium, Haifa, Israel. Abstract The recent wave of migration from Middle Eastern countries to Europe presents significant challenges to the European health profession. These include the inevitable communication gap created by differences in health care beliefs between European oncologists, health care practitioners, and refugee patients. This article presents the conclusions of a workshop attended by a group of clinicians and researchers affiliated with the Middle East Cancer Consortium, as well as four European-based health-related organizations. Workshop participants included leading clinicians and medical educators from the field of integrative medicine and supportive cancer care from Italy, Germany, Turkey, Israel, Palestine, Iran, Lebanon, Jordan, Egypt, and Sudan. The workshop illustrated the need for creating a dialogue between European health care professionals and the refugee population in order to overcome the communication barriers to create healing process. The affinity for complementary and traditional medicine (CTM) among many refugee populations was also addressed, directing participants to the mediating role that integrative medicine serves between CTM and conventional medicine health belief models. This is especially relevant to the use of herbal medicine among oncology patients, for whom an open and nonjudgmental (yet evidence-based) dialogue is of utmost importance. The workshop concluded with a recommendation for the creation of a comprehensive health care model, to include bio-psycho-social and cultural-spiritual elements, addressing both acute and chronic medical conditions. These models need to be codesigned by European and Middle Eastern clinicians and researchers, internalizing a culturally sensitive approach and ethical commitment to the refugee population, as well as indigenous groups originating from Middle Eastern and north African countries. IMPLICATIONS FOR PRACTICE: European oncologists face a communication gap with refugee patients who have recently immigrated from Middle Eastern and northern African countries, with their different health belief models and affinity for traditional and herbal medicine. A culturally-sensitive approach to care will foster doctor-refugee communication, through the integration of evidence-based medicine within a nonjudgmental, bio-psycho-social-cultural-spiritual agenda, addressing patients' expectation within a supportive and palliative care context. Integrative physicians, who are conventional doctors trained in traditional/complementary medicine, can mediate between conventional and traditional/herbal paradigms of care, facilitating doctor-patient communication through education and by providing clinical consultations within conventional oncology centers. © AlphaMed Press 2017. KEYWORDS: Cross‐cultural medicine; Doctor‐patient dialogue; Integrative medicine; Middle East; Refugees; Traditional medicine PMID: 29284761 DOI: 10.1634/theoncologist.2017-0490