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UBC Theses and Dissertations

Alternative and complementary therapy use by women living with breast cancer : a test of three models Balneaves, Linda Georgie


The overall aim of this study was to enhance knowledge of the experience of alternative and complementary therapy (ACT) use in women living with breast cancer. This was achieved by developing and testing three cognitive models of the causal relationships between selected health beliefs, sociobehavioural factors, demographic characteristics, and ACT utilization among women with breast cancer. The prevalence and patterns of ACT use were also examined. A retrospective, correlational survey design was used in this study. A random sample of 650 women with stage I or II breast cancer was selected from the British Columbia Cancer Registry, of which 577 women were eligible for study participation. Completed self-report questionnaires were received from 334 women. The survey included questions to assess perceived risk of breast cancer recurrence, symptom distress, perceived efficacy of ACTs , barriers to ACT use, perceived control, and ACT utilization. Descriptive statistics were used to describe ACT utilization. Structural equation modelling was used to test the three models of ACT use across the contexts of preventive, ameliorative, and restorative health behaviour. A substantial proportion of women with breast cancer was found to be using a variety of ACTs . Vitamin/mineral supplements, herbal remedies, and spiritual therapies were the most commonly reported ACTs, with the majority of women using fewer than five therapies following their breast cancer diagnosis and spending under $50.00 a month on ACTs . Women most often sought information about ACTs from lay sources, including family and friends and print media. The majority of women had disclosed their use of ACTs to at least one of their conventional health care provider(s). Women who had used ACTs prior to their breast cancer diagnosis and had received encouragement from significant others to use ACTs were found to have greater commitment to ACTs . Health beliefs were found to explain a minimal amount of variances in women's commitment to ACTs . Exceptions included perceived efficacy of ACTs with regards to restoring well being and perceived control over well being. Women who believed ACTs to be efficacious in improving physical and mental well being and perceived themselves to be responsible for their well being were more likely to be committed to ACTs . The study findings suggest that ACT use is a widespread phenomenon in breast cancer populations that is influenced most strongly by past health behaviour and the norms and preferences that exist within women's social groups. These findings also contribute to our understanding of ACT use by women with breast cancer as being a reflection of their commitment to self-care and wellness. The need for further research that explores the roles of family members and health care providers in treatment decisions related to ACTs and educational and counseling strategies that support informed treatment decision making are implications of this study.

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