Parents’ and primary care practitioners’ differing perspectives on traditional and complementary approaches to health (TCA) for children in a multi-ethnic community

Question

To compare parents’ and primary care practitioners’ attitudes, knowledge and beliefs regarding traditional and complementary approaches to health (TCA) for children.

Methods

This exploratory qualitative study was conducted in community settings and primary care in Northwest London. Eleven focus groups with parents from multi-ethnic communities explored the use of TCA for their children, their decision-making process and whether they communicated with healthcare practitioners on the use of TCA. Crèches and translation were used when necessary. Semi-structured one-on-one interviews were conducted with 30 primary care practitioners (GPs, nurses, health visitors and midwives) to explore their attitudes and beliefs to TCA and professional behaviour. Sampling was purposive and iterative to capture the range of ethnic groups. All interviews and focus groups were analysed using Framework Analysis, inter-rater coding and Atlas.ti software.

Results

Some practitioners were aware of the extent of TCA use in the community, but numerous areas of disparity between parents and practitioners regarding their knowledge, views and perceptions of TCA were identified. These included disparate definitions of the terms ‘traditional’ and ‘complementary’, practitioners’ underestimated the extent of TCA use, especially for routine day-to-day use of traditional home remedies and different beliefs about what types of TCA should be used. Practitioners’ perceived TCA users as affluent, ‘informed’ and in certain ethnic groups and placed greater importance on evidence and safety. In general health visitors’ views were closer to parents’, GPs’ were most disparate. These areas of disparity may have implications for patient care due to practitioners’ limited knowledge of the real-life use of TCA in the community. This may affect trust and communication within the practitioner–family relationship, limit patient-centred care and parent empowerment, and have potential safety implications.

Conclusion

Many primary care practitioners, especially GPs, had a different perspective regarding TCA compared with parents. They underestimated the extent and range of TCA use and focussed on issues that are less important to parents. This may affect the practitioner–family relationship and child healthcare.

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