Diplomarbeit Use of Complementary and Alternative Medical Methods in Turkey zur Erlangung des akademischen Grades Doktorin der gesamten Heilkunde (Dr.med.univ.) an der Medizinischen Universität Wien ausgeführt am Universitätsklinik für Innere Medizin I unter der Anleitung von Ao.Univ.-Prof. Dr.med.univ. Michael FRASS eingereicht von Ebru Yalcin 0109368 _______________________ _______________________ Wien, Juni /2019 Contents Contents ...................................................................................................................... i List of Figures ........................................................................................................... iv List of Tables ............................................................................................................ iv Zusammenfassung ..................................................................................................... 5 Abstract ..................................................................................................................... 6 1. Introduction ....................................................................................................................... 7 Complementary and Alternative Medicine: Definition and terminology....................... 8 2. Background ..................................................................................................................... 11 2.1. Healthcare in Turkey ............................................................................................... 11 2.1.1. Development of healthcare system in Turkey .................................................. 11 2.1.2. Current healthcare system in Turkey ................................................................ 14 2.2. Official regulations on CAM ................................................................................... 18 2.2.1. Official regulations on CAM around the world ................................................ 18 European Union and related countries ..................................................................... 18 United States of America ......................................................................................... 19 China ................................................................................................................... 20 2.2.2. Official CAM regulations in Turkey ................................................................ 22 2.3. CAM Methods ......................................................................................................... 24 CAM Methods Under Regulation ................................................................................ 26 2.3.1. Acupuncture............................................................................................... 26 2.3.2. Apitherapy ................................................................................................. 28 2.3.3. Hypnosis .................................................................................................... 30 2.3.4. Phytotherapy .............................................................................................. 31 2.3.5. Leech application ....................................................................................... 34 i 2.3.6. Homeopathy .............................................................................................. 35 2.3.7. Chiropractic ............................................................................................... 38 2.3.8. Cupping ..................................................................................................... 40 2.3.9. Maggot application .................................................................................... 41 2.3.10. Mesotherapy .............................................................................................. 42 2.3.11. Osteopathy ................................................................................................. 43 2.3.12. Ozone therapy ............................................................................................ 44 2.3.13. Proloterapi ................................................................................................. 46 2.3.14. Reflexology ............................................................................................... 46 2.3.15. Musicotherapy ........................................................................................... 47 Some other CAM methods ........................................................................................... 49 2.3.16. Bioresonance ............................................................................................. 49 2.3.17. Emotional Freedom Technique ................................................................. 49 2.3.18. Hot Springs ................................................................................................ 51 2.3.19. Massage ..................................................................................................... 52 2.3.20. Neural Therapy .......................................................................................... 52 3. A County in the Aegean Region of Turkey: Akhisar ..................................................... 52 General characteristics of Akhisar ........................................................................... 53 Health services in Akhisar ....................................................................................... 53 4. Methods .......................................................................................................................... 55 Sample ................................................................................................................... 55 Data Acquisition and data analysis .......................................................................... 55 Ethical approach ...................................................................................................... 56 5. Findings .......................................................................................................................... 57 5.1. Prevention of diseases and approach to the diseases ............................................. 57 5.2. Current conditions of the participants ................................................................... 58 5.3. Past experiences or indirect experiences of participants with CAM ..................... 61 ii 5.4. How participants approach to CAM methods and their habits of use ................... 74 5.5. Ways to learn about CAM ..................................................................................... 75 5.6. CAM and money/finance/insurance ...................................................................... 75 5.7. Satisfaction with CAM methods ........................................................................... 76 5.8. Recommending CAM methods ............................................................................. 77 5.9. CAM and modern medical methods ...................................................................... 77 5.10. Some CAM methods used by participants ............................................................ 77 Phytotherapy ............................................................................................................ 77 Neural therapy ......................................................................................................... 82 5.11. Views of Professionals on CAM ........................................................................... 84 E-13: Internist .......................................................................................................... 84 E-14: Manipulation and orientation specialist ......................................................... 92 E-15: Family practitioner ......................................................................................... 97 6. Results ........................................................................................................................... 100 7. Discussion ..................................................................................................................... 102 8. References ..................................................................................................................... 107 9. Acronyms and Abbreviations ....................................................................................... 122 10. Appendix ................................................................................................................ 124 iii List of Figures Figure 1 Diagram of Healthcare services.12(P-21) .............................................................. 15 Figure 2 Shifts in Health and Healthcare Services.22(P-46) ................................................ 16 Figure 3 The EFT Tapping Points179(P-How to do the EFT Tapping Basics - The Basic Recipe-The EFT Tapping Points) ........................................................................................ 50 List of Tables Table 1 Disease-Treatment .................................................................................................. 59 Table 2 CAM/Satisfaction ................................................................................................... 62 Table 3 Characteristics of Participants (2014) .................................................................. 106 iv Zusammenfassung Das Ziel der Studie ist das Wissen und Verhalten der Menschen in der Türkei in Bezug auf komplementäre und alternative Medizin (CAM)