A study of the perceptions and experiences of patients receiving homoeopathic care in the context of primary healthcare services within the public sector
Introduction Homoeopathy is recognised as a well established form of alternative medicine in the private healthcare sector of South Africa (Caldis, McLeod, Smith, 2001). Whilst local research supports the viability of homoeopathy as a primary healthcare resource; patient perception and experience with the homoeopathic service remain largely unknown (Smillie, 2010). The study addresses shortfalls in existing literature on homoeopathy, providing a qualitative evaluation of the homoeopathic healthcare service in the context of public healthcare in South Africa. The task of the study was to develop substantive theory with the aim to better understand health behaviour of patient’s utilising homoeopathic and allopathic healthcare services. Methods The study employed a qualitative study design, and explored the perceptions and experiences of patients receiving homoeopathic care at the Kenneth Gardens Homoeopathy Clinic, within the context of primary healthcare services and public sector healthcare. Data was generated through in-depth, semi-structured interviews conducted with 14 participants. Data was systematically analysed using grounded theory methods to generate substantive theory (Glaser and Strauss, 1967; Schreiber and Stern, 2001; Holloway and Wheeler, 2010). Results Data analysis revealed five main themes of influences affecting the utilisation of homoeopathic services at the Kenneth Gardens Clinic; these include context specific factors to healthcare utilisation, factors influencing healthcare utilisation, health beliefs and practices, health outcome factors and trust. The study results illustrate that participants trusted their homoeopathic provider and homoeopathic treatment outcomes; and subsequently demonstrate the direct positive influence which trust had on the utilisation of homoeopathic services in the study population. Discussion The discussion explores the significance of influences, barriers and discerning factors identified in the study on decision-making pathways in healthcare utilisation behaviour of homoeopathic and allopathic healthcare services. The significance of trust in healthcare utilisation behaviour is explored as the principle finding of the study. The study’s conceptual model is based on Anderson’s (2005) behavioural model of health service utilisation and has been adapted to demonstrate the relationship in health seeking behaviours between homoeopathic and allopathic care modalities. Recommendations The relationship between the variables illustrated in the study’s proposed adapted model need to be further tested using quantitative research methods. Trust in healthcare, and in particular with homoeopathy, is a subject which merits further exploration.