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anthroposophic medicine); certificates in phytotherapyamong private physicians; patient demand for CAM; servicesoffered and time required; and referrals for CAM treat-ments.

Materials and methods: Written survey of 750 physicians(500 German-speaking; 250 French-speaking) in primarycare practices (FMH Praktische Arzte, FMH Innere Medizin,FMH Allgemeinmedizin, and FMH Padiatrie). Response rate:50.4%.

Results: In total, 14.1% of the 750 respondents hadcertificates of qualification in one of the abovementionedCAM disciplines. In 2007, most certificates were in the areaof TCM/acupuncture, followed by homoeopathy. Patientdemand for CAM: Approximately 50% of patients askedabout CAM treatment less than once a week; 20% of patientsasked about CAM once a week; and 30% of patients askedabout CAM more than once a week.

Services offered and referrals: 30.4% of the respondentsoffered CAM treatment. Homoeopathy and phytotherapywere the most frequently offered services, followed byTCM/acupuncture. CAM services were offered by therespondents either in addition to standard services (i.e.more than 50% of respondents who offered CAM servicesspent less than 25% of their time doing so) or as theirpredominant services (i.e. occupying more than 75% of theirtime). Altogether, 62.5% of the respondents referredpatients for CAM treatments. The majority of referrals werefor TCM/acupuncture. Of the 37.5% of respondents who didnot refer their patients, 40% provided CAM servicesthemselves.

Conclusion: Approximately 75% of the participatingphysicians offered CAM services themselves or referredpatients for CAM treatments.

10.1016/j.eujim.2008.08.063

Health by self-regulation: Towards an evidence-based fundamental concept for science and practiceof integrative medicine

E. Baarsa,b

aLouis Bolk Instituut, Healthcare & Nutrition,Driebergen, NetherlandsbUniversity of Applied Sciences Leiden,Leiden, Netherlands

One of the key aspects of Integrative Medicine isevidence-based health promotion. However, until now thereis a lack of scientific consensus on the concepts of health andhealth promotion. In this presentation, the newly developedconcept of ‘health by self-regulation’ will be introduced andaspects of its validity will be described.

At first the historic development of the concept of healthduring the last centuries will be reviewed. It will bedemonstrated that throughout history two elements havebeen central in the conceptualization of health: wholenessand balance. Furthermore, it will be demonstrated that in

the development of conceptualization of health, a new stepis made. The focus has changed from the state of ‘completephysical, mental and social well-being as described in thedefinition of the World Health Organization in 1946 towardsthe processes that are responsible for providing wholenessand balance on all levels in human beings. Secondly, thecore elements of the concept will be described in generaland specifically for the three sub-domains: physical health,psychosocial health and meaning in life. Then the validity ofthe concept will be explored by demonstrating that theconcept is internally consistent, is in accordance with otherrelevant theories (e.g. self-organizing systems, systemsbiology, chronobiology, salutogenesis, hygiogenesis) and isin accordance with the empirical phenomena. Finally, theimplications of the concept for science and practice will bedemonstrated.

The new concept of health by self-regulation will providea scientific solid fundament that will enable the integrationof a conventional ‘fighting disease’ approach and a ‘healthpromotion’ approach in a scientific way. Thereby it will offera contribution to the further development of IntegrativeMedicine.

10.1016/j.eujim.2008.08.064

A qualitative analysis of patients’ experiences ofacupuncture: Implications for understanding non-specific effects

F. Bishopa, G. Lewitha, L. Yardleyb

aUniversity of Southampton, ComplementaryMedicine Research Unit, Southampton, UKbUniversity of Southampton, School of Psychology,Southampton, UK

Background: Acupuncture is a popular form of alter-native medicine. It has shown large non-specific effects, butwhich factors contribute to these effects is unclear. Wetherefore aimed to identify the psychosocial factors thatcould contribute to treatment outcomes in acupuncture.

Methods: We interviewed a purposive sample of 35individuals (29 women) who had used acupuncture forvarious conditions and to varying effect. We used frameworkanalysis to summarise and interpret the data.

Findings: Participants described intra-personal and in-ter-personal experiences before, during and after acupunc-ture needling that could contribute to treatment outcomes.Key themes in the analytic framework reflect individualphysicality, cognition and emotion; social negotiation andsupport through the therapeutic relationship and closesocial networks; and societal and environmental influences.

Discussion: The psychosocial context of acupuncturefrom patients’ perspective is broad. We must expandplacebo theories in order to generate more comprehensiveunderstandings of non-specific treatment effects in complexinterventions.

10.1016/j.eujim.2008.08.065