Exploring the Behavioural Intentions of Men with Prostate Cancer Toward the Use of Complementary and Alternative Medicine: A Study at Korle-Bu Teaching Hospital

Exploring the Behavioural Intentions of Men with Prostate Cancer Toward the Use of Complementary and Alternative Medicine: A Study at Korle-Bu Teaching Hospital | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Exploring the Behavioural Intentions of Men with Prostate Cancer Toward the Use of Complementary and Alternative Medicine: A Study at Korle-Bu Teaching Hospital Bonney Osei, Luke Laari, Josephine Mpomaa Kyei This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7235147/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 15 You are reading this latest preprint version Abstract Background : The global use of Complementary and Alternative Medicine (CAM) is steadily increasing. Patients diagnosed with prostate cancer often turn to CAM to manage or improve their condition. Various factors affect the decision to use CAM, either as a substitute for or alongside conventional therapies. This study aimed at exploring the behavioural intentions of men diagnosed with prostate cancer toward the use of CAM. Methods : The study used an exploratory descriptive qualitative design. Sixteen (16) men with prostate cancer receiving treatment at the Teaching Hospital were purposively selected for the study. A semi-structured interview guide was specifically developed and used to collect data from the participants. The entire interview was audio-recorded, transcribed verbatim, and analyzed through thematic content analysis, coding, and categorization. Results : Findings from the study indicated that factors such as legalization and regulation of CAM treatments, integration of herbal remedies into conventional treatments, extension of the National Health Insurance Scheme to cover CAM therapies, and approval of herbal treatments by the Food and Drugs Authority (FDA) and medical doctors positively influence CAM use among men with prostate cancer. Conclusion : The men diagnosed with prostate cancer are likely to use CAM therapies if certain measures, such as the legalization and regulation of CAM, along with FDA or medical doctors’ approval, are implemented. Complementary and alternative medicine use prostate cancer herbal medicine motivational factors intention 1. BACKGROUND Complementary and Alternative Medicine (CAM) has been defined to encompasses various health practices outside of conventional treatments, such as herbal therapies [1]. Over the past few decades, CAM has gained substantial popularity and is widely used across the globe [2]; and the media and internet marketing are the key drivers of the current high levels of its usage [3, 4]. The use of CAM is gaining increasing popularity and support among patients with cancers, particularly those with prostate cancer, worldwide [5]. Studies have indicated that the global average of patients with cancer using CAM is 51% [6, 7]. It is estimated that around one in four men diagnosed with prostate cancer worldwide use at least one form of CAM [8, 9]. The popularity of CAM therapies, including homeopathy, acupuncture, and chiropractic treatments, has risen significantly in developed countries [8]. According to data from the World Health Organization (WHO), between 25% and 50% of the total population in developed countries uses CAM [10]. Likewise, in developing countries like African countries, nearly 80% of the total population turn to CAM for treatments [11]. Patients with cancers often turn to CAM for a variety of reasons [12]. Studies have shown that patients diagnosed with prostate cancer use CAM to manage cancer symptoms and side effects of conventional cancer treatments, boost immune system, to improve quality of life, and to feel recovered and well managed [13-16]. Besides, many patients with cancer turn to CAM because they believe it is effective, safe, affordable and easily accessible [17].A systematic review of published articles on CAM use in patients with cancers revealed that individuals with cancer frequently turn to CAM to enhance well-being, minimize chemotherapy side effects, alleviate anxiety, boost self-esteem, and improve overall quality of life [18]. This is consistent with findings from several other studies, which identified the main reasons for CAM use among patients with cancers as improving health, fostering hope, boosting the immune system, managing the ill effects of cancer and its treatments [19, 20]. Notably, patients with cancer use CAM in different ways. In a study, Berretta and associates found that the physicians discussed and suggested CAM interventions to their patients before they were used [21]. However, Källman and colleagues indicated that hospital attendees used CAM therapies, such as herbal medications, after their cancer diagnosis without consulting their physicians [22]. Many studies have reported that individuals use CAM because they are familiar with some of the techniques involved in preparing and administering herbal medicines [23] and indicated heating or boiling to be techniques used in preparing such treatments [24, 25]. Furthermore, Tembane and Andel et al observed that patients in African countries like Ghana and Gabon used various plant species in a number of recipes and formulations for rectal insertions [26, 27]. The implementation of measures such as regularization or legalization of CAM, along with plans to guide visits to herbal centers, can motivate individuals to use CAM products [28]. In a study, Mutola and colleagues indicated that certifying and scientifically evaluating traditional medicines promotes regulation and integration of CAM into mainstream healthcare, and cancer patients’ willingness to use such treatments [29]. Similarly, Asase indicated in a study that training of herbalists and regulating CAM use promote the safety and patronage of herbal medicines [30]. Also, in a study to determine the factors influencing people’s intention to use CAM, Kretchy and colleagues found that implementing appropriate public health policies, such as counseling and evidence-based complementary treatments, is essential for integrating herbal medicine practitioners into the main healthcare system and guiding individuals in seeking herbal medicine treatments [31]. Likewise, Drozdoff and Armson, along with their respective colleagues, pointed out in their studies that introducing CAM counseling sessions and the guideline questionnaire in routine cancer care in the biomedical healthcare systems increased individual’s willingness to use CAM [32, 33]. In addition, Asare and colleagues found in their study that extending the health insurance policy to cover CAM therapies increased the utilization of such treatments [34]. Moreover, the use of CAM is influenced by both personal and social factors [35]. Mothibe and associates affirmed in their study that people in Africa use CAM because they believe traditional medicines have been used long before the arrival of biomedical treatments and continue to be use today [28]. Many patients diagnosed with prostate cancer in Ghana utilize CAM; and according to LaMorte, people act a behaviour with intents [36]. Also, the reviewed literature shows that most studies on this topic have been conducted outside Ghana, highlighting a gap in research within the Ghanaian context. Therefore, the present study aimed to explore the behavioural intentions of men diagnosed with prostate cancer in Ghana to use CAM treatment. The outcome of this study will contribute to increasing understanding of the intent and motivations men diagnosed with prostate cancer have concerning the use of CAM. The study will also guide Ministry of Health, Ghana Health Service and other stakeholders of health in the best way to integrate CAM into the mainstream healthcare system. 2. METHODS 2.1 Study Design and Setting A qualitative exploratory descriptive design was employed. This design was chosen for the study because it offers a comprehensive understanding of the phenomenon by examining the factors motivating men diagnosed with prostate cancer in their use of CAM. The study was conducted in a Teaching Hospital in Ghana. A semi-structured interview guide was specifically developed for this study to collect data from participants and it has been provided as Supplementary File 1 (English version). The interview guide was developed in line with the research objective and was divided into two sections: A and B. Section A included the participants’ socio-demographic information, while Section B contained the main open-ended research questions. A pre-test of the interview guide was conducted with two men who met the inclusion criteria. Face-to-face interviews were conducted in English at a location, date, and time convenient for both the participants and the researchers. Each interview lasted between 20 and 30 minutes. The researcher kept the field records. The researcher employed thematic content analysis to analyzed the data alongside as the data were being gathered. 2.2 Sampling Technique and Sample size A purposive sampling technique was used in selecting participants for the study. The study included sixteen (16) men diagnosed with prostate cancer, as data saturation was reached after interviewing the sixteenth participant. 2.3 Inclusion and Exclusion Criteria The inclusion criteria for the study comprised men aged thirty years and older who were diagnosed with prostate cancer, had no significant comorbidities, were using CAM, and were receiving conventional treatment at the Oncology Medical Outpatient of the Teaching Hospital. Whereas the exclusion criteria included men with prostate cancer who had significant comorbidities, were weak, had limited availability, or were unwilling to participate in the study. 2.4 Ethical Considerations The research received approval from the Institutional Review Board (IRB) of the Teaching Hospital. Consent forms were presented to the men who agreed to participate in the study, and they were asked to sign after meeting the inclusion criteria. To ensure confidentiality and anonymity, coded names and pseudonyms were used in place of the participants’ real names. Privacy was maintained by interviewing the individual participants in the Unit head's office. Given the study’s setting, the researchers implemented strict measures, including hand washing, wearing of face masks, and avoiding shaking handshakes. 2.5 Data Analysis Data analysis was done concurrently with data collection. After each interview session, the recorded data was transcribed word-for-word. The analysis was conducted using thematic content analysis. The researchers reviewed the transcribed interview data, highlighting descriptions relevant to the topic being studied. Key words or phrases were then selected as codes to represent each distinct unit of meaning. The transcribed data, along with the identified words, phrases, ideas, and sentences were noted. Similar codes were grouped to form subthemes, and these subthemes were then combined into broader themes. 3. RESULTS Data was analysed using thematic content analysis and one main theme and four subthemes emerged from the data. The major theme included the behavioural intention of men with prostate cancer toward CAM use, and the four sub-themes comprised legalization of CAM, regulation on the patronage of CAM, policy on restrictions to CAM centers and ways to use CAM. 3.1 Demographic Data of Participants The participants in the study were all adults aged between 50 and 79 years. The participants comprised six Akans, four Ga, one Walla, three Ewes, one Wassa and one person who identified as Gyakwasi or Kyereponi. They were all fluent in English language. Thirteen of the participants were urban dwellers, fifteen were married, and fourteen were Christians. Nine of the participants had tertiary education and the majority of them were retired and unemployed. 3.2 Intention of Men with Prostate Cancer toward CAM Use This theme focused on participants’ intentions toward CAM use. The outcome of the study showed that participants intend to use the treatment (CAM) if certain measures such as legalizing herbal treatment and regulating its usage are implemented. These measures are the behavioural intentions the men diagnosed with prostate cancer have toward the use of CAM. 3.2.1 Legalization of CAM Treatment The findings from the study showed that men with prostate cancer have specific intentions that influence whether they will use CAM in the future. Some of the participants disclosed that CAM should be regularised to be used for treatment. “I think that traditional medicine should be regularised; if government can control and legalise herbal treatments then that will be fine.” PJ “The majority of herbal practitioners we come across on the streets are doing that on their own, and so if food and drugs board authority approves such medicinal products then they will be use.” PN 3.2.2 Regulation of Patronage of CAM The outcomes of the study revealed specific intentions that will determine the use of CAM among men with prostate cancer. Some participants indicated that expert opinions and government interventions were crucial in guiding and directing the use of CAM for treatment. “As I said, government should step in and, regulate CAM therapies; formalise them then we know such treatments are safe to be use.” PJ Another participant specified that specialisation and improvement in service delivery are essential. “But what I‟m saying is, we should advise herbal practitioners to specialise in one area they are good like what is done in Korle-Bu here and if people will come if they know about it.” PG 3.2.3 Policies on Restrictions to CAM Centers The results of the study revealed clear intentions that will influence men with prostate cancer to use CAM. One participant stated that implementing strategies to integrate herbal medicine into mainstream treatment would reduce unnecessary visits to herbal centers and promote proper use of CAM therapies. “Ermh the fact is when someone falls sick, people try to find out if he has visited the hospital. so, if CAM is to be use then there should be a policy implementing it in hospitals.” PL Another participant stated that implementing policies to fund treatment of prostate cancer treatment would reduce the need for men with prostate cancer to regularly visit herbal centers for treatment. “Eerr like I said, the intention will be in relation to money. so, if the government will formulate and implement policies to support those with prostate cancer it will discourage them to seek treatment at TM centers anyhow and anywhere.” PF 3.2.4 Ways to use CAM for Treatment The study’s findings revealed several pathways for using CAM treatment that could influence patients diagnosed with prostate cancer to seek out CAM therapies. To begin with, some of the participants mentioned methods used in preparing CAM therapies. They explained that CAM therapy was prepared by cooking, boiling, or soaking the herbs to extract the active ingredients “You add ‘prekese’ and about four or five kinds of trees and boil them in a pot and drink or take the concoction that is produced.” PN Also, some of the participants indicated that the therapy (CAM) can be taken orally and/or rectally. “Sometimes, the herbal medicines are in galloons and you will drink them, and some too you will take it rectally. I was using mine for enema.” PI Again, one participant suggested that approval from the Food and Drugs Board should precede the use of herbal medicine. “Eerr, the drugs board should make more research about herbal medicine before such drugs come out for use because I do not expect one medicine to cure more than 6 or 5 illness.” PD Moreover, some of the participants emphasized that medical practitioners should be informed about the intention to use CAM therapies. “But people should not try to use herbal medicine and get addicted. In all situations, you have to find out from your biomedical doctor first before you use it.” PO Finally, two of the participants stated that a visit to the hospital is essential and should precede the use herbal medicine. “The best practice is to visit a biomedical practitioner or the hospital so that your prostate will be assessed. And understand that while the doctor is treating then you can take the herbal medicine.” PN 4. DISCUSSION 4.1 Main Findings The purpose of the study was to investigate the behavioural intentions of men diagnosed with prostate cancer toward the use of CAM. The findings highlighted key participants’ intentions regarding CAM use and are compared with results from other studies. The literature supports various intentions influencing the use of CAM among men with prostate cancer. The findings reveal that legalizing CAM treatments would encourage men with prostate cancer to use these therapies in the future. Mothibe and associates supported this fact that enacting the Traditional Health Practitioners Act will promote the acceptance of traditional health practitioners [ 28 ]. The results suggest that legalizing CAM will provide formal recognition, foster wider acceptance and validate its use for treatment purposes. This could provide legal recognition for traditional health practices and enhance their legitimacy and integration into the mainstream healthcare system. Despite these promising results, our study had a relatively small sample size (n = 16), which may limit generalizability. The study also revealed that men with prostate cancer were willing to use CAM products if their production and use were to be regulated- through licensing CAM practitioners, certifying products, and encouraging specialization in healing. These findings align with other studies that indicated that regulation helped distinguish between genuine and pseudo-traditional medicines, standardize the genuine ones, and makes them more comparable to biomedicine for practical use [ 30 , 38 ]. Similarly, Mutola and colleagues argued that certification and scientific evaluation of traditional medicines (TMs) are essential for achieving control and integration of TMs into conventional health system [ 29 ]. This implies that men with prostate cancer will be more inclined to use CAM products when there are clear regulations, including licensed practitioners, certified products, and specialized expertise in the field. Therefore, such regulations would enhance trust and foster greater acceptance of CAM therapies. In the present study, participants disclosed that establishing policies to integrate TMs into conventional treatment and to fund prostate cancer care will support and promote the use of CAM products. This finding aligns with several studies highlighting the need for appropriate public health policies, such as counseling and evidence-based complementary treatments, to facilitate the inclusion of herbal medicine practitioners (HMPs) in mainstream healthcare in Ghana [ 31 , 32 ]. Similarly, Asare et al and Mantey emphasized in their respective studies that expanding health insurance coverage to include drugs associated with TM care is essential for solidifying integrative care and promoting the use of CAM therapies [ 34 , 39 ]. The results indicate that such policies will help formalize CAM treatments and provide financial support to individuals who will resort to CAM for cure. This, in turn, may help promote and sustain the use of CAM therapies among men diagnosed with prostate cancer. In this study, the participants disclosed several directions for using CAM therapies, including preparation and administration methods, obtaining FDA approval, and first visiting an orthodox hospital. These findings are supported by several studies indicating that CAM users were familiar with herbal medicine preparation and administration techniques and consulted their biomedical doctors before using approved CAM therapies [ 23 , 40 ]. It can be inferred from the results that some of the CAM therapies were prepared by the users themselves hence they were educated on the methods used in making ready the treatment for use and how to apply them. As a result, they had a good understanding on how to use these medicines. Besides, some of the participants mentioned that cooking, heating, or soaking, and oral or rectal routes were among the methods used in preparing and administering CAM therapies respectively. These findings are supported by several studies that reported heating or boiling as techniques used in preparing herbal medicines, with oral and rectal routes being primary methods of administration [ 24 – 26 ]. The results suggest that heating or boiling are common methods for preparing herbal medicines, and oral and rectal routes are the most widely used methods for administering these treatments. This could indicate that these methods are standardized and widely accepted in the preparation and administration of herbal therapies. Moreover, the men with prostate cancer in the present study indicated that visits to an orthodox hospital and the intention to use CAM should first be communicated to biomedical practitioners. This finding aligns with the outcomes of a study which found that physicians discussed and recommended CAM interventions to their patients before they patronized CAM therapies [ 21 ]. This may suggest that discussion about CAM should be incorporated into clinician-patient communication. This would allow doctors to offer proper guidance on CAM use, maximize its potential benefits, and ultimately enhance the healthcare systems. However, this finding contradicts the results of studies which reported that some of the patients used herbal medicines before visiting health facilities and other clients resorted to CAM after their cancer diagnosis without consulting their physicians [ 22 , 41 ]. The discrepancy in the outcomes may be due to several factors such as differences in study settings, the personal characteristics of participants, and variations in the conditions at the various centers where participants received care and treatment. Additionally, the participants in this study suggested that only approved CAM products should be used. This would help assure users of the efficacy and safety of the products being utilized. These findings are similar to those of a study by Kretchy and associates, who reported that participants in their study used herbal medicinal products certified by the Food and Drugs Board Authority in Ghana [ 31 ]. The results indicate that CAM therapies should be certified before they are used as treatment. This will ensure that the therapies are safe to be used and the men with prostate cancer would be encouraged to patronize such treatments in the future. 4.2 Strengths and Limitations The study provided a comprehensive understanding of the behavioural intentions of the men diagnosed with prostate cancer toward CAM. However, the small sample size of sixteen men diagnosed with prostate cancer does not provide a proper representation of all the intentions about CAM use. Additionally, since the study was conducted at a single hospital in Ghana, generalizing the findings to other regions may be challenging. 4.3 Implication for Practice Nurses and other healthcare providers are expected to educate patients about their treatment options to support informed decision-making. Therefore, it is essential for healthcare providers to receive training in CAM through workshops and by incorporating CAM education into nursing and medical curricula across various institutions. Recognizing patients’ interest in CAM encourages a more holistic approach to culturally congruent care. Moreover, support systems and policies such as legal recognition and regulation of CAM and extension of National Health Insurance to cover approved CAM therapies help build trust in CAM and improve their access. CONCLUSION The study revealed that men with prostate cancer intended to use CAM if measures such as the legalization and regulation of CAM, the inclusion of CAM treatments under the National Health Insurance Scheme, and approval by medical doctors and the FDA were implemented. Abbreviations CAM : Complementary and alternative medicine CM: Complementary medicine FDA: Food and drugs authority HM : Herbal medicine IRB: Institutional review board MoH : Ministry of health WHO: World Health Organization Declarations ETHICAL CONSIDERATIONS AND CONSENT TO PARTICIPATE The Institutional Review Board (IRB) of the Teaching Hospital was consulted for an ethical clearance, and an informed consent from participant(s) was obtained. The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. CONSENT FOR PUBLICATION Publication approval has been granted by relevant authorities CLINICAL TRIAL NUMBER Clinical trial number not applicable AVAILABILITY OF DATA AND MATERIALS Materials and data will be made available on request COMPETING INTERESTS The authors declare no conflict of interest. FUNDING The authors did not receive any specific financial support or funding for this work. AUTHOR CONTRIBUTIONS Study concept and design: Bonney Osei (BO), Josephine Mpomaa Kyei (JMK) and Luke Laari (LL); acquisition of data: BO; analysis and interpretation of data: BO, JMK and LL; drafting of the manuscript: JMK and LL; critical revision of the manuscript: BO, JMK and LL. ACKNOWLEDGEMENT The authors would like to show appreciation to the management of the Korle-Bu Teaching Hospital and staffs of the Medical Out-patient Department of the Oncology Unit and all who contributed to this study. References Cancer Research UK. The difference between complementary and alternative therapies (CAMs) . Published on(2024). Retrieved 14 August 2024, from https://www.cancerresearchuk.org/about-cancer/treatment/complementary-alternative- therapies/about/difference-between-therapies. Møller SR, Ekholm O, Christensen AI. Trends in the use of complementary and alternative medicine between 1987 and 2021 in Denmark. 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Critical Public Health, 2019;29(4),424–434. https://doi.org/10.1080/09581596.2019.1594696 Mantey A K. Integrating Traditional Medicine into Orthodox Practice: A Case Study of Lekma Hospital in Accra, Ghana. [Thesis, Ensign Global College]. 2017. https://repository.ensign.edu.gh/xmlui/handle/123456789/161 Tugume P and Nyakoojo C. Ethno-pharmacological survey of herbal remedies used in the treatment of paediatric diseases in Buhunga parish, Rukungiri District, Uganda. BMC Complementary and Alternative Medicine, 2019;19(1),353. https://doi.org/10.1186/s12906- 019-2763-6. Ashraf H, Salehi A, Sousani M and Sharifi MH. Use of Complementary Alternative Medicine and the Associated Factors among Patients with Depression. Evidence-Based Complementary and Alternative Medicine: eCAM, 2021, 6626394. Additional Declarations No competing interests reported. Supplementary Files InterviewGuidefortheStudy.pdf Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 26 Nov, 2025 Reviews received at journal 28 Oct, 2025 Reviewers agreed at journal 14 Oct, 2025 Reviewers agreed at journal 14 Oct, 2025 Reviews received at journal 09 Oct, 2025 Reviews received at journal 08 Oct, 2025 Reviewers agreed at journal 26 Sep, 2025 Reviewers agreed at journal 23 Sep, 2025 Reviews received at journal 15 Sep, 2025 Reviewers agreed at journal 15 Sep, 2025 Reviewers invited by journal 13 Sep, 2025 Editor invited by journal 01 Sep, 2025 Editor assigned by journal 01 Sep, 2025 Submission checks completed at journal 25 Aug, 2025 First submitted to journal 25 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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BACKGROUND","content":"\u003cp\u003eComplementary and Alternative Medicine (CAM) has been defined to encompasses various health practices outside of conventional treatments, such as herbal therapies [1]. Over the past few decades, CAM has gained substantial popularity and is widely used across the globe [2]; and the media and internet marketing are the key drivers of the current high levels of its usage [3, 4].\u003c/p\u003e\n\u003cp\u003eThe use of CAM is gaining increasing popularity and support among patients with cancers, particularly those with prostate cancer, worldwide [5]. Studies have indicated that the global average of patients with cancer using CAM is 51%\u0026nbsp;[6, 7]. It is estimated that around one in four men diagnosed with prostate cancer worldwide use at least one form of CAM [8, 9].\u003c/p\u003e\n\u003cp\u003eThe popularity of CAM therapies, including homeopathy, acupuncture, and chiropractic treatments, has risen significantly in developed countries [8]. According to data from the World Health Organization (WHO), between 25% and 50% of the total population in developed countries uses CAM [10]. Likewise, in developing countries like African countries, nearly 80% of the total population turn to CAM for treatments [11].\u003c/p\u003e\n\u003cp\u003ePatients with cancers often turn to CAM for a variety of reasons\u0026nbsp;[12]. Studies have shown that patients diagnosed with prostate cancer use CAM to manage cancer symptoms and side effects of conventional cancer treatments, boost immune system, to improve quality of life, and to feel recovered and well managed [13-16]. Besides, many patients with cancer turn to CAM because they believe it is effective, safe, affordable and easily accessible [17].A systematic review of published articles on CAM use in patients with cancers revealed that individuals with cancer frequently turn to CAM to enhance well-being, minimize chemotherapy side effects, alleviate anxiety, boost self-esteem, and improve overall quality of life [18]. This is consistent with findings from several other studies, which identified the main reasons for CAM use among patients with cancers as improving health, fostering hope, boosting the immune system, managing the ill effects of cancer and its treatments [19, 20].\u003c/p\u003e\n\u003cp\u003eNotably, patients with cancer use CAM in different ways. In a study, Berretta and associates found that the physicians discussed and suggested CAM interventions to their patients before they were used [21]. However, Källman and colleagues \u0026nbsp;indicated that hospital attendees used CAM therapies, such as herbal medications, after their cancer diagnosis without consulting their physicians [22]. Many studies have reported that individuals use CAM because they are familiar with some of the techniques involved in preparing and administering herbal medicines [23] and indicated heating or boiling to be techniques used in preparing such treatments [24, 25]. Furthermore, Tembane and Andel et al observed that patients in African countries like Ghana and Gabon used various plant species in a number of recipes and formulations for rectal insertions [26, 27].\u003c/p\u003e\n\u003cp\u003eThe implementation of measures such as regularization or legalization of CAM, along with plans to guide visits to herbal centers, can motivate individuals to use CAM products [28]. In a study, Mutola and colleagues indicated that certifying and scientifically evaluating traditional medicines promotes regulation and integration of CAM into mainstream healthcare, and cancer patients’ willingness to use such treatments [29]. Similarly, Asase\u0026nbsp;indicated in a study that training of herbalists and regulating CAM use promote the safety and patronage of herbal medicines [30]. Also, in a study to determine the factors influencing people’s intention to use CAM, Kretchy and colleagues found that implementing appropriate public health policies, such as counseling and evidence-based complementary treatments, is essential for integrating herbal medicine practitioners into the main healthcare system and guiding individuals in seeking herbal medicine treatments [31]. Likewise, Drozdoff and Armson, along with their respective colleagues,\u0026nbsp; pointed out in their studies that introducing CAM counseling sessions and the guideline questionnaire in routine cancer care in the biomedical healthcare systems increased individual’s willingness to use CAM [32, 33]. In addition, Asare and colleagues found in their study that extending the health insurance policy to cover CAM therapies increased the utilization of such treatments [34].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMoreover, the use of CAM is influenced by both personal and social factors [35]. Mothibe and associates affirmed in their study that people in Africa use CAM because they believe traditional medicines have been used long before the arrival of biomedical treatments and continue to be use today [28].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMany patients diagnosed with prostate cancer in Ghana utilize CAM; and according to LaMorte, people act a behaviour with intents [36]. Also, the reviewed literature shows that most studies on this topic have been conducted outside Ghana, highlighting a gap in research within the Ghanaian context. Therefore, the present study aimed to explore the behavioural intentions of men diagnosed with prostate cancer in Ghana to use CAM treatment. The outcome of this study will contribute to increasing understanding of the intent and motivations men diagnosed with prostate cancer have concerning the use of CAM. The study will also guide Ministry of Health, Ghana Health Service and other stakeholders of health in the best way to integrate CAM into the mainstream healthcare system. \u0026nbsp;\u003c/p\u003e"},{"header":"2. METHODS","content":"\u003cp\u003e\u003cstrong\u003e2.1 Study Design and Setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA qualitative exploratory descriptive design was employed. This design was chosen for the study because it offers a comprehensive understanding of the phenomenon by examining the factors motivating men diagnosed with prostate cancer in their use of CAM. The study was conducted in a Teaching Hospital in Ghana. A semi-structured interview guide was specifically developed for this study to collect data from participants and it has been provided as Supplementary File 1 (English version). The interview guide was developed in line with the research objective and was divided into two sections: A and B. Section A included the participants\u0026rsquo; socio-demographic information, while Section B contained the main open-ended research questions. A pre-test of the interview guide was conducted with two men who met the inclusion criteria. Face-to-face interviews were conducted in English at a location, date, and time convenient for both the participants and the researchers. Each interview lasted between 20 and 30 minutes. The researcher kept the field records.\u0026nbsp;The researcher employed thematic content analysis to analyzed the data alongside as the data were being gathered.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 Sampling Technique and Sample size\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA purposive sampling technique was used in selecting participants for the study. The study included sixteen (16) men diagnosed with prostate cancer, as data saturation was reached after interviewing the sixteenth participant.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.3 Inclusion and Exclusion Criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe inclusion criteria for the study comprised men aged thirty years and older who were diagnosed with prostate cancer, had no significant comorbidities, were using CAM, and were receiving conventional treatment at the Oncology Medical Outpatient of the Teaching Hospital. Whereas the exclusion criteria included men with prostate cancer who had significant comorbidities, were weak, had limited availability, or were unwilling to participate in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.4 Ethical Considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research received approval from the Institutional Review Board (IRB) of the Teaching Hospital. Consent forms were presented to the men who agreed to participate in the study, and they were asked to sign after meeting the inclusion criteria. To ensure confidentiality and anonymity, coded names and pseudonyms were used in place of the participants\u0026rsquo; real names. Privacy was maintained by interviewing the individual participants in the Unit head\u0026apos;s office. Given the study\u0026rsquo;s setting, the researchers implemented strict measures, including hand washing, wearing of face masks, and avoiding shaking handshakes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.5 Data Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData analysis was done concurrently with data collection. After each interview session, the recorded data was transcribed word-for-word. The analysis was conducted using thematic content analysis. The researchers reviewed the transcribed interview data, highlighting descriptions relevant to the topic being studied. Key words or phrases were then selected as codes to represent each distinct unit of meaning. The transcribed data, along with the identified words, phrases, ideas, and sentences were noted. Similar codes were grouped to form subthemes, and these subthemes were then combined into broader themes.\u003c/p\u003e"},{"header":"3. RESULTS","content":"\u003cp\u003eData was analysed using thematic content analysis and one main theme and four subthemes emerged from the data. The major theme included the behavioural intention of men with prostate cancer toward CAM use, and the four sub-themes comprised legalization of CAM, regulation on the patronage of CAM, policy on restrictions to CAM centers and ways to use CAM.\u003c/p\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e3.1 Demographic Data of Participants\u003c/h2\u003e\u003cp\u003eThe participants in the study were all adults aged between 50 and 79 years. The participants comprised six Akans, four Ga, one Walla, three Ewes, one Wassa and one person who identified as Gyakwasi or Kyereponi. They were all fluent in English language. Thirteen of the participants were urban dwellers, fifteen were married, and fourteen were Christians. Nine of the participants had tertiary education and the majority of them were retired and unemployed.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Intention of Men with Prostate Cancer toward CAM Use\u003c/h2\u003e\u003cp\u003eThis theme focused on participants\u0026rsquo; intentions toward CAM use. The outcome of the study showed that participants intend to use the treatment (CAM) if certain measures such as legalizing herbal treatment and regulating its usage are implemented. These measures are the behavioural intentions the men diagnosed with prostate cancer have toward the use of CAM.\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section3\"\u003e\u003ch2\u003e3.2.1 Legalization of CAM Treatment\u003c/h2\u003e\u003cp\u003eThe findings from the study showed that men with prostate cancer have specific intentions that influence whether they will use CAM in the future. Some of the participants disclosed that CAM should be regularised to be used for treatment.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;I think that traditional medicine should be regularised; if government can control and legalise herbal treatments then that will be fine.\u0026rdquo; PJ\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;The majority of herbal practitioners we come across on the streets are doing that on their own, and so if food and drugs board authority approves such medicinal products then they will be use.\u0026rdquo; PN\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section3\"\u003e\u003ch2\u003e3.2.2 Regulation of Patronage of CAM\u003c/h2\u003e\u003cp\u003eThe outcomes of the study revealed specific intentions that will determine the use of CAM among men with prostate cancer.\u003c/p\u003e\u003cp\u003eSome participants indicated that expert opinions and government interventions were crucial in guiding and directing the use of CAM for treatment.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;As I said, government should step in and, regulate CAM therapies; formalise them then we know such treatments are safe to be use.\u0026rdquo; PJ\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAnother participant specified that specialisation and improvement in service delivery are essential.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;But what I‟m saying is, we should advise herbal practitioners to specialise in one area they are good like what is done in Korle-Bu here and if people will come if they know about it.\u0026rdquo; PG\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section3\"\u003e\u003ch2\u003e3.2.3 Policies on Restrictions to CAM Centers\u003c/h2\u003e\u003cp\u003eThe results of the study revealed clear intentions that will influence men with prostate cancer to use CAM.\u003c/p\u003e\u003cp\u003eOne participant stated that implementing strategies to integrate herbal medicine into mainstream treatment would reduce unnecessary visits to herbal centers and promote proper use of CAM therapies.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;Ermh the fact is when someone falls sick, people try to find out if he has visited the hospital. so, if CAM is to be use then there should be a policy implementing it in hospitals.\u0026rdquo; PL\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAnother participant stated that implementing policies to fund treatment of prostate cancer treatment would reduce the need for men with prostate cancer to regularly visit herbal centers for treatment.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;Eerr like I said, the intention will be in relation to money. so, if the government will formulate and implement policies to support those with prostate cancer it will discourage them to seek treatment at TM centers anyhow and anywhere.\u0026rdquo; PF\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section3\"\u003e\u003ch2\u003e3.2.4 Ways to use CAM for Treatment\u003c/h2\u003e\u003cp\u003eThe study\u0026rsquo;s findings revealed several pathways for using CAM treatment that could influence patients diagnosed with prostate cancer to seek out CAM therapies.\u003c/p\u003e\u003cp\u003eTo begin with, some of the participants mentioned methods used in preparing CAM therapies. They explained that CAM therapy was prepared by cooking, boiling, or soaking the herbs to extract the active ingredients\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;You add \u0026lsquo;prekese\u0026rsquo; and about four or five kinds of trees and boil them in a pot and drink or take the concoction that is produced.\u0026rdquo; PN\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e Also, some of the participants indicated that the therapy (CAM) can be taken orally and/or rectally.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;Sometimes, the herbal medicines are in galloons and you will drink them, and some too you will take it rectally. I was using mine for enema.\u0026rdquo; PI\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAgain, one participant suggested that approval from the Food and Drugs Board should precede the use of herbal medicine.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;Eerr, the drugs board should make more research about herbal medicine before such drugs come out for use because I do not expect one medicine to cure more than 6 or 5 illness.\u0026rdquo; PD\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eMoreover, some of the participants emphasized that medical practitioners should be informed about the intention to use CAM therapies.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;But people should not try to use herbal medicine and get addicted. In all situations, you have to find out from your biomedical doctor first before you use it.\u0026rdquo; PO\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eFinally, two of the participants stated that a visit to the hospital is essential and should precede the use herbal medicine.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;The best practice is to visit a biomedical practitioner or the hospital so that your prostate will be assessed. And understand that while the doctor is treating then you can take the herbal medicine.\u0026rdquo; PN\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"4. DISCUSSION","content":"\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003e4.1 Main Findings\u003c/h2\u003e\u003cp\u003eThe purpose of the study was to investigate the behavioural intentions of men diagnosed with prostate cancer toward the use of CAM. The findings highlighted key participants\u0026rsquo; intentions regarding CAM use and are compared with results from other studies. The literature supports various intentions influencing the use of CAM among men with prostate cancer.\u003c/p\u003e\u003cp\u003eThe findings reveal that legalizing CAM treatments would encourage men with prostate cancer to use these therapies in the future. Mothibe and associates supported this fact that enacting the Traditional Health Practitioners Act will promote the acceptance of traditional health practitioners [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. The results suggest that legalizing CAM will provide formal recognition, foster wider acceptance and validate its use for treatment purposes. This could provide legal recognition for traditional health practices and enhance their legitimacy and integration into the mainstream healthcare system. Despite these promising results, our study had a relatively small sample size (n\u0026thinsp;=\u0026thinsp;16), which may limit generalizability.\u003c/p\u003e\u003cp\u003eThe study also revealed that men with prostate cancer were willing to use CAM products if their production and use were to be regulated- through licensing CAM practitioners, certifying products, and encouraging specialization in healing. These findings align with other studies that indicated that regulation helped distinguish between genuine and pseudo-traditional medicines, standardize the genuine ones, and makes them more comparable to biomedicine for practical use [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. Similarly, Mutola and colleagues argued that certification and scientific evaluation of traditional medicines (TMs) are essential for achieving control and integration of TMs into conventional health system [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. This implies that men with prostate cancer will be more inclined to use CAM products when there are clear regulations, including licensed practitioners, certified products, and specialized expertise in the field. Therefore, such regulations would enhance trust and foster greater acceptance of CAM therapies.\u003c/p\u003e\u003cp\u003eIn the present study, participants disclosed that establishing policies to integrate TMs into conventional treatment and to fund prostate cancer care will support and promote the use of CAM products. This finding aligns with several studies highlighting the need for appropriate public health policies, such as counseling and evidence-based complementary treatments, to facilitate the inclusion of herbal medicine practitioners (HMPs) in mainstream healthcare in Ghana [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Similarly, Asare et al and Mantey emphasized in their respective studies that expanding health insurance coverage to include drugs associated with TM care is essential for solidifying integrative care and promoting the use of CAM therapies [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]. The results indicate that such policies will help formalize CAM treatments and provide financial support to individuals who will resort to CAM for cure. This, in turn, may help promote and sustain the use of CAM therapies among men diagnosed with prostate cancer.\u003c/p\u003e\u003cp\u003eIn this study, the participants disclosed several directions for using CAM therapies, including preparation and administration methods, obtaining FDA approval, and first visiting an orthodox hospital. These findings are supported by several studies indicating that CAM users were familiar with herbal medicine preparation and administration techniques and consulted their biomedical doctors before using approved CAM therapies [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. It can be inferred from the results that some of the CAM therapies were prepared by the users themselves hence they were educated on the methods used in making ready the treatment for use and how to apply them. As a result, they had a good understanding on how to use these medicines. Besides, some of the participants mentioned that cooking, heating, or soaking, and oral or rectal routes were among the methods used in preparing and administering CAM therapies respectively. These findings are supported by several studies that reported heating or boiling as techniques used in preparing herbal medicines, with oral and rectal routes being primary methods of administration [\u003cspan additionalcitationids=\"CR25\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. The results suggest that heating or boiling are common methods for preparing herbal medicines, and oral and rectal routes are the most widely used methods for administering these treatments. This could indicate that these methods are standardized and widely accepted in the preparation and administration of herbal therapies. Moreover, the men with prostate cancer in the present study indicated that visits to an orthodox hospital and the intention to use CAM should first be communicated to biomedical practitioners. This finding aligns with the outcomes of a study which found that physicians discussed and recommended CAM interventions to their patients before they patronized CAM therapies [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. This may suggest that discussion about CAM should be incorporated into clinician-patient communication. This would allow doctors to offer proper guidance on CAM use, maximize its potential benefits, and ultimately enhance the healthcare systems. However, this finding contradicts the results of studies which reported that some of the patients used herbal medicines before visiting health facilities and other clients resorted to CAM after their cancer diagnosis without consulting their physicians [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. The discrepancy in the outcomes may be due to several factors such as differences in study settings, the personal characteristics of participants, and variations in the conditions at the various centers where participants received care and treatment. Additionally, the participants in this study suggested that only approved CAM products should be used. This would help assure users of the efficacy and safety of the products being utilized. These findings are similar to those of a study by Kretchy and associates, who reported that participants in their study used herbal medicinal products certified by the Food and Drugs Board Authority in Ghana [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. The results indicate that CAM therapies should be certified before they are used as treatment. This will ensure that the therapies are safe to be used and the men with prostate cancer would be encouraged to patronize such treatments in the future.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003e4.2 Strengths and Limitations\u003c/h2\u003e\u003cp\u003eThe study provided a comprehensive understanding of the behavioural intentions of the men diagnosed with prostate cancer toward CAM. However, the small sample size of sixteen men diagnosed with prostate cancer does not provide a proper representation of all the intentions about CAM use. Additionally, since the study was conducted at a single hospital in Ghana, generalizing the findings to other regions may be challenging.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\u003ch2\u003e4.3 Implication for Practice\u003c/h2\u003e\u003cp\u003eNurses and other healthcare providers are expected to educate patients about their treatment options to support informed decision-making. Therefore, it is essential for healthcare providers to receive training in CAM through workshops and by incorporating CAM education into nursing and medical curricula across various institutions. Recognizing patients\u0026rsquo; interest in CAM encourages a more holistic approach to culturally congruent care. Moreover, support systems and policies such as legal recognition and regulation of CAM and extension of National Health Insurance to cover approved CAM therapies help build trust in CAM and improve their access.\u003c/p\u003e\u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThe study revealed that men with prostate cancer intended to use CAM if measures such as the legalization and regulation of CAM, the inclusion of CAM treatments under the National Health Insurance Scheme, and approval by medical doctors and the FDA were implemented.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eCAM\u003c/strong\u003e: Complementary and alternative medicine\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCM:\u003c/strong\u003e Complementary medicine\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFDA:\u0026nbsp;\u003c/strong\u003eFood and drugs authority\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHM\u003c/strong\u003e: Herbal medicine\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIRB:\u003c/strong\u003e Institutional review board\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMoH\u003c/strong\u003e: Ministry of health\u003c/p\u003e\n\u003cp\u003eWHO: World Health Organization\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eETHICAL CONSIDERATIONS AND CONSENT TO PARTICIPATE\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Institutional Review Board (IRB) of the Teaching Hospital was consulted for an ethical clearance, and an informed consent from participant(s) was obtained.\u0026nbsp;The study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONSENT FOR PUBLICATION\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePublication approval has been granted by relevant authorities\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCLINICAL TRIAL NUMBER\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eClinical trial number not applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAVAILABILITY OF DATA AND MATERIALS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMaterials and data will be made available on request\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCOMPETING INTERESTS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFUNDING\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors did not receive any specific financial support or funding for this work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAUTHOR CONTRIBUTIONS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStudy concept and design: Bonney Osei (BO), Josephine Mpomaa Kyei (JMK) and Luke Laari (LL); acquisition of data: BO; analysis and interpretation of data: BO, JMK and LL; drafting of the manuscript: JMK and LL; critical revision of the manuscript: BO, JMK and LL.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eACKNOWLEDGEMENT\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to show appreciation to the management of the Korle-Bu Teaching Hospital and staffs of the Medical Out-patient Department of the Oncology Unit and all who contributed to this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eCancer Research UK. \u003cem\u003eThe difference between complementary and alternative therapies \u0026nbsp;\u003c/em\u003e\u003cem\u003e(CAMs)\u003c/em\u003e. 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Scientific evidence is very important for me‖: The impact of behavioral intention and the wording of user inquiries on repli2017; 73, 320-327.\u003c/li\u003e\n \u003cli\u003eLaMorte-Wayne W. Behavioral change model. Boston University School of Public 85 Health, 2019.\u003c/li\u003e\n \u003cli\u003ePrime R. Thematic Content Analysis\u0026mdash;A Guide to Thematic Analysis. Retrieved from https://bestdissertationwriter.com/thematic-content-analysis/dies.Published on 2024. Retrieved 18 April 2025, from https://journals.co.za/doi/10.25159/2663-6697/11238\u003c/li\u003e\n \u003cli\u003eCloatre E. Law and biomedicine and the making of ‗genuine\u0026rsquo; traditional medicines in global health. Critical Public Health, 2019;29(4),424\u0026ndash;434. https://doi.org/10.1080/09581596.2019.1594696\u003c/li\u003e\n \u003cli\u003eMantey A K. Integrating Traditional Medicine into Orthodox Practice: A Case Study of Lekma Hospital in Accra, Ghana. [Thesis, Ensign Global College]. 2017. https://repository.ensign.edu.gh/xmlui/handle/123456789/161\u003c/li\u003e\n \u003cli\u003eTugume P and Nyakoojo C. Ethno-pharmacological survey of herbal remedies used in the treatment of paediatric diseases in Buhunga parish, Rukungiri District, Uganda. BMC Complementary and Alternative Medicine, 2019;19(1),353. https://doi.org/10.1186/s12906- 019-2763-6.\u003c/li\u003e\n \u003cli\u003eAshraf H, Salehi A, Sousani M and Sharifi MH. Use of Complementary Alternative Medicine and the Associated Factors among Patients with Depression. Evidence-Based Complementary and Alternative Medicine: eCAM, 2021, 6626394.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-complementary-medicine-and-therapies","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcam","sideBox":"Learn more about [BMC Complementary Medicine and Therapies](https://bmccomplementmedtherapies.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Complementary Medicine and Therapies","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Complementary and alternative medicine, use, prostate cancer, herbal medicine, motivational factors, intention","lastPublishedDoi":"10.21203/rs.3.rs-7235147/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7235147/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: The global use of Complementary and Alternative Medicine (CAM) is steadily increasing. Patients diagnosed with prostate cancer often turn to CAM to manage or improve their condition. Various factors affect the decision to use CAM, either as a substitute for or alongside conventional therapies. This study aimed at exploring the behavioural intentions of men diagnosed with prostate cancer toward the use of CAM.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: The study used an exploratory descriptive qualitative design. Sixteen (16) men with prostate cancer receiving treatment at the Teaching Hospital were purposively selected for the study. A semi-structured interview guide was specifically developed and used to collect data from the participants. The entire interview was audio-recorded, transcribed verbatim, and analyzed through thematic content analysis, coding, and categorization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Findings from the study indicated that factors such as legalization and regulation of CAM treatments, integration of herbal remedies into conventional treatments, extension of the National Health Insurance Scheme to cover CAM therapies, and approval of herbal treatments by the Food and Drugs Authority (FDA) and medical doctors positively influence CAM use among men with prostate cancer.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The men diagnosed with prostate cancer are likely to use CAM therapies if certain measures, such as the legalization and regulation of CAM, along with FDA or medical doctors’ approval, are implemented.\u003c/p\u003e","manuscriptTitle":"Exploring the Behavioural Intentions of Men with Prostate Cancer Toward the Use of Complementary and Alternative Medicine: A Study at Korle-Bu Teaching Hospital","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-22 11:06:36","doi":"10.21203/rs.3.rs-7235147/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-26T16:28:18+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-28T20:16:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"121903402052319922978572676176326847671","date":"2025-10-15T00:30:31+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"129271274045272707822160516077059354186","date":"2025-10-14T07:35:13+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-09T08:58:34+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-08T14:14:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"135823489277015866423534108144081290284","date":"2025-09-26T04:35:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"334751381572017152436816567941354314745","date":"2025-09-23T08:43:28+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-15T13:10:41+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"236147953785763751181587957525741079393","date":"2025-09-15T11:27:02+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-09-13T10:35:01+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-09-01T15:27:37+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-01T15:26:20+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-25T12:08:09+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Complementary Medicine and Therapies","date":"2025-08-25T12:05:05+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-complementary-medicine-and-therapies","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bcam","sideBox":"Learn more about [BMC Complementary Medicine and Therapies](https://bmccomplementmedtherapies.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Complementary Medicine and Therapies","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c9ec1d1d-6bba-400e-b5e4-3d4519bf7b9c","owner":[],"postedDate":"September 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-01-23T09:11:53+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-22 11:06:36","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7235147","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7235147","identity":"rs-7235147","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}