Which terms for traditional, complementary and integrative medicine would be the most useful in Germany? Results from a large online cross-sectional study

INTRODUCTION: The World Health Organization recently issued new definitions of traditional medicine, complementary medicine and integrative medicine (TCIM), raising questions about their implementation in different languages. This paper explores the knowledge and perceptions of TCIM terms in the German public with the aim of identifying term(s) that could be the most useful in public and political dialogue on TCIM in Germany. METHOD: This study is based on a cross-sectional survey of an online-representative sample of the German-speaking residential population aged 18-75 years (n=4,065), using a comprehensive questionnaire on TCIM use, attitudes and terms. Descriptive analyses were performed and decision trees calculated, using Exhaustive Chi-squared Automatic Interaction Detection (CHAID) to identify predictors of self-perceived TCIM benefit. RESULTS: The German term "Naturheilkunde" (literal translation from German: "knowledge of natural healing") was the most familiar term (55.3%), followed by alternative medicine (43.8%), complementary medicine (19.2%) and integrative medicine (15.6%). Conventional medicine generated the most positive attitude (63.1%), followed by NHK (52.0%), integrative medicine (41.1%), complementary medicine (35.0%) and alternative medicine (25.1%). The CHAID algorithm identified a positive attitude to "Naturheilkunde" as the most significant predictor (p<0.001) for experiencing benefit from TCIM. Attitudes towards complementary medicine or alternative medicine were no relevant predictors in this analysis. CONCLUSIONS: The historically rooted German term "Naturheilkunde" was the best known and positively connoted TCIM term in our study. Furthermore, a positive attitude towards Naturheilkunde was strongly associated with experiencing benefit from TCIM. While "integrative medicine" is yet unfamiliar within the German public, the positive connotations it evokes and its perceived benefits suggest it also has potential for public discourse. We recommend a national Delphi process with TCIM-experts and -stakeholders in Germany to clearly define, prioritize and align commonly used TCIM terms in Germany. The selection of terminology for public discourse should consider the insights from this study as well as appropriate communication expertise.