Open Journal of Social Sciences, 2015, 3, 293-299
Published Online July 2015 in SciRes.
How to cite this paper: Platan ia , S. and Santisi, G. (2015) Use of Alternative and Complementary Medicine by Old Italians
Adults: The Determinant of Choice. Open Journal of Social Sciences, 3, 293-299.
Use of Alternative and Complementary
Medicine by Old Italians Adults:
The Determinant of Choice
Silvia Platania*, Giuseppe Santisi
Department of Educational Sciences, University of Catania, Catania, Italy
Email: *splatani@unic
Received 22 June 2015; accepted 25 July 2015; published 28 July 2015
Copyright © 2015 by authors and Scientific Research Publishing Inc.
This work is licensed under the Creative Commons Attribution International License (CC BY).
Complementary and alternative medicine (CAM) is the term for medical products and practices
that aren’t part of standard care. Although using complementary and alternative medicines (CAM)
is becoming increasingly prevalent in Italy, research in complementary and alternative therapy in
older adults is limited. This study investigates the predictors and the determinant of choice of us-
ing complementary and alternative medicine (CAM) in older adult consumers [1]-[3]. The sample
consisted of 150 Italian older consumers who used alternative medicine in the last year. The older
adults interviewed were 52 males (34.7%) and 98 females (65.3%) and the average age was 65.4
(SD = 0.76). The results of this study showed a strong dissatisfaction of respondents with the tra-
ditional medical treatments because the alternative’s medicine treatments are considered more
Consumption, Medicine, Behavior, Desire, Health, Older Adults
1. Introduction
In the last years, the purchase’s motivation and the behaviors of the consumers have been the main points of
many researches. The interest for those researches arises from the consideration, which is now universally ac-
cepted that consumption tends to get not only things or services, but also free time and all daily dimensions;
through it there is an ongoing investigation by the consumer to meet their own needs in order to achieve person-
al well-being. The current notion of consumerism mainly concerns the role that the consumer has the interaction
Corresponding author.
S. Platania, G. Santisi
with self and identity. Pur chasing a product means to know a sto ry and identify with a new wor ld meaning that
identity becomes imitations game[4].
In addition to the utilitarian logic there are new dimensions to approach the consumption: emotion, symbol,
aesthetics, relation and desire. Indeed the desire’s logic precedes (in chronological order) the rational-instru-
mental one: the desire is present from birth, while cognitive skills related to perception and learning will in-
crease gradually and slowly [5]. The desire (instinct) and the imagination (the mode of mind which people try to
achieve) are the first experiences of the world and together form the first important way to question and find out
a positive reply to own need and well-being. The consumer society raises the logic of desire, usually hidden in a
corner of the consumer’s mind in order to enab le po s t-modern people to explore again their relationship with the
real, to make the feeling of lack of response and the sense of their needs tolerable. According to this point of
view the consumption’s self is a continuous representation of self-knowledge: Im just not wha t I am, but also
what other people think of me and specially I represent what I am or what I want to be perceived by others
through my consumer behavior[6]. The self-knowledge can be regarded as an experience related to skills and
competencies, successes and failures, values, aims and goals. In essence, this knowledge constitutes the choice
to join a specific lifestyle. A special type of consumer that has evolved in recent years, moving from a mere pas-
sive consumer tied to the logic of utility to a consumer active and demanding, especially for what concerns his
welfare, is the consumer called older adult. This one often determines his own choices based on his life style.
The traditional idea of older adult is to believe that the members of the third age as a social category have li-
mited needs; thanks to those researches this thought about the third age is changed. The most recent socio-eco-
nomic report reveals that within the next forty year s, people over sixty years in the world will be more than two
billion and the per centage of older adults in the total population will rise from 24.5% to 37%. The evolution of
expectancy life has created a great revolution in socio-anthropological older adu lts because the consumer is the
one who is able to dictate economic demand and to address their needs in a qualitative sense [7] [8]. The aging
processes is a time when older adult, free from the burdens and difficulties of adulthood, can engage new stimu-
lating hobbies: The new version of longevity evolves over daily and is characterized by a process of continuous
revision of the destinations, routes and strategies to achieve them [9].
The new socio-affective dimension allows older adults to redesign their existence with new perspectives to
reach a new wellness. The places where this research can be made coincide with consumers experiences that
allow the opportunity to develop lifestyles and identities that can become real stimulus for a new phase of own
existence. The older adult consumers in Italy also belong to a group composed by sophisticated consumers (es-
pecially in the range between 55 and 65 years). P hysical well-being and mental well-being have to coexist, be-
cause one shouldn’t exclude the other objectives in the wellness’s research; in r elation to this need th e search for
cures and unconventional therapies that are able to satisfy this desire has increased.
The number of people who uses complementary and alternative medicine is growing. In all the natural medi-
cines, man is seen as a microcosm inside the macrocosm [10]; they argue forcefully that every phenomenon in-
volves the entire system of balances that surrounds the individual. The main objective of this research is to find
the choice’s determinants (in terms of motivation and desire) of the CAM by older adults consumers.
2. CAM and Quality of Life in the Older Adults
The life’s quality concept as a measurable entity is relatively recent; it can be described by a series of areas or
dimensions of human experience, which is just not about physical conditions and symptoms but also about the
ability of an individual to get satisfaction from the daily in relation to their expectations and to their ability to
achieve what they want. From medical point of view the concept of life’s quality is related to the concept of
health, defined as the set of the life’s qualitative aspects of the individual correlated to do mains of disease and
health, and therefore editable by medicine. The definition of health given by OMS is: A complete state of,
physical, psychological and social well-be ing, and not just the absence of illness. According to those consider-
ations we have a new idea of wellness, that is not anymore closed and standardized, but related with the new
type of consumer of alternative medicine, characterized by multiple self and by multiple demands that which
have the purpose of reaching a different life’s style. In the last few years the number of people that addresses to
unconventional therapies and practices is growing. This adherence to alternative medicine is unmistakable
marks of escape from the orthodox scientific medicine, a sign of dispute, dissatisfaction, towards to a medical
practice that doesn’t respect or forget, indeed, the person’s and the individual’s overall structure [11]. The need
S. Platania, G. Santisi
for safety and the h ealth’s expectations, together with the aspiration of a global well-being, lead to an incessant
demand of physical and mental wellness.
These factors together lead the consumer to turn to unconventional medicine. Older adults are turning to
complementary and alternative medicine (CAM) but what sets CAM apart from traditional medicine is not only
different techniques and medicines but also the way medicine is practiced. “Its not just about what tools are
used ”. CAM practitioner s generally relate to their patients with respect, spending lots of time with them and fo-
cusing on people’s wellness rather than their problems [12] [13]. In conclusion: “For diagnoses that accompany
aging such as cancer, neurological diseases, psychiatric disorders, and physical disabilities, CAM has often
been used in addition to or in place of unsuccessful conventional methods of treatment. This new and
up-to-the-minute compendium of reliable and authoritative information on complementary and alternative
therapies seeks to provide information that older adults may use as they seek to improve their health and quality
of life[14]. The field of Complementar y and Alternativ e Medicine (CAM) is expected to grow tremendous ly in
the next few years.
3. Methodology
3.1. Sample and Data Collection Procedures
The sample consisted in 150 Italian older consumers who used alternative medicine in the last year. The older
adults interviewed were 52 males (34.7%) and 98 females (65.3%) and the average age of 65.4 (SD = 0.76). Re-
gard to the educational level and income, most participants have high school degrees (67.4%) and an income
rang ed from €30.000 to €70.000 (71.2 %). Finally, with regard to the profession, most of the participants are re-
tired (79.6%), followed by university professor (12.4%) and entrepreneurs/managers (8%). Participants have
been interviewed through a questionnaire containing measures of investigated constructs. The interview was
held inside hospital alternative medicine present in Italy.
3.2. Measur e
3.2.1. Reasons That Guide the Purchase
To detect the Hierarchical Value Maps of Bagozzi [15] [16], participants have been asked to list up to five rea-
sons for choosin g CAM. Therefore, for eve ry reason, they have been asked to explain the reasons for its impor-
tance. Once expressed the reason of the importance, we further asked to explain why it was important just ex-
pressed. Were identified 2250 goal that were generated assigned to categories according to the rule of achieve
maximal agreement for within categories similarity and between category dissimilarity in the meaning [17] [18].
Four Judge coded all motives and 15 different categories were identified: Adversity to standard care, Product
quality, Product quality, High efficacy, Curios ity, Easy of care, Viable a lternative, Natural, Organoleptic qua li-
ties, Mode, Reliable remedy, Ethical reasons, Hint, Less expensive, Ancient health care, Quality of life.
3.2.2. Behavioral Basis of Purchase
To identify behavioral basis of purchase, the intentions and the behavioral variables that influence them were
measured [19] [20].
Behavioral intentions. This variable was measured by the item: “How likely are you to repurchase Comple-
mentary and Alternative Medicine?”. Participants responded on a 4-point scale from very unlikely to very likely.
Evaluative and affective a ttitude. Consumers were asked to evaluate the concept “Complementary and Alter-
native Medicine is” on 177-points semantic differential items [21]: ten assessed evaluation attitude (e.g. use-
ful-useless) and seven assessed affective attitude (e.g. “pleasant-unpleasant”). The alphas for the affective and
evaluative attitud e are equa l respectively to 0.74 and 0.77.
Social identity. Participants have been asked to express the relationship between two identities (Who Buys
Complementary and Alternative Medicineand Yourself) expressing an opinion on a 7-point scale, from
widely separated to completely overlapped [22].
Subjective norms. To detect this construct we asked participants to answer the question “People most impo r-
tant for me endorse my decision to buy Complementary and Alternative Medicine”, on a 4-point scale (from
completely false to completely true).
Desire. To detect this construct we asked consumers to express their opinion on a 4-point scale (from com-
S. Platania, G. Santisi
pletely false to completely true) on the statement “I would like to buy again Complementary and Alternative
Perceived behavioral control. This variable was measured through the statement “If I wish, it would be easy
for me to buy more Complementary and Alternative Medicine”. Participants responded on a 4-point scale from
completely false to completely true.
3.3. Statistical Analysis
Measures of reasons that guide the purchase of CAM from older adults were subjected to a series of claim that
an arguer provides in defense of position taken. Any argument can be supported directly by multiple claims as
evidence. Each claim can be challenged on the basis of its justification. The succession of the reasoning yields a
network of support for an argument going from specific to general. The first why-question asked older adults to
provide up to five reasons for their consumer choice. After indicating whether or not they would take action
respondents were then asked to provide their personal motives for doing so. A semi-structured elicitation pro ce-
dure was used to uncover distinctive motives and relationship between motives. The specific procedure was an
adaptation of the laddering method previously employed by researchers to motives for joining, or re-enlisting in,
the military [15].
The behavioral basis of purchase was also examined by regression linear stepwise by software SPSS 21.0.
Stepwise linear regression is a method of regressing multiple variables while simultaneously removing those
that arent important.
4. Results
4.1. Reasons That Guide Purchasing Behavior
In order to detect the motivational aspects of the consumer choice of CAM, the answers provided by participants
were categorized into 15 categories ( Table 1). The implication matrix was constructed. This matrix lists reasons,
Table 1. Implication matrix for older adult CAM’s consumer.
Ratio 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Out-degrees
Adverse to standard care 0 0 1 0 2 0 1 0 0 0 2 0 0 0 6 12
Product quality 0 0 7 0 3 1 23 0 0 0 0 0 0 12 3 49
High efficacy 15 14 0 0 9 7 11 0 1 6 0 5 0 6 17 91
4. Curiosity
8 4 0 0 0 2 2 0 16 0 1 0 0 0 2 35
Easy of care 0 3 4 0 0 0 23 0 0 8 1 0 0 2 7 48
Viable alternative 8 6 2 1 3 0 27 0 1 2 2 1 0 0 2 55
Natural 8 14 22 1 15 2 0 0 0 11 1 12 0 9 9 104
Organoleptic qualities 0 0 0 0 0 0 4 0 0 1 0 0 0 0 8 13
Mode 0 2 3 3 0 0 1 1 0 0 0 4 0 0 2 16
10. Reliable remedy
4 2 4 0 4 0 5 0 1 0 0 1 1 2 8 32
11. Ethical reasons
1 1 0 0 0 0 15 0 0 0 0 0 0 0 4 21
Hint 4 3 14 4 1 5 4 0 2 0 1 0 0 9 1 48
13. L
ess expensive 1 0 0 0 0 0 1 0 0 6 0 0 0 0 0 8
Ancient health care 2 2 7 2 3 0 6 1 0 4 2 4 0 0 7 40
Quality of life 0 4 7 1 4 0 18 3 0 12 0 0 0 4 0 53
In-degrees 51 55 71 12 44 17 141 5 21 50 10 27 1 44 76 625
S. Platania, G. Santisi
number of times each reason leads to another reason, the in-degrees (number of ti mes each reason was the sub-
ject of a connection), and out-degrees (number of times each reason has been the object and origin). Starting
from the matrix of the implication s, the hierarchical trees have been constructed. Within the hierarchical tr e e, the
reasons were sorted according to the abstraction index1 [15] [16], which expresses the degree to which a r eason
is the ultimate goal to be reached: the higher the value, the more the reason was abstract. The relationships
within the hierarchy tree are those mentioned by at least the 5% of participants for both groups, that is, those re-
lationships which reach at least a frequency of 7.
Regard to older adults consumers who purchase Alternative and complementary medicine , the most abstract
category is “Adverse to standard care”, this category is linked to other categories such as “Curiosity”, “Mode”,
“High efficacy” and “V iable alternative”. Therefore, it se ems that th e first choice orientation is tied mostly to the
concept of quality and desire of alternative care. A second orientation that could be defined as more “Practical
is “High efficacy”. This category, which is also the most central2 is connected to other categories such as
“Product quality”, “Natural”, “Hint”, “Quality of life”, “Easy of care” and “Viable alternative”. It points out
another order of important reasons for the older adult Cam’s consumer, is the desire a treatment that delivers a
better life’s quality (Figure 1).
4.2. The Behavioral Basis of Purchase
As regards the variables that affect the intention to repurchase the product (subjective norms, perceived beha-
vioral control, desire, social identity, evaluative and affective attitude) a stepwise linear regression was applied
(Table 2).
Figure 1. Cognitive maps of reasons for older adult CAM’s consumer (N = 150;
cut off = 8). The most abstract category is “Adverse to standard care”.
Table 2. Stepwise linear regression for older adults that consumer CAM. Dependent variable: intention.
Step Variables Beta R2 R2 Change
1 Desire 0.87*** 0.76***
2 Desire 0.69***
Perceived behavioral control 0.29*** 0.81*** 0.05*
Note. Betas are standardized coefficients. *p < 0.05; **p < 0.01; ***p < 0.001.
1The general formula for computing abstraction ratio can be written as: In-degrees/In-degrees + Out-degrees. The abstractness ratio mea
ures the proportion of times a motive serve a des tination or end in a lin kage, as opposed to a source [18]. The assumption is “
that the more
abstract a motive, the more likely it will b e an en d motive. A va lue of 1.00 for a mo tive on th e abstra ctness ra tio can be co nsidered a grou
ding motive[18].
2The general formula for computing index of centrality is: Out-degree + In-degree/to tal relation [15]. Index of cen trality measure how fr
quently a particular motive is involved in linkages with other motives.
S. Platania, G. Santisi
Regarding older adults consumers who buy alternative and complementary medicine, the purchase intent de-
rived largely desire, followed by perceived behavioral control. The symbolic focus of consumption in postmo-
dernity is desire, the se desires are constructed through the symbolic linkage between consumption and research
of wellness.
5. Discussion
The most important innovation of consumerism today is the interaction that the consumer establishes with the
self and identity. The first concept that allows to read these elements, is th e belief that the consumer society b e-
gins when the means of production allow a surplus of product compared to the wealthy purchasing power,
which until then had been directed to the proposal of consumption [23]. Simultaneously, a process intended to
change the socio-cultural ethics of worker starts and it emerges as an earthly vision that n arrows the horizon at
hic et nunc of happiness permitted by consumption and social complicity [24]. One of the consequences of th ese
changes in perspective and meaning, is observable since in a growing interests by the consumer to the different
medical practices also called “official”. The last years, indeed, are characterized by the explosion of this pheno-
menon, diversified in different areas of consumption: homeopathy, alternative medicine and physiotherapy. The
behavior’s style s belonging to th is type of consumption begin to emerge in the nineties, when it develops and is
promoted the adherence to the principles of social ethics orientated to the respect for person and the care of
physical and mental wellb eing. Nowadays, unlike in the 80s, period in which the consumerism was considered a
way to promote the personal identity and the research of new lifestyles, much consumers prefer the consume of
the “being” rather than the consume of “ostentation” [25], choosing therefore to be projected, in a increasing
way, in the direction of the so called, “consumerism ecology”. This is based mainly on the research of a collec-
tive wealth, as well as the individu a l on e , and the sp read attention to financial, social, and ethic aspects related to
con s umer i sm. W ith the coming of the post-modern society, so there has been a transformation of the related so-
cial and cultural aspects which has affected the individual and collective sensibility introducing different theo-
retical and pragmatic variations, at the values of our society. The results identify the motivations leading in d i-
viduals to turn to alternative medicine, confirming this phenomenon’s growing. Moreover they shows the evo lu-
tion of the consumer as actor of the decision-making process and also as a supporter of the market; in this way
he would be able to satisfy the self needs and to comply with the New consumption’s symbol.
The hope of being able to rely on a medicine mor e welfare-orientedb ecausenatural, is stron gly linked to
the dissatisfaction of tr aditional methods that are invasive and aseptic to consumer’s eyes.
The results of this study showed a strong dissatisfaction of respondents with the traditional medical treatments
because they are considered more invasive. Objective of this research was to investigate motivational, cognitive,
and behavioral aspects leading the older adult consumers of CAM to purchase the product. Some considerations
deserve to be mentioned. Regarding to the reasons that guide the purchasing behavior: older adults consumers
are oriented to the choice by “Adverse traditional care” that is linked to other categories such as “Quality of life”,
“Alternative” and “Hint”. Therefore, it seems that the first choice orientation is tied mostly to the concept of
quality and health. The hope to rely upon a natural medicine oriented toward individual’s well-being is strongly
related with t he consum e r’s in satisfaction with traditional cure, whic h are conside red as invasi ve a nd im personal .
6. Conclusion
Finally, with regard to the behavioral bases of purchase, older adult consumers choose CAM to repurchase
products especially because they receive pleasure; this is determined by a process of identification that the older
adults build up with the CAM, by the growing desire that they will be mature in relation to this brand and by the
belief that they may be able to develop and perform a certain behaviour in relation to it [19]. The limitation of
the study presented certainly relates to the small number of older adults we interviewed, which does no t allow us
to assert whether our findings are reliable within a national context, whether there is an orientation toward the
consumption of the type indicated in the results, or whether other indications emerge. In this sense, we intend in
the future to overcome this limitation by expanding the research sample size, involving other Italian regions.
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