This study investigated health care professionals’ perceptions of the current circumstances surrounding TCM for prevention and treatment in TCM hospitals and TCM departments in general hospitals. A total of 75.5% of the respondents had knowledge of TCM for chronic disease care and prevention, which approximated the fair knowledge (50–75%) reported by Suganya et al. in India . To some extent, these results reflect the inadequate understanding of TCM for chronic disease care and prevention among health care professionals. At the same time, we can also see that HCPs with a better knowledge of TCM preventive and health care services are more likely to adopt and apply it in daily work. So it is necessary to improve their knowledge through more TCM training and medical practice. Also the more opportunities of applying TCM preventive health care technologies in the work, the more HCPs can understand the concept of TCM “Zhi-Wei-Bing”, recognize its necessity more, and have greater confidence in implementation.
Interestingly, older health care professionals (40 years of age and older) had better knowledge of TCM for prevention and treatment than younger health care professionals (40 years of age and younger). Though older individuals might become familiar with TCM at an earlier age than young individuals, because chronic diseases are more prevalent among older adults, the latter have greater requirements for preventive and therapeutic services . Some surveys showed that health care professionals’ knowledge of TCM for prevention and health care were primarily obtained from government-issued literature . Thus, internal promotional systems are an important method to improve their knowledge, along with publicizing the concept and philosophy of TCM. In our study, health care professionals acknowledged that educational presentations, the use of television and networking were more effective methods of disseminating TCM prevention and treatment information, whilst face-to-face discussions and recommendations from family and friends were less effective. These findings indicate that health care professionals are likely to trust official sources of information; therefore, government, social media and professional bodies might exert a positive effect on the further popularization of TCM for prevention and treatment.
Experts and researchers concluded that health care practitioners were optimistic about CAM; 67% would recommend its use and 63.3% believed that combination therapy using TCM and Western medicine was superior to Western medicine alone [8, 10, 11]. Medical personnel in Africa also had satisfactory experiences with CAM and identified an urgent need to include CAM in the health systems [12, 13]. The health care professionals in this study were positive about applying and constructing a prevention and health care system incorporating TCM characteristics. Most respondents were willing to utilize TCM measures for chronic disease care and prevention. This finding correlates with the results of another study in China, in which 86% of the medical personnel had positive attitudes towards TCM prevention and treatment . Furthermore, most health care professionals agreed that hospitals should implement chronic disease care and prevention projects. Substantial data suggest that health care professionals would prefer to choose and incorporate CAM into their health services [14,15,16,17]. Perhaps due to the long history of TCM, its role has been widely confirmed . The philosophy of ‘Zhi-Wei-Bing’ and its characteristics of simplicity, convenience, lower cost, and effectiveness in TCM have been accepted and promoted widely, and TCM treatment and health care services have been widely applied. Furthermore, perhaps the disadvantages of Western medicine in the treatment of chronic diseases have fuelled health care professionals’ optimism about TCM . According to patients, CAM may not only cure  but also may counterbalance the adverse effects of Western medicine [21,22,23], improve physical and mental health, promote positive medical outcomes and wellness [24,25,26,27], etc. TCM may also enhance the comprehensive outcomes of preventive and treatment efforts and heighten the effectiveness of health interventions and assessments . The conventional HCPs were ready to accept the idea of integrative medicine and the potential role of TCM products and practices in healthcare delivery . However, practitioners’ understanding of CAM must be improved, with specific attention to issues of safety, regulation of evidence-based practice of CAM products and services in Ghana .
Approximately half of the health care professionals believed that current TCM preventive and health care services in the hospital had fundamental advantages, such as a favourable political congruence, professional personnel, broad trust among patients and others; however, some disadvantages remained. Some findings indicated that only 28.75% of practitioners believed that existing preventive and health care services demonstrated TCM characteristics, far less than those who believed that the services had no TCM characteristics (59%) [5, 6]. While despite the overall positive attitude towards CAM therapies, Ghanaian nurses do not perceive themselves to have sufficient knowledge of CAM . To date, the Chinese government has introduced and implemented numerous policies and regulations throughout the country, particularly regarding TCM use in community health service centres. TCM for prevention and treatment is acknowledged and used increasingly by Chinese citizens. However, the use of conventional methods such as those of Western medicine remains the first and most common choice because of their excellent medical systems and rapid results [12, 31]. Fewer than half of the health care professionals were content with the current TCM preventive and health care services provided, and half reported having a neutral attitude. This finding indicates that the role of TCM in current prevention and health care remains unclear and that the role of TCM has not been fully explored.
The characteristics and advantages of TCM for prevention and treatment are powerful weapons for chronic disease care and prevention . TCM hospitals and community health service institutions already have the capability to provide TCM prevention and health care services. However, they still need to diligently study and develop TCM prevention and health care service products, and to provide team building for medical personnel. The government must vigorously cultivate TCM HCPs, not only to increase training opportunities, but also to improve training contents, emphasize skills training, and set training content according to their work characteristics and work needs.The main skills of HCPs can include health status identification technology, health state intervention technology, Chinese medicine health assessment and physical fitness assessment, common prevention and rehabilitation programs, TCM preventive health care guidelines for high-risk groups of common diseases, and TCM health care technical operating norms.
A training system for HCPs in Chinese medicine should be established. It is necessary to require practitioners to have corresponding qualifications, such as qualifications of practicing physicians. Then a reasonable training plan should be established and training materials should be prepared. And combining job training with college education will make training more effectively.
According to the single factor analysis, position and work experience were significantly associated with health care professionals’ perceptions of TCM for prevention and health care services. Studies in Iran found that 88.4% of the participants had no previous complementary and traditional medicine education . Therefore, the training of health care team members, particularly that of nurses and doctors, regarding the applications, benefits and side effects of complementary and traditional medicine is recommended . To address the challenge of inadequate familiarity with and knowledge of TCM in China, continuing education in TCM is recommended for above-mentioned targeted health care professionals [33, 34]. Education for HCPs make us acknowledge HCPs’ beliefs strongly influence health teaching for patients and families. HCPs need to critically examine and reflect on the impact of culture, society and the media on their own health beliefs . Additionally, reliable and accessible information concerning TCM for prevention and treatment should be made available in hospitals for both health care professionals and patients. In order to implement evidenced-based practice and teach in line with current evidence nurses need to critically examine and reflect on the impact of culture, society and the media on their own health beliefs . Regarding the lack of work experience, organized education and training opportunities may address this challenge. The chi-squared test showed a significant association between older age and longer work experience with higher satisfaction with TCM among health care professionals. The enthusiasm of health care professionals directly affects their service attitude and quality; thus, the overall enhancement of TCM for prevention and treatment in hospitals is crucial.
Furthermore, hospitals’ outlooks on the application of TCM for chronic disease care and prevention and whether the services reflect TCM characteristics might contribute to differences in the perspectives and satisfaction levels of health care professionals. Overall, we suggest the improved development of TCM preventive and health care services, positive outlooks of hospitals towards TCM for prevention and treatment, and the incorporation of TCM-based methods into hospitals’ practices concerning chronic disease care and prevention. Hospitals should strengthen the training of high-level TCM HCPs, improve the reward mechanism, and prevent the outflow of talents. As hospitals become more proactive regarding TCM practice for prevention and treatment, health care professionals will be more likely to have better knowledge of and higher satisfaction with TCM. Traditional Chinese medicine preventive and health care services should be rooted in TCM hospitals and general hospitals as centres of care, and aligned with community health service centres.
This study has some limitations. The first is related to the background setting and small sample size. When the questionnaires were distributed, some administrative and support staff surveys were admixed into the survey, which led to smaller matched samples. The five selected cities were TCM pilot locations, and their TCM development was relatively advanced; thus, the research results were not representative of the whole country. Second, the data were gathered from health care professionals’ self-reporting regarding their TCM awareness and practices, without spot visits and objective verification. To the best of our knowledge, this study was one of the few domestic projects to evaluate current TCM for chronic disease care and prevention from the perspective of health care professionals in hospitals rather than communities, which might be a starting point for similar follow-up studies. The evaluation of the specific satisfaction and outcome indicators of TCM for prevention and treatment is necessary.