Phytotherapy in spa treatment: knowledge, use and opinions of spa patients, visitors and residents of a spa town (Inowrocław, Poland)
DOI:
https://doi.org/10.12775/JEHS.2026.95.76505Keywords
Phytotherapy, herbal medicine, spa treatment, balneology, Kneipp therapy, health educationAbstract
Introduction: Herbal medicine is among the oldest therapeutic traditions and is deeply rooted in European spa culture, most fully expressed in the system of Sebastian Kneipp. In Polish spas, however, phytotherapy is used only marginally, and public knowledge of medicinal plants is fading.
Aim: To assess the knowledge of phytotherapy and attitudes towards its use in spa treatment and in self-treatment among spa patients, visitors and residents of the Polish spa town of Inowrocław, answering five research questions with five research and five statistical hypotheses.
Material and Methods: A diagnostic survey with an original closed-ended questionnaire was carried out on 19 May 2013 near the brine graduation towers in Inowrocław (58 valid questionnaires; 41 women, 17 men; 28 spa patients, 18 visitors, 12 residents). Group-level results were converted from the thesis charts into whole-person counts and analysed with descriptive statistics, Clopper-Pearson confidence intervals, exact binomial tests, Freeman-Halton and Fisher exact tests with Holm correction, and correspondence analysis. Methods that need individual-level data (canonical, discriminant, cluster and factor analysis) could not be applied.
Results: Only 13 of 57 respondents (22.8%; 95% CI 12.7-35.8) had ever used phytotherapy in a spa, and a physician had never proposed herbal treatment to 40 of 58 (69.0%; 95% CI 55.5-80.5). Herbs were nevertheless used on their own by 35 of 46 spa patients and visitors (76.1%). Of 57 respondents, 46 (80.7%; 95% CI 68.1-90.0) wanted herbal medicine promoted more and 46 (80.7%) favoured extending it in spas; nobody opposed either proposal. Residents more often did not know herbs (8/12 vs 4/27 spa patients and 5/18 visitors; exact p = 0.006), but this did not remain significant after correction for 14 comparisons (adjusted p = 0.078). Only the preparation of home-made cosmetics differed significantly between groups after correction (adjusted p = 0.009; Cramér's V = 0.48). Correspondence analysis described two dimensions (60.6% and 39.4% of inertia) that separated residents, spa patients and visitors.
Conclusions: Phytotherapy is rarely used in Polish spa medicine despite clear social demand. Evidence-based health education, careful integration of herbal treatment into spa programmes under medical supervision, and larger multi-centre studies with individual-level data, which would allow multivariate analyses, are recommended.
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