Complementary and alternative therapies: survey of knowledge and attitudes of health professionals at a tertiary pediatric/women's care facility

Assessment of Knowledge and Communication Regarding Complementary and Alternative Medicine Among Physicians in Madinah City

INTRODUCTION

Despite the recognition of the importance of physician knowledge and physician-patient communication about the use of complementary and alternative medicine (CAM), few studies have explored this issue. Therefore, this study aims to assess physicians' knowledge and physician-patient communication regarding CAM.

METHODS

A cross-sectional study was conducted among physicians working at governmental hospitals and primary healthcare centers in Madinah, Saudi Arabia. The data collection tool was a validated English language questionnaire distributed using social media platforms. The questionnaire included sections to assess physician knowledge and communication about CAM.

RESULTS

Of the 373 completed questionnaires, around 151 (40.5%) of the respondents stated that they have a poor level of knowledge about CAM, and 272 (72.9%) need to gain additional knowledge to properly counsel patients on CAM. Medical journals were the main source of knowledge about CAM. There were 121 (32.4%) physicians who believed that <20% of their patients use some form of CAM, and 180 (48.3%) believed that <20% of their patients spontaneously reported their CAM use without prompting or direct questioning. Around 180 (48.3%) of physicians believed that they asked <20% of their patients about using CAM. Regarding barriers that limit communication with the patient about CAM, the highest percentage was insufficient knowledge about CAM (137, 36.7%).

CONCLUSION

The study showed that a significant number of physicians lack the appropriate knowledge about CAM and most of them agreed to gain additional knowledge to properly counsel their patients. Further research is needed to evaluate physicians' knowledge about CAM using a more objective method.

Herbal medicine use in Thai patients with type 2 diabetes mellitus and its association with glycemic control: A cross-sectional evaluation

Introduction

Herbal medicine has been integrated into Thai culture for many centuries. However, studies on using herbal medicine in combination with antidiabetic agents for glycemic control in managing diabetes are limited. Herein, we aimed to assess the use of herbal medicines with different dosages of antidiabetic agents and their association with glycemic control in Thai patients with type 2 diabetes mellitus (T2DM).

Methods

This hospital-based study included 739 patients with T2DM who consecutively visited four district hospitals in Thailand. An interviewer-administered questionnaire was used to collect patient-specific information, including hemoglobin A1c (HbA1c) levels. Chi-square and logistic regression analyses were used to assess associations and predictors, respectively.

Results

The prevalence of herbal medicine use was 37.5% (n = 264); 70.5% of the patients received information about herbal medicine usage for glycemic control from their relatives and friends, and 21 herbal plants were consumed in combination with their prescribed antidiabetic drugs. The use of herbal medicine was associated with the patients’ educational level (p = 0.001), income (p < 0.001), and duration of diabetes (p < 0.001). Good glycemic control (HbA1c < 7.0%) was associated with the use of bitter gourd in combination with 500 mg/day of the antidiabetic drug metformin (adjusted odds ratio = 8.33, 95% confidence interval = 1.04–66.49, p = 0.046). These patients were 2.92 times more likely to have good glycemic control than those who relied solely on 500 mg/day of metformin (adjusted OR = 2.921, 95% CI = 1.227–6.952, p = 0.015).

Conclusions

The prevalence of herbal plant use was associated with different variables, including age, BMI, T2DM duration, and metformin dosage. Among the 21 herbal plants, the consumption of bitter gourd with 500 mg/day of metformin was associated with good glycemic control.

German physicians' perceptions and views on complementary medicine in pediatric oncology: a qualitative study

Complementary and alternative medicine (CAM) use in children with cancer has a high prevalence. If (parents of) patients bring up the topic of CAM, pediatric oncologists (POs) face considerable challenges regarding knowledge and professional behavior. In this study, we explore German POs' understanding of CAM and related attitudes as well as challenges and strategies related to CAM discussions by means of semi-structured interviews analyzed according to principles of qualitative thematic analysis with parents of children with cancer. We could conduct 14 interviews prior to theoretical saturation. The interviews had a duration of 15-82 min (M = 30.8, SD = 18.2). Professional experience in pediatric oncology was between 0.5 and 26 years (M = 13.8, SD = 7.6). Main themes identified were a heterogeneous understanding and evaluation of CAM, partly influenced by personal experiences and individual views on plausibility; the perception that CAM discussions are a possible tool for supporting parents and their children and acknowledgement of limitations regarding implementation of CAM discussions; and uncertainty and different views regarding professional duties and tasks when being confronted with CAM as a PO. Our interdisciplinary interpretation of findings with experts from (pediatric) oncology, psychology, and ethics suggests that there is need for development of a consensus on the minimal professional standards regarding addressing CAM in pediatric oncology.

Herbal medicine from the perspective of type II diabetic patients and physicians: what is the relationship?

Background

Diabetes mellitus (DM) is a major public health problem and one of the most challenging diseases worldwide. According to the World Health Organization (WHO), the Kingdom of Saudi Arabia (KSA) has the second highest rate of diabetes in the Middle East and seventh highest globally. Some diabetic patients may prefer to use alternative approaches such as herbal remedies to control their blood glucose level and this study aims to assess the prevalence of herbal usage and to evaluate users’ and doctors’ knowledge, attitudes and beliefs about herbal medicine as well as the patient/doctor relationship in this regard.

Method

A cross-sectional survey was conducted in several hospitals and medical centres in Makkah, KSA, between January and March 2019. Around 289 type II diabetic patients and 105 doctors were interviewed.

Results

We found that 68% of the participants were frequent consumers of herbal remedies, especially cinnamon, ginger and fenugreek. Patients’ knowledge of herbal usage was mainly gleaned from family and friends as well as social media, and we found that many (71.4%) did not bother to consult or inform their doctors about their choice to self-medicate with herbs. Patients had no concerns regarding the efficacy and safety of herbal usage use in diabetes, as around half of the participants believe that herbal medicine is effective (54%) and safe (46%) for treating symptoms of diabetes. Two-thirds of the doctors (66%) routinely ask patients whether they use herbs for their condition. Although 25% of the doctors took a positive view of herbal medicine in relation to diabetes, others expressed concerns with the rise in herb use and want to see more attention paid to safety aspects.

Conclusion

The study concludes that herbal remedies are commonly used by diabetic patients and that a gap exists in the relationship between patients and doctors concerning the disclosure of herbal remedy use and views on its safety.

Asthma patients' perception on their care pathway: a qualitative study

Because of insufficient asthma control in many patients, the collaboration between stakeholders is regarded as a promising strategy to improve asthma outcomes. This study explored the perceptions of French adult asthma patients on their care pathway. We conducted a qualitative study based on the interviews of 30 asthma patients aged 18–40 years, recruited in French primary care. We performed a thematic analysis of the data collected, using the NVivo software. According to the patients, the stakeholders involved in asthma management included those visible to healthcare professionals (patient, general practitioner, specialist(s), pharmacist, physiotherapist, family and friends) and those concealed by the patients (complementary and alternative practitioners); other stakeholders, such as nurses and occupational physicians, were not involved. Asthma management at diagnosis and follow-up phases proved to be unstructured, and were associated with poor patient education. This was supported by patients’ ambivalence (in relation to illness and treatments), poor communication between patients and healthcare professionals (lack of listening and use of inappropriate vocabulary by physicians, underreporting of alternative medicine use by patients) and weak cooperation between professionals (limited to interaction between the general practitioner and the specialist, either pulmonologist or allergist). Asthma management would probably benefit from a more coordinated care pathway at each phase of the disease that is consistent with the expectations and goals of the patients. It should be based on improved organization (involvement of other healthcare professionals and the patient as partners) and processes (regular follow-up, specific tools such as peak flow meter or action plan).

Complementary and Alternative Medicine: Italian Validation of a Questionnaire on Nurses' Personal and Professional Use, Knowledge, and Attitudes

BACKGROUND

Patients are showing an increasing interest in the use of complementary and alternative medicine (CAM). Most nurses are open to the adoption of CAM into clinical nursing practice, but they may experience a lack of knowledge about the safe and effective use of these therapies. Several studies concerning nurses' knowledge and attitudes toward CAM have been published, but only in one, the authors (Shorofi and Arbon) used a validated questionnaire. In Italy, there are no validated questionnaires to investigate this aspect of nursing practice.

PURPOSE

To test the psychometric properties of the Italian Shorofi and Arbon questionnaire for use with Italian nurses.

METHODS

A forward-backward translation method was used to translate the questionnaire from English to Italian. Content validity, face validity and reliability were established.

RESULTS AND CONCLUSIONS

This study examined the potential usefulness of the Shorofi and Arbon questionnaire for the evaluation of CAM knowledge of Italian speaking nurses, which showed good content validity and good reliability.

Experiences and Attitudes of Nurses Regarding Complementary Health Approaches Used by Themselves and Their Patients

Nurses' attitudes and experiences may affect the level of patient exposure to complementary health approaches (CHA), both now and in the future. The purpose of this study was to describe nurses' experience of CHA and their personal and professional attitudes to the use of CHA. The sample consisted of 220 nurses working at a university hospital in Antalya, Turkey. Data were collected using a questionnaire developed by the researchers. Nurses had a positive attitude toward CHA and reported mixed experiences of CHA for allergies, pain, and stress. This study may contribute to increased awareness of the potentially important role of nurses in delivery of CHAs. Hospital nurses should receive more training on CHA. Nurses should discuss the potential benefits and risks of CHA with patients.

A review of nurses' knowledge, attitudes, and ability to communicate the risks and benefits of complementary and alternative medicine

AIMS AND OBJECTIVES

This study reviewed existing literature to investigate how frequently nurses include complementary and alternative forms of medicine in their clinical practice. In so doing, we investigated nurses' knowledge of and attitudes towards complementary and alternative medicine as well as their ability to communicate the risks and benefits of these therapies with patients.

BACKGROUND

Little information is available concerning nurses' knowledge and attitudes towards complementary and alternative medicine or how they incorporate these therapies into their practice. In addition, little is known about the ability of nurses to communicate the risks and benefits of complementary and alternative medicine to their patients.

STUDY DESIGN

This study used a scoping review method to map and synthesise existing literature.

DATA SOURCES

Both electronic and manual searches were used to identify relevant studies published between January 2007 and January 2014.

REVIEW METHODS

The review was conducted in five stages: (1) identification of research question(s), (2) locate studies, (3) selection of studies, (4) charting of data, and (5) collating, summarising, and reporting of results.

RESULTS

Fifteen papers met the inclusion criteria for this review, among which 53·7% referenced how frequently nurses include complementary and alternative medicine in their practice. We found that 66·4% of nurses had positive attitudes towards complementary and alternative medicine; however, 77·4% did not possess a comprehensive understanding of the associated risks and benefits. In addition, nearly half of the respondents (47·3-67·7%) reported feeling uncomfortable discussing complementary and alternative medicine therapies with their patients.

CONCLUSION

The lack of knowledge about complementary and alternative medicine among nurses is a cause for concern, particularly in light of its widespread application.

RELEVANCE TO CLINICAL PRACTICE

Findings from this study suggest that health care professionals need to promote evidence informed decision-making in complementary and alternative medicine practice and be knowledgeable enough to discuss complementary and alternative medicine therapies. Without involvement of complementary and alternative medicine communication on the part of our profession, we may put our patients at risk of uninformed and without medical guidance.

A descriptive study on complementary and alternative medicine use in 0 to 1-year-old infants and nurses' awareness and recommendation for complementary and alternative medicine

This study aimed to determine complementary and alternative medicine (CAM) recommended by midwives and nurses and used by mothers on their 0 to 1-year-old infants. A cross-sectional survey design was used. The sample of the study consisted of 65 midwives and mothers of 349 infants registered at these health-care centres. The frequency of CAM use on a regular basis by mothers participating in the study on their infants was 24.6%, whereas the frequency of CAM use for a while was 41.3%. Of the mothers using CAM, 81.5-98.5% stated that the method they were employing was useful. The mothers used CAM on their infants, and the midwives and nurses recommended CAM use. However, the midwives and nurses themselves should be first trained to be able to inform individuals/mothers about CAM. Evidence-based studies on CAM are needed.

Exploring the decision to disclose the use of natural products among outpatients: a mixed-method study

Background

There is little understanding of the reasons for the limited communication between patients and conventional healthcare professionals regarding patients’ use of complementary and alternative medicine (CAM). The purpose of this study is to explore the predictors of outpatients’ decision to disclose their use of natural products to conventional healthcare professionals.

Methods

A mixed method design was used. Quantitative data were obtained through a survey and qualitative data were obtained from semi-structured interviews. A total of 257 outpatients who fulfilled the criteria of having used natural products prior to the interview were recruited for this study. Subsequently, 39 patients of those who completed the survey were further selected to take part in an in-depth qualitative interview.

Results

Predictors of the decision to disclose the use of natural products to conventional healthcare professionals included age, frequency of clinic visits, knowledge of the natural products and the attitude towards the benefits of CAM use. The themes that emerged from the qualitative data included safeness of the natural products, consulting alternative sources of information, apprehension regarding the development of negative relationships with healthcare professionals and reactions from the healthcare professionals.

Conclusions

Understanding the factors and reasons affecting patients’ decision as to whether to disclose their use of natural products provides an opportunity for conventional healthcare professionals to communicate better with patients. It is important to encourage patients to disclose their use of natural products in order to provide responsible health care as well as increasing patient safety regarding medication usage.

Pattern and predictors of complementary and alternative medicine (CAM) use among pediatric patients with epilepsy

Parents of pediatric patients with chronic conditions such as epilepsy increasingly opt for complementary and alternative medicine (CAM). However, data on the pattern and reasons of CAM use in childhood epilepsy are scarce. The objectives of this study were as follows: first, to characterize CAM use among pediatric patients with epilepsy by assessing its spectrum, prevalence, costs, and frequency of use; second, to evaluate the influence of CAM use on compliance and satisfaction with conventional care as well as to explore parent-child neurologist communication concerning CAM; and third, to investigate predictors of CAM use. A postal survey was administered to all parents of pediatric outpatients with epilepsy aged 6 to 12, who have received treatment at the neuropediatric outpatient clinic of the University Children's Hospital Heidelberg between 2007 and 2009. One hundred thirty-two of the 297 distributed questionnaires were suitable for inclusion in statistical analysis (44.7%). Forty-nine participants indicated that their children used CAM during the previous year (37.1%). Thirty different types of CAM were used, with homeopathy (55.1%), osteopathy (24.5%), and kinesiology (16.3%) being the most commonly named. A mean of 86€ (0€-500€) and 3h (1 h-30 h) per month was committed to CAM treatment. Only 53% of the users informed their child neurologist of the additional CAM treatment, while 85.6% of all parents wished to discuss CAM options with their child neurologist. Seventy-five percent of users considered the CAM treatment effective. Among the participants most likely to seek CAM treatment are parents whose children show a long duration of epileptic symptoms, parents who make use of CAM treatment themselves, and parents who value a holistic and natural treatment approach. A substantial portion of pediatric patients with epilepsy receive CAM treatment. The high prevalence of use and significant level of financial and time resources spent on CAM indicate the high importance of these treatment options for parents. On the other hand, communication concerning CAM with the child neurologist is largely insufficient despite the wish to speak about CAM. Complementary and alternative medicine users' high compliance with conventional treatment and high perceived effectiveness of CAM support an integrative approach to CAM for pediatric patients with epilepsy. Our study implies that in addition to open parent-child neurologist communication, active inquiry on CAM treatments is necessary to enable informed decision making by parents and to establish the suitability of CAM treatment for the patient. Reliable predictors for CAM use, which allow for improved identification of patients with a high likelihood to receive CAM treatment, are the duration of the illness, use of CAM by the parents themselves, and the desire of the parents to receive a holistic and natural treatment for their child.

A nationwide survey of nurses' attitudes toward music therapy and their need for education in its application

BACKGROUND

Music therapy is increasingly used to help heal patients. However, there is a significant gap in the literature about nurses' attitudes toward and need for education in music therapy for nursing practice. This cross-sectional study was conducted to describe nurses' attitudes toward music therapy and determine their need for education in music therapy.

METHODS

Participants included 1,197 nurses who were recruited from hospitals in different regions of Taiwan.

RESULTS

Participants expressed positive attitudes toward music therapy. Most participants were willing to learn about music therapy. "Skill in using musical instruments" was the most frequently identified educational need. Further study of the discrepancy between the attitudes toward "performing music therapy" and "learning music therapy" is needed to clarify why nurses expected that they would receive no support for attending music therapy education.

CONCLUSION

Given participants' attitudes toward music therapy and their motivation for learning, nursing administrators and educators may consider developing policies to further the advancement of music therapy in educational programs and practice.

Complementary and alternative medicine use among patients presenting to a pediatric otolaryngology clinic

OBJECTIVES

This study sought to quantify and characterize complementary and alternative medicine (CAM) use among patients presenting to a pediatric otolaryngology clinic with the aim of increasing CAM use awareness for the practicing pediatric otolaryngologist.

METHODS

Four hundred thirty-four caregivers of patients presenting to a pediatric otolaryngology clinic were surveyed regarding their child's use of CAMs. Demographic information, perceived benefits, and sources of information regarding CAM was collected. Spearman correlation coefficient was used to assess strength of associations.

RESULTS

Three-hundred and sixty-four caregivers completed the survey (83.9% response rate). The children of 69% of respondents had utilized CAM, and 46% were using CAM at the time of the survey. Higher income and chronic illness in the child were significant predictors of CAM use. The children of older and married parents were more likely to have utilized CAM (non-significant). The most common agents were multivitamins (43%) and vitamin D (32%). Parents whose children used more CAMs were more likely to perceive a benefit.

CONCLUSIONS

A significant proportion of pediatric otolaryngology patients utilized CAM in our study population. The most commonly used agents are mostly benign, but others may have more unknown consequences. It is crucial that otolaryngologists ask specifically about these agents, as they potentially interact with prescription medications and some may lead to surgical complications.

Knowledge about complementary, alternative and integrative medicine (CAM) among registered health care providers in Swedish surgical care: a national survey among university hospitals

Background

Previous studies show an increased interest and usage of complementary and alternative medicine (CAM) in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals.

Method

A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included.

Result

A total of 737 (42.0%) questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in such research. Half of the participants (55.8%) were positive to learning such therapy. Communication about CAM between patients and the health care professions was found to be rare.

Conclusion

There is a lack of knowledge about CAM and research about it among registered health care professions in Swedish surgical care. However, in contrast to previous studies the results revealed that the majority perceived it as important to gain knowledge in this field.

Case-based online modules to teach graduate-level nursing students about complementary and alternative medical therapies

We integrated complementary and alternative medicine (CAM)-related content into selected core courses in our master's-level curriculum. To facilitate students' application of the content, we developed evidence-based online case studies and evaluated their effectiveness by comparing students' pretest and posttest scores on multiple-choice quizzes. Findings suggest that evidence-based online case studies are an effective strategy for teaching graduate nursing students about the clinical issues surrounding patients' use of CAM therapies.

Complementary and alternative medicine and critical care nurses: a survey of knowledge and practices in Australia

BACKGROUND

The increasing and widespread use of complementary and alternative medicine in the general population requires health-care professionals to have a knowledge and appreciation of their use to ensure that decisions about care are appropriate, safe and meet patients' needs. This is also the case for critical care nurses. Presently, healthcare professionals including nurses have limited formal education on complementary and alternative medicine. Critical care nurses' role in relation to complementary and alternative medicine is important for two patient care reasons: some can adversely interact with conventional medicines and others can potentially improve patient's well-being. Australian critical care nurses' knowledge of complementary and alternative medicine is unknown.

PURPOSE

To identify Australian critical care nurses' assessment practices, attitudes, knowledge, and use of complementary and alternative medicine in practice.

METHODS

A descriptive, exploratory online survey of Australian critical care nurses through a national critical care nursing database was undertaken during early 2011.

FINDINGS

Five of twenty-eight therapies were endorsed by the respondents (n=379) most positively regarding legitmacy, knowledge, benefit and use in practice: exercise; diet; counselling/psychology; relaxation techniques; and massage. The findings also suggest that a specific area within patient files promotes the practice of identifying and recording current complementary and alternative medicine use and that the majority of respondents supported further education.

CONCLUSION

Critical care nurses although supporting a number of therapies also identified a need for increased knowledge and understanding. As the findings also suggest that patients and families are requesting a range of therapies there is a need to investigate the provision of appropriate educational resources for critical care nurses to ensure safe and evidence-based care.

Personal use of complementary and alternative medicine (CAM) by U.S. health care workers

OBJECTIVE

To examine personal use of complementary and alternative medicine (CAM) among U.S. health care workers.

DATA

Data are from the 2007 Alternative Health Supplement of the National Health Interview Survey. We examined a nationally representative sample of employed adults (n = 14,329), including a subsample employed in hospitals or ambulatory care settings (n = 1,280).

STUDY DESIGN

We used multivariate logistic regression to estimate the odds of past year CAM use.

PRINCIPAL FINDINGS

Health care workers are more likely than the general population to use CAM. Among health care workers, health care providers are more likely to use CAM than other occupations.

CONCLUSIONS

Personal CAM use by health care workers may influence the integration of CAM with conventional health care delivery. Future research on the effects of personal CAM use by health care workers is therefore warranted.

Use of complementary and alternative medicine by those with a chronic disease and the general population--results of a national population based survey

Background

The use of complementary and alternative medicine (CAM) is becoming more common, but population-based descriptions of its patterns of use are lacking. This study aimed to determine the prevalence of CAM use in the general population and for those with asthma, diabetes, epilepsy and migraine.

Methods

Data from cycles 1.1, 2.1 and 3.1 of the Canadian Community Health Survey (CCHS) were used for the study. The CCHS is a national cross-sectional survey administered to 400,055 Canadians aged ≥12 between 2001-2005. Self-reported information about professionally diagnosed health conditions was elicited. CCHS surveys use a multistage stratified cluster design to randomly select a representative sample of Canadian household residents. Descriptive data on the utilization of CAM services was calculated and logistic regression was used to determine what sociodemographic factors predict CAM use.

Results

Weighted estimates show that 12.4% (95% Confidence Interval (CI): 12.2-12.5) of Canadians visited a CAM practitioner in the year they were surveyed; this rate was significantly higher for those with asthma 15.1% (95% CI: 14.5-15.7) and migraine 19.0% (95% CI: 18.4-19.6), and significantly lower for those with diabetes 8.0% (95% CI: 7.4-8.6) while the rate in those with epilepsy (10.3%, 95% CI: 8.4-12.2) was not significantly different from the general population.

Conclusion

A large proportion of Canadians use CAM services. Physicians should be aware that their patients may be accessing other services and should be prepared to ask and answer questions about the risks and benefits of CAM services in conjunction with standard medical care.

Knowledge, attitudes, and use of complementary and alternative therapies among clinical nurse specialists in an academic medical center

BACKGROUND

There has been an increase in the use and awareness of complementary and integrative therapies in the United States over the last 10 years. Clinical nurse specialists (CNSs) are in an ideal place to influence this paradigm shift in medicine to provide holistic care.

PURPOSE

This study was designed to describe the knowledge, attitudes, and use of complementary and alternative medicine (CAM) by CNSs in a large Midwest medical center.

DESIGN

This study used a descriptive exploratory correlational design.

SAMPLE/SETTING

Seventy-six CNSs who work in various inpatient and outpatient units within this medical facility were surveyed electronically, in the fall of 2008, using a 26-item questionnaire developed by the research team.

METHOD

Data were analyzed using descriptive statistics.

FINDINGS

The results demonstrate that CNSs at this academic medical center use several CAM therapies for their personal use and for professional practice with patients. The top therapies that CNSs personally used were humor, massage, spirituality/prayer, music therapy, and relaxed breathing. The top therapies requested most by patients were massage, spirituality/prayer, healing touch, acupuncture, and music therapy. The results indicated that most CNSs thought CAM therapies were beneficial and that there was some evidence for use of these therapies for use by patients or by CNSs.

IMPLICATIONS

The results of this study will help to determine educational needs and clinical practice of CAM therapies with CNSs at this academic medical center. The survey used and the research results from this study can be a template for other CNSs to use to begin to address this topic of CAM use in other hospitals and clinical settings. This survey could be used to explore CAM use by patients in specialty areas for practice enhancement.

Perceptions of complementary therapies among Swedish registered professions in surgical care

There is increasing interest in complementary and alternative medicine (CAM) among healthcare professions. However, no studies have been conducted in Sweden or in a surgical context. The aim of this study is to describe different perceptions of complementary therapies among registered healthcare professions in Swedish surgical care. Sixteen interviews were conducted with registered physicians, nurses, physiotherapists and clinical dieticians at a Swedish university hospital. Analysis was made with a phenomenographic research approach. The findings showed variations in perceptions of the definition of complementary therapies. A constructive approach toward use was observed, but there was a conflict in matters of indications and contraindications, and also criticism over a lack of knowledge. There was seen to be a need for education to be able to act professionally. Scepticism over high costs of treatment was highlighted. In conclusion, a need for policies on management, education and research in the field of CAM should be addressed.

Knowledge of Florida nurses and dietitians regarding dietary supplements

BACKGROUND

Health care professionals should exhibit competency about dietary supplements to support the high number of Americans taking these products.

OBJECTIVES

To evaluate the knowledge of Florida nurses and dietitians regarding dietary supplements.

METHODS

Florida nurses (n=600) and dietitians (n=600) were randomly selected to participate in a self-reported online survey. The actual knowledge of these professionals regarding nutrient-based and herbal supplements was evaluated by a quiz.

RESULTS

Data of 89 dietitians and 64 nurses were analyzed using independent sample t-test and Pearson's correlation. The actual knowledge of both professionals revealed a mean correct score of 12.98+/-6.16 (maximum score=30). Dietitians had a significantly greater knowledge of dietary supplements when compared to nurses (P=0.000). Both professionals were more knowledgeable on nutrient-based supplements than herbal.

CONCLUSIONS

Both groups had a fairly low knowledge of side effects of dietary supplements and their interactions with common medications, and seem to require additional education in this area. Focused training can be designed to improve professionals' knowledge about dietary supplements.

Complementary medicine for psychiatric disorders in children and adolescents

PURPOSE OF REVIEW

To examine recent empirical studies of herbal and dietary treatments for psychiatric disorders in children and adolescents.

RECENT FINDINGS

Very few quality studies into the use of omega-3 fatty acids, St John's wort, dietary manipulations, kava, gingko and lemon balm in managing psychiatric disorders have been conducted in children and adolescents.

SUMMARY

A number of herbal treatments show promise, but much more empirical research is required to establish their efficacy in the paediatric population.