ED staff members' personal use of complementary therapies and their recommendations to ED patients: a southeastern US regional survey

Spiritual Care Activities of Nurses Using Nursing Interventions Classification (NIC) Labels

PURPOSE

To describe the spiritual care activities of nurses as subsequently identified in the Nursing Interventions Classification (NIC) labels.

METHODS

Data were taken from a larger study that used a multiple triangulation research design to describe spiritual perspectives, interventions, and attitudes of 1,000 Sigma Theta Tau International members. Data analysis included descriptive and multivariate statistics for quantitative items, and content analysis for responses to questions.

FINDINGS

97 respondents reported providing 32 spiritual care activities. Ten NIC labels actually mapped the nurses' spiritual care activities.

CONCLUSIONS

Spiritual care activities involve a broad spectrum of interventions that may be unique to each patient. The 32 spiritual care activities described by the nurses provide new knowledge regarding core spiritual care activities. The use of NIC labels can facilitate documentation of spiritual care activities in diverse practice settings.

PRACTICE IMPLICATIONS

This study supports greater specificity in describing spiritual care interventions to a level that allows replication and advancement of knowledge.

What do clinicians want? Interest in integrative health services at a North Carolina academic medical center

Background

Use of complementary medicine is common, consumer driven and usually outpatient focused. We wished to determine interest among the medical staff at a North Carolina academic medical center in integrating diverse therapies and services into comprehensive care.

Methods

We conducted a cross sectional on-line survey of physicians, nurse practitioners and physician assistants at a tertiary care medical center in 2006. The survey contained questions on referrals and recommendations in the past year and interest in therapies or services if they were to be provided at the medical center in the future.

Results

Responses were received from 173 clinicians in 26 different departments, programs and centers. There was strong interest in offering several specific therapies: therapeutic exercise (77%), expert consultation about herbs and dietary supplements (69%), and massage (66%); there was even stronger interest in offering comprehensive treatment programs such as multidisciplinary pain management (84%), comprehensive nutritional assessment and advice (84%), obesity/healthy lifestyle promotion (80%), fit for life (exercise and lifestyle program, 76%), diabetes healthy lifestyle promotion (73%); and comprehensive psychological services for stress management, including hypnosis and biofeedback (73%).

Conclusion

There is strong interest among medical staff at an academic health center in comprehensive, integrated services for pain, obesity, and diabetes and in specific services in fitness, nutrition and stress management. Future studies will need to assess the cost-effectiveness of such services, as well as their financial sustainability and impact on patient satisfaction, health and quality of life.

Complementary and Alternative Medicine: Oncology Nurses' Experiences, Educational Interests, and Resources

PURPOSE/OBJECTIVES

To describe oncology nurses' experiences with patients communicating interest in or use of complementary and alternative medicine (CAM) therapies along with oncology nurses' CAM resources and educational interests.

DESIGN

National mailed survey.

SETTING

A national medical center and research institute.

SAMPLE

A random sample of 850 Oncology Nursing Society (ONS) members who are RNs involved in direct patient care.

METHODS

Respondents completed a demographic questionnaire and the Nurse Complementary and Alternative Medicine Knowledge and Attitude Survey. Initial analysis compared the demographics of the sample to the ONS membership. Descriptive analysis was used to further describe nurses' experiences with patients communicating interest in or use of CAM, nurses' interest in CAM education, and nurses' use of CAM resources.

MAIN RESEARCH VARIABLES

Experiences, resources, interests, and CAM therapies.

FINDINGS

Oncology nurses reported their experiences with patients who communicated interest in or use of CAM therapies. Respondents demonstrated considerable interest in learning more about specific CAM therapies and used a variety of resources to find information on CAM therapies.

CONCLUSIONS

Assessing oncology nurses' experiences, resources used, and interest in learning about CAM therapies is the first step in determining the learning needs of oncology nurses in the direct patient care environment. The next step is to obtain baseline information on oncology nurses' CAM knowledge and attitudes for developing and providing appropriate education. CAM education will provide nurses with knowledge to support and advocate for their patients.

IMPLICATIONS FOR NURSING

Oncology nurses are the bridge to help patients safely integrate evidence-based CAM therapies into conventional treatment.

Expanding the Dialogue on Prayer Relevant to Holistic Care

Because prayer is the most frequently used spiritual practice, it is beneficial to address the relationship between prayer and spiritual care needs. Raising awareness among nurses of the meaning of prayer practices in healthcare settings may strengthen holistic care. This article presents a synthesis of nursing theory on prayer and spirituality for holistic care and attempts to expand an understanding of prayer practices related to traditions of increasingly diverse patients and caregivers. In addition, a 4-point guide for spiritual caregiving is presented to help nurses address human responses in the spiritual domain.

Complementary therapy in critical care settings: a review of surveys and implications for nurses

Critical care nurses have been leaders in this field and need to further expand their influence in the work environment and healthcare system. The time is ideal for initiating meaningful system-wide changes in policy and practice. This review provides an historical context of surveys conducted in a variety of critical care settings in this country. It is important for nurses to become familiar with these studies to communicate better with others and make recommendations based on research. Critical care nurses can maintain their lead by becoming principal investigators in this area of research. In this day and age there is no reason to dismiss or arbitrarily evaluate the use of CAM. Consumer use does not end when crossing over the threshold of a healthcare setting. The focus should be equally spread over safety issues and modalities that can enhance an individual's quality of life. The staff has an ethical and legal responsibility to be aware of and knowledgeable about any healthcare modality practiced by their patients regardless of whether "sufficient" randomized, double-blind controlled studies have been completed.

Prayer's clinical issues and implications

Because prayer frequently sustains coping and brings comfort, it is an important resource for nurses to support or offer. How shall nurses incorporate prayer in nursing practice? This article explores practical aspects of including prayer in bedside nursing care, including suggestions for assessment, supporting patients when beliefs about prayer challenge, discussing prayer with clients for whom prayer may be harmful, overcoming nursing barriers to prayer, and more.

Nurse attitudes towards the use of complementary and alternative therapies in critical care

BACKGROUND

There is increasing demand for complementary/alternative therapies (CAT) in critical care, however, critical care nurses' perspectives regarding CAT are unknown.

OBJECTIVES

This study was conducted to determine critical care nurses' knowledge, attitudes, and use of CAT.

SAMPLE/SETTING

A total of 348 critical care registered nurses working at least 40% in medical, surgical, cardiac, neurological, and pediatric ICUs at 2 tertiary-level hospitals in a large Midwestern city were surveyed. One hospital is a 926-bed private, urban hospital and the second is an 1868-bed academic-affiliated medical center.

METHODS

A survey was distributed to all critical care nurses described above.

RESULTS

The level of knowledge reported by 138 nurse respondents was greatest for diet, exercise, massage, prayer, and music therapy. Use of therapies was related to knowledge and training and consistent with beliefs of legitimacy and perceptions of beneficial effects. Despite barriers including lack of knowledge, time, and training, 88% of respondents were open or eager to use CAT, and 60% reported moderate or greater desire to use CAT.

CONCLUSIONS

Critical care nurses are open to CAT use and many use them in their own practice. Because use was associated with knowledge, recommendations for future research include increasing the scientific base and enhancing knowledge to promote evidence-based incorporation of CAT in practice.

Knowledge levels and attitudes of staff nurses in Israel towards complementary and alternative medicine

AIMS

The purpose of this study was to determine the knowledge level and attitudes of Israeli nurses towards complementary and alternative medicine and what factors are related to these variables.

BACKGROUND

Over recent years there has been increased interest among the lay public and health care professionals in complementary and alternative medicine (CAM). Previous studies have shown that several variables such as education, income, age, perceived health status and satisfaction with medical therapy are associated with use of CAM. Conflicting reports were found with respect to the relationship between health locus of control and the use of CAM. Israel is a small country comprised mostly of immigrants from vastly differing cultures with differing beliefs about health and health care. Nurses whose origins are similar to the general population are also caregivers who are used to integrating diverse therapies into the plan of care devised with the client. No study was found which investigated these issues among Israeli nurses.

DESIGN/METHODS

A systematic random sample of 369 staff nurses working at a major academic medical centre in Jerusalem, Israel were invited to participate in the study. Informed consent was obtained. Four self-administered, pencil and paper, questionnaires were distributed to the study participants: a questionnaire designed by the authors to determine the level of knowledge and attitudes towards complementary and alternative medicine; a questionnaire which measured satisfaction with the patient-physician relationship; a questionnaire which measured health locus of control; and a demographic questionnaire. Participants received a packet containing the questionnaire and a note explaining the study. The anonymous questionnaires were collected by the ward secretaries and sent in bulk to the researchers.

RESULTS

Results demonstrated that nurses in this sample perceived that they had little knowledge of complementary and alternative medicine but were very interested in learning more. Few used complementary and alternative medicine in their nursing practice but levels of personal use were similar to that of the general population. Nurses who used complementary and alternative medicine were satisfied with their care.

CONCLUSIONS

In general, nurses tended to be wary of the use of complementary and alternative medicine. Nurses were also not satisfied with their relationships with their physicians. Those of middle age were more likely to use complementary and alternative medicine but no other demographic characteristics were associated with knowledge or attitudes towards complementary and alternative medicine. Nurses had higher levels of internal health locus of control which was associated with more positive attitudes and knowledge levels of complementary and alternative medicine.

Adolescent use of alternative and complementary therapies. A framework for research

Increasing numbers of U.S. adolescents are using alternative and complementary therapies, seemingly mirroring the trend among adults. Patterns of use among adolescents may be different from those of adults, however, due to the unique biological, psychological, and social factors affecting this population. Although there is a growing body of literature on utilization and efficacy of alternative and complementary therapies, few studies have included or focused on adolescents. Such research is needed. Social learning theory provides an appropriate theoretical framework to address the complex web of factors underlying health-care-seeking behavior of adolescents, allowing for consideration of the critical factor of individual expectations in their health care choices. Research on adolescents' utilization of alternative and complementary therapies is important for providers and policy makers concerned with the present and future health of youth.