Critical Care Nurses’ Desire to Use Complementary Alternative Modalities (CAM) in Critical Care and Barriers to CAM Use:

Generating Evidence of Critical Care Nurses' Perceptions, Knowledge, Beliefs, and Use of Music Therapy, Aromatherapy, and Guided Imagery

BACKGROUND

Critical care settings are known to be fast-paced and technologically advanced. To optimize humanistic care, integration of evidence-based complementary and alternative therapies holds promise. However, evidence of critical care nurses' use of complementary and alternative therapies in clinical practice has not been evaluated recently.

OBJECTIVES

This study sought to determine critical care nurses' perspectives of music therapy, aromatherapy, and guided imagery (GI) including perceptions of legitimacy, self-reported knowledge, interest in gaining knowledge, beliefs of harm/benefits, professional use, personal use, recommendations for use in critical care practice, and requests for these therapies by critical care patients or families.

METHODS

A descriptive cross-sectional design with repeated measures was conducted with critical care nurses (N = 53) practicing in 3 intensive care units at a Midwestern academic-affiliated medical center. The nurses' current perceptions, knowledge, beliefs, and use of music therapy, aromatherapy, and GI were assessed. In addition, an evaluation of the consistency of participants' responses using the Critical Care Nurses' Use of Complementary Therapies survey was performed on a subset of the sample (n = 15) at 2 time points 4 to 6 weeks apart.

RESULTS

Most nurses (66%-83%) endorsed the legitimacy of these therapies for use with their patients. Nurses had the most knowledge of aromatherapy, followed by music therapy and GI; they showed interest in gaining further knowledge of the therapies even when reporting "some" to "a lot" of knowledge. Nurses showed a positive response regarding their beliefs about the benefits of each therapy. Professional use was highest for aromatherapy (85%), followed by music therapy (75%), corresponding with greater self-reported knowledge and personal use. A majority recommended aromatherapy (79%) and music therapy in practice (64%) and reported that these therapies were requested by patients or families. Responses on the survey items at 2 time points of administration showed consistency.

DISCUSSION

On the basis of the overall survey responses, developing a robust scientific base and addressing educational needs through expanding resources and continuing education programs may promote use of these therapies to benefit patients in critical care.

Innovative solutions: registered nurses' perceptions of the work environment before and after adult intensive care unit renovations

Today, healthcare and healthcare professionals are constantly undergoing change. Environmental, interpersonal, and intrapersonal changes, along with caring for critically ill patients, present many challenges for those working in critical care. Change process research can be very helpful in guiding the change process for those working and healing in the critical care environment.

Challenges of implementing a feasibility study of acupuncture in acute and critical care settings

A majority of people in the United States use complementary and alternative therapies, and this use is increasing. With the increasing interest, providers must evaluate potential risks and benefits of these therapies. This article describes challenges of a feasibility study of acupuncture as a potential therapeutic adjunct to prevent atrial fibrillation following coronary artery bypass graft surgery. Institutional review board approval, consent logistics, implementation issues, and rapid changes in clinical practice were the primary challenges faced. Unique technological features of the institution helped address these challenges. The study protocol was acceptable to staff, patients, and family and was considered safe for these patients. However, the protocol was not feasible as designed; therefore, the efficacy of acupuncture could not be determined. Continued research is needed to evaluate the effectiveness of acupuncture to prevent atrial fibrillation following coronary artery bypass graft surgery. Recommendations for future studies of complementary and alternative therapies in acute and critical care settings are offered.