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Beck AJ, Barber T, McKenzie H, Thorlakson J, Dell C, Keeping-Burke L. Perceptions and experiences of health care professionals and staff with animal-assisted interventions in health care settings: a qualitative systematic review protocol. JBI Evid Synth 2022; 20:924-930. [PMID: 35019870 DOI: 10.11124/jbies-21-00151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to examine the perceptions and experiences of health care professionals and staff in implementing or coordinating animal-assisted interventions in health care settings. INTRODUCTION Animal-assisted interventions are applied in the areas of health, education, and human services to help improve individuals' health and wellness. The positive effects of animal-assisted interventions on individuals have been shown in multiple health disciplines from pediatrics to long-term care and include outcomes such as decreased feelings of loneliness and increased feelings of support. The increase of animal-assisted interventions in human health initiated growing research on health care professionals' perceptions and experiences of these interventions. No current qualitative systematic reviews have focused solely on health care professionals' and staff's perceptions of animal-assisted interventions. Conducting such a review will advance understanding of how these providers perceive and engage with animal-assisted interventions as well as their influence and role in coordinating these interventions. INCLUSION CRITERIA This review will consider qualitative primary studies that address the perceptions and experiences of health care professionals and staff in implementing or coordinating animal-assisted interventions in health care settings. Studies published from database inception to present and in English will be considered. METHODS Nine bibliographic databases will be systematically searched for published and unpublished studies by employing a three-step search strategy. Two reviewers will independently appraise the studies and extract qualitative data using the standardized JBI critical appraisal and data extraction instruments. Findings from the review will be categorized according to similarity in meaning and categories subjected to a meta-synthesis to produce a single comprehensive set of synthesized findings. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO (CRD42021258909).
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Affiliation(s)
- Amy J Beck
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada Department of Family Medicine, University of Alberta, Edmonton, AB, Canada Department of Sociology, University of Saskatchewan, Saskatoon, SK, Canada Cameron Science, Technology, and Business Library, University of Alberta, Edmonton, AB, Canada Nursing and Health Sciences, University of New Brunswick, Saint John, NB, Canada The University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: A JBI Centre of Excellence, Saint John, NB, Canada
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Bolton RE, Bokhour BG, Dvorin K, Wu J, Elwy AR, Charns M, Taylor SL. Garnering Support for Complementary and Integrative Health Implementation: A Qualitative Study of VA Healthcare Organization Leaders. J Altern Complement Med 2021; 27:S81-S88. [PMID: 33788605 DOI: 10.1089/acm.2020.0383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: Healthcare organization leaders' support is critical for successful implementation of new practices, including complementary and integrative health (CIH) therapies. Yet little is known about how to garner this support and what motivates leaders to support these therapies. We examined reasons leaders provided or withheld support for CIH therapy implementation, using a multilevel lens to understand motivations influenced by individual, interpersonal, organizational, and system determinants. Design and setting: We conducted qualitative interviews with leaders in seven Veterans Health Administration medical centers that offered at least three CIH therapies to Veterans and were identified as early adopters of CIH therapies. Subjects: Participants included 12 executive leaders and 34 leaders of key clinical services, including primary care, mental health, physical medicine and rehabilitation, and pain. Measures: We used a thematic analysis to examine leaders' narratives of barriers and facilitators to implementation including their attitudes toward CIH therapies, perceptions of evidence, engagement in implementation, and decisions to provide concrete support for CIH therapies. Drawing from Greenhalgh's Diffusion of Innovation framework, we organized themes according to the influence of individual determinants, two levels of inner setting, and outer system context on CIH implementation. Results: Leaders' decisions to provide or withhold support were driven by considerations across multiple levels including (1) individual attitudes/knowledge, perceptions of evidence, and personal experiences; (2) interpersonal interactions with trusted brokers, patients, and loved ones/colleagues/staff; (3) organizational concerns surrounding relative priorities, local resources, and metrics/quality/safety; and (4) system-level policy, bureaucracy, and interorganizational networks. These considerations interacted across levels, with components at organizational and system levels sometimes prevailing over individual perceptions and experiences. Conclusions: Garnering leaders' support for CIH therapy implementation should address their considerations at multiple levels. Implementation strategies designed to shift individual attitudes alone may be insufficient for securing leaders' support without attention to broader organizational and system-level contextual issues.
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Affiliation(s)
- Rendelle E Bolton
- VA Bedford Healthcare System, Center for Healthcare Organization and Implementation Research, US Department of Veterans Affairs, Bedford, MA, USA
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Barbara G Bokhour
- VA Bedford Healthcare System, Center for Healthcare Organization and Implementation Research, US Department of Veterans Affairs, Bedford, MA, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Kelly Dvorin
- VA Bedford Healthcare System, Center for Healthcare Organization and Implementation Research, US Department of Veterans Affairs, Bedford, MA, USA
| | - Juliet Wu
- VA Bedford Healthcare System, Center for Healthcare Organization and Implementation Research, US Department of Veterans Affairs, Bedford, MA, USA
| | - Anashua Rani Elwy
- VA Bedford Healthcare System, Center for Healthcare Organization and Implementation Research, US Department of Veterans Affairs, Bedford, MA, USA
- Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Martin Charns
- VA Boston Healthcare System, Center for Healthcare Organization and Implementation Research, US Department of Veterans Affairs, Boston, MA, USA
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA, USA
| | - Stephanie L Taylor
- Greater Los Angeles VA Medical Center, HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, US Department of Veterans Affairs, Los Angeles, CA, USA
- Department of Medicine and University of California Los Angeles, Los Angeles, CA, USA
- Department of Health Policy and Management, University of California Los Angeles, Los Angeles, CA, USA
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Niemtzow R, Baxter J, Gallagher RM, Pock A, Calabria K, Drake D, Galloway K, Walter J, Petri R, Piazza T, Burns S, Hofmann L, Biery J, Buckenmaier C. Building Capacity for Complementary and Integrative Medicine Through a Large, Cross-Agency, Acupuncture Training Program: Lessons Learned from a Military Health System and Veterans Health Administration Joint Initiative Project. Mil Med 2018; 183:e486-e493. [DOI: 10.1093/milmed/usy028] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/06/2018] [Indexed: 11/15/2022] Open
Affiliation(s)
- Richard Niemtzow
- United States Air Force Acupuncture and Integrative Medical Center, Joint Base Andrews, 1060W Perimeter Road, Joint Base Andrews, MD
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD
| | - John Baxter
- Malcolm Grow Medical Clinics and Surgery Center, Joint Base Andrews, 1060W Perimeter Road, Joint Base Andrews, MD
| | - Rollin M Gallagher
- Penn Pain Medicine Center, University of Pennsylvania, 1840 South Street, Tuttleman Center, Philadelphia, PA
| | - Arnyce Pock
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD
| | - Kathryn Calabria
- Malcolm Grow Medical Clinics and Surgery Center, Joint Base Andrews, 1060W Perimeter Road, Joint Base Andrews, MD
| | - David Drake
- Hunger Holmes McGuire VA Medical Center, 1201 Broad Rock Boulevard, Richmond, VA
- Virginia Commonwealth University, 907 Floyd Avenue, Richmond, VA
| | - Kevin Galloway
- Defense and Veterans Center for Integrative Pain Management, 11300 Rockville Pike, Suite 709, Rockville, MD
| | - Joan Walter
- Samueli Institute, 1150 Kersey Road, Silver Spring, MD
| | - Richard Petri
- William Beaumont Army Medical Center, 5005 North Piedras Street, El Paso, TX
| | - Thomas Piazza
- Malcolm Grow Medical Clinics and Surgery Center, Joint Base Andrews, 1060W Perimeter Road, Joint Base Andrews, MD
| | - Stephen Burns
- Malcolm Grow Medical Clinics and Surgery Center, Joint Base Andrews, 1060W Perimeter Road, Joint Base Andrews, MD
| | - Lew Hofmann
- Malcolm Grow Medical Clinics and Surgery Center, Joint Base Andrews, 1060W Perimeter Road, Joint Base Andrews, MD
| | - John Biery
- Naval Branch Health Clinic, 450 Turner Street, Pensacola, FL
| | - Chester Buckenmaier
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD
- Defense and Veterans Center for Integrative Pain Management, 11300 Rockville Pike, Suite 709, Rockville, MD
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Fletcher CE, Mitchinson AR, Trumble E, Hinshaw DB, Dusek JA. Providers' and Administrators' Perceptions of Complementary and Integrative Health Practices Across the Veterans Health Administration. J Altern Complement Med 2016; 23:26-34. [PMID: 27925776 DOI: 10.1089/acm.2016.0236] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Use of complementary and integrative health (CIH) therapies is being promoted by the Veterans Health Administration (VA), but promotion may not equate to adoption. The purpose of this study was to explore whether perceptions regarding CIH at one VA medical center (VAMC) were similar to perceptions from a sample of other VAMCs. DESIGN This article reports a subset of qualitative findings from a mixed-methods study. SETTING/PARTICIPANTS Sites were recruited through a VA-wide CIH listserver. On the basis of site description (e.g., therapies offered, interest in CIH), sustained site interest, and geographic location, recorded interviews of 22 persons were conducted at 6 sites across the country. OUTCOME MEASURES Interviewees were asked the same questions as the single-site VAMC study respondents. RESULTS Variable access to CIH services across the VA created the need for workarounds. Multiple barriers (e.g., limited space and challenging credentialing) and facilitators (e.g., strong champion and high veteran demand) were cited. Respondents described nonpharmacologic pain control, the usefulness in treating mental health and/or post-traumatic stress disorder issues, and improvement of staff morale as additional reasons to promote CIH. Findings confirmed those from the earlier single-site VAMC phase of the study. Even the highest-performing sites reported struggling to meet veterans' demands for delivery of CIH. CONCLUSIONS Almost half of active-duty military personnel report the use of at least one type of CIH therapy. As active-duty personnel transition to veteran status, both their physical and mental healthcare needs can potentially benefit from CIH therapies. The VA must actively support local enthusiastic CIH proponents and receive congressional support if it is to actually meet its stated goal of providing personalized, proactive, patient-driven healthcare through the promotion of comprehensive CIH services to veterans.
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Affiliation(s)
| | | | | | | | - Jeffery A Dusek
- 2 Integrated Health Research Center , Penney George Institute for Health and Healing, Allina Health, Minneapolis, MN
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Tagharrobi Z, Mohammadkhan Kermanshahi S, Mohammadi E. Clinical nurses' perceptions of the opportunities for using complementary therapies in Iranian clinical settings: A qualitative study. Complement Ther Clin Pract 2016; 24:11-8. [DOI: 10.1016/j.ctcp.2016.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 04/18/2016] [Accepted: 04/19/2016] [Indexed: 11/30/2022]
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Griffin KH, Nate KC, Rivard RL, Christianson JB, Dusek JA. Referrals to integrative medicine in a tertiary hospital: findings from electronic health record data and qualitative interviews. BMJ Open 2016; 6:e012006. [PMID: 27456330 PMCID: PMC4964262 DOI: 10.1136/bmjopen-2016-012006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To examine patterns of, and decision-making processes, informing referrals for inpatient access to integrative medicine (IM) services at a large, acute care hospital. DESIGN Retrospective electronic health record review and structured qualitative interviews. SETTING A 630-bed tertiary care hospital with an IM service available to inpatients. PARTICIPANTS IM referrals of all inpatients aged ≥18 years between July 2012 and December 2014 were identified using the hospital's electronic health record. Fifteen physicians, 15 nurses and 7 administrators were interviewed to better understand roles and perspectives in referring patients for IM services. RESULTS In the study hospital, primary sources of referrals for IM services were the orthopaedic and neuroscience/spine service lines. While the largest absolute number of IM referrals was made for patients with lengths of stay of 3 days or fewer, a disproportionate number of total IM referrals was made for patients with long lengths of stay (≥10 days), compared with a smaller percentage of patients in the hospital with lengths of stay ≥10 days. Physicians and nurses were more likely to refer patients who displayed strong symptoms (eg, pain and anxiety) and/or did not respond to conventional therapies. IM referrals were predominantly nurse-initiated. A built-in delay in the time from referral initiation to service delivery discouraged referrals of some patients. CONCLUSIONS Conventional providers refer patients for IM services when these services are available in a tertiary hospital. Referral patterns are influenced by patient characteristics, operational features and provider perspectives. Nurses play a key role in the referral process. Overcoming cultural and knowledge differences between conventional and IM providers is likely to be a continuing challenge to providing IM in inpatient settings.
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Affiliation(s)
- Kristen H Griffin
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
| | - Kent C Nate
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Rachael L Rivard
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
| | - Jon B Christianson
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Jeffery A Dusek
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
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Anderson JG, Friesen MA, Swengros D, Herbst A, Mangione L. Examination of the Use of Healing Touch by Registered Nurses in the Acute Care Setting. J Holist Nurs 2016; 35:97-107. [PMID: 27149995 DOI: 10.1177/0898010116644834] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Acute care nursing is currently undergoing unprecedented change, with health systems becoming more open to nonpharmacological approaches to patient care. Healing Touch (HT) may be a valuable intervention for acute care patients. Research has shown that HT helps both the patient and the caregiver; however, no study to date has examined the impact that the education of nurses in and their use of HT have on daily care delivery in the acute care setting. The purpose of the current qualitative study was to examine the use of HT by registered nurses in the acute care setting during their delivery of patient care, as well as the impact of education in and use of HT on the nurses themselves. Five themes were identified: (1) use of HT techniques, processes, and sequence; (2) outcomes related to HT; (3) integration of HT into acute care nursing practice; (4) perceptions of HT, from skepticism to openness; and (5) transformation through HT. Education in HT and delivery of this modality by nurses in the acute care setting provide nurses with a transformative tool to improve patient outcomes.
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Green BN, Johnson CD, Daniels CJ, Napuli JG, Gliedt JA, Paris DJ. Integration of Chiropractic Services in Military and Veteran Health Care Facilities: A Systematic Review of the Literature. J Evid Based Complementary Altern Med 2016; 21:115-30. [PMID: 26677851 DOI: 10.1177/2156587215621461] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 11/16/2015] [Indexed: 02/06/2023] Open
Abstract
This literature review examined studies that described practice, utilization, and policy of chiropractic services within military and veteran health care environments. A systematic search of Medline, CINAHL, and Index to Chiropractic Literature was performed from inception through April 2015. Thirty articles met inclusion criteria. Studies reporting utilization and policy show that chiropractic services are successfully implemented in various military and veteran health care settings and that integration varies by facility. Doctors of chiropractic that are integrated within military and veteran health care facilities manage common neurological, musculoskeletal, and other conditions; severe injuries obtained in combat; complex cases; and cases that include psychosocial factors. Chiropractors collaboratively manage patients with other providers and focus on reducing morbidity for veterans and rehabilitating military service members to full duty status. Patient satisfaction with chiropractic services is high. Preliminary findings show that chiropractic management of common conditions shows significant improvement.
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Affiliation(s)
- Bart N Green
- Naval Medical Center San Diego, San Diego, CA, USA National University of Health Sciences, Lombard, IL, USA
| | | | | | - Jason G Napuli
- National University of Health Sciences, Lombard, IL, USA Bay Pines VA Healthcare System, Bay Pines, FL, USA New York Chiropractic College, Seneca Falls, NY, USA
| | | | - David J Paris
- VA Northern California Health Care System, Redding, CA, USA Palmer College of Chiropractic, Davenport, IA, USA
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Schuman D. Veterans' Experiences using Complementary and Alternative Medicine for Posttraumatic Stress: A Qualitative Interpretive Meta-Synthesis. SOCIAL WORK IN PUBLIC HEALTH 2016; 31:83-97. [PMID: 26799661 DOI: 10.1080/19371918.2015.1087915] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Combat Veterans struggling with combat-related post(*)traumatic stress disorder and subthreshold symptoms often look outside the conventional behavioral health care system for treatment because standard care has not met their needs. This study utilized a qualitative interpretive metasynthesis to describe the lived experience of combat Veterans seeking complementary and alternative health therapies for posttraumatic stress symptoms. This research aimed to understand what attracts these Veterans to complementary and alternative medicine techniques and how they benefit from their experiences with nonconventional therapies. Findings suggest the need for further research into increasing access and eliminating disparities for Veterans seeking more integrative care.
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Affiliation(s)
- Donna Schuman
- a School of Social Work, The University of Texas at Arlington , Arlington , Texas , USA
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Fletcher CE, Mitchinson AR, Trumble EL, Hinshaw DB, Dusek JA. Perceptions of other integrative health therapies by Veterans with pain who are receiving massage. JOURNAL OF REHABILITATION RESEARCH AND DEVELOPMENT 2016; 53:117-26. [PMID: 27004453 PMCID: PMC4829362 DOI: 10.1682/jrrd.2015.01.0015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 09/15/2015] [Indexed: 11/05/2022]
Abstract
Veterans are increasingly using complementary and integrative health (CIH) therapies to manage chronic pain and other troubling symptoms that significantly impair health and quality of life. The Department of Veterans Affairs (VA) is exploring ways to meet the demand for access to CIH, but little is known about Veterans' perceptions of the VA's efforts. To address this knowledge gap, we conducted interviews of 15 inpatients, 8 receiving palliative care, and 15 outpatients receiving CIH in the VA. Pain was the precipitating factor in all participants' experience. Participants were asked about their experience in the VA and their opinions about which therapies would most benefit other Veterans. Participants reported that massage was well-received and resulted in decreased pain, increased mobility, and decreased opioid use. Major challenges were the high ratio of patients to CIH providers, the difficulty in receiving CIH from fee-based CIH providers outside of the VA, cost issues, and the role of administrative decisions in the uneven deployment of CIH across the VA. If the VA is to meet its goal of offering personalized, proactive, patient-centered care nationwide then it must receive support from Congress while considering Veterans' goals and concerns to ensure that the expanded provision of CIH improves outcomes.
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Affiliation(s)
- Carol Elizabeth Fletcher
- Department of Research, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI
| | - Allison R. Mitchinson
- Department of Medicine, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI
| | - Erika L. Trumble
- Department of Research, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI
| | - Daniel B. Hinshaw
- Department of Palliative Care, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI
| | - Jeffery A. Dusek
- Abbott Northwestern Hospital, Penney George Institute, Minneapolis, MN
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Practitioner Perspectives on Delivering Integrative Medicine in a Large, Acute Care Hospital. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:394040. [PMID: 26693242 PMCID: PMC4674616 DOI: 10.1155/2015/394040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/12/2015] [Indexed: 02/08/2023]
Abstract
Background. We describe the process and challenges of delivering integrative medicine (IM) at a large, acute care hospital, from the perspectives of IM practitioners. To date, minimal literature that addresses the delivery of IM care in an inpatient setting from this perspective exists. Methods. Fifteen IM practitioners were interviewed about their experience delivering IM services at Abbott Northwestern Hospital (ANW), a 630-bed tertiary care hospital. Themes were drawn from codes developed through analysis of the data. Results. Analysis of interview transcripts highlighted challenges of ensuring efficient use of IM practitioner resources across a large hospital, the IM practitioner role in affecting patient experiences, and the ways practitioners navigated differences in IM and conventional medicine cultures in an inpatient setting. Conclusions. IM practitioners favorably viewed their role in patient care, but this work existed within the context of challenges related to balancing supply and demand for services and to integrating an IM program into the established culture of a large hospital. Hospitals planning IM programs should carefully assess the supply and demand dynamics of offering IM in a hospital, advocate for the unique IM practitioner role in patient care, and actively support integration of conventional and complementary approaches.
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Juberg M, Jerger KK, Allen KD, Dmitrieva NO, Keever T, Perlman AI. Pilot study of massage in veterans with knee osteoarthritis. J Altern Complement Med 2015; 21:333-8. [PMID: 25966332 DOI: 10.1089/acm.2014.0254] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To (1) assess the feasibility and acceptability of Swedish massage among Department of Veterans Affairs (VA) health care users with knee osteoarthritis (OA) and (2) collect preliminary data on efficacy of Swedish massage in this patient group. DESIGN Experimental pilot study. SETTING Duke Integrative Medicine clinic and VA Medical Center, Durham, North Carolina. PATIENTS Twenty-five veterans with symptomatic knee OA. INTERVENTIONS Eight weekly 1-hour sessions of full-body Swedish massage. OUTCOME MEASURES Primary: Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and global pain (Visual Analog Scale [VAS]). Secondary: National Institutes of Health Patient Reported Outcomes Measurement Information System-Pain Interference Questionnaire 6b (PROMIS-PI 6b), 12-Item Short-Form Health Survey (SF-12 v1) and the EuroQol health status index (EQ-5D-5L), knee range of motion (ROM), and time to walk 50 feet. RESULTS Study feasibility was established by a 92% retention rate with 99% of massage visits and 100% of research visits completed. Results showed significant improvements in self-reported OA-related pain, stiffness and function (30% improvement in Global WOMAC scores; p=0.001) and knee pain over the past 7 days (36% improvement in VAS score; p<0.001). PROMIS-PI, EQ-5D-5L, and physical composite score of the SF-12 also significantly improved (p<0.01 for all), while the mental composite score of the SF-12 and knee ROM showed trends toward significant improvement. Time to walk 50 feet did not significantly improve. CONCLUSIONS Results of this pilot study support the feasibility and acceptability of Swedish massage among VA health care users as well as preliminary data suggesting its efficacy for reducing pain due to knee OA. If results are confirmed in a larger randomized trial, massage could be an important component of regular care for these patients.
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Affiliation(s)
- Michael Juberg
- 1Duke Integrative Medicine, Duke University Medical Center, Durham, NC
| | - Kristin K Jerger
- 1Duke Integrative Medicine, Duke University Medical Center, Durham, NC
| | - Kelli D Allen
- 2Department of Medicine, Division of Rheumatology, and Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.,3Health Services Research and Development Service, Durham Veterans Affairs Medical Center, Durham, NC
| | - Natalia O Dmitrieva
- 4Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Teresa Keever
- 1Duke Integrative Medicine, Duke University Medical Center, Durham, NC
| | - Adam I Perlman
- 1Duke Integrative Medicine, Duke University Medical Center, Durham, NC
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