Complementary Medicine and the Role of Oncology Nurses in an Acute Care Hospital: The Gap Between Attitudes and Practice

Perception, attitudes, knowledge of using complementary and alternative medicine for cancer patients among healthcare professionals: A mixed-methods systematic review

BACKGROUND

With the rapid increase in the prevalence of cancer worldwide, the utilization of complementary and alternative medicine (CAM) has increased among cancer patients. This review aimed to understand the perception, attitudes, and knowledge of healthcare professionals toward using CAM for cancer patients.

METHODS

A mixed-methods systematic review was undertaken in four databases. Inclusion criteria were primary studies reporting perception, attitudes, and knowledge of healthcare professionals for using CAM for cancer patients were eligible. A mixed-methods convergent synthesis was carried out, and the findings were subjected to a GRADE-CERQual assessment of confidence.

RESULTS

Forty-two studies were chosen. The majority of the studies were quantitative and had less than 100 participants. Most publications were from European countries, and oncology was the highest among the specialties. The review found the following themes: feasibility of having negative adverse effects, low expectations of using CAM among HCPs, potential positive effects of using CAM, specific CAM training may be helpful, no concrete regulations to promote CAM practice, and poor physician-patient communication.

CONCLUSIONS

Nurses had more positive views than other professions; oncologists were concerned regarding herb-drug interactions; integration of CAM into the healthcare system was favorable; HCPs felt the need to participate in specific CAM training; and HCPs agreed that CAM education should be provided more regularly. Future studies should explore the studies views of cancer patients and details of in-depth evidence of CAM in oncology settings.

The impact of clinical nurses' perception of hospital ethical climates on their organizational citizenship behavior: A cross-sectional questionnaire survey

BACKGROUND

As the main force in the development of healthcare, nurses have the longest contact time with patients in clinical practice, their perception of the hospital ethical climates affecting nurses' attitudes and related ethical issues. hospital ethical climates have become an essential environmental factor for nurses to make and implement ethical decisions.

OBJECTIVE

This study aims to investigate the current status of nurses' perception of the hospital ethical climates and the nurses' organizational citizenship behavior, exploring the impact of the nurse's perception of the hospital ethical climates on the nurses' organizational citizenship behavior.

METHODS

A cross-sectional survey adopted, random sampling and cluster sampling were used to select 624 nurses from August 2019 to February 2020. The hospital ethical climate scale and organizational citizenship behavior scale were used as the questionnaire. The data was analyzed by SPSS 21.0 software. On-the-job clinical nurses who had been employed in the hospital for more than 1 year were eligible. Nurses who were administratively punished by the hospital or health administrative authorities were excluded.

RESULTS

The average scores of hospital ethical climates were 4.30 (standard deviation: 0.44), with organizational citizenship behavior 4.42 (standard deviation: 0.42). The correlation coefficient between nurses' perception of hospital ethical climates and organizational citizenship behavior was 0.359 (P < .01). Nurses' perception of the relationship between managers, patients and nurses could explain 23.1% of altruistic toward colleagues; Nurses' perception of the relationship between nurses, hospital, doctors could explain 21.2% of organizational identification. Nurses' perception of the relationship between hospital, nurses and doctors could explain 12.3% of conscientiousness; Nurses' perception of the relationship between managers, doctors could explain 7.6% of interpersonal harmony. Nurses' perception of the relationship between managers, nurses and doctors could explain 6.6% of protection company resources.

CONCLUSION

There is a correlation between nurses' perceptions of hospital ethical climate and organizational citizenship behavior, nurses' perceptions of hospital ethical climate influencing nurses' organizational citizenship behavior in different ways. Managers should focus on the changes of nurses' perception of hospital ethical climates, to promote the nurse to make more beneficial behavior to the organization.

A pre-post evaluation of oncology healthcare providers' knowledge, attitudes, and practices following the implementation of a complementary medicine practice guideline

PURPOSE

Complementary medicine (CM) use is prevalent among cancer patients, yet it is often not assessed by oncology healthcare providers (HCPs). The purpose of this study was to evaluate oncology HCPs' knowledge, attitudes, and practices surrounding CM use before and after the implementation of a practice guideline focusing on standardizing assessment and documentation of CM.

METHODS

Oncology HCPs across a provincial cancer agency were invited to participate in the study. The implementation strategy included an initial education session for HCPs and standardized CM assessment forms. Pre-post surveys assessing knowledge, attitudes, and practices related to CM were completed by HCPs prior to attending the education session and following the 4-month implementation period. Paired t-tests were conducted to determine differences between baseline and follow-up surveys.

RESULTS

A total of 31 oncology HCPs completed both baseline and follow-up surveys, with over 3700 patient CM assessment forms being completed during the 4-month study period. At the end of the study, HCPs reported greater CM knowledge (p < 0.001), readiness to support cancer patients' CM decisions (p = 0.002), and willingness to consult with another HCP about CM (p = 0.004). No significant change in HCPs' reported attitudes towards CM, or other clinical practices related to CM were observed.

CONCLUSION

Implementing a practice guideline, including a CM education session and a standardized assessment form, was found to improve oncology HCPs' self-reported CM knowledge and readiness to answer cancer patients' questions about CM. The findings provide support for future knowledge translation research aimed at standardizing how CM is addressed within cancer care settings.

The effect of education on nursing personnel's knowledge and attitudes regarding the use of integrative care techniques with hospice and palliative care patients

PURPOSE

To examine the effect of education on nursing personnel's knowledge and attitudes regarding the use of hand massage, breathing techniques, and essential oils with hospice and palliative care patients.

BACKGROUND

Unrelieved, end of life pain is common among hospitalized patients on hospice and palliative care units. Integrative care techniques such as hand massage, breathing techniques, and essential oils can be available to use with these individuals. Nursing personnel are often unaware of other techniques that are not a traditional pharmacology approach to pain.

METHODS

A quasi-experiment was conducted to evaluate the effect of an educational intervention on nursing personnel's knowledge and attitudes regarding the use of three integrative care techniques (hand massage, breathing techniques, and essential oils) with hospice and palliative care patients in an acute care setting. Data on knowledge and attitudes were collected pre- and postintervention.

RESULTS

Following the intervention, improvements in nursing personnel's attitudes and knowledge toward the use of the three techniques were found.

CONCLUSION

Results of this study suggest that education of nursing personnel may positively influence knowledge and attitudes toward providing hand massage, breathing techniques, and essential oil for end of life patients.

Collaborative networks and thematic trends of research on the application of complementary and alternative medicine in cancer patients: A bibliometric analysis

BACKGROUND

and purpose: Complementary and Alternative Medicine(CAM) has been greatly used in cancer patients. This research aimed to explore the research priorities of CAM for cancer patient's treatment.

METHODS

Web of Science(WoS), HistCite, BibExcel, GunnMap and VOSviewer were used to extract and visualize information.

RESULTS

2768 articles published in 789 journals were indexed in the WoS from 1989 to 2018. The USA(n = 1009) and Technion-Israel Institute Technology(n = 58) were the most prolific country and institution, respectively. Keywords co-occurrence analysis indicated that the research hotspots around the world formed five clusters, so did the author co-citation analysis. The research priorities of the top-five countries, the top-three prolific authors and the co-citation core authors were also discussed, which reveals the differences and similarities among them.

CONCLUSION

This study delineates a framework for better understanding the situational use of CAM in cancer patients, which could help health care workers to prioritize and organize future research.

Health Literacy: What Do You Know?

Part of my clinical role involves educating and informing patients about the risks and benefits of the various treatment options related to prostate cancer. Like many bed- or chairside nurses, I spend a lot of time talking and listening to my patients. I am sometimes surprised when I get a call from a patient who seemingly did not hear or understand something that I told him or her. I know I told the patient, and I think I am a good educator, so why the confusion? The answer is, in part, simple-health literacy (or the lack thereof).
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