Complementary and alternative therapies (CAT) in academic programs and nursing practice: Is more education is needed?

Prevalence of Traditional, Complementary, and Integrative Medicine Training, Its Different Practices, and Associated Sociodemographic Factors: A Study with Brazilian Nurses

Objective: To analyze the prevalence of nurses trained in traditional, complementary, and integrative medicine (TCIM), the different practices, and associated sociodemographic factors. Methods: This quantitative, cross-sectional study was implemented online in Brazil from June 2021 to January 2022 among 1,154 nurses using a questionnaire comprising open- and closed-ended questions. The Stata IC software, version 16.0, was used in the statistical analysis. The dependent variable was training in TCIM, and the prevalence of different TCIM practices was also investigated. The independent variables included sociodemographic information. Descriptive and inferential statistical tests were performed. This study was approved by the Institutional Review Board at the Federal University of Rio Grande do Sul and was developed according to the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) initiative. Results: The prevalence of TCIM training was 43.50%. Most participants were women (89.49%), Brazilian (99.65%), aged 39.71 on average (SD = 10.37), and had an income of up to four times the minimum wage (52.43%). The prevalence of professionals implementing TCIM in their practice among those with training was 64.60%. They reported working up to 2 h a week (36.96%) in primary health care settings (33.40%) and providing individual consultations (78.0%). After the adjusted analysis, TCIM training appeared significantly associated with age (p < 0.001), the region where the workplace is located (p < 0.001), and income (p < 0.001). Auriculotherapy (59.96%) stood out among the TCIM practices in which nurses were trained. Conclusions: Almost half of the nurses working in Brazil have training in TCIM and sociodemographic factors such as age, region of work, and income are significantly associated with this training.

Iranian Nurses' Knowledge, Attitude, and Practice of Complementary Therapies for Pain Management

INTRODUCTION

Complementary therapies (CTs) are being increasingly used by people with health issues and recommended by their health care providers. Although there are numerous studies available that address nurses' knowledge and attitudes regarding pain management, there are few that include the use of CTs by nurses in Iran. Therefore, this study was conducted in selected areas of Iran to assess nurses' knowledge, attitudes, and current practice regarding the use of CTs.

METHODS

A cross-sectional study was conducted on a random sample of 850 nurses from various regions of Iran between 2020 and 2022. A questionnaire was used that consisted of seven items addressing demographic characteristics, 15 items to assess knowledge, 25 items to address attitude and 22 items to address the practice of CTs in the area of pain relief. Descriptive and inferential statistics were used to analyze the data.

RESULTS

The participants' mean age was 33.26 ± 7.24 years. Most nurses (89.9%) had not received formal education on CTs. However, 78.6% of nurses reported personal use of CTs, and 62.3% reported using or recommending it to their patients at least once. Regarding the knowledge of CTs, nurses scored 5.81 on a 15 points scale indicating a considerable gap in their knowledge of CTs. Regarding attitudes toward the specific therapies, nurses believed that massage is highly (46.4%) or moderately (31.6%) effective in pain relief. Regarding effectiveness, nurses ranked the following as the top four CTs: music therapy, humor, hydrotherapy, and use of cold / heat.

CONCLUSION

The nurses in this study scored low on knowledge of CTs, meaning that they knew little about CTs. However, they showed a favorable attitude toward CTs and a majority of them had a history of personal use, and recommending some types of CTs to their patients for pain relief. Therefore, it is crucial for nurse managers to provide opportunities to acquire knowledge of CTs. Moreover, nurse educators should advocate for updating nursing curricula to include CTs as an essential component of pain management education.

Traditional and complementary treatment use in wound care: A descriptive study in Turkey

OBJECTIVES

This study was conducted to determine the use of traditional and complementary treatment in wound care and the opinions of individuals in Turkey.

METHODS

The descriptive study was completed with 536 adult individuals. The research data were collected using the "Personal Information Form", "Questionnaire on Traditional and Complementary Treatment Methods Used in Wound Care" and "Questionnaire on Opinions Regarding the Use of Traditional and Complementary Treatment in Wound Care" prepared in line with the literature. Descriptive statistics were used in the evaluation of the data.

RESULTS

When a wound occurs on the body, 31 % of the participants reported that they first applied traditional and complementary treatment. It was determined that the participants experienced surgical wounds (55.7 %) and burn wounds (46.1 %) the most. The first three biological-based approaches used by individuals in wound care were hypericum perforatum (60.8 %), aloe vera (39.6 %), and honey (36.8 %). In other approaches used by individuals in wound care, the first three methods are prayer (54.1 %), vaseline application (47.1 %), and massage (37.8 %), respectively. In addition, 64.7 % of the individuals reported that they thought these methods were useful in wound care, 60.1 % reported that they accelerated healing, and 46.8 % reported that they prevented scarring.

CONCLUSION

It was determined that individuals commonly used various traditional and complementary treatment methods in wound care. It is also noteworthy that these methods are highly accepted by individuals. Therefore, it is important for nurses, who play a key role in wound care, to know the methods commonly used in society and to follow the developments in this field.

Complementary and Alternative Therapies (CATs) in Nursing Education in Spanish Universities

BACKGROUND

The use of complementary therapies in the general population is increasing, so it is necessary to understand the training that health professionals receive in this type of therapy in their training plans, as they are often the primary source of information for patients. Our aim was to investigate Spanish universities that offer subjects on complementary therapies in their nursing degree programs.

METHODS

This study is an observational, descriptive, cross-sectional study. For this purpose, we used a document published on the website of the Ministry of Universities as the working document. Additionally, a literature search was conducted up to September 2023 in the PubMed database, along with reverse searches.

RESULTS

Out of a total of 62 universities, only 16 (29%) offer a subject related to this type of therapy, 27.5% (11) are public universities and 22.7% (5) are private universities, most of them being optional subjects.

CONCLUSIONS

The training content on complementary care in nursing degree programs in Spanish universities is scarce, highlighting the potential benefit of expanding and promoting it, in line with the recommendations of the World Health Organization.

Why it's time to unite science-based and alternative care in holistic nursing

Sally Star, Holistic Health Practitioner and Nurse with specialisms in specialist community public health nursing, educator, and Founder Member, Holistic Nurses UK (www.linkedin.com/in/sallystaratbioelectriclife).

Effectiveness of flipped teaching on the knowledge and self-efficacy of nursing personnel in non-pharmacological pain management-aromatherapy: a quasi-experiment

BACKGROUND

Aromatherapy is effective in treating pain; however, aromatherapy is not offered in formal nursing education in Taiwan. This study designed aromatherapy training courses for nurses using the flipped teaching approach and explored the effectiveness of the method, which can serve as a reference for future aromatherapy courses.

METHODS

A quasi-experimental design and convenience sampling were adopted. The participants were nurses who had been employed for over one year in two hospitals in Taiwan. Forty nurses were included in the experimental and control groups. The intervention of this study was performed in February 2020. Nurses in the control group received one hour of introduction to the use of aromatherapy in pain management. This class was delivered using the traditional teaching method, during which a researcher served as the lecturer. Nurses in the experimental group received a 2.5-h flipped teaching course on aromatherapy. Two weeks before classroom activities, the nurses in the experimental group watched a 30-min aromatherapy concept video on an e-learning teaching platform. Thereafter, the nurses participated in two hours of classroom teaching in both groups. The course design included group discussions, mind mapping, case discussion, practice with essential oils, and do-it-yourself essential oil preparation.

RESULTS

Pre- and post-test knowledge and self-efficacy in aromatherapy were assessed. There were no significant differences in the pre-test knowledge and self-efficacy scores between the two groups. The test was analyzed using a generalized estimating equation. Post-test knowledge and self-efficacy results showed that the change in scores in the experimental group was significantly better than that in the control group, indicating that flipped teaching improved the participants' knowledge and self-efficacy in aromatherapy.

CONCLUSIONS

This study confirmed that flipped teaching was effective in helping nursing personnel learn aromatherapy. Implementation of aromatherapy by nurses in clinical practice and its impact on patient care should be further assessed.

Iranian nurses' knowledge and attitude toward complementary and alternative medicines: Is there any relation with quality of nursing care?

BACKGROUND

Nurses play an important role in advising and guiding patients on effective treatments, and in this situation, it is better to be aware of complementary and alternative medicine (CAM) as well as the effects and side effects of different procedures. In addition, the quality of nursing care is directly related to the nurse's knowledge of the different treatments and preventions of different diseases and conditions. The present study aimed to investigate Iranian nurses' knowledge and attitude toward complementary and alternative medicines (CAMs) as well as their correlation with the quality of patient care.

MATERIALS AND METHODS

This cross-sectional study included 267 clinical nurses from three hospitals in southern Iran. The participants were recruited using convenience sampling methods in 2020-2021. A demographic questionnaire, knowledge and attitude toward CAM questionnaires, and the Quality Patient Care Scale were used to collect data.

RESULTS

The mean score of CAM knowledge was 26.51, which was less than the questionnaire midpoint of 39. The mean score of attitudes toward CAM was 63.84, which was more than the questionnaire midpoint of 57. The mean score of the quality of patient care was 197.80, which was more than the questionnaire midpoint of 130. There was no significant correlation between knowledge about CAM, quality of patient care, and its dimensions. In addition, there was no significant correlation between attitudes toward CAM, quality of patient care, and its dimensions (P > 0.05).

CONCLUSION

The results of the present study showed that nurses' attitudes toward the use of CAM are positive and can be a sign of their readiness to use and further integrate clinically approved CAM in patient nursing care. Due to the role of nurses in patient care and treatment, there is a need to increase nurses' knowledge of CAM, and its training should be included in the nursing curriculum. More studies are needed to identify nurses' knowledge and attitudes toward CAM and its impact on the quality of nursing care.

Reasons Office-Based Physicians in the United States Recommend Common Complementary Health Approaches to Patients: An Exploratory Study Using a National Survey

Objective: To examine the reasons why office-based physicians do or do not recommend four selected complementary health approaches to their patients in the context of the Andersen Behavioral Model. Design: Descriptive estimates of physician-level data from the 2012 National Ambulatory Medical Care Survey (NAMCS) Physician Induction Interview, a nationally representative survey of office-based physicians (N = 5622, weighted response rate = 59.7%). Setting/Location: The United States. Outcome measures: Reasons for the recommendation or lack thereof to patients for: herbs and other non-vitamin supplements, chiropractic/osteopathic manipulation, acupuncture, and mind-body therapies (including meditation, guided imagery, and progressive relaxation). Differences by physician sex and medical specialty were described. Results: For each of the four complementary health approaches, more than half of the physicians who made recommendations indicated that they were influenced by scientific evidence in peer-reviewed journals (ranging from 52.0% for chiropractic/osteopathic manipulation [95% confidence interval, CI = 47.6-56.3] to 71.3% for herbs and other non-vitamin supplements [95% CI = 66.9-75.4]). More than 60% of all physicians recommended each of the four complementary health approaches because of patient requests. A higher percentage of female physicians reported evidence in peer-reviewed journals as a rationale for recommending herbs and non-vitamin supplements or chiropractic/osteopathic manipulation when compared with male physicians (herbs and non-vitamin supplements: 78.8% [95% CI = 72.4-84.3] vs. 66.6% [95% CI = 60.8-72.2]; chiropractic/osteopathic manipulation: 62.3% [95% CI = 54.7-69.4] vs. 47.5% [95% CI = 42.3-52.7]). For each of the four complementary health approaches, a lack of perceived benefit was the most frequently reported reason by both sexes for not recommending. Lack of information sources was reported more often by female versus male physicians as a reason to not recommend herbs and non-vitamin supplements (31.4% [95% CI = 26.8-36.3] vs. 23.4% [95% CI = 21.0-25.9]). Conclusions: There are limited nationally representative data on the reasons as to why office-based physicians decide to recommend complementary health approaches to patients. Developing a more nuanced understanding of influencing factors in physicians' decision making regarding complementary health approaches may better inform researchers and educators, and aid physicians in making evidence-based recommendations for patients.

The effect of a virtual simulation-based educational application on nursing students' belief and self-efficacy in communicating with patients about complementary and alternative medicine

BACKGROUND

Simulation-based learning that focuses on the development and assessment of communication and counseling skills can help nursing students achieve better skill performance and gain self-confidence with decision-making ability. It is unknown whether virtual simulation as an instructional design significantly improves educational outcomes than a traditional lecture with low-fidelity simulation in students.

OBJECTIVES

The aim was to explore the effect of a virtual simulation-based educational smartphone application on nursing students' beliefs and self-efficacy in communicating with patients about complementary and alternative medicine (CAM) use.

DESIGN

A quasi-experimental study with pretest-posttest nonequivalent control group design.

SETTINGS AND PARTICIPANTS

A total of 101 nursing students, who were in their second or third-year nursing program at a Southern Taiwan university volunteered to participate in the academic year 2020-2021. Participants were assigned to an experimental or control group in an elective course.

METHODS

All participants received a 4-hour lecture that included an in-class lecture with low-fidelity simulation (paper-based scenarios) about the risk-benefit assessment of a patient's CAM use. The experimental group received a series of 13 virtual simulation exercises with clinical scenarios by means of a smartphone application. Data from belief and self-efficacy scales were collected at the beginning and end of the course from September 2020 to February 2021. Descriptive and inferential statistics were analyzed using the IBM® SPSS® version 23.0.

RESULTS

Although both groups significantly improved their belief and self-efficacy scale scores, the experimental group had significant differences in overall self-efficacy in communicating with patients about CAM use compared with the control group, specifically the CAM perceptions and self-confidence scores.

CONCLUSIONS

Although both in-class and virtual simulation improved nursing students' belief and self-efficacy, the virtual simulation-based educational app is effective as an adjunct learning tool in significantly increasing nursing students' self-efficacy in communicating with patients about CAM use to help minimize their risks.