The Attitudes of Health Care Workers in the Use of Alternative Medical Care in Patient Settings - Essay Example

Tracy MF, Lindquist R, Watanuki S, 2003 described a study of 348 critical care registered nurses working in critical ICUs at two tertiary-level hospitals. The aim was to determine the nurses’ knowledge, attitudes, and use of complementary/alternative therapies (CAT). Eighty-eight percent of those surveyed were open or eager to use CAT, and 60% reported moderate or greater desire to use CAT. This was in spite of barriers like lack of knowledge, time, and training. The level of knowledge was highest for diet, exercise, massage, prayer, and music therapy. From this, it was concluded that “critical care nurses are open to CAT use and many use them in their own practice” (Tracy MF, Lindquist R, Watanuki S, 2003). Increasing the scientific base and enhancing knowledge to promote evidence-based incorporation of CAT in practice is recommended. However, in primary care, the use of complementary and alternative medicine (CAM) is still not widespread.

A study was therefore conducted to assess primary care health workers’ perceptions of need and of some ways to integrate CAM in primary care (Van Haselen RA, Reiber U, Nickel I, 2004).

Eighty-three percent had previously referred (or influenced referral) for CAM treatments. Sixty-eight percent of referrals were after patients' request, 58% after conventional treatments failed and evidence (36%). The majority (82%) felt that CAM therapies should be provided by health professionals trained in CAM or doctors (66%). 70% felt that the integration of CAM could lead to cost savings, but 55%, felt it could also lead to cost increases. Acupuncture (41%) had the greatest interest, homeopathy (30%) and therapeutic massage/aromatherapy (26%). From this study, it was concluded that there is considerable interest in CAM among primary care professionals, and many are already referring or suggesting referral, and many were in favor of integrating CAM in mainstream primary care. The need of the hour is further education or information of primary care health professionals about CAM.

Sohn PM, Loveland Cook CA, 2002, conducted a study to find the level and source of nurse practitioner knowledge about complementary alternative health care practices, as well as their referral practices. Eighty-three percent recommended complementary alternative treatments to their patients, the most frequent treatments being massage therapy, chiropractic care, acupuncture or acupressure, nutritional therapy and herbal treatment. However, an overwhelming majority of 60% had to rely on their personal experiences, and journals for this knowledge, whereas only 24% reported that formal nurse practitioner education was a source of knowledge.

It was concluded that although the majority of nurse practitioners recommend the use of complementary alternative therapies to patients, their source of knowledge is not derived from formal professional education. Therefore, complementary alternative therapies need to be incorporated in formal academic programs, professional conferences and in-service education opportunities. (Sohn PM, Loveland Cook CA, 2002.)

Specific innovative approaches

Therapeutic touch (TT), is one innovative CAM approach and is proposed as an adjunct to pharmacological intervention. “Therapeutic touch is a non-invasive, holistic practice that promotes comfort, relaxation, stress reduction and heating. Clinical studies suggest that TT prolongs the interval between analgesics” (Apostle-Mitchell M, MacDonald G, 1997). Since many recent publications have questioned the efficacy of therapeutic touch (TT), a study was performed to document the physiologic and psychodynamic responses during and following the administration of TT (Cox C, Hayes J, 1999). Significant correlations of psychodynamic responses were demonstrated, and it was concluded that it is possible for critically ill patients to experience periods of relaxation and sleep in an otherwise stressful environment and that TT enhances relaxation and sleep in such patients.

Data from a continuous quality improvement (CQI) clinical study, which is the largest published sample size of therapeutic touch (TT) to date, suggests, “TT, when provided in the clinical setting, promotes comfort, calmness, and well-being among hospitalized patients”(Newshan G, Schuller-Civitella D, 2003). The patients were also reportedly highly satisfied with TT. In order to evaluate the TT program, the Patient Satisfaction Survey and TT Performance Improvement Tool were developed.
Research Utilization Implications


Many of the characteristics of such complementary therapies make it difficult or impossible to conduct randomized controlled trials. Practitioners have variable approaches with customized treatments, treatment combinations and outcomes, which is difficult to measure. (Marwick C, 2005).

The majority of nurse practitioners recommended complementary alternative treatments to their patients and were enthusiastic about the use of such treatments for their patients. But there is still a lack of formal recognition and integration of these therapies in their training.

As evidence about complementary medicine is gradually accumulating, it requires the incorporation of evidence-based practice.