Purpose: Complementary and alternative medicine (CAM) includes many forms of therapy, such as pet therapy or Reiki. These therapies can be used as an adjunct or alternative treatment to Western medicines which are more commonly used in the United States (US) (Leppin, James, Yost, & Tilburt, 2014). CAM is broadly defined as non-Western medicine that provides a benefit to patients with minimal adverse effects (Leppin, et. al, 2014). CAMs have been effective in reducing chronic, acute, and cancer-related pain, as well as other forms of pain (Trail-Mahan, Mao, & Bawel-Brinkley, 2013). Nurses are integral in managing pain and monitoring patients for adverse effects and play a key role in promoting the use of adjunctive therapies such as CAMs. While the evidence, both internationally and in the US, supports that most nurses endorse the use of CAMs (Chu & Wallis, 2007; Lorenc, Blair, & Robinson, 2014; Rojas-Cooley & Grant, 2009; Tracy et al., 2005; Trail-Mahan et. al, 2013), these therapies continue to be underutilized. Since there has been no significant change in CAM utilization within the last decade, barriers to integration must be assessed (Chang & Chang, 2015). Determining nurses' knowledge, attitudes and beliefs about CAMs is necessary for the successful implementation and utilization of these therapies for patient benefit. The purposes of this study were to examine nurses' knowledge, attitudes, and beliefs about medicines in general, and Complementary and Alternative Medicines (CAMs) specifically, their relationships to CAM referrals for pain management, and identify predictors for referrals.
Methods: This descriptive, correlational study used an online Qualtrics survey to collect data from direct care nurses at a large medical center in the southeastern United States. The online survey consisted of the Complementary and Alternative Medicines and Beliefs Inventory (CAMBI), the Beliefs about Medicine Questionnaire (BMQ), and four open-ended questions. Referral data was obtained from the Information Management Department at this medical center.
Results: Among 218 nurses who completed the survey (15.12% response rate), a majority (85%) supported CAM use, but only 32% reported utilizing CAMs with patients. Beliefs about CAMs did not predict referral rate (B= .012, Wald χ2 (1, N=218) = 0.265, p= 0.606). Medical surgical, emergency department (ED), and perioperative nurses scored higher on their CAMBI total score and were more likely to refer for CAM therapies when compared to intensive care unit (ICU) nurses.
Conclusion: Beliefs about CAMs were not related to referrals for CAM therapies. Nurses encountered extrinsic barriers to CAM utilization, such as a lack of education. This study suggests the need for further education on the nurse’s role in CAM utilization, and the process of referrals and role of CAM specialists. Understanding the link between nurses’ knowledge, attitudes, and treatment beliefs and their relationship to CAM utilization provides direction for future educational interventions.
