Sigma Theta Tau International (STTI) convened the Global Advisory Panel on the Future of Nursing & Midwifery (GAPFON®), which presented a report including research strategies to address both global health and professional issues. The GAPFON® Report (2017) identified research needed to provide evidence of the contribution of nursing and midwifery to disease prevention and positive health outcomes regionally and globally. According to the World Health Organization (WHO), the use of complementary and alternative medicine (CAM) is on the rise in and key to improving the patient experience and population health. The National Center for Complementary and Integrative Health (NCCIH) within the US National Institute of Health (NIH) defines complementary medicine as non-mainstream, non-western practice used for health and wellness together with conventional medicine. Complementary care emphasizes a holistic, patient-focused approach to health and wellness including mental, emotional, functional, spiritual, social, and community aspects in treating the whole person (NCCIH, 2018). Complementary care services typically focus on dealing with stress, identifying fears, reframing hope, and regaining control. Such programs often move individuals toward a deeper understanding of life and enable those afflicted with serious illness and chronic health issues to find meaning in their lives when they most need it enhancing their quality of life (Dossey, 2016). The NCCIH’s (2016) strategic plan identifies three core complementary and integrative health research objectives including:
- Advance Fundamental Science and Methods Development through advancing the understanding of the mechanisms through which mind and body approaches affect health, resiliency, and well-being and developing new and improved research methods and tools for conducting rigorous studies of complementary health approaches and their integration into health care.
- Improve Care for Hard-to-Manage Symptoms through conducting research studies in “real world” clinical settings to test the safety and efficacy of complementary health approaches, including their integration into health care.
- Foster Health Promotion and Disease Prevention through investigating mechanisms of action of complementary and integrative health approaches in health resilience and practices that improve health and prevent disease across the lifespan in diverse populations.
The Institute of Medicine (IOM) report Living Well With Chronic Illness: A Call for Public Health Action describes immediate and precise actions that are needed to reduce the burden of chronic illness and argues for conducting outcome-oriented research and program evaluation on interventions used for chronic illnesses (2013). Many suffering from chronic illness combine conventional approaches to healing with a variety of complementary services, often creating unexpected synergistic effects. Research is needed to address the gap between studies focusing on the safety and efficacy of complementary services to the reported well-being of those who use them (Dossey, 2016). If the use of nontraditional practices is to be evaluated comprehensively, research focus needs to extend to multiple aspects of the healing experience, including how those receiving care perceive the results. What is often lacking is an understanding of the benefits of these practices and an evaluation of changes from the individual’s perspective at the level of the whole person (quality of life, well-being, functionality, and meaningfulness). To address this issue, Ritenbaugh et al. (2011) developed the Self- Assessment of Change (SAC) measure, a survey instrument designed to identify the extent of perceived personal changes following participation in complementary interventions. This instrument follows the NCCIH’s (2016) strategic plan objective number one and enables researchers to collect data on changes that are meaningful to patients.
Methods: The Self- Assessment of Change (SAC) measure was used as a survey instrument to assess perceived changes in quality-of-life measures related to participation in complementary services consisting of a variety of nontraditional therapies and programs at Pathways: A Health Crisis Resource Center. Pathways offers a variety of services, including one-to-one sessions using nontraditional healing therapies, support groups, educational classes, and practice groups such as yoga and meditation for those facing serious health challenges. These services are offered free of charge through community financial support using volunteer practitioners. People diagnosed with serious health challenges who self-selected Pathways services from 2007 through 2009 were surveyed and the resulting data were used to assess perceived changes participants ascribed to their experience with complementary services at Pathways.
Results: Quantitative data analysis was conducted using participant demographics together with participant ratings of items from the “Self-Assessment of Change” (SAC) measure developed at the University of Arizona, Tucson. Qualitative data analysis was conducted on written responses to an additional survey question: “To what extent has your participation at Pathways influenced your healing process?” Participants reported experiencing significant changes across all components of the SAC quantitative measure. Qualitative responses to the open-ended survey question identified perspectives on the culture of Pathways and a shift in participants’ perceptions of well-being based on their experience of Pathways services.
Conclusion: These findings supported participation in services provided by the Pathways organization revealing that active involvement in the experience of a healing process improved perceptions of quality of life and well-being.