Objective: The purpose of this study was to design and test a reliable and valid instrument to determine the frequency of use of Complementary/Alternative Medicine (CAM) use among women diagnosed with breast cancer. Design: A descriptive cross-sectional survey was used to pilot test the instrument after the instrument was designed using a content validity index. Sample: One hundred and five predominantly Caucasian women (mean age 59 years) with a diagnosis of breast cancer were recruited from the Southeast area and a rural Mid-western area. Intervention and Outcome Variables: Psychometric evaluation of use of complementary/alternative therapies (CAM) survey reliability and validity testing. Methods: The instrument "Use of Complementary/Alternative Therapies Survey" (UCATS) was designed using a content validity index, and reliability was determined using coefficient alpha. Exploratory factor analysis using a principal components analysis was used to identify primary components (factors) embedded within the survey. Frequency of CAM use was calculated for 33 individual therapies listed on the survey, and among three survey-defined subscales of CAM therapies (diet and nutritional supplements, stress-reducing techniques, and traditional/ethnic medicines). Findings: The reported prevalence of use of the individual CAM varied considerably from a high of 73% for vitamins/minerals to a low use of none for colored light treatments (Table 2). Overall, the CAM therapies thought to be represented in the hypothesized subscale Traditional/Ethnic Medicines had the lowest reported frequency of use. The coefficient alpha estimate for the total survey was 0.86. Estimates for the individual hypothesized subscales were 0.67 for Diet and Nutritional Supplements, 0.79 for Stress-Reducing Techniques, and 0.80 for Traditional/Ethnic Medicines (Table 3). The principal component analysis resulted in a two-factor solution with nine items that loaded heavily and uniquely on a factor conceptualized as "Stress and Anxiety Reduction" and six items that loaded heavily and uniquely on a factor conceptualized as "Dietary and Physical Manipulation" (Table 4). The remaining five items (vitamins/minerals, prayer/spiritual healing, massage, reflexology, aromatherapy) indicated moderate loadings on both factors one and two and thus were interpreted as equivocal items. Similar results were observed for both the orthogonal and oblique rotation solutions. Conclusions: Preliminary data of this instrument indicate it is a reliable and valid instrument for use with women with breast cancer. Additional work is needed to improve the range of items and to test the instrument on other populations. Results may vary depending upon type of cancer or type of illness and this would require further investigation. Use of CAM by women with breast cancer is believed to be increasing, however, limited data exist on the frequency and predictors of its use in this patient population, and therefore a reliable and valid instruments are needed to determine use. Implications for Nursing Practice: If nurses can determine which CAM therapies women are using, they can further educate women with breast cancer on safe use of CAM therapies. If instruments are developed that comprehensively assess frequency of use, reasons and symptoms, women can be assisted in determining CAM interventions that may augment breast cancer treatment.
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