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PubMed2003

Oncology professionals' communication with cancer patients about complementary therapy: a survey.

OBJECTIVE: To compare the communication practices of three groups of oncology professionals with regard to discussion of complementary therapies with cancer patients. DESIGN: A mail survey was completed by a randomly selected, nationwide sample of oncology physicians, oncology nurses, and oncology social workers in the United States. MAIN OUTCOME MEASURES: Respondents indicated how often they initiated discussion of complementary therapies, their comfort level discussing this subject, and the perceived impact on the patient-professional relationship. RESULTS: Significantly more of the social workers reported that they initiated discussion of complementary therapy compared to physicians and nurses. Physicians and social workers reported being equally comfortable with this topic and more so than nurses. More of the social workers reported believing that discussing complementary therapies can enhance the patient-professional relationship. CONCLUSIONS: Oncology social workers were more amenable to discussing complementary therapies than physicians or nurses. The impact of communication on patient outcomes is addressed.

Adult↗

PubMed2003

Sustaining the cocoon: the emotional inoculation produced by complementary therapies in palliative care.

The aim of this study is to explore, from a medical sociological perspective, the use of complementary therapies by palliative care nurses. This paper shows how the conceptual vocabulary developed by Giddens [Giddens A. (1990) The Consequences of Modernity. Polity Press, Cambridge; Giddens A. (1991) Modernity and Self-Identity. Polity Press, Cambridge] relating to trust, ontological security, existential anxiety and the importance of protective cocoons, facilitates understanding of the use of complementary therapies in palliative care. This is a qualitative study based on semi-structured interviews. During analysis both thematic content and narrative form of the interviews are scrutinized. Analysis shows that the concepts Giddens developed enable the use of complementary therapies to be seen in new ways. In particular, they facilitate the application of a complementary therapy being seen as an emotional inoculation. Similar to the emotional inoculation Giddens speaks about, an infant receiving from its caretaker in childhood which enables a child to have a protective cocoon which it carries round with it throughout life and can draw on when faced with difficulties, the application of a complementary therapy in palliative care can be seen in terms of a booster injection being received by an adult, from their professional caretaker, in time of particular need. This injection sustains a person's protective cocoon at a time of vulnerability.

Attitude of Health Personnel↗

PubMed1999

How effective are complementary therapies for HIV and AIDs?--A systematic review.

Complementary treatments are often used by HIV-infected individuals. Yet little is known about their effectiveness. The aim of this systematic review was therefore to summarize the published evidence for or against the effectiveness of complementary therapies in HIV-positive people. A comprehensive literature search was conducted to locate all randomized clinical trials (RCTs) of complementary therapies. Data were extracted in a standardized fashion and evaluated critically. Fourteen studies met our pre-defined inclusion/exclusion criteria; 2 of herbal treatments, 5 of vitamins and other supplements, 5 of stress management, one of massage therapy, and one of acupuncture. They fall into 2 broad categories of 'cure' and 'care'. While the former category yields few encouraging results, the latter group of studies is more promising. In particular, stress management may prove to be an effective way to increase the quality of life. It is concluded that few rigorous trials of complementary treatments for HIV exist. The domain of complementary medicine may lie in the care for HIV-infected individuals with a view of increasing their quality of life. This notion requires further rigorous investigation.

Acquired Immunodeficiency Syndrome↗

PubMed2001

Integrating complementary therapies into health care education: a cautious approach.

The movement of complementary therapy training and education into higher education in the United Kingdom (UK) and the interest in alternative therapeutic approaches within the health professions presents an ideal opportunity for multidisciplinary teaching and shared learning. The diversity and similarities of complementary therapies and areas of convergence with conventional healthcare practice can be explored. The recent publication of the House of Lords Select Committee on Science and Technology report on complementary and alternative medicine (HL Paper 123) provides a broader context for discussion and makes specific recommendations about regulation, education and research in the UK. This paper considers the appropriateness of integrating complementary therapies into education for conventional healthcare practitioners, what we should integrate, and when might be the most appropriate time in the education of healthcare practitioners to introduce different therapeutic modalities and their respective philosophical languages. Rather than present a range of solutions, the paper raises some fundamental issues that are central to the integration of complementary therapeutic approaches. If these issues are neglected as we hurry to incorporate different 'techniques' into our conventional practice, we may simply be left with additional tools that we are ill equipped to use.

Complementary Therapies↗

PubMed2005

Complementary therapies in palliative care: a summary of current evidence.

Complementary therapies are often cited as a possible alternative to the management of symptoms in palliative care, as another element in the armoury for coping with unmanageable problems. But how efficacious are these therapies, and what is the evidence to support their use in symptom management? Patients who are in the terminal stages of illness or require palliative care are in a very vulnerable position, so are they being exploited or are there real benefits from using complementary therapies? This article review some of the evidence currently available.

Acupuncture Therapy↗

PubMed1996

Common misunderstandings about complementary therapies for patients with cancer.

Common misunderstandings exist surrounding the use of complementary therapies for patients with cancer. These problems and misunderstandings may prevent some patients from receiving these potentially beneficial treatments which may enhance quality of life, offer symptomatic relief and self help. Many of these misunderstandings are based on heresay and lack of awareness concerning the role that these therapies may play in complementary cancer care. It is the aim of this article to help dispel these misunderstandings and to provide a greater degree of clarity in this area. In this way, patients may be able to receive the full benefit of a range of complementary therapies in cancer care.

Complementary Therapies↗

PubMed1995

Complementary therapy and the mother's wishes.

Midwives cannot ignore the growing interest from clients who wish to use complementary therapies. However, midwives have a duty to ensure that their clients are aware of the advantages and the dangers of particular therapies. Co-operation with complementary therapists is to be encouraged, but the midwife must never delegate responsibility for her client. Managers should arrange for midwives to receive training in particularly complementary therapies, so that midwives may widen the scope of their professional practice. Midwives whose clients request complementary therapies may find themselves asked to provide hypnotism, aromatherapy or another therapy that may conflict with the accepted standards of midwifery practice. A mother might also wish to use homeopathic remedies for an underlying condition.

Clinical Competence↗

PubMed2005

Spiritual complementary therapies in cancer care.

OBJECTIVES: To review literature documenting the frequency of use and efficacy of spiritual complementary therapies. Implications for clinical practice and research that reflect this literature are offered. DATA SOURCES: Data based research on complementary therapy usage and clinical articles about selected mind/body therapies. CONCLUSION: Spiritual complementary therapies are among the most frequently used. Prayer, spiritual healing, and meditation are the most frequently used spiritual therapies. Equivocal evidence supports their efficacy. IMPLICATIONS FOR NURSING PRACTICE: Although spiritual practices may not be considered a "therapy," clinicians should assess and support these practices. Clinicians should only pray with patients when observing ethical guidelines.

Complementary Therapies↗

PubMed1998

Alternative and complementary therapy use in pediatric oncology patients in British Columbia: prevalence and reasons for use and nonuse.

PURPOSE: Alternative and complementary therapies are infrequently studied in pediatric populations. We performed a population-based survey to aid health care workers in identifying and counseling parents who may use these remedies. PATIENTS AND METHODS: We retrospectively surveyed the parents of 583 pediatric patients diagnosed with cancer in British Columbia between 1989 and 1995. Prevalence and factors that influence the use and nonuse of alternative and complementary therapies were estimated. RESULTS: Alternative and complementary therapies were used by 42% of 366 respondents. Herbal teas, plant extracts, and therapeutic vitamins were the most commonly used alternative therapies. Relaxation/imagery strategies, massage, and therapeutic touch were the most commonly used complementary techniques. Factors that influenced the use of alternative/complementary therapies were prior use (chi2 = 60.0, P < .0001), prior positive attitude towards these remedies (chi2 = 41.6, P < .0001), soliciting information from family and friends (chi2 = 70.5, P < .0001) or from alternative care givers (chi2 = 58.7, P < .0001), high risk of death at diagnosis (chi2 = 9.6, P < .002), and advanced education of the father (chi2 = 7.4, P < .006) or mother (chi2 = 8.6, P < .003). Parents who used alternative/complementary therapies did so in conjunction with conventional medicine (98%). Lack of knowledge and fear of interference with conventional therapies were the most common reasons cited for nonuse. No parent believed that the quality of life of their child deteriorated due to the use of alternative/complementary therapies. CONCLUSION: Alternative and complementary therapy use in pediatric oncology patients is common. Factors have been identified that may be associated with undertaking their use.

Adolescent↗

PubMed2002

Complementary therapy involvement of physicians: implications for practice and learning.

OBJECTIVE: We studied physicians' current and desired clinical role functions within the complementary health paradigm and their perceptions of the necessary educational programs to support them. DESIGN AND SETTING: A questionnaire to determine clinical activities within different complementary therapies was developed and mailed-out to 837 eligible physicians in Hamilton, Ontario, Canada, using a modified Dillman approach. RESULTS: The overall response rate to the mailed survey was 49.8% (417/837), with response rates of 50.2% (115/229) for family physicians and 49.7% (302/608) for specialists. The amount of interactions around complementary therapies between physicians, their patients and complementary therapists appears to be low. At the same time, there is a growing interest among physicians about complementary therapies, particularly with respect to developing their knowledge about efficacy and enhancing their skills in assessment and counselling. CONCLUSIONS: The differential levels of acceptance of different therapies by physicians will influence integration of complementary therapies in mainstream medicine.

Chi-Square Distribution↗

PubMed2003

Use of complementary therapies by women attending a specialist premenstrual syndrome clinic.

In this study, we investigate the use of complementary therapies by women attending a specialist premenstrual syndrome (PMS) clinic in the UK. Data was collected via an anonymous questionnaire survey of 100 women attending the clinic. Results showed 91% of women had used at least one form of complementary therapy for the management of their premenstrual symptomatology although only 35% were current users. Over half (53%) felt that these therapies had been of some benefit. Prescribed medication for PMS was being used by 71% of women at the time of the questionnaire and 83% of these women were satisfied with the perceived success of conventional therapy. In conclusion, the vast majority of women attending a specialist PMS clinic in the UK have used complementary therapies to treat this chronic debilitating condition but few continue use long-term. Treatment may be instigated by the woman with advice from her informal support network and/or her physicians. However as use is so prevalent, but with few randomized controlled trials conducted to show their benefits or risks, it is important to improve awareness of these therapies, both in qualitative and quantitative terms. Satisfaction with prescribed medications did not appear to be influenced by complementary therapy use in this group of women.

Adult↗

PubMed1994

Complementary therapies and midwifery practice.

A midwife's priority is the optimum well-being of mothers and babies: complementary therapies offer a range of additional tools if used judiciously, but can be dangerous if misused. Midwives should keep up-to-date with contemporary practice by learning about complementary therapies and anticipating demand before it arises. Midwives must refer to the UKCC publications to understand professional accountability in relation to complementary therapies. There is a need for more research into complementary therapies, and midwives should consider undertaking and publishing their own trials in order to widen the body of knowledge.

Clinical Competence↗

PubMed2003

Clinical training in complementary therapies for the 21st century.

Over the past 6 years an innovative portfolio of degree courses in complementary therapies has been developed at the University of Westminster. In 1996, when the first three courses of the BSc Scheme were validated, the high-quality clinical experience needed to consolidate the academic and practical skills was planned. The opening of the unique multidisciplinary Polyclinic in 1998 marked the beginning of an exciting clinical training and research dimension to the University's complementary therapies provision. The Polyclinic represents a unique opportunity for integrated medicine, not only with other healthcare professionals but also between complementary therapies. The rationale for the creation of the Polyclinic is discussed. The development of the integrated medicine theme of the Complementary Therapies Scheme and its consolidation within the clinical experience for the students is described. The further enrichment of the students' clinical experience with placements in other healthcare settings is also described. The development of the clinical provision is discussed including clinical governance, the management structures, and influence of nursing and midwifery, introduction of supervision for the clinic tutors, data collection and plans for the future.

Complementary Therapies↗

PubMed2001

Adjustment to illness of cancer patients treated by complementary therapy along with conventional therapy.

This pilot study compares the adjustment to illness, i.e. psychosocial and psychological distress, of 29 cancer patients being treated by complementary therapy along with conventional therapy, with a control group of 29 patients being treated by conventional therapy only. The findings indicate statistical differences in the brief symptom inventory scale (BSI), namely, the psychological distress of patients who received conventional therapy only was more severe than those being treated by complementary therapy with conventional therapy. No statistical differences, however, were found between the two groups in terms of psychosocial adjustment to the illness (PAIS). The findings lead to a recommendation that complementary therapy should be offered by public medical facilities as part of the standard treatment for cancer patients in order to ease psychological distress.

Adaptation, Psychological↗

PubMedDate not supplied

Complementary therapy use in HIV/AIDS.

OBJECTIVE: To examine the social psychological aspects of complementary therapy use in HIV/AIDS health care and to identify what happens in a person's illness management process when incorporated into their care for HIV-related symptoms. METHODS: Grounded theory research method guided sampling, data collection and analysis with 21 males at various AIDS service organizations. FINDINGS: A grounded theory model Finding a Way to Live was developed. Participants experienced a six-stage process whereby the HIV served as a precondition for a profound self-transformation; a commitment to and rediscovery of the meaning of life. Complementary therapies, referred to as 'tools' by the participants, were cited as an integral part of how people living with HIV found wellness within their illness. The type of therapy, meanings attached to them, intention for and frequency of use corresponded to where individuals were in the six-stage process. As participants began to experience personal growth, the nature of the therapies shifted from those being highly tangible and focusing on the physical self to those facilitating inner awareness, such as meditation. CONCLUSIONS: The process of integration was a complex, ongoing process wherein complementary therapies were an integral part of facilitating learning, self-discovery and ultimately, healing.

Adult↗

PubMed2001

Developing and evaluating complementary therapy services: Part 1. Establishing service provision through the use of evidence and consensus development.

The integration of complementary therapies within the British National Health Service (NHS) in the context of limited evidence of effectiveness has been much debated, as has the need for the provision of health services to be more evidence-based. In June 1994, a project was launched within a South-East London NHS Hospital Trust to introduce complementary therapy (acupuncture, homeopathy, and osteopathy), in the context of an evaluation program. This followed approximately 4 years of working toward raising the profile of complementary therapies within the hospital through study days, workshops, and providing a massage and osteopathic service for staff. A survey of local general practitioners highlighted areas of complementary therapy provision and interest in referring patients to a hospital-based service. A steering group was established to draw together a proposal for funding the service. Evidence for the effectiveness of acupuncture, homeopathy, and osteopathy was presented at a multidisciplinary seminar. A consensus development process, using a modified Delphi technique to establish referral indicators followed this. This study provides a useful model of service development in the absence of good quality evidence for the effectiveness of clinical interventions.

Attitude of Health Personnel↗

PubMed1999

Prevalence and patterns of the use of complementary therapies among prostate cancer patients: an epidemiological analysis.

PURPOSE: We determine the prevalence and patterns of the use of complementary therapies among patients with and those at high risk for prostate cancer. MATERIALS AND METHODS: A cross-sectional survey was performed of men presenting to 2 urban tertiary urology clinics for prostate cancer evaluation or followup, and those attending a prostate cancer support group. All men diagnosed with and those at high risk (positive family history or abnormal prostate specific antigen) for prostate cancer were eligible for study. A 9-item self-administered, anonymous questionnaire about complementary therapies was administered. RESULTS: Of 357 patients who received the survey 155 from the urology clinics and 113 from the support group responded, for a total response rate of 75%. Of the patients presenting to urology clinics and the support group 27.4 and 38.9% with and 25.8 and 80% at high risk for prostate cancer, respectively, used some form of complementary therapy. The use significantly differed according to disease status (p = 0.001), and was highest among men who were clinically disease-free after radical therapy. Of the patients 24% did not inform the urologist of using alternative therapy. CONCLUSIONS: The prevalence of the use of complementary therapy among patients with or at increased risk for prostate cancer was high and dependent on the disease state. Urologists should be aware of this pattern of use, and consider the potential effects when assessing patients for and with prostate cancer.

Aged↗

PubMed1998

Complementary therapies: research, education and practice in nursing.

There has been an increase in interest in complementary therapies amongst the general public and health care practitioners in recent years. Nurses integrating complementary therapies into their practice are not always adequately prepared due to the diversity of the therapies and the duration of the courses. Guidelines are broad and general, and there is no set standard nor minimum educational requirements related to the therapies in which nurses can integrate in their practice. This paper aims to raise awareness of nurses practising complementary therapies the need for research into practice and efficacy, education and policy development.

Complementary Therapies↗