Predictors of oncology nurse asking and referring behaviors about complementary and alternative medicine

Christine Spencer, The University of Texas School of Public Health


BACKGROUND: CAM use is prevalent among cancer patients, and characteristics of healthcare professionals may predict CAM inquiry and referral patterns. Our goal was to identify these characteristics in community oncology nurses using self-reported data. METHODS: Baseline data was collected by nurse and patient questionnaires asking about CAM use and knowledge as part of a multicenter clinical trial to increase nurse communication about CAM. Frequencies and multi-level nested linear and logistic regression models were used to assess predictors of nurse inquiry about CAM during the last 5 patient visits and whether or not nurses referred patients for CAM therapy. RESULTS: 175 nurses, mean age 45 and median 19 years of experience (range=0-41) participated; 82% were staff nurses and 12% were nurse practitioners. 53% reported asking at least one of their last 5 patients about CAM use; 42% had referred a patient to a CAM provider. Comfort discussing CAM was associated with predicting referral (p=0.001) and inquiry (p=0.002), while massage was associated with inquiry only and coursework on trended toward significance in predicting inquiry (p=0.072). Those who were "very comfortable" discussing CAM were 3.49 (95% CI: 1.03-11.94) times more likely to ask and 3.60 (95% CI: 1.40-9.58) times more likely to refer patients for CAM therapy compared to the those who were uncomfortable in these discussions. Oncology nurses who reported having a taken courses or had a degree or certification in CAM were 4.12 (95% CI: 1.65-10.07) times more likely to ask and 15.18 (95%CI: 6.17-70.11) times more likely to refer compared to those without training, and were also more likely to refer patients for CAM therapy. CONCLUSIONS: Nurse characteristics, specifically comfort and education levels regarding CAM were both important factors in this study of nurse clinical behaviors. Because few nurses had formal CAM education, it is unlikely that their comfort was derived from evidence. Oncology institutions that prioritize evidence-based medicine should consider introducing CAM education into their employee development frameworks.

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Recommended Citation

Spencer, Christine, "Predictors of oncology nurse asking and referring behaviors about complementary and alternative medicine" (2014). Texas Medical Center Dissertations (via ProQuest). AAI1569952.