Gender differences among medical students in attitudes to learning about complementary and alternative medicine

OBJECTIVES: To explore gender differences in attitudes to CAM among Year 1, 2 and 3 medical students. DESIGN: Survey; seven-item self-administered questionnaire. SETTING: Plenary lectures at the start of semester 2 of the academic year at the University of Birmingham Medical School. RESULTS: 35.6% of 662 students were male and 64.4% female. Females were more likely than males to feel CAM has an important role in healthcare (p < 0.001). This difference increased through the medical course (p < 0.05). Females gave a more positive rating than males to the use of five therapies in healthcare (p < 001). Females were more positive than males about learning the theory (p < 0.001) and practice (p < 0.001) of CAM and a greater amount of CAM curriculum time (p < 0.001). CONCLUSIONS: If CAM teaching is optional females may be more likely to choose it. An unexpected consequence of more women than men entering medical school may be a positive impact on the development of integrated medicine.     

Knowledge, attitudes, and practices of baccalaureate nursing students regarding oral health assessment

Good oral health is important to overall health. Oral and pharyngeal cancers account for 2% of all cancers, yet no significant improvement in mortality has been demonstrated over the past 30 years. Nurses are in a unique position to integrate and conduct oral health assessments across a wide range of practice settings. Although nursing programs include health assessment and promotion in their curricula, there is poor integration of oral health as a focus. This study aimed to identify the knowledge, attitudes, and practices of baccalaureate nursing students about oral health assessment. A convenience sample of 163 students in two undergraduate courses within a baccalaureate nursing education program was surveyed. Findings indicated that these nursing students felt that oral health was essential to their nursing practice; however, they did not have a full understanding of the key components of an oral health examination or about effective smoking cessation strategies.     

Knowledge levels and attitudes of staff nurses in Israel towards complementary and alternative medicine

AIMS: The purpose of this study was to determine the knowledge level and attitudes of Israeli nurses towards complementary and alternative medicine and what factors are related to these variables. BACKGROUND: Over recent years there has been increased interest among the lay public and health care professionals in complementary and alternative medicine (CAM). Previous studies have shown that several variables such as education, income, age, perceived health status and satisfaction with medical therapy are associated with use of CAM. Conflicting reports were found with respect to the relationship between health locus of control and the use of CAM. Israel is a small country comprised mostly of immigrants from vastly differing cultures with differing beliefs about health and health care. Nurses whose origins are similar to the general population are also caregivers who are used to integrating diverse therapies into the plan of care devised with the client. No study was found which investigated these issues among Israeli nurses. DESIGN/METHODS: A systematic random sample of 369 staff nurses working at a major academic medical centre in Jerusalem, Israel were invited to participate in the study. Informed consent was obtained. Four self-administered, pencil and paper, questionnaires were distributed to the study participants: a questionnaire designed by the authors to determine the level of knowledge and attitudes towards complementary and alternative medicine; a questionnaire which measured satisfaction with the patient-physician relationship; a questionnaire which measured health locus of control; and a demographic questionnaire. Participants received a packet containing the questionnaire and a note explaining the study. The anonymous questionnaires were collected by the ward secretaries and sent in bulk to the researchers. RESULTS: Results demonstrated that nurses in this sample perceived that they had little knowledge of complementary and alternative medicine but were very interested in learning more. Few used complementary and alternative medicine in their nursing practice but levels of personal use were similar to that of the general population. Nurses who used complementary and alternative medicine were satisfied with their care. CONCLUSIONS: In general, nurses tended to be wary of the use of complementary and alternative medicine. Nurses were also not satisfied with their relationships with their physicians. Those of middle age were more likely to use complementary and alternative medicine but no other demographic characteristics were associated with knowledge or attitudes towards complementary and alternative medicine. Nurses had higher levels of internal health locus of control which was associated with more positive attitudes and knowledge levels of complementary and alternative medicine.     

Medical students' attitudes about complementary and alternative medicine

OBJECTIVE: To compare the attitudes about complementary and alternative medicine (CAM) of medical students from two different medical schools and at different stages of their medical training (first and third years). DESIGN: Four-group, cross-sectional, self-administered survey study. SETTINGS AND SUBJECTS: Three hundred and eleven (311) students from two British medical schools (Newcastle and London). OUTCOME MEASURES: Self-reported knowledge of, attitudes about, and beliefs about CAM. RESULTS: Third-year students thought CAM overall was less effective than first-year students and also were significantly less interested in training in CAM techniques. The 43 attitude statements factored into six interpretable factors. A medical school x year ANOVA on the factor scores showed many results consistent with the first part of the study. First-year students seemed more eager to be taught CAM than third-year students, and students at Newcastle were more positive about CAM than those at University College London. CONCLUSIONS: Education at medical school does influence attitudes to CAM. As their orthodox medical training proceeds, medical students seem to increase their skepticism about CAM.     

Taiwanese nurses' attitudes towards and use of complementary and alternative medicine in nursing practice: a cross-sectional survey

BACKGROUND: Increasingly, nurses in Western countries express positive attitudes to complementary and alternative medicine (CAM) but lack knowledge, access to education and organisational policy to guide practice. It is unclear whether nurses in developed Asian countries mirror or differ from this profile. OBJECTIVES: To determine the attitudes towards and use of CAM by registered nurses in Taiwan. DESIGN: Cross sectional survey. SETTING: A Nursing College in eastern Taiwan. PARTICIPANTS: Registered nurses (N=170) working in various clinical settings who were studying a post registration Bachelor of Nursing conversion course. METHODS: Questionnaire distributed to nurses during class time. RESULTS: Most nurses had positive attitudes to CAM and most used therapies, like massage, occasionally in practice. However, none had formal qualifications in CAM and most perceived that there were insufficient resources or organisational policy to facilitate practice. CONCLUSIONS: Taiwanese nurses need more formal education about CAM and require access to clear policies regarding the safe use of CAM in nursing practice.     

Developing a measure of attitudes: the holistic complementary and alternative medicine questionnaire

We have developed an 11-item scale, the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ). Six of the HCAMQ items relate to beliefs about the scientific validity of complementary and alternative medicine (CAM), and five to beliefs about holistic health (HH). The HCAMQ was completed by 50 patients attending a CAM clinic and 50 attending rheumatology outpatients; the former completed it twice. Factor analysis (oblique rotation) showed that the CAM and HH items measured distinct but related constructs. The HCAMQ has good test retest reliability (r=0.86, 0.82 and 0.77 for the total, CAM subscale and HH subscale, respectively). The individuals attending CAM clinics were significantly more positive on the CAM but not the HH subscale of the HCAMQ and also used less antibiotics than those attending rheumatology outpatients. Positivity towards CAM on the total HCAMQ and subscales was significantly associated with lower age, increased vitamin use, reduced painkiller use, and, other than on the HH subscale, less antibiotic use. The reason why the HH subscale failed to distinguish between the two patient groups or predict less antibiotic use is unknown. The HCAMQ appears to have good internal validity, but its external validity remains to be established.     

Knowledge,attitudes and practices among healthcare professionals regarding complementary alternative medicine use by patients with hypertension and type 2 diabetes mellitus in Western Jamaica

ObjectivesThis study investigated the knowledge, attitudes, and practices (KAP) of healthcare professionals (HCPs) regarding CAM use for Hypertension (HTN) and Type 2 Diabetes Mellitus (T2DM) among patients in western Jamaica, and to determine HCPs’ perceptions of the need for training on CAM.DesignA cross-sectional study was conducted from May to August 2019.SettingHCPs serving patients with HTN and T2DM in chronic disease clinics in western Jamaica completed a self-administered questionnaire that provided data on their sociodemographic characteristics, training, and KAP of CAM.Main outcome measureThe data identified factors associated with discussion and recommendation of CAM to patients and personal use of CAM by HCPs.ResultsType of profession (physicians vs nurses OR = 2.17; 95 % CI = 1.07−4.42 and pharmacists vs nurses OR = 8.67; 95 % CI = 2.83−26.57) was significantly associated with discussion of CAM. Training on CAM was significantly associated with discussion (OR = 2.36; 95 % CI = 1.26−4.42), recommendation (OR = 2.72; 95 % CI = 1.36–5.42), and personal use of CAM (OR = 2.90; 95 % CI = 1.69−4.97). Dieticians and nutritionists had 4.56 higher odds of personal use of CAM (95 % CI = 1.16−17.86), and personal use of CAM was significantly associated with discussion (OR = 8.94; 95 % CI = 4.76−16.80) and recommendation (OR = 7.17; 95 % CI = 3.54–14.51) of CAM. The majority of HCPs (70–89 %) agreed that there is a need to include CAM in professional training programs.ConclusionThe results of this study can be used to guide development of programs for training HCPs on knowledge and safe use of CAM so that they can better serve their patients.     

Pharmacists' patterns of use,knowledge, and attitudes toward complementary and alternative medicine

OBJECTIVES: To determine the patterns of use, knowledge, and attitudes toward complementary and alternative medicine (CAM) among pharmacists. DESIGN: Anonymous self-administered survey. SETTINGS: 61st International Congress of International Pharmaceutical Federation (FIP), Singapore Traditional Chinese Medicine (TCM) Research Symposium, and retail and hospital pharmacies in Singapore. SUBJECTS: Pharmacists attending the FIP Congress, TCM Symposium, and pharmacists working in retail and hospital pharmacies. OUTCOME MEASURES: Frequency of use of different types of CAM by demographic attributes, knowledge scores, and attitudinal scores. RESULTS: Of the 430 surveys received, 420 fit the criteria for inclusion. Of the pharmacists, 84.3% reported use of some form of CAM in their lifetime. CAM was used for chronic and acute conditions. There was no difference in use of CAM based on gender and income. The mean score on the knowledge test was 7.23 of 10. Of the pharmacists, 72.6% were moderately satisfied with CAM and 79.4% indicated they would recommend CAM to family and friends. They received information on CAM from books/magazines (64%), friends/family (35.7%), and the Internet (31.4%). Eighty-one percent (81%) of pharmacists felt they had inadequate skills and knowledge to counsel patients on herbal medicine and 90.5% felt the professional curricula should have more components on CAM. CONCLUSIONS: The use of CAM among pharmacists is widespread and prevalent. The increased use of CAM necessitates the need for more education. Pharmacists acknowledge that CAM may have a place in health care and accept their role as information providers. There is also a need for reliable sources of information on CAM.     

Implications for education in complementary and alternative medicine: a survey of entry attitudes in students at five health professional schools

INTRODUCTION: The National Institutes of Health provided grants to the Oregon Health & Science University (OHSU) and 14 other allopathic academic health centers for the development of curricula in complementary and alternative medicine (CAM). A key component of the curriculum evaluation for OHSU was provided by a survey assessing attitudes toward CAM and selected personality characteristics of entering students in chiropractic, naturopathic, Oriental, and allopathic medicine in the Pacific Northwest and Upper Midwest. METHODS: A survey containing a variety of assessments of attitudes toward CAM and the personality traits of adventurousness and tolerance to ambiguity was administered to students entering four Portland, Oregon doctoral-level health professional schools and an allopathic medical school in the Upper Midwest (University of Nebraska College of Medicine) during the 2004-2005 academic year. RESULTS: Students of naturopathy (n = 63) and Oriental Medicine (n = 71) were the most "CAM positive," adventurous and tolerant of ambiguity, and Midwestern allopathic medical students (n = 58) the least. In general, chiropractic students (n = 89) and allopathic medical students from the Pacific Northwest (n = 95) were intermediate in CAM attitudes between these two groups (all p < 0.05). Female students were more "CAM positive" in all schools compared to male students. CONCLUSIONS: Students have high levels of interest in CAM upon entrance to their schools. Health professional discipline, geographic location, personality qualities, and gender appear to influence CAM attitudes in entering students.     

Nursing students' and faculty members' knowledge of, experience with, and attitudes toward complementary and alternative therapies

This study was designed to describe and compare the knowledge, experience, and attitudes of nursing faculty and students (undergraduate and graduate) regarding complementary and alternative therapies (CAT). A cross-sectional survey (N = 153) of undergraduate (n = 41) and graduate (n = 57) students and faculty (n = 55) was conducted in one school of nursing. Most participants were White (87%) and female (78%). More than 70% of the students and faculty agreed that clinical care should integrate the use of CAT. More than 85% desired more education about CAT, especially in undergraduate nursing curricula. More than 65% agreed that the clinical nurse specialist or nurse practitioner role should include the use of CAT in their practice, and more than 50% agreed that they had some knowledge of CAT, but only approximately 30% had some experience with CAT. Faculty and students expressed positive attitudes toward integrating CAT into the undergraduate nursing curriculum and nursing practice. Faculty development and nursing research are needed to facilitate curriculum change and integrate CAT into nursing programs at all levels.     

Teaching medical students complementary and alternative medicine using evidence-based principles

OBJECTIVES: Introducing new ideas such as complementary and alternative medicine (CAM) and evidence-based medicine (EBM) to medical students early in their education may help to nurture their interest. This study evaluated the effectiveness of teaching CAM using EBM principles and assessed changes in student perceived knowledge, attitudes, and skills following a new curriculum on CAM. DESIGN: A before-and-after evaluation using a one-page, anonymous questionnaire. Setting and subjects: All third year students of a state, public medical school in Texas. INTERVENTION: A new curriculum comprising interactive sessions on CAM, EBM, and basic principles of epidemiology and biostatistics. OUTCOME MEASURES: Changes in student-perceived knowledge, attitudes, and skills. RESULTS: Of 67 students, complete data were obtained for 54 (81%). The majority reported that the new instruction in CAM (98%), EBM (96%), biostatistics (91%), and epidemiology (87%) would be of some benefit in their future work. Significant changes were reported in the areas of appraising a clinical trial (p < 0.0001), critiquing the medical literature (p < 0.01), and the appropriateness of integrating EBM and CAM in the medical school curriculum (p < 0.05). There were modest increases in the mean responses on their skill level in reading/understanding the medical literature (3.40-3.52), comfort level in reading the medical literature (3.53-3.67), and preparedness in designing a research study (2.12-2.39) based on a five-point Likert scale, although not statistically significant. CONCLUSIONS: Medical students could be effectively taught CAM using EBM principles. In addition, a short, interactive curriculum on an important topic has a positive impact on medical students' desires to acquire new knowledge. This should be a good motivational message to family medicine educators regarding the contribution to new knowledge such as CAM.