Awareness and practice of complementary therapies in hospital and community settings within Essex in the United Kingdom
Section snippets
Background to study
The House of Lords Select Committee1 acknowledged the use of Complementary and alternative therapies (CAM) as being widespread and increasing. The integration of CAM into healthcare was recommended and the Government's response stated, “that the lead clinician would be responsible for assessing the patient's need as appropriate for CAM”. The House of Lords Select Committee1 recommended that all CAM practitioners within the NHS should be qualified to a specified level, in line with other
Conflict of role with nursing
Rankin-Box4 and Mantle5 suggested that there may be resistance to nurses incorporating complementary therapy into their role and indicate that this could be due to time constraints and conflict over duality of roles. Stuttard and Walker6 maintain that the practise of complementary therapies remains a contentious issue and practitioners are often viewed with scepticism. They recommend that complementary therapy be delivered as a separate entity. Whilst this could be perceived as utopian, it
Current practice
It is evident some nurses and midwives are complementary therapies. Danbrook12 surveyed nurses working for a trust that held qualifications in complementary therapies but were not using it within their work. Whilst her study was small, there was no Trust policy concerning whether complementary therapies be considered an extension of nursing. In addition, the level of competence needed to practice within the NHS was not considered.
Within General Practice, standards are set in Primary Care Trust
Methodology
A postal survey was mailed to all hospital wards and Primary Care Trust. These questionnaires were addressed to the ward manager or nurse within each area. The questionnaire was divided into 3 areas: (1) the survey used open-ended questions to identify individual's awareness of CT; (2) current clinical practices within their area; (3) and finally if they used complementary therapy within their practice.
As we wished to identify individual understanding of the term and practice of complementary
Analysis
In total, 1500 questionnaires were posted to wards and 500 to GP practices, with an envelope bearing the return address. They were bulk enveloped with the hope that ward clerks/sisters would distribute them to all their staff. We received 165 responses giving a 9% return rate. Whilst this is a very low return, the number of returns from the trust was very good. It appeared that only one or two departments such as Accident and Emergency and ophthalmic had not responded. Having reflected and
Q1. Asked what they understood complementary therapy to mean
As seen in Fig. 1, the majority of responses highlighted complementary therapies supporting on-going treatment regimes in both Trust and GP areas maintaining the view that the use of complementary therapies can be used in conjunction to other medical treatments. It is interesting to note that community nurses were likely to give responses to quality of life and health issues than within Trust responses. Luff and Thomas19 observed the provision of complementary therapies in Primary Care and
Section 2. The questionnaire asked the respondents to identify their practice areas
As the questionnaire was distributed widely throughout the whole of the Trust and within the community setting, there were areas, which did not respond at all, whilst other areas provided many responses.
Paediatrics 8 Physiotherapy 10 Vascular/surgical 6 Orthopaedics 6 CCU 4 Maternity 5 Oncology 5 Learning disabilities 1 OPD 1 ITU 1 Theatres 1 Renal 2 Infection control 1 Breast care 3 Stoma care 3 Urology 1 Plastics 3 Diabetes 1 Cardiology 1 Resuscitation 1
We were encouraged that 20 wards responded to our questionnaire.
Section 3: Respondents were asked whether they had training in any complementary therapies
Individuals were asked to identify which professional body they registered with and whether they were using them in private areas alone or used them within NHS practice areas too. From the 165 responses only 8 people in the Trust held a qualification in complementary therapies; 8 people within the GP practice areas were training but had not qualified yet.
Educational programmes
The APU (Anglia Polytechnic University) Complementary Medicine programme is contracted partly by the trust and partly by privately funded students. Ten students have obtained a qualification in complementary therapies within the Mid Essex area. The authors were surprised to see so few practitioners within the Trust and GP areas holding qualifications. What was of more concern was that those practitioners who held qualification were not always able to identify whether they had any professional
Discussion
The return rate identified a common problem associated with postal questionnaires and response rates and also with sending questionnaires on mass to departments/areas of practice. As identified earlier some departments were not accounted for and these responses may have affected the results. There were subtle differences within the Trust responses and GP responses and may indicate greater freedom or opportunities for patients to access complementary therapies in the community setting.
Many
Conclusion
Lewith23 indicates that the way forward is ‘complementary medical nurses’, who already possess the clinical responsibility and assessment skills that are required to assess the need. Peters24 postulates that complementary therapy is unsupported in mainstream practice, as the need is never assessed. His Royal Highness Prince Charles31, 43 in representing the Foundation of Integrated Medicine41, 42 commented on the integration of complementary and allopathic medicine at Glastonbury Health Centre
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