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The Integration of Holistic Nursing Practices and Complementary and Alternative Modalities into Curricula of Schools of Nursing
Abstract
Schools of nursing in the United States have responded to the increasing consumer use of complementary and alternative modalities and consumer demand for health professionals knowledgeable in complementary and alternative modalities by incorporating holistic nursing practices and complementary and alternative modalities into their curricula.
To determine the extent to which US schools of nursing have incorporated holistic nursing practices and complementary and alternative modalities into their curricula.
Electronic web-based survey.
Surveys were sent to 585 US schools of nursing.
Sample (n = 125) of deans and directors (or their designees) of Baccalaureate and higher degree US nursing programs at schools holding membership in the American Association of Colleges of Nursing (AACN).
Demographics of US schools of nursing, percentages of schools who utilized the American Holistic Nurses' Association (AHNA) definition of holistic nursing practice and the Holistic Core Curriculum Guidelines, and percentage of complementary and alternative modalities incorporated into the curricula.
Almost 60% (n = 74) of the responding schools used the definition of holistic nursing practice in their curricula and were familiar with the Holistic Nursing Core Curriculum. The majority (84.8%, n = 106) included complementary and alternative modalities in their curricula.
The study provides preliminary evidence that US. schools of nursing are incorporating holistic nursing practices and complementary and alternative modalities into their curricula reflecting a response to increased consumer use of complementary and alternative modalities and consumer demand for health professionals who are knowledgeable about complementary and alternative modalities.
... There is a substantive and expanding literature that documents the integration of HH and/or CAM into professional schools of health education curricula. The mind-body-spirit orientation of a holistic healing model has been a core component of the nursing profession, curriculum, and standards of practice since its beginnings (Fenton & Morris, 2003;Halco´n, Leonard, Snyder, Garwick, & Kreitzer, 2001). Burke et al. (2004Burke et al. ( , p. 1118 identified a difference in the perceived meanings between HH and CAM stating, ''This difference . . . ...
... Until recently, biomedical education had not considered HH/CAM, although as its integration within allopathic education increases, this is less frequently the case (Barzansky & Etzel, 2003;Baugniet, Boon, & Ostbye, 2000;Lie & Boker, 2006;Patterson & Graf, 2000). Fenton and Morris (2003) documented a similar transition in CAM curricular offerings in baccalaureate and advanced nursing programs. Kreitzer et al. (2008) and Pearson and Chesney (2007) ...
... Interestingly, the majority of respondents, 67%, indicated that HH/CAM content or courses had been added during the last 1-4 years. This is in keeping with the findings of Barzansky and Etzel (2003), Fenton and Morris (2003), and Lie and Boker (2006) regarding the increased inclusion of HH/CAM in health practitioners' curricula. Opportunity exists to further expand curricula, as many respondents indicated HH/CAM was more likely to be included in courses not specifically HH/CAM focused (see Table 2). ...
Rising public interest in and use of holistic health (HH) practices and complementary and alternative medicine (CAM) has created a need for health care providers to become knowledgeable in these areas. HH/CAM content is increasingly included in curricula of professional health education, a trend less clear in associate, certificate, and diploma programs of 2-year colleges. A survey of directors and coordinators of allied health and nursing programs at New Jersey county colleges was conducted to determine curricular presence of HH/CAM and program constituency awareness of institutionally accessible HH/CAM information resources. Results indicated: rising interest in HH/CAM instruction; multiple forces influencing HH/CAM inclusion; HH/CAM strengthening programs; and uncertainty regarding knowledge of and perceived use of library HH/CAM resources. By including HH/CAM, New Jersey's allied health and nursing programs are progressively aligned with consumer use, and trends of professional health schools.
... 2,32 In 2003, a study was performed with more than 100 nursing schools and determined that most of the respondent schools (85%) were including some education around CAMs and some aspects of the core curriculum for holistic nursing. 33 However, the study did not explore the depth of the CAMs/holistic material that was covered, how CAMs and holistic modalities were presented and taught, the faculty members' experiences with CAMs and holism, or the extent of student's clinical or personal experience with CAMs and holistic modalities. 33 The article did not mention how or if the holistic nursing core values of or concepts such as presence, intentionality, unconditional acceptance, self-care, and sacred space were addressed by the curricula. ...
... 33 However, the study did not explore the depth of the CAMs/holistic material that was covered, how CAMs and holistic modalities were presented and taught, the faculty members' experiences with CAMs and holism, or the extent of student's clinical or personal experience with CAMs and holistic modalities. 33 The article did not mention how or if the holistic nursing core values of or concepts such as presence, intentionality, unconditional acceptance, self-care, and sacred space were addressed by the curricula. Holistic nursing and the personal healing journey are experiential processes, and students will be more likely to grow in their understanding of holism via the support of faculty who are experienced in holistic modalities. ...
... 34 Many nursing programs likely offer some coursework in CAMs, yet giving the students the opportunity to apply holistic modalities in the workplace, remains elusive. Although nationally faculty familiarity with CAMs and holistic core competencies is probably fairly high, 33 it is not likely that many schools are developing full programs on the basis of the American Holistic Nurses Association Core Competencies, 34 and faculty themselves may need to gain experience with these modalities in order to adequately support student learning. 32 The issue for many nurses may be that there is limited access to a truly holistic nursing educational experience, versus the occasional holistic elective or nonthreaded singular exposures to holistic modalities in traditional nursing education venues. ...
This article examines holism and healing in nursing as a paradigm and explores at how the use of an integral approach may help articulate and guide the future of contemporary caring-healing-holistic-sustainable nursing practices.
... Over recent decades, alongside increasing integration of CM into medical schools and health care organizations [6], we have witnessed a trend toward incorporating CM studies into the curriculum of nursing schools [2,4,8]. Ref [8] investigated the extent of incorporation of CM into the curricula of nursin,g schools. ...
... Over recent decades, alongside increasing integration of CM into medical schools and health care organizations [6], we have witnessed a trend toward incorporating CM studies into the curriculum of nursing schools [2,4,8]. Ref [8] investigated the extent of incorporation of CM into the curricula of nursin,g schools. Of the 585 questionnaires sent out to nursing schools, 125 were returned (a 21% response rate). ...
Objective:
The objective of the research was to explore attitudes of hospital nurses toward integrative medicine (IM).
Design:
A special training program was developed in the Bnai-Zion medical center, a public hospital in Israel, where an innovative IM program was launched.
Methods:
65 nurses from 22 wards were asked at the beginning and the end of the program to complete an open-ended questionnaire concerning three major aspects: 1) their attitudes toward complementary medicine and its integration, 2) the importance and impact of the training program and 3) how they perceive their potential role in promoting IM in the wards.
Results:
Nurses perceive themselves as boundary actors, who can play an important role in promoting IM within the wards. IM training programs for hospital nurses are recommended. This empowers nurses while restoring to clinical practice the essence of nursing as an integrative healing discipline.
... Our findings are consistent with those of similar studies conducted in various countries. For example, in a study by Fenton et al. [35] on the integration of complementary and alternative therapies into nursing school curricula in the United States, 125 out of 585 schools (21%) responded to an online questionnaire. While 97% (121) of the schools offered or planned to offer courses on CAT, only 19 (15%) had compulsory CAT courses, and 46 (36.8%) offered optional subjects. ...
Background: The use of complementary therapies in the general population is increasing, so it is necessary to understand the training that health professionals receive in this type of therapy in their training plans, as they are often the primary source of information for patients. Our aim was to investigate Spanish universities that offer subjects on complementary therapies in their nursing degree programs. Methods: This study is an observational, descriptive, cross-sectional study. For this purpose, we used a document published on the website of the Ministry of Universities as the working document. Additionally, a literature search was conducted up to September 2023 in the PubMed database, along with reverse searches. Results: Out of a total of 62 universities, only 16 (29%) offer a subject related to this type of therapy, 27.5% (11) are public universities and 22.7% (5) are private universities, most of them being optional subjects. Conclusions: The training content on complementary care in nursing degree programs in Spanish universities is scarce, highlighting the potential benefit of expanding and promoting it, in line with the recommendations of the World Health Organization.
... The global increase in demand for TCM has led some medical schools in Western and many Asian countries to include TCM in their curricula (Fenton and Morris, 2003). In the 19 articles included in this systematic review, the frequency of those who want to be trained in TCM or who want to train themselves in vocational training ranged from 21.9% to 85.3%. ...
... Sometimes, bio-medical practitioners suggest TCAM to patients. The increase in demand for TCAM has led to the inclusion of some Asian countries in the curriculum of medical schools as well as in some western medical schools (Fenton and Morris, 2003). Although TCAM knowledge has been known for some time to aid in childbirth practices, acute injuries, infectious diseases and treatments for parasites, it has been overlooked in large-scale international health programs (Hollenberg et al., 2008). ...
With the Covid-19 pandemic process, it is thought that people who want to be protected from the negative effects of the virus will turn to complementary and alternative medicine products with modern medicine in order to increase their body resistance and stay healthy. It will be important for businesses to track changes in consumer purchase intention and behavior towards these products. This study aims to examine the behavior of buying complementary and alternative medicine products of the Covid-19 epidemic within the framework of theory of planned behavior. In the research, an online questionnaire was applied to 402 people using the convenience sampling method. The structural equation modelling was used to determine the factors affecting buying behavior. As a result of the structural equation modelling, it was confirmed that attitude and perceived behavioral control variables have a positive and significant effect on the intention of buying complementary and alternative medicine. It was determined that subjective norms did not have a positive and significant effect on the intention to purchase complementary and alternative medicine. It was concluded that buying intention and perceived behavioral control had a positive and significant effect on buying behavior for complementary and alternative medicine products
... Nursing as a profession, who play an important role in the health-care group, has long claimed the term holistic and has incorporated the word, using various definitions, into nursing literature and practice literature [11]. Nurses who adapt a holistic approach in patient care need to have knowledge of its Study of complementary and alternative medicine usage of cancer patients receiving medical oncology clinic medicine and its relationship with their quality of life side effects and reliability of CAM [12]. ...
... Less clinically experienced nurses were often recent graduates from schools that included CAM topics in the curriculum. This is consistent with a North American study that found that practicing nurses, who were familiar with CAM, were also recent nursing graduates (Fenton & Morris, 2003). This suggests that integrating CAM topics into the curriculum may help improve nurses' knowledge and provide a comprehensive foundation for informed beliefs and attitudes in Indonesia. ...
The aim of this study was to explore nurses' knowledge and attitudes toward the use of complementary and alternative medicine (CAM) among cancer patients in a palliative care setting. A descriptive qualitative approach was used in this study. Semistructured interviews were conducted with 10 nurses recruited using purposive sampling. The data were analyzed using an inductive semantic approach. Thematic analysis identified that nurses possess limited knowledge of CAM. Nurses were skeptical toward CAM and less confident to recommend its use. Four main themes (and two subthemes) emerged: Understanding of CAM, Hesitative Attitudes, Personal Experience, and Preferences in Learning about CAM. There is a need to integrate CAM topics into nursing education programs in order to develop nurses' knowledge and build positive attitudes toward CAM use. Sufficient knowledge and positive attitudes toward CAM would support safety and quality of care in management of patients with cancer who use or are contemplating using CAM.
... Explicitly including information about CIM in the current nursing, midwifery, and dietetic education programs is significant. In some schools in the world, CIM practices have been integrated into the standard education program (32,33). A variety of sources of information about CIM practices were consulted by students ( ...
Objectives: This study aimed to determine the attitudes and practices of students in the nursing, midwifery, and dietetics departments of the Faculty
of Health Sciences concerning complementary and integrative medicine (CIM).
Method: A descriptive cross-sectional survey was performed among students of the Faculty of Health Sciences in the academic year 2013-2014. The
study used a questionnaire prepared by the researchers as a data collection form.
Results: A statistically significant difference was found in the use of CIM practices between the students according to their gender, class, and
department. The most commonly known type of CIM among the students was herbal medicine. The participants stated that their main sources of
information were their mothers or relatives.
Conclusion: The study indicated that students have positive opinions and attitudes about CIM. A great majority of the students agreed that CIM should
be included in their school’s curriculum.
Keywords: Complementary and Integrative Medicine, midwifery, nursing, dietetics
... Hollenbergstressed TM was continuously being neglected by medical schools despite evidence of its significant influence within African countries (Hollenberg, Zakus, Cook, & Wei, 2008). But this global increase in demand for alternativemedicine has led some medical schools in Western and many Asian countries to incorporate TM into their curricula (Fenton & Morris, 2003). Hence 85% of Korean, 77% of Canadian and 20% of Japan medical schools taught alternative medicine (Kim, 2012). ...
... Educating biomedical and CAPs about each other's discipline and clinical approaches may facilitate collaboration through careful yet deliberate efforts to bring the aforementioned philosophies closer to each other. While the addition of the non-biomedical paradigm to biomedical education has been discussed elsewhere (Chitindingu et al., 2014;Fenton & Morris, 2003;Hollenberg, Zakus, Cook, & Xu, 2008;Kim et al., 2012;Nxumalo, Alaba, Harris, Chersich, & Goudge, 2011), it was all but ignored by participants in the current study. In view of the well-known practice by patients to seek care from both biomedical and CAPs concurrently, the value of biomedical care providers understanding nonbiomedical methods is clear (Chitindingu et al., 2014;Nortje et al., 2016). ...
We examined the scope of collaborative care for persons with mental illness as implemented by traditional healers, faith healers, and biomedical care providers. We conducted semistructured focus group discussions in Ghana, Kenya, and Nigeria with traditional healers, faith healers, biomedical care providers, patients, and their caregivers. Transcribed data were thematically analyzed. A barrier to collaboration was distrust, influenced by factionalism, charlatanism, perceptions of superiority, limited roles, and responsibilities. Pathways to better collaboration were education, formal policy recognition and regulation, and acceptance of mutual responsibility. This study provides a novel cross-national insight into the perspectives of collaboration from four stakeholder groups. Collaboration was viewed as a means to reach their own goals, rooted in a deep sense of distrust and superiority. In the absence of openness, understanding, and respect for each other, efficient collaboration remains remote. The strongest foundation for mutual collaboration is a shared sense of responsibility for patient well-being.
... Many studies related to nursing education suggests that faculty development programs are needed in order to ensure that information regarding alternative therapies is integrated into nursing curricula (Fenton & Morris 2003;Kim et al. 2006;Avino 2011). Moore (2010: 612) reviewed the rationale for CAT in nursing school curricula. ...
Globally, the use of alternative therapies by both the public and healthcare workers has escalated. Due to the popularity and frequent use, the need for identifying the perceptions of professional nurses regarding alternative therapies was vital. In South Africa, research on alternative therapies within a nursing context is still in infancy. Empirical work undertaken internationally has led to renewed interest in this topic, which has resulted in its benefits being increasingly documented. A quantitative exploratory research approach was used in this study. A total of 616 questionnaires were distributed across nine participating hospitals, and a 63% of the target population responded. Arrangements were made with the management of each institution with regards to convenient days and times to make contact with the professional nurses. The findings of the study revealed that professional nurses did make use of various forms of alternative therapies. Prayer/spirituality (69%; n = 265), nutritional supplements 59% (n = 207) and music therapy 51% (n = 199) were the most frequently used alternative therapies. About 57.9% (n = 204) of the nurses were satisfied with the information received in nursing education with regards to support groups in nursing care; prayer/spirituality; nutritional supplements; music therapy and massage therapy. The findings further showed that 70.6% (n = 272) thought that alternative therapies were beneficial rather than a threat to patient's health. Although 66.1% (n = 254) of professional nurses encountered patients who enquired about alternative therapies, only 39.6% (n = 153) expressed confidence in advising patients about these therapies.
... The factors associated with the usage rate of CAM were the gender, duration of disease, advanced stages of cancer, socio-economic status and educational level. In another study assessing the use of CAM in Eskisehir by random sampling method, 60% of the respondents have been found to use various CAM methods previously and the authors have concluded that accessibility and cost of the health services have a significant impact on the overall usage rate of CAM 11 . ...
This descriptive study was conducted to assess the knowledge and usage rate of CAM in School of Health Sciences students. This survey was carried out with 172 nursing students which were taking education during the summer term. The datas were collected with the questionnaire form that is prepared by the researchers based on literature. The questionnaire form consisted of items about sociodemographic characteristics, knowledge, usage rate and benefits situations of the CAM in the students. Datas were evaluated by using licensed SPSS 20. The majority of students evaluated that CAM methods are very important (60.5%) or important (6.4%) in eliminating health problems. CAM methods were found to be used mainly for relieving pain. The most known and used methods were praying and massage among female students. On the other hand, males more commonly used massage method compared to females. In conclusion, we recommend that CAM methods should be included in the curriculum of nursing and other health sciences education and that in-service training should be included to these issues. ÖZET Bu tanımlayıcı çalışma Sağlık Yüksekokulu öğrencilerinin tamamlayıcı ve alternatif tıp (TAT)'ı bilme ve kullanma durumunu değerlendirmek için yapılmıştır. Çalışma yaz döneminde eğitim gören 172 hemşirelik öğrencisi ile yürütülmüştür. Veriler araştırmacılar tarafından literatüre dayalı hazırlanan veri toplama formu ile toplanmıştır. Veri toplama formu; sosyo-demografik özellikler, öğrencilerin TAT bilgisi, kullanma oranı ve yararlanma durumları hakkındaki sorulardan oluşmaktadır. Veriler lisanslı SPSS 20 istatistik programı ile değerlendirilmiştir. Öğrencilerin büyük çoğunluğu TAT yöntemlerini sağlık problemlerini ortadan kaldırma yönünden çok önemli (%60,5) ve önemli (%6,4) olarak değerlendirmiştir. TAT yöntemlerinin en çok ağrıyı azaltmada kullanıldığı bulunmuştur. Özellikle kız öğrenciler arasında en çok bilinen ve kullanılan yöntem; dua etme ve masaj olarak belirtilirken; erkek öğrenciler tarafından ise masaj yöntemi belirtilmiştir. Sonuç olarak; TAT yöntemleri hemşirelik ve diğer sağlık bilimleri öğrencilerinin eğitim müfredatında yer almalı ve hizmet içi eğitimlerde bu konulara yer verilmelidir.
... Nursing as a profession, who play an important role in the health-care group, has long claimed the term holistic and has incorporated the word, using various definitions, into nursing literature and practice literature [11]. Nurses who adapt a holistic approach in patient care need to have knowledge of its Study of complementary and alternative medicine usage of cancer patients receiving medical oncology clinic medicine and its relationship with their quality of life side effects and reliability of CAM [12]. ...
... [66] Amerika'daki hemşirelik okulların %84'ünün müfredatında tamamlayıcı ve alternatif tedavi yöntemleri yer almaktadır. [67] Türkiyede Hemşirelik eğitimi veren okullarda, "Tamamlayıcı ve alternatif tedaviler" başlığı altında veya içeriğinde ders henüz bulunmamaktadır. Sıklıkla bu tür eğitimlerin kurs programları ile verildiği görülmektedir. ...
Patients with cancer apply for complementary medicine methods for the ineliminable symptoms such as nauseavomiting. Complementary and alternative medicine methods administered by patients in whom chemotherapy induced nausea vomiting developed were explained in this study. The primary complementary and alternative medicine methods that cancer patients frequently use were herbal products, relaxation, hypnosis, acupuncture, acupressure, yoga, meditation, massage, music, reflexology, cryotherapy, and aromatherapy. Nurses need to be knowledgeable about these practices in order to achieve their goal, prevent harmful effects, and abuse of patients. Nurses were expected to develop their practice regarding the use of complementary therapies, determine effective strategies, guide patient to use complementary methods based on evidence, and direct patients/healthy individuals to apply complementary therapies effectively and correctly.
... In some instances, bio-medical practitioners recommend TCAM to patients if they fail to respond to allopathic treatment. This global increase in demand for TCAM has led some medical schools in Western and many Asian countries to incorporate TCAM into their curricula [14]. ...
Traditional, complementary and alternative (TCAM) medicine is consumed by a large majority of the South African population. In the context of increasing overall demand for healthcare this paper investigates the extent to which South African medical schools have incorporated TCAM into their curriculum because of the increased legislative and policy interest in formally incorporating TCAM into the health care system since democracy in 1994.
Heads of School from seven South African medical schools were surveyed telephonically.
One school was teaching both Traditional African Medicine (TM) and CAM, five were teaching either TM or CAM and another was not teaching any aspect of TCAM.
In conclusion, there is a paucity of curricula which incorporate TCAM. Medical schools have not responded to government policies or the contextual realities by incorporating TCAM into the curriculum for their students. South African medical schools need to review their curricula to increase their students' knowledge of TCAM given the demands of the population and the legislative realities.
... Although a majority of schools of nursing in the United States include some content on complementary and alternative modalities (Fenton & Morris, 2003;Richardson, 2003), most focus on didactic content and few incorporate an experiential component (Richardson, 2003). Integration of content and experiential learning about CAT can promote students' critical thinking and communication skills, self-care and healing practices, and leadership skills in addressing the public's demand for these therapies (Richardson, 2003). ...
Efforts are under way in many nursing education programs across the United States to incorporate content into curricula on complementary/alternative therapies (CAT). Many of these efforts focus on didactic presentation of content. There is an absence of nursing programs that provide students with opportunities to actually experience and practice CAT skills; little is known about how these hands-on learning experiences affect confidence in applying selected CAT skills in beginning nursing practice. This article highlights efforts at the University of Minnesota School of Nursing to integrate practice and experience in selected CAT skills (music, hand massage, imagery, breathing/ mindfulness, reflexology) into an existing senior undergraduate clinical skills laboratory course. Students (n= 86) who participated in the class reported significant increases in their confidence levels after the experiential sessions for all of the CAT skills practiced. Directions for future curriculum integration efforts are discussed as well as opportunities for expansion of CAT skills experiences.
... Likewise, a recent survey conducted by Koenig et al. [12] showed that 90% of US medical schools have courses or content on S/H. Additionally, Fenton et al. found that 58% of US nursing schools offered content on spirituality in their curricula [17]. ...
Background
According to recent surveys, 59% of British medical schools and 90% of US medical schools have courses or content on spirituality and health (S/H). There is little research, however, on the teaching of S/H in medical schools in other countries, such as those in Latin America, Asia, Australia and Africa. The present study seeks to investigate the current status of teaching on S/H in Brazilian medical schools.
Methods
All medical schools in Brazil (private and public) were selected for evaluation, were contacted by email and phone, and were administered a questionnaire. The questionnaire, sent by e-mail, asked medical school directors/deans about any S/H courses that were taught, details about those courses, S/H lectures or seminars, importance of teaching this subject for medical school directors, and medical schools characteristics.
Results
A total of 86 out of 180 (47.7%) medical schools responded. Results indicated that 10.4% of Brazilian Medical Schools have a dedicated S/H courses and 40.5% have courses or content on spirituality and health. Only two medical schools have S/H courses that involve hands-on training and three schools have S/H courses that teach how to conduct a spiritual history. The majority of medical directors (54%) believe that S/H is important to teach in their schools.
Conclusion
Few Brazilian medical schools have courses dealing specifically with S/H and less than half provide some form of teaching on the subject. Unfortunately, there is no standard curriculum on S/H. Nevertheless, the majority of medical directors believe this issue is an important subject that should be taught.
... Cornman, Carr, and Heitkemper (2006) worried about missed benefits of unused CAM and possible adverse reactions of CAM when misused, contending that all health care workers should "possess knowledge regarding the assessment of CAM use". Thus, it is not surprising that, over the past two decades, inclusion of CAM education has increased in medical schools (Wetzel, Eisenberg, and Kaptchuk 1998;Wetzel et al. 2003) and nursing schools (Fenton and Morris 2003;Helms 2006). ...
To examine personal use of complementary and alternative medicine (CAM) among U.S. health care workers.
Data are from the 2007 Alternative Health Supplement of the National Health Interview Survey. We examined a nationally representative sample of employed adults (n = 14,329), including a subsample employed in hospitals or ambulatory care settings (n = 1,280).
We used multivariate logistic regression to estimate the odds of past year CAM use.
Health care workers are more likely than the general population to use CAM. Among health care workers, health care providers are more likely to use CAM than other occupations.
Personal CAM use by health care workers may influence the integration of CAM with conventional health care delivery. Future research on the effects of personal CAM use by health care workers is therefore warranted.
... 7 In comparison, Fenton and Morris surveyed 125 US baccalaureate nursing programs holding membership in the American Association of Colleges of Nursing and reported that 59% specifically included holistic nursing practice in their curriculum. 8 In general, not all schools of nursing include CAM in the curriculum, and the amount and depth of the content varies. Given the extent of CAM use in the United States, nursing schools should include information on these treatment modalities in their programs of study. ...
A comprehensive assessment of the knowledge, attitudes, and practices of nursing faculty and students related to complementary and alternative medicine (CAM) of one state in the Mid-Atlantic region of the United States was conducted and information was obtained from faculty about CAM content in their individual courses. Using a descriptive study design, a 32- and a 23-question online surveys were sent through e-mail to faculty and students, respectively. The response rate was: faculty 76% (N=117) versus students 41% (N=578). Positive support was found with regard to the addition of CAM into the nursing curriculum (81% students vs 92% faculty). Faculty provided some CAM didactic content to students on an inconsistent basis. It is unknown what CAM competencies students are expected to achieve. Integrating in the curriculum, experiential learning, a broad view of CAM therapies and holistic concepts, and evidence regarding CAM therapies is necessary. The results informed a plan for a professional development program for faculty.
... However, such courses are usually dependent on a relatively small cadre of CAM-informed nurse educators. Faculty development programs are needed to ensure that information about CAM is incorporated into nursing curricula across courses and at different levels (Fenton & Morris, 2003; Halcón et al., 2003; Kim et al., 2006; Richardson, 2003). ...
As part of the National Center for Complementary and Alternative Medicine (CAM) R25 Education Grant Program, a faculty development program for integrating CAM into the nursing curriculum was instituted in 2003-2006. The Integrating CAM program was composed of a number of elements; the primary strategy included a series of 4-week didactic and experiential summer CAM "Camps," attended by 27 faculty members. Camps were designed to influence faculty integration of CAM material into course offerings. The Integrating CAM program was evaluated via a series of faculty and student surveys regarding CAM competencies, attitudes, and perceptions. For more than half of the faculty (out of the 43 who responded), the program yielded a moderate-to-strong influence on incorporation of CAM material into course content and moderate-to-great increases in both enthusiasm for CAM and perceived CAM knowledge gains. Students at all levels (undergraduate, master's, and doctoral; n = 184) reported that their courses contained CAM content; for 70% of students, their CAM knowledge increased; for 50% of students, level of CAM interest increased. Self-reported student CAM competencies were significantly greater in 2006-2007 (n = 191) than those in 2003-2004 (n = 143). Results support the strategy of broadly infusing the nursing curriculum with CAM content via faculty development.
... However, some geriatric nurses may not be familiar with integrating spirituality into the management of emotional distress (Sellers & Haag, 1998) and would benefit from advanced clinical training in holistic, complementary, and alternative interventions. Such training opportunities are offered through schools of nursing (Fenton & Morris, 2003), professional organizations (e.g., the American Holistic Nurses Association), and continuing education programs (e.g., the Healing Touch Program™, http:// www.healingtouch-program.com/). Advance training in these areas could increase geriatric nurses' confidence and ability to help their older patients with depression management plans. ...
The purpose of this pilot study was to explore the approaches to depression care preferred by older home-care patients and examine characteristics associated with those preferences. Twenty-eight long-term home-care patients, ages 62 to 95, were interviewed. Patients ranked their depression care preferences and provided rationale for their responses. Results indicated prayer was preferred by the highest percentage of patients (50%). Comparing patients with and without depression experience, prayer was preferred by the latter group. The results highlight the importance of addressing patient preferences during care planning to improve participation in geriatric depression care management.
... On the provider side, clinical training is improving. Many medical schools in the United States now offer CAM courses in their curricula, as do numerous nursing, osteopathic, pharmacy , and public health programs (Bhattacharya, 2000; Burke et al., 2001; Dutta et al., 2003; Fenton and Morris, 2003; Saxon et al., 2004). CAM options in medical schools included elective CAM classes, the incorporation of CAM material into required courses, CAM rotations for residents, and the integration of CAM content into clinical case conferences (Carlston et al., 1997; Hui et al., 2002; Kligler et al., 2000; Wetzel et al., 1998 ). ...
Efforts to build a complementary and alternative medicine (CAM) education and research infrastructure have been productive. Development has focused largely on graduate, postgraduate, and professional level training. This paper examines baccalaureate programs, looking at the prevalence and characteristics of CAM and holistic health training in the United States.
A comprehensive literature and web site search was conducted to find educational institutions offering baccalaureate programs in CAM or holistic health. Search criteria included accredited undergraduate programs terminating in a minor, an AA, or a BA/BS degree.
A search of health and education databases produced marginal results. Internet searches, by contrast, were very productive in locating CAM or holistic health-related programs generally and baccalaureate programs specifically. The most effective search strings included terms such as "holistic health," "minor," "certificate," and "undergraduate." Using these terms, 5 programs were found in the United States that met the inclusion criteria: Arizona State University East, Bastyr University, San Francisco State University, Metropolitan State College of Denver, and Georgian Court College.
Preparing tomorrow's scholars and clinicians to contribute meaningfully to this emerging healthcare paradigm will require a plan that integrates all elements of higher education. The creation of a truly effective workforce of CAM-competent M.D.s, nurses, health educators, pharmacists, and other allied health professionals will increasingly necessitate baccalaureate preparation. Curriculum discussions at the campus, state, and national levels are needed.
... The paucity of holistic nursing research reveals the need for ongoing definition, description, and focus for the creation of knowledge. Table 2 [64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82] provides examples of holistic research found in the litera-ture. The table intends to be representational and not exhaustive of the ex-tensive work in holistic nursing research that is beginning to evolve (see Table 2). ...
Holistic nursing is a discipline focused on healing the whole person and dedicated to understanding and supporting the premise of holistic health of the patient and promoting healing in practitioners, patients, families, social groups, and communities. An explication of knowledge related to caring and healing in the human health experience and in holistic nursing is informed by the individual nurse's paradigmatic stance. Holistic nursing research is complex and focuses on healing, particularly healing of self, others, systems, and communities at large. This article discusses the competing paradigmatic perspectives, theoretic perspectives supporting holistic research, fundamental patterns of knowing and knowledge generation, a framework for holistic research, and the challenges of conducting holistic research. Recommendations for future research agenda are presented.
A sudden stroke is a traumatic condition causing emotional response to their family identified as the psychological response of post-traumatic incident. The Kubler-Ross approach describes the stages of phsychological response of loss on family toward the sudden stroke incident of the client i.e. denial, anger, bargaining, depression, and acceptance. Identification of the stages after losing incident increase the understanding of how people process to the loss emotionally and cognitively. This research aimed to identify the percentage of respondents on each stage of psychological response of loss on family based on Kubler-Ross approach when the first time client of stroke was attacked in Tugurejo Hospital Semarang. This study involved 30 respondents by using purposive sampling technique. This research was descriptive quantitative by using univariat analysis to analyze each variable study. The data were collected by using a questionnaire. The result of this study showed that denial was suffered by 16,7% (5 respondents), there was no respondent suffered from anger; bargaining was suffered by 96,7% (29 respondents), depression was suffered by 30% (9 respondents), and acceptance was suffered by 96,7% (29 respondents). The study concluded that the most widely experienced responses of family were bargaining and acceptance since 100% (30 respondents) were Javanese who embraced the teaching “silent is gold” and “acceptance”. They did not speak orally but they retained an unpleasant feeling and even traumatic in their mind. Acceptance of Javanese respondents made them considered that everything coming to their life were a matter that must be accepted as it was.
A unique, integrative look at information-based medicine. The convergence of medical science, biology, pharmacology, biomedical engineering, healthcare, and information technology is revolutionizing medical and scientific practice, and has broader social implications still being understood. The Engines of Hippocrates provides a unique, integrative, and holistic look at the new paradigm of information-based medicine, covering a broad range of topics for a wide readership. The authors take a comprehensive approach, examining the prehistory, history, and future of medicine and medical technology and its relation to information; how history led to such present-day discoveries as the structure of DNA, the human genome, and the discipline of bioinformatics; and what the future results of these discoveries may hold. Their far-ranging views are their own and not necessarily those of the IBM Corporation or other employers. The Engines of Hippocrates helps readers understand: Forces shaping the pharmaceutical and biomedical industries today, including personalized medicine, genomics, data mining, and bionanotechnology. The relationship between pharmaceutical science today and other disciplines such as philosophy of health, history, economics, mathematics, and computer science. The integrated role alternative and non-Western medicines could play in a new, information-based medicine. Practical, ethical, organizational, technological, and social problems of information-based medicine, along with a novel data-centric computing model and a self-adaptive software engineering model, and corresponding information technology architectures, including perspectives on sharing remote data efficiently and securely for the common good. An unmatched, cross-disciplinary perspective on the big picture of today and tomorrow's medicine, The Engines of Hippocrates provides a reference to interested readers both inside and outside the pharmaceutical and medical communities, as well as a peerless classroom supplement to students in a wide variety of disciplines.
The concepts of integrative health or integrative medicine are reviewed with an analysis and synthesis of the meaning of these concepts for nursing and nursing education. The passages of public laws that have influenced US health policy are reviewed along with the increase in funding for research as it relates to the increased use of these modalities by health care consumers. It is proposed that schools of nursing adopt and implement curriculum that addresses integrative health care. The goal is to educate nurses about these important concepts and prepare them for the health care consumers that increasingly use them.
The purpose of this pilot study was to explore the approaches to depression care preferred by older home-care patients and examine characteristics associated with those preferences. Twenty-eight long-term home-care patients, ages 62 to 95, were interviewed. Patients ranked their depression care preferences and provided rationale for their responses. Results indicated prayer was preferred by the highest percentage of patients (50%). Comparing patients with and without depression experience, prayer was preferred by the latter group. The results highlight the importance of addressing patient preferences during care planning to improve participation in geriatric depression care management.
The current and projected increase in newly diagnosed cancer patients and survivors supports the nation's need to prepare a nursing workforce that is skilled to meet the health care needs of these individuals. It is likely that cancer patients, especially survivors, will receive care from nurses without specialized oncology education who work in various nononcology clinical settings. Because of the lacking practice standards and educational guidelines for nurses who care for cancer survivors in nononcology settings, this article describes findings of a national survey that identified the importance and depth of cancer-care content included in accredited prelicensure registered nurse programs (diploma, associate and baccalaureate degrees). Findings revealed that a gap exists between respondents' reported importance and depth of cancer-care content currently taught and that importance rated consistently higher than depth taught. Lack of time was the most frequently cited barrier. Results will be used to design generalist oncology resources for nurse educators. [J Nurs Educ. 2013;52(x):xxx-xxx.].
The purposes of this study were to describe the advice that expert holistic nurses gave to nursing students regarding the theory and practice of holistic nursing and to describe nursing students' experience and perceptions of their interaction with the experts.
This was a qualitative descriptive study.
Nursing students who attended the 2008 and 2009 conferences of the American Holistic Nurses Association interviewed expert holistic nurses, asking them for advice for beginners. Students recorded the interviews on paper and wrote their perceptions of interacting with experts. The data were examined for recurring themes.
The most common advice from the experts was regarding the importance of self-care, person-centered care, touch, and lifelong learning. Students' perceptions of the interviews included feeling empowered to accomplish goals, gaining a greater understanding of holistic nursing, and feeling admiration for the holistic nurse experts.
Giving students the opportunity to interact with nurse experts in an individual, informal setting is a useful educational strategy that increases knowledge, promotes socialization to the nursing profession, and offers students opportunities for professional networking.
The use of complementary and alternative medicines (CAM) is growing rapidly within the western world and the nexus with conventional health care services is expanding. Many nurses and other conventional health care providers are not only using CAM themselves but see many of their clients using these medicines and therapies. The attitudes to CAM can influence client satisfaction and client use of different therapies and many practitioners of conventional health care are seeking education and information to enhance their knowledge and use of CAM. This paper reflects on the attitudes to CAM and the education needs and services in the field of CAM as identified by western health care providers, in particular nurses.
The scope of nursing practice is expanding to include the use of complementary and alternative therapies (CAT). This expansion is occurring because of changes in professional and societal attitudes toward the use of such therapies. In this article, we discuss the use of CAT and the development of medical and nursing educational programs related to these therapies in Eastern and Western societies. In addition, we identify future directions for incorporating content on such therapies into nursing education programs in the United States. We suggest that undergraduate nursing programs need to introduce the philosophy of Oriental medicine and content on some of the common therapies and that graduate nursing programs that include content on the use of CAT in nursing practice can possibly be developed.
Increased access and familiarity with computer technology has enhanced research data collection and analysis processes. Use of the Internet in these processes is rapidly becoming an alternative to traditional paper and pencil methods and can be a useful tool in conducting nursing education research. The purpose of this article is to discuss the use of online survey methodologies to identify nursing education trends and disseminate information nationwide. Advantages, disadvantages and pitfalls of using e-mail in conducting a Web-based survey are presented. The authors describe relevant aspects of developing and implementing an online survey; relate their experience in using this survey method with regard to its strengths and limitations; and, comment regarding efficacy of electronic collection and analysis of research data. The authors' experience in conducting a previously published national study of the integration of holistic nursing practices and complementary and alternative modalities in curricula of baccalaureate and higher degree schools of nursing is used as an exemplar. The authors conclude that, regardless of the current status of technology and lack of computer support in some schools of nursing, an online national survey is a valuable tool in conducting research in nursing education and increasingly will be the method of choice for gathering survey data.
The integration of Complementary and alternative medicine (CAM) interventions into healthcare practices is becoming more popular and frequently accessed by patients. Various disciplines have integrated CAM techniques education into the preparation of their practitioners in response to this, but this varies widely, as does its success. Students'experiences of such education in pre-registration is largely unknown in the UK, and methods by which to successful achieve effective learning within this arena are largely unreported within the literature.
This study highlighted three specifics aims; to examine the perspectives of pre-registration nursing students on being taught massage skills during pre-registration nurse education; to identify the learning and development that occurs during massage skills training; and to identify methods of enhancing the provision of such skills training and its experience.
This paper demonstrates the value of integrating complementary therapies into nurse education, developing the holistic approach of student nurses and their concept of caring. In addition it contributes significantly to the knowledge base of the effectiveness of the value of CAM education in nurse preparation, highlighting the high value students place on CAM education and demonstrating notable development in the preparation of holistic practitioners. The method utilised also yielded ways to improve the delivery of such education, and demonstrates how creative teaching methods can motivate and enhance effective learning.
In 2002, the University of Washington School of Nursing (SON) partnered with Bastyr University on a five-year plan to offer a four-week intensive "CAM Camp" (CAMp) for SON faculty members and medical students from across the country. The four-week educational program introduced attendees to various complementary and alternative medicine (CAM) modalities through didactic and experiential learning.
To enhance complementary and alternative medicine content in a SON curriculum and to increase SON faculty knowledge and understanding about (1) the range of CAM therapies, (2) the theoretic and cultural backgrounds of these therapies, and (3) their potential contributions to the health of diverse populations.
A descriptive pretest, posttest design was used to compare pre-CAMp CAM knowledge and CAM course content with post-CAMp knowledge levels of faculty and course CAM content.
On post-CAMp surveys, familiarity with CAM modalities was rated with mixed results as compared with positive reports on the qualitative interviews. Interview results were more positive about CAM in general and were less specific about individual CAM topics. Statistically significant increases in competences were evident in each of 13 competencies rated with four competencies at P < .01. The number of required and elective courses containing CAM content increased as did the CAM content in continuing education conferences offered by the SON.
Content on integrative healthcare and complementary and alternative medicine is now being taught in hundreds of educational programs across the country. Nursing, medical, osteopathic, chiropractic, acupuncture, naturopathic, and other programs all are finding creative and innovative ways to include these approaches into new models of education and practice. In this column we spotlight such innovations in integrative health care and CAM education. The goal is to present readers with specific educational interventions that they may wish to adapt into new or ongoing educational efforts at their institution or program. We invite you to submit brief descriptions of efforts in your institutions that reflect the creativity, diversity, and interdisciplinary nature of the field. Please submit to either Dr. Sierpina at [email protected]
/* */ or Dr. Kreitzer at [email protected]
/* */ Submissions should be brief, 300-400 words, as we plan to synopsize several projects in each issue. We also wish to link the information in the summary to a larger body of information at a website or other resource, so please include that information as well as your e-mail contact.
This descriptive essay summarizes the recommendations rendered by 40 holistic nurse educators attending the 22nd American Holistic Nurses' Association Annual Gathering of Holistic Nurses regarding perceived barriers to integrating concepts of holistic nursing into undergraduate nursing education programs. This paper also presents proposed strategies for promoting more positive attitudes and acceptance of holistic nursing in undergraduate nursing programs.
h4>ABSTRACT
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.
AUTHORS
Received: March 7, 2005
Accepted: June 17, 2005
Dr. So Sun Kim is Associate Professor, College of Nursing, Yonsei University, and Dr. Kwuy Bun Kim and Dr. Sok are Professors, College of Nursing Science, Kyung Hee University, Seoul, South Korea. Dr. Erlen is Doctoral Program Coordinator and Professor, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.
Address correspondence to Sohyune R. Sok, PhD, RN, Professor, 412 College of Nursing Science, Kyung Hee University, #1 Hoegi-dong Dongdaemun-gu, Seoul, South Korea 130-701; e-mail: 5977sok@khu.ac.kr .</P
The purpose of this study was to examine acceptance of change of the healthcare paradigm from reductionism to holism among consumers of healthcare, physicians, and registered nurses. Inaccuracy in perception of acceptance of the holistic paradigm can limit conversation about and use of complementary therapies. Study results did not show a significant difference in acceptance of change between the 3 groups.
This article emphasizes the importance of holistic concepts in nursing and curriculum development. Grounded in the work of Florence Nightingale, nursing education prepares practitioners to meet the holistic needs of clients. The basic tenets offered by the American Holistic Certification Corporation and the American Holistic Nurses' Association are used to describe essential content in a nursing program emphasizing holism. Strategies for introducing holistic nursing into curriculum and overcoming barriers to including holistic nursing in nursing education are discussed. Examples are provided through the experiences of two schools of nursing that successfully incorporated holistic nursing concepts.
As interest in CAM continues to increase, schools of medicine, nursing, and other health professional training programs are being encouraged to integrate content on CAM into curricula.
To assess the attitudes of faculty and staff toward CAM in medicine, nursing, and pharmacy within an academic health center.
A survey was used to obtain data on general attitudes toward CAM, personal use, training needs, and perceived barriers to use.
The survey was taken of 627 faculty and students employed or enrolled at the University of Minnesota. The overall response rate exceeded 50% for both students and faculty.
More than 90% of faculty and students believe that clinical care should integrate the best of conventional and CAM practices and that health professionals should be prepared to advise patients about commonly used CAM methods; 88% of faculty and 84% of students indicated that CAM should be included in their school's curriculum. While there were similarities between the 3 faculty groups, the nursing faculty expressed the greatest interest in practicing CAM.
Faculty and students within medicine, nursing, and pharmacy have favorable attitudes toward the integration of CAM within education and clinical care. Personal use of CAM and training is limited. Lack of evidence is perceived to be the most significant barrier to integration of CAM into Western medicine. The high degree of receptivity suggests the need for both faculty training and curriculum development.
Context.— With the public's increasing use of complementary and alternative medicine,
medical schools must consider the challenge of educating physicians about
these therapies.Objectives.— To document the prevalence, scope, and diversity of medical school education
in complementary and alternative therapy topics and to obtain information
about the organizational and academic features of these courses.Design.— Mail survey and follow-up letter and telephone survey conducted in 1997-1998.Participants.— Academic or curriculum deans and faculty at each of the 125 US medical
schools.Main Outcome Measures.— Courses taught at US medical schools and administrative and educational
characteristics of these courses.Results.— Replies were received from 117 (94%) of the 125 US medical schools.
Of schools that replied, 75 (64%) reported offering elective courses in complementary
or alternative medicine or including these topics in required courses. Of
the 123 courses reported, 84 (68%) were stand-alone electives, 38 (31%) were
part of required courses, and one (1%) was part of an elective. Thirty-eight
courses (31%) were offered by departments of family practice and 14 (11%)
by departments of medicine or internal medicine. Educational formats included
lectures, practitioner lecture and/or demonstration, and patient presentations.
Common topics included chiropractic, acupuncture, homeopathy, herbal therapies,
and mind-body techniques.Conclusions.— There is tremendous heterogeneity and diversity in content, format,
and requirements among courses in complementary and alternative medicine at
US medical schools.
This Clinical Practice Exchange focuses on alternative healing in nurse-midwifery practice. It features interviews with six certified nurse-midwives (CNMs) who practice complementary therapies (CTs). The healing modalities they use include homeopathy, Healing Touch, hypnosis, herbal healing, mindfulness meditation, and water healing. The CNMs discuss their training to practice CTs, how they use alternative healing with clients, and how they integrate this with midwifery practice. The interviews are followed by an Alternative Healing Directory composed of 37 CNMs who responded to a Call, which appeared several times in Quickening and JNM. Each midwife's listing includes contact information, CTs practiced, and special interests in networking with other CNMs about alternative healing. The JNM hopes that this Directory will be a catalyst for networking and communication that will move forward the discussion, practice, and research of alternative healing within the midwifery community.
Many people use unconventional therapies for health problems, but the extent of this use and the costs are not known. We conducted a national survey to determine the prevalence, costs, and patterns of use of unconventional therapies, such as acupuncture and chiropractic.
We limited the therapies studied to 16 commonly used interventions neither taught widely in U.S. medical schools nor generally available in U.S. hospitals. We completed telephone interviews with 1539 adults (response rate, 67 percent) in a national sample of adults 18 years of age or older in 1990. We asked respondents to report any serious or bothersome medical conditions and details of their use of conventional medical services; we then inquired about their use of unconventional therapy.
One in three respondents (34 percent) reported using at least one unconventional therapy in the past year, and a third of these saw providers for unconventional therapy. The latter group had made an average of 19 visits to such providers during the preceding year, with an average charge per visit of 13.7 billion, three quarters of which (12.8 billion spent out of pocket annually for all hospitalizations in the United States.
The frequency of use of unconventional therapy in the United States is far higher than previously reported. Medical doctors should ask about their patients' use of unconventional therapy whenever they obtain a medical history.
The growing interest in and use of alternative and complementary therapies by health care professionals and laypersons, the incorporation of these therapies in medical curricula and practice, and the greater acceptance of the legitimacy of such treatment methods require that nurse educators consider how this content may be incorporated into curricula. The authors propose that prelicensure students learn the premises that support such healing practices and develop skill in eliciting and evaluating patients' use of alternative therapies. In-depth study of one or more complementary therapies may be the focus of continuing education or elective courses. Students in graduate programs may investigate the safety and efficacy of nonorthodox therapies.
Throughout the course, students are encouraged to examine "self" in relation to their own beliefs about health and healing. They are prompted to share their personal experiences, based on the healing practices of their own cultural and ethnic backgrounds, in group discussions.
Nurse educators are considering the inclusion of complementary and alternative therapies in nursing curricula with increasing frequency, motivated at least in part by the ever-increasing public enthusiasm for these therapies. This article addresses the differing paradigms between orthodox Western medicine and complementary and alternative therapies, describing the research, language, educational, legal, financial, and ethical issues related to the use of complementary and alternative therapies. Additionally, it presents sources of current standards, along with examples of teaching these therapies at the undergraduate, graduate and continuing education levels and suggests strategies for teaching these therapies.
With the increasing use of complementary therapies by the general population, nursing faculty are challenged to educate their students about these therapies. The authors designed a course to provide students with a broad overview of selected complementary therapies commonly used in the United States. In preparation for the course, the authors evaluated graduate nursing students' awareness, use, and practice patterns of complementary therapies in their rural state. A high percentage (82%) of those students thought it was important for healthcare professionals to understand complementary therapies. The course has been offered three times, once using an interactive video network and twice using a 5-day workshop format.
Integration of Complementary Therapies in the Nurse Practitioner Curriculum
- L Rauckhorst
Rauckhorst L, Integration of Complementary Therapies in the Nurse Practitioner Curriculum. Clinical Excellence for Nurse Practitioners. 1997;1(4): 257-265
Geraldine (Polly) Bednash, Executive Director
- Personal
Personal conversation with Dr. Geraldine (Polly) Bednash, Executive Director, American Association of Colleges of Nursing, October 22, 2002
NP program first to include alternative therapies in nursing curriculum
- D Sussman
Sussman D, Holistic Nursing: NP program first to include alternative therapies in nursing curriculum. NurseWeek. 2000; 13(8): 31