Complementary and alternative medicine practices (CAM) are often classified into broad categories, such as body and mind medicine, natural products, manipulative and body-based therapies . The National Institute of Complementary Medicine states that CAM, “is a broad domain of healing resources that encompasses all health systems, modalities, and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health system of a particular society or culture in a given historical period” . The range of CAM treatments includes naturopathy, acupuncture, massage therapy, yoga, herbal medicine, chiropractic, and homeopathy . Up to 69.8% of Australians have used at least one form of CAM, and 44.1% have visited a CAM practitioner in the previous 12 months .
The increased use of CAM among the general community has been attributed to the increased availability of information on the internet, contacts with other cultures that traditionally use CAM, the view that CAM is safer and less expensive than conventional medications and a growing recognition that many factors contribute to health and well-being .
Personal experience, faculty attitudes and family background ranked amongst the most common factors influencing pharmacy students’ attitudes towards CAM and their likelihood of recommending CAM therapies to future patients . More than half of a cohort of pharmacy students had changes in attitudes and beliefs toward CAM, and an increased likelihood of recommending CAM therapies in future practice when they completed a course on CAM therapies .
Although the use of CAM therapies has been increasing in recent years, the debate about the clinical efficacy of these therapies has been controversial amongst many medical professionals. This has been largely due to a lack of scientific data surrounding many CAM therapies, compounded by variations in knowledge level and appreciation of the existing evidence about CAM amongst different healthcare professionals.
In the United States osteopathic medical students exhibit a positive attitude toward CAM with 83% reporting self-use of at least 1 CAM modality . Older students were more likely than younger students to use a larger number of CAM modalities . Female osteopathic medical students had more positive attitudes towards CAM therapies compared to their male counterparts and they were more likely to recommend CAM therapies to their patients .
A study conducted in 10 pharmacy schools in the United States demonstrated that the majority of students agreed that CAM knowledge would be needed in future pharmacy practice, however they did not necessarily possess that knowledge at the time of questioning. Students also agreed that there are limitations to conventional medicine and that patient’s values and beliefs should be integrated into the patient care process. Furthermore, the study concluded that female students and those who had previous experience with CAM exhibited a more favorable attitude towards CAM .
Acute care nurses in the United States reported an increase in patients seeking CAM therapies to cope with pain, particularly when they experienced inadequate pain relief from mainstream medicine . Approximately half (51%) of the nurses surveyed demonstrated poor baseline information regarding CAM and even fewer (47%) were able to accurately describe or define CAM and CAM terminology . This was linked to an inability to educate their patients on the different CAM therapies available and those that may be beneficial in pain management. Nevertheless, attitudes towards CAM were positive with the majority agreed that patients have a right to incorporate CAM therapies into their conventional medical treatments. The nurses also believed that the use of CAM therapies by patients should be disclosed .
A further survey of nursing students and staff reinforced these findings that clinical care ought to incorporate the best of CAM therapies and highlighted a positive attitude towards incorporating CAM into nursing practice. However, this study also highlighted the lack of education amongst nurses in relation to CAM therapies .
There does not appear to be any previous research on chiropractic students’ or Australian nursing students’ knowledge and attitudes toward CAM.
It seems important that as healthcare providers interact with patients seeking CAM in an age of patient centered care they are able to give patients advice and potentially options (where possible) for the management of disease or pain, and this may involve consideration of CAM therapies. Healthcare providers also need to be able to educate patients regarding the evidence for CAM therapies, their prognosis, adverse events and contraindications. To be able to accomplish this, healthcare providers, including chiropractors and nurses, should have a basic knowledge of other treatment options such as CAM.
In summary, there is limited research regarding knowledge, attitudes, influences and use of complementary and alternative medicine among Australian chiropractic and nursing students. The aims of this study were therefore to:
evaluate the knowledge of nursing and chiropractic students about CAM.
determine their attitudes and beliefs regarding the use of CAM.
determine whether or not chiropractic and nursing students would recommend CAM to their future patients. For chiropractors this means other than their own interventions.
investigate the factors that influence their attitudes and beliefs and their likelihood of using or recommending CAM to future patients.
compare the findings between nursing and chiropractic students and determine similarities and differences.