Nurse and patient characteristics predict communication about complementary and alternative medicine

BACKGROUND The aim of this study was to identify nurse factors (eg, knowledge, practices, and clinical habits regarding complementary and alternative medicine [CAM] as well as demographic factors) and patient characteristics (eg, age, sex, and treatment status) associated with nurses' CAM inquiry and referral patterns. METHODS Baseline data were collected with nurse/patient questionnaires about CAM use and knowledge as part of a multicenter CAM educational clinical trial. Frequencies and nested regression models were used to assess predictors of nurses' inquiries about and referral to CAM therapies. RESULTS Six hundred ninety-nine patients participated in the study. For patients, female sex (odds ratio [OR], 1.50; P =.019) and cancer recurrence (OR, 1.45; P =.05) were predictive of nurses' inquiries about and referral to CAM therapies. A total of 175 nurses with a mean age of 45 years and a mean experience of 20 years participated; 79% were staff nurses, and 11% were nurse practitioners. Fifty-three percent asked at least 1 of their last 5 patients about CAM use; 42% referred patients to CAM therapy. Nurses who reported being "somewhat comfortable" (OR, 2.70; P =.0001) or "very comfortable" (OR, 3.88; P <.0001) about discussing CAM, self-reported use of massage (OR, 2.20; P <.0001), and had formal CAM education (OR, 4.14; P =.0001) were more likely to ask about CAM use. Nurses who reported being "somewhat comfortable" (OR, 2.54; 95% confidence interval, 1.47-4.41; P =.0008) or "very comfortable" (OR, 7.46; P <.00001) and had formal CAM education (OR, 2.96; P <.0001) were also more likely to refer patients to CAM therapies. CONCLUSIONS Both patient and nurse characteristics were associated with discussions about CAM. Oncology institutions that prioritize evidence-based medicine should consider introducing CAM education to their nursing staff.