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J Adv Nurs. 2002 Jul;39(1):9-16.

Nurse practitioner knowledge of complementary alternative health care: foundation for practice.

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  • 1Jewish Hospital College of Nursing and Allied Health, Washington University Medical Center, St Louis, Missouri 63108, USA.



With the increasing use of complementary alternative treatments by the general public in the United States of America (USA), it is critical that nurse practitioners have the most up-to-date information about the use and safety of these modalities. A strong knowledge base is crucial in delivering competent and culturally sensitive care, yet the level and source of nurse practitioner knowledge in this area is largely unknown. The purpose of this study was to investigate the level and source of nurse practitioner knowledge of complementary alternative health care practices, as well as their referral practices involving these treatments.


Using a cross-sectional descriptive research design, a sample of 151 nurse practitioners from Missouri and Oregon completed an adapted version of Sapp's self-administered survey that explored these issues. Evaluation of the psychometric properties of the adapted instrument demonstrated good face validity, test-retest reliability (kappa = 0.81) and internal consistency reliability were 0.90 and 0.92 for two subscales with continuous response categories.


Eighty-three percent of the nurse practitioners recommended complementary alternative treatments to their patients with the most frequent being massage therapy, chiropractic care, acupuncture or acupressure, nutritional therapy and herbal treatment. However, only 24% reported that formal nurse practitioner education was a source of knowledge about these treatments. Instead, over 60% relied on their personal experiences for this knowledge, as well as lay and professional journals.


Nearly 9 out of 10 nurse practitioners recommend the use of complementary alternative therapies to patients, but their source of knowledge is not derived from professional education. Attention needs to be given to increasing content about complementary alternative therapies in formal academic programs, professional conferences and in-service education opportunities.

[PubMed - indexed for MEDLINE]
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