Acceptance of Complementary and Alternative Therapy among Nurses: A Q-methodological Study

Ae-Kyung Kim

doi:10.7475/kjan.2017.29.4.441

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Kim: Acceptance of Complementary and Alternative Therapy among Nurses: A Q-methodological Study

Original Article

Korean J Adult Nurs 2017;29(4):441-449.

Published online: 9 August 2017

DOI: https://doi.org/10.7475/kjan.2017.29.4.441

Acceptance of Complementary and Alternative Therapy among Nurses: A Q-methodological Study

Ae-Kyung Kim, Ph.D., RN

Department of Nursing, Dankook University, Cheonan, Korea

Corresponding author: Kim, Ae-Kyung Department of Nursing, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan 31116, Korea. Tel: +82-41-550-3885, Fax: +82-41-559-7902, E-mail: aekim@dankook.ac.kr

Received 30 May 201724 July 2017 Accepted 26 August 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Perceptions of nurses regarding complementary and alternative therapies(CATs) acceptance illustrate how CATs can be applied in nursing practice and become the empirical basis for the expansion of nursing role. Purpose is to identify nurses’ perception of CATs acceptance.

Methods

A Q-methodological study, which allows for analysis of subjectivity of data, was used. A convenience P-sample was consisted of 36 nurses. Twenty-seven Q-statements were derived from a literature review and interviews with six nurses, and were then categorized on a normal distribution using a 9-point scale. The collected data were analyzed using the QUANAL PC Program.

Results

Three types of perception regarding acceptance of CATs were identified among nurses. Type I was called the “ cautious type”; Type II, the “ positive acceptance type”; and Type III, the “ considering reality type.”

Conclusion

Along with further exploration of the scientific evidence of CATs, adequate nursing education, and finding ways to overcome the obstacles needed for acceptance of effective and empirically tested CATs into a nursing practice, the results of this study may help promoting application of CATs as a nursing practice.

Keywords: Nurses, Perception, Complementary therapies, Alternative medicine

REFERENCES

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Table 1.

Depiction of Q-sorting Scale

	Disagree				Natural				Agree
Score	-4	-3	-2	-1	0	1	2	3	4
No. of cards	2	2	3	4	5	4	3	2	2

Table 2.

Eigenvalues, Variance, and Cumulative Variance for Type of Awareness (N=36)

Variables	Type I	Type II	Type III
Eigenvalue	11.89	3.78	2.28
Variance (%)	0.31	0.10	0.06
Cumulative variance	0.31	0.41	0.47
Type I=cautious type; Type II	I=positive acc	ceptance type;

Type III=considering reality type.

Table 3.

Correlation Matrix (N=36)

Variables	Type I	Type II	Type III
Variables	r	r	r
Type I	1.00
Type II	.20	1.00
Type III	.36	.47	1.00
Type I=cautious t	type; Type II=pos	sitive acceptance ty	ype;

Type III=considering reality type.

Table 4.

Demographic Characteristics and Factor Weight for P-sample (N=36)

Type	No.	Factor weight	Age (year)	Education	Religion	Living place	Job	Working place	Hospital size	Place of work	Career as nurse (year)
Type I (n=9)	6	0.78	29	Master	None	Town	Nurse	IM	100~299	General hospital	5
	10	0.88	37	Bachelor	None	City	Nurse	GS	100~299	General hospital	14
	13	0.66	34	Bachelor	Catholic	Town	Nurse	GS	100~299	General hospital	10
	19	0.59	38	Bachelor	None	Town	Nurse	IM	100~299	Hospital	15
	21	0.44	34	Bachelor	Buddhist	City	Nurse	Geriatric	＜99	Geriatric hospital	7
	23	0.82	30	Bachelor	Protestant	City	Nurse	IM	100~299	General hospital	4
	25	0.95	38	Master	None	Town	Nurse	GS	100~299	Hospital	15
	34	0.67	32	Bachelor	Protestant	Metropolis	Student	None	None	University	6
	36	0.90	38	PhD	Catholic	Metropolis	Professor	None	None	University	13
Type II (n=20)	1	1.58	29	Bachelor	None	City	Nurse	ER	100~299	General hospital	6
	2	1.04	37	Bachelor	None	Town	Nurse	GS	100~299	General hospital	14
	5	1.63	23	Bachelor	None	City	Nurse	IM	100~299	General hospital	1
	8	1.06	22	Bachelor	None	City	Nurse	GS	100~299	General hospital	1
	9	0.85	22	Bachelor	Buddhist	City	Nurse	GS	100~299	General hospital	1
	11	1.38	40	Bachelor	None	City	Nurse	GS	100~299	General hospital	18
	12	0.67	30	Bachelor	Protestant	City	Nurse	GS	100~299	General hospital	5
	14	1.58	32	Bachelor	Catholic	City	Nurse	GS	100~299	General hospital	1
	15	0.77	35	Bachelor	None	City	Nurse	GS	100~299	General hospital	6
	17	1.72	47	Bachelor	None	Metropolis	Nurse	Day care	300~499	General hospital	22
	18	0.63	39	Bachelor	Buddhist	Metropolis	Nurse	ER	100~299	General hospital	16
	20	0.95	37	Bachelor	None	Town	Nurse	Geriatric	100~299	Hospital	12
	22	0.96	39	Bachelor	Buddhist	City	Nurse	ICU	＞500	General hospital	17
	24	0.80	40	Bachelor	Catholic	City	Student	None	None	None	3
	26	0.83	42	Master	None	Metropolis	Professor	None	None	None	14
	28	1.74	40	Master	Protestant	City	Professor	None	None	None	6.6
	30	0.81	36	Master	Catholic	City	Nurse	ICU	＞500	General hospital	6
	32	0.88	40	Master	Protestant	City	Student	None	None	None	7
	33	1.78	42	Master	Protestant	City	Nurse	GS	＞500	General hospital	19
	35	1.34	52	PhD	Protestant	Metropolis	Professor	None	None	None	3
Type III (n=7)	3	0.23	34	Bachelor	Buddhist	Town	Nurse	GS	100~299	General hospital	10
	4	0.63	23	Bachelor	Protestant	City	Nurse	GS	100~299	General hospital	1
	7	0.46	24	Bachelor	None	City	Nurse	IM	100~299	General hospital	1
	16	0.55	38	Bachelor	None	City	Nurse	ER	＞500	General hospital	14
	27	1.13	38	Master	Protestant	City	Nurse	ER	＞500	General hospital	14
	29	1.07	36	Master	Protestant	City	Student	None	＞500	General hospital	7
	31	1.55	36	Master	Protestant	City	student	None	None	None	10

Type I=cautious type; Type II=positive acceptance type; Type III=considering reality type; PhD=doctor of philosophy.

Table 5.

Z-Scores of Q-statements by the Types of Awareness (N=36)

Q-statement	Type I (n=9)	Type II (n=20)	Type III (n=7)
Q-statement	Z-score	Z-score	Z-score
Q1. Utilization of CATs exhausts nurses because it consumes so much energy.	-0.30	-0.60	-0.50
Q2. Utilization of CATs is difficult because nurses lack knowledge.	-0.60	-0.20	0.20
Q3. Advantage of CATs is that they increase intimacy between nurses and patients.	1.17	1.00	0.60
Q4. Professional status of nurses could decline when they use CATs, which the general public can also learn.	-0.90	-1.71	-2.16
Q5. Nurses are the best who can approach CATs among health professionals.	-1.18	1.43	1.52
Q6. It is difficult to utilize CATs in a general hospital.	-0.20	-0.00	0.20
Q7. CATs must be used cautiously because of the side effects.	1.59	-0.30	0.80
Q8. Nurses should utilize CATs only after acquiring a license through professional training.	1.73	1.02	-0.40
Q9. It is advisable to perform CATs only on patients with chronic disease.	-1.50	-1.32	-0.60
Q10. CATs should be developed actively as a new independent area of nursing.	-1.28	1.00	0.00
Q11. CATs have no benefits except providing satisfaction to patients.	-1.20	-1.31	-2.06
Q12. Utilization of CATs should follow a standardized protocol.	0.60	-0.40	0.30
Q13. CATs should be actively developed as a new field in nursing.	-1.00	1.31	0.70
Q14. CATs should not be used on patients without the approval of doctors.	0.30	-1.75	0.90
Q15. A lack of time is the biggest obstacle to using CATs.	0.10	0.60	1.72
Q16. CATs, which lack scientific basis, should not be used without caution.	2.28	0.40	1.08
Q17. It would be desirable for hospitals to support CAT education.	0.70	1.23	0.90
Q18. If one wish to learn CATs, it is better to be certified.	1.30	0.50	-0.10
Q19. It is preferred to delay the utilization of CATs until they are acknowledged as a part of nursing.	0.30	-1.10	-0.50
Q20. It is unwise to spend one's money and time on CATs.	-0.50	-1.30	-1.20
Q21. Utilization of CATs would be possible if taught during nursing undergraduate programs.	-0.20	0.60	-0.70
Q22. CATs should be developed in a direction that benefits both hospitals and nurses.	0.80	1.66	1.26
Q23. It is difficult to utilize CATs because of their uncertain effects.	-0.60	-0.90	0.80
Q24. CATs have not advanced because of a lack of interest among nurses.	-1.30	-0.10	-0.80
Q25. Utilization of CATs in nursing practice does not necessarily increase the satisfaction and self-esteem of nurses.	0.00	-0.00	-1.46
Q26. Utilization of CATs by nurses can be hindered due to the traditional doctors.	0.00	0.10	0.30
Q27. CAT should be actively utilized in clinical practice by nurses at their discretion.	-0.20	1.00	-0.70

CATs=complementary and alternative therapies; Type I=cautious type; Type II=positive acceptance type; Type III=considering reality type.

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