Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2015 Complementary Alternative Medicine: Awareness and Perceptions of Health Care Providers Who Provide Systemic Lupus Care Carmen Ionie Bartley Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Public Health Education and Promotion Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Sciences This is to certify that the doctoral dissertation by Carmen Bartley has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Jacqueline Fraser, Committee Chairperson, Public Health Faculty Dr. Michael Schwab, Committee Member, Public Health Faculty Dr. Cynthia Tworek, University Reviewer, Public Health Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2015 Abstract Complementary Alternative Medicine: Awareness and Perceptions of Health Care Providers Who Provide Systemic Lupus Care by Carmen Ionie Bartley MSN/IH, University of Phoenix, 2006 BSN, St. Joseph’s College, 1996 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University May 2015 Abstract The purpose of this study was to explore healthcare providers’ awareness and perceptions of complementary and alternative medicine (CAM) use in providing systemic lupus erythematosus (SLE) care. This phenomenolgical study was built upon existing research indicating SLE patients’ need to foster better communication about CAM use. Participants were recruited from the Long Island Rheumalogical Clinic in the State of New York. Individual in-depth semistructered interviews were conducted to explore the awareness and perceptions of a purposive sample of 10 healthcare providers who care for patients with SLE. Transcripts were analyzed, and categorical themes were developed. Guided by the use of the shared decision-making model and self-efficacy theory, 5 themes emerged: varied knowledge and experiences with CAM varied, participants’ personal experience and perceived effectiveness led to patient guidance and advice, perceived benefits of CAM use, participants as patient advocates, and initiatives for further research. Study findings revealed that the knowledge, attitudes, and beliefs of health care providers regarding the use of CAM shed light on the importance of health promotion to guide future research, both within and beyond CAM. Strategies are recommended to increase awareness and understanding of CAM use through proper education and advocacy. This research may lead to positive social change in that providers may use the information in this research to break down barriers to communication between patients and professionals regarding CAM usage. Complementary Alternative Medicine: Awareness and Perceptions of Health Care Providers Who Provide Systemic Lupus Care by Carmen Ionie Bartley MSN/IH, University of Phoenix, 2006 BSN, St. Joseph’s College, 1996 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University May 2015 Dedication This work is dedicated to my daughter, Danielle, whose presence in my life has brought me enormous joy and a deep sense of purpose. You have inspired me to be a positive role model. Thanks for being patient and understanding, and for putting up with me through the entire journey from start to finish. My hope is that you pursue your dreams and follow them to the highest peak possible, no matter how hard or difficult the journey. To Leslie, my husband, even though you have not grasped the magnitude of the journey I undertook, you have helped me navigate a world that was challenging for me by encouraging the qualities in me that would help me accomplish this task. I dedicate this dissertation to my parents, the late Daphne Rebecca Bartley and my only remaining parent, Elvis Bartley, who at an early age instilled in me the purpose and value of education. Thanks for the great support in my education. This educational journey is a true blessing, and God be praised. To my siblings, I also dedicate this dissertation to you. I know through your unspoken words you had my back. For that, I want to say thanks for the sometimes simple questions asked: How it is going, and where are you now? Have you heard back from your chair yet? It meant a lot and reconfirmed that strength is in numbers. Although this success was achieved by me, it was not completed in isolation, and I will be forever grateful for those who have provided me with the support I needed along the journey.Your constant prayers and encouragement gave the assurance that the task at hand was conceivable. Acknowledgments I would like to acknowledge and value Dr. Jacquie Fraser, my dissertation chair, who has kept me focused with continuous support and encouragement. At times, we were both frustrated, but she constantly reminded me that my goal is achievable and is within reach. Her patience, encouragement, and unwavering support of my educational journey were invaluable as I moved from an idea to a completed study. Thank you for all of the editing and feedback that you gave me along the way. I am grateful also to Dr. Michael Schwab and Dr. Tworek, my other committee members, for their insight and recommendations, which enhanced my learning experience and added depth to the project. I see now how everyone needs a faithful guide during the writing process and how this improves the work. I will be forever grateful to Khelesh Persaud, my Canadian classmate, who endured my frustration during the most stressful moments with laughter. Without hesitation, Khelesh responded to all my phone calls, and led and held me through those moments of fear, discouragement, exhaustion, and desperation. I love you. Table of Contents List of Tables ..................................................................................................................... vi Chapter 1: Introduction to the Study ....................................................................................1 Background ....................................................................................................................1 Problem Statement .........................................................................................................4 Nature of the Study ........................................................................................................5 Research Questions ........................................................................................................6 Purpose of the Study ......................................................................................................6 Conceptual Framework ..................................................................................................7 Operational Definitions ..................................................................................................9 Assumptions, Limitations, and Delimitations ..............................................................11 Assumptions .......................................................................................................... 11 Limitations ............................................................................................................ 11 Delimitations ......................................................................................................... 12 Significance of the Study .............................................................................................12 Summary and Study Organization ...............................................................................13 Chapter 2: Literature Review .............................................................................................15 Gaps in Literature ........................................................................................................15 Search Strategies ..........................................................................................................16 Conceptual Framework ................................................................................................17 Scope of Complementary and Alternative Medicine ...................................................19 Mainstreaming CAM in Academic Institutions ...........................................................22 i Historical Background and Current Trends .................................................................25 CAM Use in the United States .............................................................................. 26 CAM Use for Chronic Conditions ........................................................................ 31 Patients’ Reluctance to Discuss Their CAM Use With Their Physician .............. 32 Types/Conditions of Individuals Who Are Drawn to CAM Use .......................... 32 Factors Affecting CAM Use ................................................................................. 35 Quality-of-Life Issues ........................................................................................... 36 Patient-Clinician