Alternative and complementary therapy use in pediatric oncology patients in British Columbia: prevalence and reasons for use and nonuse.

PURPOSE: Alternative and complementary therapies are infrequently studied in pediatric populations. We performed a population-based survey to aid health care workers in identifying and counseling parents who may use these remedies. PATIENTS AND METHODS: We retrospectively surveyed the parents of 583 pediatric patients diagnosed with cancer in British Columbia between 1989 and 1995. Prevalence and factors that influence the use and nonuse of alternative and complementary therapies were estimated. RESULTS: Alternative and complementary therapies were used by 42% of 366 respondents. Herbal teas, plant extracts, and therapeutic vitamins were the most commonly used alternative therapies. Relaxation/imagery strategies, massage, and therapeutic touch were the most commonly used complementary techniques. Factors that influenced the use of alternative/complementary therapies were prior use (chi2 = 60.0, P < .0001), prior positive attitude towards these remedies (chi2 = 41.6, P < .0001), soliciting information from family and friends (chi2 = 70.5, P < .0001) or from alternative care givers (chi2 = 58.7, P < .0001), high risk of death at diagnosis (chi2 = 9.6, P < .002), and advanced education of the father (chi2 = 7.4, P < .006) or mother (chi2 = 8.6, P < .003). Parents who used alternative/complementary therapies did so in conjunction with conventional medicine (98%). Lack of knowledge and fear of interference with conventional therapies were the most common reasons cited for nonuse. No parent believed that the quality of life of their child deteriorated due to the use of alternative/complementary therapies. CONCLUSION: Alternative and complementary therapy use in pediatric oncology patients is common. Factors have been identified that may be associated with undertaking their use.

Work-related stresses of pediatric bone marrow transplant nurses.

The stress that nurses experience when working in specialty units, such as the intensive care unit (ICU) and the neonatal intensive care unit (NICU), has been described in many studies as being a significant variable in nurse retention, job satisfaction, and quality of patient care. Although some investigation of stress has extended to other areas of nursing, one specialty where stress has not been studied is bone marrow transplant (BMT) nursing. The purpose of this study was to identify work-related stresses of pediatric BMT nurses. The convenience sample consisted of 31 RNs and LPNs who had at least 6 months of experience in a laminar air flow (LAF) BMT unit in a pediatric facility in the southwest United States. Eighteen nurses responded to a questionnaire asking them to describe two incidents in their experience that were most stressful to them. Thirty-seven incidents were collected. Categories and subcategories described in the literature, as well as from the researcher's experience, were used in the content analysis of the incidents. Each incident was analyzed independently by three nurse-judges who identified categories and subcategories in each incident. Several new subcategories were identified from the data. Negotiations for categorization occurred until full agreement among the nurse-judges was reached. Categories of stress identified, in decreasing order of frequency, included: patient care, philosophical/emotional/ethical, environment, interpersonal relations/communication, knowledge base, management of the unit, bureaucratic/political/organizational.(ABSTRACT TRUNCATED AT 250 WORDS)