An exploratory study of the relationship between alternative therapies, functional status, and symptom severity among people with multiple sclerosis.

Roy's Adaptation Model guided an exploratory study of the association of alternative therapies with functional status and symptoms in people with multiple sclerosis (MS). Data were collected from 16 volunteers by a telephone-administered interview schedule and a mailed questionnaire. All 16 respondents reported seeking traditional medical treatment and at least 1 alternative therapy (mode = 3, range = 1-9). The correlation between the number of alternative therapies and functional status was -.42; the greater the number of therapies used by the respondents, the lower their functional status. Qualitative data analysis revealed that functional status was enhanced by beneficial effects of specific alternative therapies, pacing oneself, changing the perception of self, and focusing on spiritual aspects of self. Self-reported MS symptoms were less severe following use of alternative therapies (p < .0005). Study of the differential effects of single and combined alternative therapies on functional status and symptom severity for large samples of people with MS is recommended.

Use of alternative health therapies by people with multiple sclerosis: an exploratory study.

Sixteen people with multiple sclerosis (MS) responded to a semi-structured questionnaire about their experiences with alternative therapies. No definition of alternative therapies was provided. Physical therapy, counseling, nutrition, and massage were the most frequently used alternative therapies. Other therapies included acupuncture, occupational therapy, aquatic therapy, Therapeutic Touch, yoga, passive exercise, and removal of mercury alloy tooth fillings. Almost two thirds of the respondents reported seeking an alternative health practitioner because traditional physicians offered no cure for MS. Just under one third of the respondents stated that the quality of their lives was improved by alternative therapies.

Characteristics of pediatric intermediate care units in pediatric training programs.

BACKGROUND/OBJECTIVE: To assess effective alternate care sites for the technology-dependent, but less acute critically ill child, we surveyed pediatric training programs to determine the availability and characteristics of non-neonatal pediatric intermediate care units. METHODS: A questionnaire was mailed to the program directors of all 226 United States pediatric residency programs in October 1988. Institutions were queried about pediatric residency program and hospital demographics, along with specific day-to-day management issues in an intermediate care unit. RESULTS: The intermediate care unit offers highly skilled nursing care with greater than 90% of the units primarily covered by RNs in a 1:2 or 1:3 RN/patient ratio. The technologies used in these units were similar to those technologies used in an ICU, and the average daily bed charge was 40% less than the average daily bed charge in an ICU. However, an intermediate care unit was present in only 33% of pediatric training programs and pediatric residents were not specifically trained to care for patients in these units; 37% of these units did not have daily attending physician/nurse/resident rounds, despite the complexity and degree of illness in the patients located in these units. In addition, greater than 20% of intermediate care units were predominantly staffed by RNs with degrees less than BSN. Thirteen percent of these units had a predominance of RNs with only routine experience. CONCLUSIONS: Standard levels of care and academic and financial guidelines should be established to optimize the value of pediatric intermediate care units.