Educational courses on non-pharmacologic complementary interventions for nurses across Europe : The INES mapping pilot study

Funding Information: This study is part of a larger EU-funded project called the Integrative Nursing Education Series (INES). The INES project is a European consortium between the Erasmus Medical Center Rotterdam, the Netherlands; the van Praag Institute, the Netherlands; VIA University College, Denmark; the University of Iceland and Karolinska Institutet, Sweden. The INES consortium aims to strengthen nurses' knowledge, attitudes, competencies and skills on complementary NPIs such as mindfulness, massage and relaxation exercises.This study is part of an EU funded project by Erasmus+ (KA203 Strategic Partnerships for Higher Education): ‘The Integrative Nursing Education Series’ (2019-1-NL01-KA203-060478). Funding Information: This study is part of an EU funded project by Erasmus+ (KA203 Strategic Partnerships for Higher Education): ‘The Integrative Nursing Education Series’ ( 2019-1-NL01-KA203-060478 ). Publisher Copyright: © 2022 The AuthorsBackground: Pharmacological interventions still form the mainstay of the management of pain, anxiety, sleep problems and discomfort. In Europe, an estimated 100 million people use complementary non-pharmacological interventions (NPIs) for these conditions. In their pre-registration education, nurses do not generally learn about the various types of NPIs and how patients and health care professionals can include NPIs complementary to their standard care. Some nursing schools in Europe offer elective courses on NPIs, often relying on individual initiatives. Little is publicly available about the content of these programmes and how they relate to the current nursing curriculum for EU countries. Objectives: This pilot study aims to explore and map the field of nursing education with regard to complementary NPIs for nurses in Europe. Design: A web-based open-access questionnaire administered through the online survey tool LimeSurvey® was designed by the authors. Participants: The questionnaire was sent to a purposive sample of 49 experts on nurse education and complementary NPIs from 16 European countries. All levels of education were eligible for inclusion. Methods: The questionnaire consisted of 35 items regarding course content, teaching material, teaching methods and methods of assessment. In addition, respondents were invited to perform a strengths, weaknesses, opportunities and threats (SWOT) analysis in relation to their education programme. Qualitative data was analyzed using a directive content analysis approach. Results: Between January and May 2020, thirty-one completed questionnaires from ten different countries were returned (response rate 63.3%). Massage, meditation, mindfulness and relaxation are the most taught interventions. Anxiety, stress, chronic pain, depression and sleep problems are the most common symptoms addressed. Conclusions: Currently, a consistent and European approach to education for nurses on complementary NPIs and integrative nursing is lacking. Although taught at regular nursing educational institutes, the courses discussed here are not yet embedded in mainstream education for nurses.Peer reviewe

Educational courses on non-pharmacologic complementary interventions for nurses across Europe: The INES mapping pilot study

Background: Pharmacological interventions still form the mainstay of the management of pain, anxiety, sleep problems and discomfort. In Europe, an estimated 100 million people use complementary non-pharmacological interventions (NPIs) for these conditions. In their pre-registration education, nurses do not generally learn about the various types of NPIs and how patients and health care professionals can include NPIs complementary to their standard care. Some nursing schools in Europe offer elective courses on NPIs, often relying on individual initiatives. Little is publicly available about the content of these programmes and how they relate to the current nursing curriculum for EU countries. Objectives: This pilot study aims to explore and map the field of nursing education with regard to complementary NPIs for nurses in Europe. Design: A web-based open-access questionnaire administered through the online survey tool LimeSurvey® was designed by the authors. Participants: The questionnaire was sent to a purposive sample of 49 experts on nurse education and complementary NPIs from 16 European countries. All levels of education were eligible for inclusion. Methods: The questionnaire consisted of 35 items regarding course content, teaching material, teaching methods and methods of assessment. In addition, respondents were invited to perform a strengths, weaknesses, opportunities and threats (SWOT) analysis in relation to their education programme. Qualitative data was analyzed using a directive content analysis approach. Results: Between January and May 2020, thirty-one completed questionnaires from ten different countries were returned (response rate 63.3%). Massage, meditation, mindfulness and relaxation are the most taught interventions. Anxiety, stress, chronic pain, depression and sleep problems are the most common symptoms addressed. Conclusions: Currently, a consistent and European approach to education for nurses on complementary NPIs and integrative nursing is lacking. Although taught at regular nursing educational institutes, the courses discussed here are not yet embedded in mainstream education for nurses

What are nursing students taught about complementary therapies and integrative nursing?: A literature review

Introduction: In Europe, more and more people use complementary therapies (CT) for the management of pain, anxiety, sleep problems and discomfort. However, nursing students are generally not taught about CT. Furthermore, nurses are not taught how to communicate about patients’ complementary health seeking behavior, nor how to integrate CT in their nursing practice. The aim of this literature review was to explore what has been published about CT in nursing education. Methods: A systematic search was performed in the MEDLINE, EMBASE, CINAHL and Cochrane databases. Articles on educational courses, programs and lectures were included. Instructions for nurses as part of clinical studies were excluded, as these do not reflect formal nursing education. Data was analysed with qualitative content analysis. Furthermore, we extracted data on educational context, educational content and educational methods. Results: From 5273 records, sixteen articles were eligible. The course content varied but suggested that general information about CT and hands-on techniques is important, such as practicing communication about CT and critical thinking skills. A range of methods were used to teach, but only three articles described competencies, which included emphasis on safety and good communication skills. Conclusion: Despite patients’ high CT use and demand for information from health care professionals about its use, information on how such knowledge is implemented in nursing education is scarce, especially in Europe. Developing a handbook for teachers about how to teach nursing students in Europe about CT in the context of nursing is needed

Integrating Placebo Effects in General Practice: A Cross-Sectional Survey to Investigate Perspectives From Health Care Professionals in the Netherlands

Objectives: Placebo effects, beneficial treatment outcomes due to non-active treatment components, play an important role in the overall treatment response. To facilitate these beneficial effects it is important to explore the perspectives of health care professionals (HCPs) on the integration of placebo effects in clinical care. Three themes were investigated: knowledge about placebo effects and factors that contribute to these, frequency of placebo use, and attitudes toward acceptability and transparency of placebo use in treatment. Methods: A cross-sectional survey, according to the Checklist for Reporting Results of Internet E-Surveys guidelines and STrengthening the Reporting of OBservational Studies in Epidemiology (STROBE), was conducted in the Netherlands in 2020. The survey was conducted in two samples: a (nested) short survey in 78 nurses during working shifts (sample 1) and an extended online survey in 47 general HCPs e.g., medical psychologists, oncologists, surgeons (sample 2). Results: Respondents from both samples reported to be somewhat or quite familiar with placebo effects (24.0 and 47.2%, respectively). From the six placebo mechanisms that were presented, mind-body interaction, positive expectations, and brain activity involved in placebo effects were rated as the most influential factors in placebo effects [F(5,119) = 20.921, p < 0.001]. The use of placebo effects was reported in 53.8% (n = 42) of the nurses (e.g., by inducing positive expectations), and 17.4% of the HCPs (n = 8 reported to make use of pure placebos and 30.4% of impure placebos (n = 14). Attitudes toward placebo use in treatment were acceptant, and transparency was highly valued (both up to 51%). Conclusions: The findings from this study address knowledge gaps in placebo effects in practice and provide insights in attitudes toward the integration of placebo effects from HCPs. Altogether, integrating these findings may potentially optimize treatment outcomes

Integrative nursing in Europe - A competency profile for nursing students validated in a Delphi-study

Background: Integrative nursing is a framework for providing holistic care and includes complementary therapies and non-pharmacological interventions. There is no common European approach on how to educate healthcare professionals on complementary therapies and non-pharmacological interventions for symptom management. Nurses report a lack of formal education as the main barrier to applying integrative nursing. Objectives: The aim of this study is to develop and validate integrative nursing learning outcomes in a competency profile for bachelor nursing students. Methods: A two-round Delphi study was conducted with experts on integrative nursing and/or nurse education from eight European countries. The expert panelists rated their level of agreement with learning outcomes in relation to “Knowledge, Skills, Responsibility and Autonomy” on a nine-point Likert scale (1 = strongly disagree/9 = strongly agree) and were invited to add comments in an open text field. The Rand manual's description of levels of appropriateness was used, and experts' suggestions were analyzed thematically and used for reformulating or adding learning outcomes. Results: In the first round, 19 out of 23 experts participated, versus 18 in the second round. In all, thirty-five learning outcomes within the three areas Knowledge, Skills and Responsibility/Autonomy were rated. After two Delphi rounds, twenty-four included learning outcomes were classified as appropriate, with median levels of appropriateness between 7 and 9; none had been classified as inappropriate. The learning outcomes include general knowledge about selected complementary therapies and non-pharmacological interventions, safety, national rules and regulations, communication and ethical skills and competencies for self-care actions and for applying simple evidence-based complementary therapies and non-pharmacological interventions in nursing practice. Conclusions: The competency profile consist of validated competencies; the high degree of consensus from the expert panelists makes the learning outcomes relevant for structuring a teaching module for nursing students about integrative nursing