F E AT U R E S
Supporting the Integrative Health Care Curriculum in Schools of Nursing ■
Denise Van Sant-Smith, MSN, RN The concepts of integrative health or integrative medicine are reviewed with an analysis and synthesis of the meaning of these concepts for nursing and nursing education. The passages of public laws that have influenced US health policy are reviewed along with the increase in funding for research as it relates to the increased use of these modalities by health care consumers. It is proposed that schools of nursing adopt and implement curriculum that addresses integrative health care. The goal is to educate nurses about these important concepts and prepare them for the health care consumers that increasingly use them. KEY WORDS: nursing school curriculum, integrative Holist Nurs Pract 2014;28(5):312–315
Integrative health is the terminology that is being used to describe both complementary and alternative medicine (CAM) combined with conventional medicine. It has been determined that using this name most accurately reflects the intention of this style of health care as a true integration of conventional medicine with CAM.1 Previously, the use of the term “alternative medicine” implied that this was medical care that was used in lieu of conventional medicine.1 Gradually, and with the recognition that this form of medicine was being used as an adjunct to conventional medicine and not instead of it, the terms “complementary medicine” and later “complementary and alternative medicine” or “CAM” were used.1 Currently, the preferred terminology is integrative health or integrative medicine, both of which better describe the goals of this practice modality as it seeks to incorporate the best of conventional medicine with complementary medicine to improve the care provided to patients.1 The field of integrative medicine is large with modalities that are quite varied; yet, they do share a common thread of holism in their approach to the care
Author Affiliation: Duquesne University, Pittsburgh, Pennsylvania (Ms Sant-Smith).
of patients. Integrative medicine is defined by The Consortium of Academic Health Centers for Integrative Medicine as follows: The practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, health care professionals and disciplines to achieve optimal health and healing.2(p1)
Esther Sternberg, MD, a National Institutes of Health (NIH) senior scientist and author of the book, The Balance Within: The Science Connecting Health and Emotions, described patients who increasingly expect health care that considers them as whole human beings within the context of their world using therapies that embrace this approach.3 As a result, consumer demand for these complementary therapies has increased significantly over the last 15 years.4 In response to consumer demand, the use of integrative or CAM therapies has increased by hospitals as well. The American Hospital Association reported in surveys from 1998 that 7.9% of hospitals offered CAM therapies. In 2002, the number of hospitals offering them had increased to 16.6%, and of those hospitals that were not offering these therapies, 24% responded that they had plans to add them.5
The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Correspondence: Denise Van Sant-Smith, MSN, RN, Nursing Department, Kean University, 1000 Morris Ave, Union, NJ 07083 ([email protected]; [email protected]). DOI: 10.1097/HNP.0000000000000042
HISTORY In 1991, Congress passed Public Law 102-170 providing $2 million to the NIH to focus on
312 Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Integrative Health Curriculum
unconventional medical practice, and in 1993, the Office of Alternative Medicine was established. In 1998, Public Law 105-277 established the National Center for Complementary and Alternative Medicine (NCCAM)—one of the 27 institutes that constitutes the NIH.5 The NCCAM has the task of exploring CAM with research and rigorous science. The effort is to have authoritative information released to the public concerning CAM.1 More recently, there have been 2 national policy initiatives on CAM: the White House Commission on Complementary and Alternative Medicine Policy (2002) and the Institute of Medicine CAM Study Committee (2005).6,7 Nurses were appointed to serve on both of these committees. The White House Commission on Complementary and Alternative Medicine Policy was established in March 2000 and was charged with the task of “ensuring that public policy maximizes the potential benefits of CAM therapies to consumers.”7 Consumers have long recognized the value of integrative medicine and demand has increased dramatically over the last 15 years. Data released in 2009 by the NCCAM demonstrates that approximately 38% of adults and 12% of children in the United States are using some form of CAM.4 This large growth in utilization of this type of medicine has led to the recognition of the need for policies that address the issues of education, credentialing, reimbursement, and research and the creation of an integrated care delivery system.1 Many nursing professionals already actively work in the integrative medical field in areas such as therapeutic touch, guided imagery for body-mind healing, energy healing, and wellness coaching tools. Medical school educators have been early in recognizing the need to teach alternative and complementary medicine to medical students and doctors. For the purposes of promoting integrative medicine at the national level, the Osher Center at Duke and 42 other academic medical centers, including Harvard, Yale, and Columbia, formed the Consortium of Academic Health Centers for Integrative Medicine.2 The Duke Center for Integrative Medicine, in particular, is considered a classic model of integrative care. It combines complementary and alternative treatments with Western medicine-creating an approach that is both holistic and appealing to the health care consumer.8 The enthusiasm by many physicians and medical schools for integrative medicine may be fueled by several factors. First of all, integrative medicine as a
313
more holistic approach to patient care is novel to many Western physicians who find themselves in need of education about a modality that their patients are using. Second, there is genuine interest in understanding how and why some of these modalities seem to be quite effective in the care of patients. Interestingly, many of the journal articles found concerning incorporation of integrative medicine in the curriculum were for medical schools rather than nursing schools. The American Institute of Healthcare Professionals offers continuing education units for registered nurses seeking the designation of “holistic and integrative health care practice certification”; however, very few journal articles addressing the incorporation of integrative health curriculum into prelicensure registered nurses’ nursing schools were found. Original research was conducted by Fenton and Morris9 in 2009 to determine the percentage and extent of incorporation of complementary and alternative modalities into the curricula of the baccalaureate and higher-level schools. Of 585 surveys of nursing schools, 125 were returned reporting that only 7.2% had programs endorsed by the American Holistic Nurses Credentialing Corporation http://www.ahncc.org/http://www.anhcc .org/home/certificationprocess.html.9 The researchers also looked for characteristics of the schools such as the number of faculty certified by the American Holistic Nurses’ Certification Corporation (20.8%), and they reported that many of the surveyed schools (89%) were at least familiar with the American Holistic Nurses Association definition of holistic nursing.9 The lack of research and literature on this topic of integrative curriculum in nursing schools may be related to the fact that nursing has historically approached the care of patients in a more holistic manner, and because of this, it may not be recognizing holistic care as a separate or different educational endeavor. In the research by Fenton and Morris,9 85% of the schools reported that complementary and alternative modalities were included in their curricula; however, there is a significant lack of schools with specific programs or formal courses. Taking into consideration the increased government funding, increased consumer demand, and recognition of the potential benefits of integrative health care, nursing schools should purposefully incorporate this material into the curriculum of their schools in an organized and systematic way.
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
314
HOLISTIC NURSING PRACTICE • SEPTEMBER/OCTOBER 2014
NEW POLICY The US Senate Committee on Health, Education, Labor and Pensions held 2 hearings on integrative health in February 2009. These hearings demonstrate the fact that the federal government is interested in the process by which integrative medicine can benefit the health care consumer. The titles of the 2 hearings were “Integrative Health: Pathway to Health Reform” and “Integrative Health: Pathway to a Healthier Nation.”10 In addition to these hearings, the Institute of Medicine and the Bravewell Collaborative met to explore how integrative medicine could help with the health care reform legislation and make medicine less reactive and more client-centered or proactive.4 It was determined that integrative health has a central core concern for wellness, intervention, and patient empowerment that meshes well with the desire to emphasize health, wellness, and patient empowerment.6
EDUCATION AND CRITIQUE In the hearings on integrative health, recommendations were made on educating health care professionals that included incorporating integrative health and CAM into the curriculum of undergraduate, graduate, and postgraduate levels to enable health care professionals to gain the information necessary to properly advise the public on the benefits of integrative medicine.1 Interestingly, nursing programs have not used these recommendations as enthusiastically as medical schools. In fact, the response of medical schools to integrating CAM education has been greater than that of nursing schools and 11 of the 15 NIH NCCAM R-25 CAM education grants were awarded to schools of medicine.1 Nursing may be missing out on an opportunity to receive both vital grant benefits and an opportunity to lead in what has historically been the realm of nursing—holistic care of patients. As Rachel Naomi Remen, MD, is quoted on the Integrative Nursing Institute Web site, “Nurses will be pioneers to move medicine beyond a technological feat to a healing enterprise. They have an extraordinary personal sense of what is needed to empower themselves and the patients for self healing.”11(p1) The critique of the creation of an integrative health policy and curriculum development for schools of nursing includes issues of reimbursement by third parties for integrative health services, regulation of the practice of several of the complementary modalities,
and obtaining access to research that tests these complementary therapies.1 As has been noted that increases in research and evidence will improve both reimbursement for the treatment and confidence in suggesting the complementary modality. In addition, education in this area for nursing students may inspire them to advance their degrees and/or conduct research in this area that serves again to improve our knowledge base.
NEW POLICY FOR SCHOOLS OF NURSING According to the Integrative Nursing Institute Web site, Nurses as health coaches are going to play a major role in wellness promotion and disease prevention for individuals, communities, and organization in the new Healthcare Stimulus Plan, part of the American Recovery and Reinvestment Act of 2009, signed by President Obama on February 17, 2009.5(p1)
It is essential in that role that a policy is created that improves the educational programs and opportunities available for the nursing student to understand and promote integrative medicine.
POLICY FOR PROMOTION OF INTEGRATIVE MEDICINE INSTRUCTION IN SCHOOLS OF NURSING Nursing students must receive an education that is both practical and innovative, allowing them to enter the health care field ready to promote the health status of their patients in the best possible way. Integrative health is used by millions of Americans and is being promoted by the federal government as potentially beneficial to the health care consumer. Schools of nursing education must take a leadership role in providing the necessary education to allow nurses to accomplish the following through curriculum and practical experiences that provide learning experiences with the proposed outcomes for students: r Describe integrative therapies that patients use. r Identify patient access to those therapies that might enhance, augment, or improve their treatment. r Recognize those therapies that are considered safe, effective, and complementary to primary care.
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Integrative Health Curriculum
CONCLUSION Integrative therapies are recognized as potentially beneficial to the health care consumer, and demand for these therapies continues to increase. The federal government has recognized the need for medical professionals to be educated concerning these therapies so that consumers can gain advice and education from them. In addition, funding has been made available by several government agencies to research and further develop the evidence base for these integrative treatment modalities. Nursing has historically taken a holistic approach to patients and their care. While this philosophy is evident as a general theory of nursing, it may not be cited as the policy of the nursing school and may not have been promoted through the development of specific program. A policy for schools of nursing that promotes the creation of curriculum that explains the varied types of integrative medicine and how they are used can assist both new and seasoned nurses to recognize the benefits of CAM.
REFERENCES 1. Kreitzer MJ. Integrative health: pathway to health reform and a healthier nation. In: Mason D, Leavitt J, Chaffee M, eds. Policy & Politics. St Louis, MO: Elsevier; 2012:225-230.
315
2. Consortium of Academic Health Centers for Integrative Medicine. Definition of integration medicine. www.imconsortium.org/about/home .html. Published 2009. Accessed July 8, 2013. 3. Sternberg E. The Balance Within. New York, NY: WH Freeman & Co; 2001. 4. US Department of Health and Human Services. Complementary and alternative medicine use among adults and children: United States, 2007. http://nccam.nih.gov/news/camstats/NHIS.htm. Published 2008. 5. Ananth S. Health Forum/AHA 2000-2001 Complementary and Alternative Medicine Survey. Chicago, IL: Health Forum; 2002; Accessed July 15, 2013. 6. National Center for Complementary and Alternative Medicine. Expanding Horizons in Medical Care: Strategic Plan 2005-2009. Washington, DC: US Department of Health and Human Services, National Institutes of Health; 2009. NIH Publication No. 04-5568. 7. White House Commission on Complementary and Alternative Medicine Policy. Final report. www.whccamp.hhs.gov/finalreport.html. Published 2002. Accessed July 9, 2013. 8. Kam K. What is integrative medicine? Experts explore new ways to treat the mind, body, and spirit—all at the same time. WebMD Feature. 2009. http://www.webmd.com/a-to-z-guides/features/ alternative-medicine-integrative-medicine. Accessed November 11, 2013. 9. Fenton MV, Morris DL. The integration of holistic nursing practices and complementary and alternative modalities into curricula of schools of nursing. Altern Ther Health Med. 2003;9:62-67. Accessed July 2, 2013. 10. US Senate Committee on Health, Education, Labor and Pensions. Hearings and Executive sessions. http://www.help.senate.gov/hearings/ hearing/?id=03629575-0924-cb2e-13cb-68a8065ababb. Published 2009; Accessed June 10, 2013. 11. Integrative Nursing Institute. http://www.integrativenursinginstitute .org. Published 2014.
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Supporting the Integrative Health Care Curriculum in Schools of Nursing ■
Denise Van Sant-Smith, MSN, RN The concepts of integrative health or integrative medicine are reviewed with an analysis and synthesis of the meaning of these concepts for nursing and nursing education. The passages of public laws that have influenced US health policy are reviewed along with the increase in funding for research as it relates to the increased use of these modalities by health care consumers. It is proposed that schools of nursing adopt and implement curriculum that addresses integrative health care. The goal is to educate nurses about these important concepts and prepare them for the health care consumers that increasingly use them. KEY WORDS: nursing school curriculum, integrative Holist Nurs Pract 2014;28(5):312–315
Integrative health is the terminology that is being used to describe both complementary and alternative medicine (CAM) combined with conventional medicine. It has been determined that using this name most accurately reflects the intention of this style of health care as a true integration of conventional medicine with CAM.1 Previously, the use of the term “alternative medicine” implied that this was medical care that was used in lieu of conventional medicine.1 Gradually, and with the recognition that this form of medicine was being used as an adjunct to conventional medicine and not instead of it, the terms “complementary medicine” and later “complementary and alternative medicine” or “CAM” were used.1 Currently, the preferred terminology is integrative health or integrative medicine, both of which better describe the goals of this practice modality as it seeks to incorporate the best of conventional medicine with complementary medicine to improve the care provided to patients.1 The field of integrative medicine is large with modalities that are quite varied; yet, they do share a common thread of holism in their approach to the care
Author Affiliation: Duquesne University, Pittsburgh, Pennsylvania (Ms Sant-Smith).
of patients. Integrative medicine is defined by The Consortium of Academic Health Centers for Integrative Medicine as follows: The practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, health care professionals and disciplines to achieve optimal health and healing.2(p1)
Esther Sternberg, MD, a National Institutes of Health (NIH) senior scientist and author of the book, The Balance Within: The Science Connecting Health and Emotions, described patients who increasingly expect health care that considers them as whole human beings within the context of their world using therapies that embrace this approach.3 As a result, consumer demand for these complementary therapies has increased significantly over the last 15 years.4 In response to consumer demand, the use of integrative or CAM therapies has increased by hospitals as well. The American Hospital Association reported in surveys from 1998 that 7.9% of hospitals offered CAM therapies. In 2002, the number of hospitals offering them had increased to 16.6%, and of those hospitals that were not offering these therapies, 24% responded that they had plans to add them.5
The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Correspondence: Denise Van Sant-Smith, MSN, RN, Nursing Department, Kean University, 1000 Morris Ave, Union, NJ 07083 ([email protected]; [email protected]). DOI: 10.1097/HNP.0000000000000042
HISTORY In 1991, Congress passed Public Law 102-170 providing $2 million to the NIH to focus on
312 Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Integrative Health Curriculum
unconventional medical practice, and in 1993, the Office of Alternative Medicine was established. In 1998, Public Law 105-277 established the National Center for Complementary and Alternative Medicine (NCCAM)—one of the 27 institutes that constitutes the NIH.5 The NCCAM has the task of exploring CAM with research and rigorous science. The effort is to have authoritative information released to the public concerning CAM.1 More recently, there have been 2 national policy initiatives on CAM: the White House Commission on Complementary and Alternative Medicine Policy (2002) and the Institute of Medicine CAM Study Committee (2005).6,7 Nurses were appointed to serve on both of these committees. The White House Commission on Complementary and Alternative Medicine Policy was established in March 2000 and was charged with the task of “ensuring that public policy maximizes the potential benefits of CAM therapies to consumers.”7 Consumers have long recognized the value of integrative medicine and demand has increased dramatically over the last 15 years. Data released in 2009 by the NCCAM demonstrates that approximately 38% of adults and 12% of children in the United States are using some form of CAM.4 This large growth in utilization of this type of medicine has led to the recognition of the need for policies that address the issues of education, credentialing, reimbursement, and research and the creation of an integrated care delivery system.1 Many nursing professionals already actively work in the integrative medical field in areas such as therapeutic touch, guided imagery for body-mind healing, energy healing, and wellness coaching tools. Medical school educators have been early in recognizing the need to teach alternative and complementary medicine to medical students and doctors. For the purposes of promoting integrative medicine at the national level, the Osher Center at Duke and 42 other academic medical centers, including Harvard, Yale, and Columbia, formed the Consortium of Academic Health Centers for Integrative Medicine.2 The Duke Center for Integrative Medicine, in particular, is considered a classic model of integrative care. It combines complementary and alternative treatments with Western medicine-creating an approach that is both holistic and appealing to the health care consumer.8 The enthusiasm by many physicians and medical schools for integrative medicine may be fueled by several factors. First of all, integrative medicine as a
313
more holistic approach to patient care is novel to many Western physicians who find themselves in need of education about a modality that their patients are using. Second, there is genuine interest in understanding how and why some of these modalities seem to be quite effective in the care of patients. Interestingly, many of the journal articles found concerning incorporation of integrative medicine in the curriculum were for medical schools rather than nursing schools. The American Institute of Healthcare Professionals offers continuing education units for registered nurses seeking the designation of “holistic and integrative health care practice certification”; however, very few journal articles addressing the incorporation of integrative health curriculum into prelicensure registered nurses’ nursing schools were found. Original research was conducted by Fenton and Morris9 in 2009 to determine the percentage and extent of incorporation of complementary and alternative modalities into the curricula of the baccalaureate and higher-level schools. Of 585 surveys of nursing schools, 125 were returned reporting that only 7.2% had programs endorsed by the American Holistic Nurses Credentialing Corporation http://www.ahncc.org/http://www.anhcc .org/home/certificationprocess.html.9 The researchers also looked for characteristics of the schools such as the number of faculty certified by the American Holistic Nurses’ Certification Corporation (20.8%), and they reported that many of the surveyed schools (89%) were at least familiar with the American Holistic Nurses Association definition of holistic nursing.9 The lack of research and literature on this topic of integrative curriculum in nursing schools may be related to the fact that nursing has historically approached the care of patients in a more holistic manner, and because of this, it may not be recognizing holistic care as a separate or different educational endeavor. In the research by Fenton and Morris,9 85% of the schools reported that complementary and alternative modalities were included in their curricula; however, there is a significant lack of schools with specific programs or formal courses. Taking into consideration the increased government funding, increased consumer demand, and recognition of the potential benefits of integrative health care, nursing schools should purposefully incorporate this material into the curriculum of their schools in an organized and systematic way.
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
314
HOLISTIC NURSING PRACTICE • SEPTEMBER/OCTOBER 2014
NEW POLICY The US Senate Committee on Health, Education, Labor and Pensions held 2 hearings on integrative health in February 2009. These hearings demonstrate the fact that the federal government is interested in the process by which integrative medicine can benefit the health care consumer. The titles of the 2 hearings were “Integrative Health: Pathway to Health Reform” and “Integrative Health: Pathway to a Healthier Nation.”10 In addition to these hearings, the Institute of Medicine and the Bravewell Collaborative met to explore how integrative medicine could help with the health care reform legislation and make medicine less reactive and more client-centered or proactive.4 It was determined that integrative health has a central core concern for wellness, intervention, and patient empowerment that meshes well with the desire to emphasize health, wellness, and patient empowerment.6
EDUCATION AND CRITIQUE In the hearings on integrative health, recommendations were made on educating health care professionals that included incorporating integrative health and CAM into the curriculum of undergraduate, graduate, and postgraduate levels to enable health care professionals to gain the information necessary to properly advise the public on the benefits of integrative medicine.1 Interestingly, nursing programs have not used these recommendations as enthusiastically as medical schools. In fact, the response of medical schools to integrating CAM education has been greater than that of nursing schools and 11 of the 15 NIH NCCAM R-25 CAM education grants were awarded to schools of medicine.1 Nursing may be missing out on an opportunity to receive both vital grant benefits and an opportunity to lead in what has historically been the realm of nursing—holistic care of patients. As Rachel Naomi Remen, MD, is quoted on the Integrative Nursing Institute Web site, “Nurses will be pioneers to move medicine beyond a technological feat to a healing enterprise. They have an extraordinary personal sense of what is needed to empower themselves and the patients for self healing.”11(p1) The critique of the creation of an integrative health policy and curriculum development for schools of nursing includes issues of reimbursement by third parties for integrative health services, regulation of the practice of several of the complementary modalities,
and obtaining access to research that tests these complementary therapies.1 As has been noted that increases in research and evidence will improve both reimbursement for the treatment and confidence in suggesting the complementary modality. In addition, education in this area for nursing students may inspire them to advance their degrees and/or conduct research in this area that serves again to improve our knowledge base.
NEW POLICY FOR SCHOOLS OF NURSING According to the Integrative Nursing Institute Web site, Nurses as health coaches are going to play a major role in wellness promotion and disease prevention for individuals, communities, and organization in the new Healthcare Stimulus Plan, part of the American Recovery and Reinvestment Act of 2009, signed by President Obama on February 17, 2009.5(p1)
It is essential in that role that a policy is created that improves the educational programs and opportunities available for the nursing student to understand and promote integrative medicine.
POLICY FOR PROMOTION OF INTEGRATIVE MEDICINE INSTRUCTION IN SCHOOLS OF NURSING Nursing students must receive an education that is both practical and innovative, allowing them to enter the health care field ready to promote the health status of their patients in the best possible way. Integrative health is used by millions of Americans and is being promoted by the federal government as potentially beneficial to the health care consumer. Schools of nursing education must take a leadership role in providing the necessary education to allow nurses to accomplish the following through curriculum and practical experiences that provide learning experiences with the proposed outcomes for students: r Describe integrative therapies that patients use. r Identify patient access to those therapies that might enhance, augment, or improve their treatment. r Recognize those therapies that are considered safe, effective, and complementary to primary care.
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Integrative Health Curriculum
CONCLUSION Integrative therapies are recognized as potentially beneficial to the health care consumer, and demand for these therapies continues to increase. The federal government has recognized the need for medical professionals to be educated concerning these therapies so that consumers can gain advice and education from them. In addition, funding has been made available by several government agencies to research and further develop the evidence base for these integrative treatment modalities. Nursing has historically taken a holistic approach to patients and their care. While this philosophy is evident as a general theory of nursing, it may not be cited as the policy of the nursing school and may not have been promoted through the development of specific program. A policy for schools of nursing that promotes the creation of curriculum that explains the varied types of integrative medicine and how they are used can assist both new and seasoned nurses to recognize the benefits of CAM.
REFERENCES 1. Kreitzer MJ. Integrative health: pathway to health reform and a healthier nation. In: Mason D, Leavitt J, Chaffee M, eds. Policy & Politics. St Louis, MO: Elsevier; 2012:225-230.
315
2. Consortium of Academic Health Centers for Integrative Medicine. Definition of integration medicine. www.imconsortium.org/about/home .html. Published 2009. Accessed July 8, 2013. 3. Sternberg E. The Balance Within. New York, NY: WH Freeman & Co; 2001. 4. US Department of Health and Human Services. Complementary and alternative medicine use among adults and children: United States, 2007. http://nccam.nih.gov/news/camstats/NHIS.htm. Published 2008. 5. Ananth S. Health Forum/AHA 2000-2001 Complementary and Alternative Medicine Survey. Chicago, IL: Health Forum; 2002; Accessed July 15, 2013. 6. National Center for Complementary and Alternative Medicine. Expanding Horizons in Medical Care: Strategic Plan 2005-2009. Washington, DC: US Department of Health and Human Services, National Institutes of Health; 2009. NIH Publication No. 04-5568. 7. White House Commission on Complementary and Alternative Medicine Policy. Final report. www.whccamp.hhs.gov/finalreport.html. Published 2002. Accessed July 9, 2013. 8. Kam K. What is integrative medicine? Experts explore new ways to treat the mind, body, and spirit—all at the same time. WebMD Feature. 2009. http://www.webmd.com/a-to-z-guides/features/ alternative-medicine-integrative-medicine. Accessed November 11, 2013. 9. Fenton MV, Morris DL. The integration of holistic nursing practices and complementary and alternative modalities into curricula of schools of nursing. Altern Ther Health Med. 2003;9:62-67. Accessed July 2, 2013. 10. US Senate Committee on Health, Education, Labor and Pensions. Hearings and Executive sessions. http://www.help.senate.gov/hearings/ hearing/?id=03629575-0924-cb2e-13cb-68a8065ababb. Published 2009; Accessed June 10, 2013. 11. Integrative Nursing Institute. http://www.integrativenursinginstitute .org. Published 2014.
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
