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Work Environment Facilitators to the Availability of Complementary and Alternative Therapies in Perinatal Hospices

Wool, Charlotte PhD, RN; Kozak, Leila E. PhD; Lindley, Lisa C. PhD, RN

Journal of Hospice & Palliative Nursing: October 2015 - Volume 17 - Issue 5 - p 391–396
doi: 10.1097/NJH.0000000000000167
Feature Articles

Increasingly, patients and clinicians are considering palliative care interventions during pregnancy for the maternal-fetal dyad when a life-limiting diagnosis is confirmed. Nurses are at the forefront of providing hospice and palliative care that includes planning interventions for infants nearing the end of life. However, little is known about the work environment facilitators to the availability of complementary and alternative medicine (CAM) therapies. Using a national database of perinatal hospice and palliative care providers, we describe the types of CAM therapies available and explore the influence of the nurse work environment on the availability of CAM therapies with multivariate regression analysis. This study shows that having an education environment where clinicians are trained, along with a highly educated registered nurse support staff, and a bachelor of science in nursing–educated staff was critical to the availability of CAM therapies. The clinical implications for hospice and palliative nurses caring for infants and their families are discussed.

Charlotte Wool, PhD, RN, is assistant professor, Department of Nursing, York College of Pennsylvania.

Leila E. Kozak, PhD, is project director, VA Puget Sound Health Care System and University of Washington–Seattle, School of Public Health, Health Services Department.

Lisa C. Lindley, PhD, RN, is assistant professor, College of Nursing, University of Tennessee–Knoxville.

Address correspondence to Charlotte Wool, PhD, RN, Department of Nursing, York College of Pennsylvania, 441 Country Club Road, York, PA 17403 (

This publication was made possible by grant number K01NR014490 from the National Institute of Nursing Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute of Nursing Research or National Institutes of Health.

The authors have no conflicts of interest to disclose.

© 2015 by The Hospice and Palliative Nurses Association.