A Self-Report Measure of Clinicians' Orientation toward Integrative Medicine.
OBJECTIVE
Patients in the U.S. often turn to complementary and alternative medicine (CAM) and may use it concurrently with conventional medicine to treat illness and promote wellness. However, clinicians vary in their openness to the merging of treatment paradigms. Because integration of CAM with conventional medicine can have important implications for health care, we developed a survey instrument to assess clinicians' orientation toward integrative medicine.


METHODS
A convenience sample of 294 acupuncturists, chiropractors, primary care physicians, and physician acupuncturists in academic and community settings in California.


METHODS
We used a qualitative analysis of structured interviews to develop a conceptual model of integrative medicine at the provider level. Based on this conceptual model, we developed a 30-item survey (IM-30) to assess five domains of clinicians' orientation toward integrative medicine: openness, readiness to refer, learning from alternate paradigms, patient-centered care, and safety of integration.


RESULTS
Two hundred and two clinicians (69 percent response rate) returned the survey. The internal consistency reliability for the 30-item total scale and the five subscales ranged from 0.71 to 0.90. Item-scale correlations for the five subscales were higher for the hypothesized subscale than other subscales 75 percent or more of the time. Construct validity was supported by the association of the IM-30 total scale score (0-100 possible range, with a higher score indicative of greater orientation toward integrative medicine) with hypothesized constructs: physician acupuncturists scored higher than physicians (71 versus 50, p<.001), dual-trained practitioners scored higher than single-trained practitioners (71 versus 62, p<.001), and practitioners' self-perceived "integrativeness" was significantly correlated (r=0.60, p<.001) with the IM-30 total score.


CONCLUSIONS
This study provides support for the reliability and validity of the IM-30 as a measure of clinicians' orientation toward integrative medicine. The IM-30 survey, which we estimate as requiring 5 minutes to complete, can be administered to both conventional and CAM clinicians.
Hsiao
An-Fu
AF
UCLA Department of Medicine, Division of GIM/HSR, 911 Broxton Plaza, Los Angeles, CA 90095-1736, USA.
Hays
Ron D
RD
Ryan
Gery W
GW
Coulter
Ian D
ID
Andersen
Ronald M
RM
Hardy
Mary L
ML
Diehl
David L
DL
Hui
Ka-Kit
KK
Wenger
Neil S
NS
D000328:Adult; D001291:Attitude of Health Personnel; D000529:Complementary Therapies; D019033:Delivery of Health Care, Integrated; D005260:Female; D019538:Health Care Surveys / Q000379:methods; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D014481:United States