title: Work environment facilitators to the availability of complementary and alternative therapies in perinatal hospices.
abstract: 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 described the types of CAM therapies available and explored the influence of the nurse work environment on the availability of CAM therapies with multivariate regression analysis. This study showed that having an education environment where clinicians are trained, along with a highly educated RN support staff, and a BSN educated staff were critical to the availability of CAM therapies. The clinical implications for hospice and palliative nurses caring for infants and their families were discussed.
authors.affiliation: Department of Nursing, York College of Pennsylvania.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Wool
authors.affiliation: VA Puget Sound Health Care System; University of Washington - Seattle, School of Public Health, Health Services Department.
authors.forename: Leila E
authors.initials: LE
authors.lastname: Kozak
authors.affiliation: University of Tennessee - Knoxville, College of Nursing.
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Lindley
keywords: CAM; hospice care; palliative care; perinatal; work environment