Table 3.
Themes - Definition | Sample Coded Text |
---|---|
Knowledge/opinions | |
Knowledge -what the respondent actually knows about CAM at the VHA or CAM in general. |
“They have also started offering those in the CLC.” “We’re doing Tai Chi, yoga, things of that sort.” “We pay for some alternative and complimentary measures outside of the VA.” |
Attitudes/Opinions -a personal point of view not necessarily based upon fact. |
“I like adjunct rather than alternative. Alternative implies rather than the proven treatment.” “It needs to be scientifically based as much as possible; more clinical trials.” “I’m just so excited that we are trying some alternative approach to really help them recuperate or maintain their quality of life.” |
Information/background -data that assist in understanding the current situation. |
“There is a faculty development program in CAM offered by the affiliated university.” “That’s something being considered for VISN-wide implementation.” “It’s a big part of VHA’s strategic plan for the next 5 years.” |
Priorities -areas that the respondent thinks should receive attention first. |
“I would pick massage therapy and possibly acupuncture.” “Physicians want numbers.” “Work on the emotional pain and suffering and stress that people are going through.” |
Benefits to patients and staff | |
Values/benefits -how CAM contributes to patient care and well-being. |
“There’s science behind what we’re doing to benefit veterans. There are processes in place.” “Massage therapy focusing on our palliative care group. We’ve had a lot of success.” “It’s yoga for actually reworking; it’s like a physical therapy.” |
Veterans -issues of particular importance to veterans. |
“It gives them some tools so they can take ownership of their pain management.” “Many have a strong love for their pets.” “Many of them have been suffering from PTSD and other wounds.” |
Staff satisfaction/wellness -benefits to the practitioner/promotion of practitioner wellness. |
“We have a lot of anxious veterans. Their nurses could benefit from having people come work with their patients.” “Rewarding and empowering especially when traditional medicine has little else to offer.” “Maybe if we bring in more CAM nursing can change culturally to be more into self-care. If we don’t take care of ourselves we have nothing to give.” |
Barriers and facilitators to the promotion of CAM | |
Barriers -factors that make it harder to promote CAM in the VHA. |
“People’s personal biases and prejudices and such.” “The medical center needs to be on board too. So that’s a potential barrier.” “There is no designated job class for massage therapy within VHA.” |
Facilitators -factors that make it easier to promote CAM in the VHA. |
“There would definitely need to be a champion.” “To organize it in a way that it’s rational, that it respects our resource limitations.” “Individuals with the experience who can present their findings or work.” |
Abbreviations: CAM = Complementary and Alternative Medicine; VHA = Veterans Health Administration; CLC = Community Living Center; VA = Veterans Affairs; PTSD = Post Traumatic Stress Disorder.