Submitted in fulfillment of the requirements for the Degree in Masters of Technology in Nursing, Durban University of Technology, Durban, South Africa, 2015. / INTRODUCTION Globally, the use of alternative therapies by the public as well as healthcare workers has been widely documented. In South Africa, no studies have been done on alternative therapies specifically related to nurses. The vast amount of media attention with regards to alternative therapies related to the positive and negative outcomes has sparked major interest in this topic. The aim of the study was to determine the perceptions of professional nurses at nine hospitals within the uMgungundlovu District, South Africa, towards alternative therapies in a nursing context. OBJECTIVES OF THE STUDY The objectives of the study were to determine the professional nurses’ perceptions as well as knowledge of alternative therapies. The possible barriers in providing alternative therapies in nursing practice was also explored in order to make recommendations to guide professional nurses with regard to alternative therapies in patient care. METHODOLOGY A quantitative exploratory research approach underpinned this study. A survey questionnaire was used to obtain information from professional nurses who had consented to participate. The total population of professional nurses was 1218. A total of 616 questionnaires were distributed to participants at the nine participating hospitals. Three hundred and eighty six (386) questionnaires were returned, which resulted in a 63% response rate. FINDINGS It was evident from the data that professional nurses used various forms of alternative therapies. The results revealed that almost 69% (n=265) used prayer/spiritual healing, followed by 53.9% (n=207) who used nutritional supplements, whilst 51.9% (n=199) used music therapy. Participants rated their satisfaction on the information received regarding alternative therapies in nursing education as follows: prayer/spiritual healing 71.1% (n=271), nutritional supplements 71.7% (n=273), music therapy 57.9% (n=220), massage therapy 46.7% (n=216) and support groups 80.3% (n=306). About two thirds (n=272) felt that alternative therapies was beneficial rather than a threat to patient’s health. However, 60% (n=229) agreed that the use of alternative therapies that were not tested in a scientific manner should be discouraged. More than 80% (n=313) of the sample thought that health professionals should have the ability to advise patients in the clinical setting about the most commonly used alternative therapies. More than half of the sample (n=254) stated that they did encounter patients in the clinical setting who enquired about alternative therapies. Only 39.6% (n=153) stated that they felt confident to advise patients about alternative therapies, whilst 26.7% (n=103) stated that they were unable to do so. As the evidence base for the use of alternative therapies grows, so too does the demand increases for the integration of alternative therapies in nursing education. Nurses being the patient’s advocate need to be well versed regarding the use and safety aspects of alternative therapies.

BACKGROUND: Complementary and alternative medicine (CAM) use has steadily increased globally over the past two decades and is increasingly playing a role in the healthcare system in the United States. CAM practice-based effectiveness research requires an understanding of the settings in which CAM practitioners provide services. This paper describes and quantifies practice environment characteristics for a cross-sectional sample of doctors of chiropractic (DCs), licensed acupuncturists (LAcs), and licensed massage therapists (LMTs) in the United States. METHODS: Using a cross-sectional telephone survey of DCs (n = 32), LAcs (n = 70), and LMTs (n = 184) in the Tucson, AZ metropolitan area, we collected data about each location where practitioners work, as well as measures on practitioner and practice characteristics including: patient volume, number of locations where practitioners worked, CAM practitioner types working at each location, and business models of practice. RESULTS: The majority of practitioners reported having one practice location (93.8% of DCs, 80% of LAcs and 59.8% of LMTs) where they treat patients. Patient volume/week was related to practitioner type; DCs saw 83.13 (SD = 49.29) patients/week, LAcs saw 22.29 (SD = 16.88) patients/week, and LMTs saw 14.21 (SD =10.25) patients per week. Practitioners completed surveys for N = 388 practice locations. Many CAM practices were found to be multidisciplinary and/or have more than one practitioner: 9/35 (25.7%) chiropractic practices, 24/87 (27.6%) acupuncture practices, and 141/266 (53.0%) massage practices. Practice business models across CAM practitioner types were heterogeneous, e.g. sole proprietor, employee, partner, and independent contractor. CONCLUSIONS: CAM practices vary across and within disciplines in ways that can significantly impact design and implementation of practice-based research. CAM research and intervention programs need to be mindful of the heterogeneity of CAM practices in order to create appropriate interventions, study designs, and implementation plans.

BACKGROUND:Some researchers think that patients with higher expectations for CAM therapies experience better outcomes and that enthusiastic providers can enhance treatment outcomes. This is in contrast to evidence suggesting conventional medical providers often reorient patient expectations to better match what providers believe to be realistic. However, there is a paucity of research on CAM providers' views of their patients' expectations regarding CAM therapy and the role of these expectations in patient outcomes.METHODS:To better understand how CAM providers view and respond to their patients' expectations of a particular therapy, we conducted 32 semi-structured, qualitative interviews with acupuncturists, chiropractors, massage therapists and yoga instructors identified through convenience sampling. Interviews were recorded, transcribed and analyzed thematically using Atlas ti version 6.1.RESULTS:CAM providers reported that they attempt to ensure that their patients' expectations are realistic. Providers indicated they manage their patients' expectations in a number of domains-- roles and responsibilities of providers and patients, treatment outcomes, timeframe for improvement, and treatment experience. Providers reported that patients' expectations change over time and that they need to continually manage these expectations to enhance patient engagement and satisfaction with treatment.CONCLUSIONS:Providers of four types of CAM therapies viewed patients' expectations as an important component of their experiences with CAM therapy and indicated that they try to align patient expectations with reality. These findings suggest that CAM providers are similar in this respect to conventional medical providers.

Thesis (M.Tech.: Homoeopathy)-Dept. of Homoeopathy, Durban University of Technology, 2007 xiii, 181 leaves / The objectives of the following study were to determine: 1.The sphere of action of Erythrina lysistemon 30CH on healthy provers who recorded the signs and symptoms produced in order to determine the substances potential usefulness in a future clinical setting according to the Law of similars. 2. To test the efficacy of a triple blind proving methodology, which had never been done before at this institution. 3. To analyse the symptoms produced from this proving according to the doctrine of signatures. / M

Submitted in fulfillment of the requirements for the Master’s Degree in Technology: Homoeopathy, Durban University of Technology, Durban, South Africa, 2016. / Introduction Homoeopathy is recognised as a well established form of alternative medicine in the private healthcare sector of South Africa (Caldis, McLeod, Smith, 2001). Whilst local research supports the viability of homoeopathy as a primary healthcare resource; patient perception and experience with the homoeopathic service remain largely unknown (Smillie, 2010). The study addresses shortfalls in existing literature on homoeopathy, providing a qualitative evaluation of the homoeopathic healthcare service in the context of public healthcare in South Africa. The task of the study was to develop substantive theory with the aim to better understand health behaviour of patient’s utilising homoeopathic and allopathic healthcare services. Methods The study employed a qualitative study design, and explored the perceptions and experiences of patients receiving homoeopathic care at the Kenneth Gardens Homoeopathy Clinic, within the context of primary healthcare services and public sector healthcare. Data was generated through in-depth, semi-structured interviews conducted with 14 participants. Data was systematically analysed using grounded theory methods to generate substantive theory (Glaser and Strauss, 1967; Schreiber and Stern, 2001; Holloway and Wheeler, 2010). Results Data analysis revealed five main themes of influences affecting the utilisation of homoeopathic services at the Kenneth Gardens Clinic; these include context specific factors to healthcare utilisation, factors influencing healthcare utilisation, health beliefs and practices, health outcome factors and trust. The study results illustrate that participants trusted their homoeopathic provider and homoeopathic treatment outcomes; and subsequently demonstrate the direct positive influence which trust had on the utilisation of homoeopathic services in the study population. Discussion The discussion explores the significance of influences, barriers and discerning factors identified in the study on decision-making pathways in healthcare utilisation behaviour of homoeopathic and allopathic healthcare services. The significance of trust in healthcare utilisation behaviour is explored as the principle finding of the study. The study’s conceptual model is based on Anderson’s (2005) behavioural model of health service utilisation and has been adapted to demonstrate the relationship in health seeking behaviours between homoeopathic and allopathic care modalities. Recommendations The relationship between the variables illustrated in the study’s proposed adapted model need to be further tested using quantitative research methods. Trust in healthcare, and in particular with homoeopathy, is a subject which merits further exploration. / M

The aim of the research reported here is to answer the following primary research questions: Is the relationship between CAM, the medical profession and the State changing in Portugal? If there has been a change, how and why has such a change occurred? Two CAM therapies, acupuncture and homeopathy, have been chosen as case studies. The main sources of data were in-depth individual interviews and documents. The research sample (n=41) was made of three groups of interviewees: (1) 20 traditional CAM practitioners, (2) 10 orthodox medical doctors not committed to CAM and (3) 11 orthodox medical doctors committed to CAM. This research draws on a neo-Weberian perspective of professions which emphasises the power relations between related occupational groups who seek to gain or maintain power and status in their field of work. This research also makes extensive use of the concept of ‘countervailing powers' (Light, 2010), as it attempts to illuminate the influence of CAM practitioners on Portuguese healthcare, as well as the influence of other powerful players, such as the State, and major corporations, such as pharmaceutical and health insurance companies, on CAM's relationship with the medical profession. On the basis of this research, I argue that the relationship between CAM, the medical profession and the State has changed in Portugal over the last 16 years. I suggest a concept that helps to explain CAM practitioners' recent countervailing actions within the Portuguese mainstream healthcare. This concept is ‘camisation', a process through which everyday human problems are transformed into health problems which are treated in CAM terms and within a CAM framework. Although the main drivers of camisation have been CAM practitioners, I also show how the Portuguese State, the medical profession and the pharmaceutical industry have all been active collaborators in this process, whilst maintaining different interests and constantly bargaining and negotiating to maximise their power and status within the field of healthcare.

This mini-dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Homoeopathy, Durban University of Technology, 2007. / The objectives of the following study were to determine: 1.The sphere of action of Erythrina lysistemon 30CH on healthy provers who recorded the signs and symptoms produced in order to determine the substances potential usefulness in a future clinical setting according to the Law of similars. 2. To test the efficacy of a triple blind proving methodology, which had never been done before at this institution. 3. To analyse the symptoms produced from this proving according to the doctrine of signatures. / M

Mini-dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Homoeopathy, Durban University of Technology, 2007. / The first objective of this study was to determine the symptomatology that the plant remedy Peucedanum galbanum 30CH, produced in healthy individuals, so that it could be prescribed according to the Law of Similars, as required by homoeopathy. The second objective was to analyse this symptomatology in relation to the doctrine of signatures. It was hypothesised that Peucedanum galbanum 30CH would produce symptomatology in healthy individuals which would correlate to the doctrine of signatures of the plant. / M

Mini-dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Homoeopathy, Durban University of Technology, 2007. / This research study was conducted to elucidate the total symptomatology that the plant Peucedanum galbanum in the thirtieth centesimal potency would produce on healthy individuals so that it may be prescribed according to the Law of Similiars. A further aim of the investigation was to compare this remedy to other remedies yielding the highest numerical values and total number of rubrics on repertorisation of the proving symptoms. Wagner (2007), in a concurrent study, analysed the proving results of Peucedanum galbanum in relation to the doctrine of signatures. It was hypothesised that Peucedanum galbanum 30CH would produce recognizable signs and symptoms in healthy provers, and that the comparative study of this remedy would highlight the differences and similarities between remedy symptoms and thus confusion as to indication is eliminated, plus a fuller understanding of the remedy and its relationship to other remedies is gained. / M

This mini-dissertation was submitted in partial compliance with the requirements for the Master's Degree in Technology: Homoeopathy, Durban Institute of Technology, 2007. / This study aimed to assess the perceptions and career choices made by Technikon Witwatersrand Homoeopathy graduates from 1998 to 2004. It is noted that Technikon Witwatersrand (TWR) is now known as University of Johannesburg; however as the name change did not occur at the time of this study, this study refers to this institution as TWR throughout. The study was designed to investigate their demographic composition as well as aspects concerning career choices, the status of their practices and the reality of Homoeopathy being a viable and satisfactory career choice. / M