Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Jane M. Georges, PhD, RN, Chairperson; Lisa K. Hawthorne, PhD, RN, Committee Member; Cynthia D. Connelly, RN, PhD, FAAN, Committee Member; Janelle A. Bird, DNP, AGNP, Committee Member


CAM, naturopathic, complimentary, medicine, holistic, nursing education


Purpose: The purpose of this embedded case study was to describe the preparation for and utilization of complimentary alternative modality (CAM) interventions by an experienced Doctor of Nursing Practice (DNP) prepared nurse practitioner (NP) working in an outpatient setting.

Background: Given the widespread use of CAM by the American public and the potential complications involved in combining CAM and standard medical care, a lack of educational preparation in CAM interventions by NPs delivering primary care in outpatient health care settings represents both a potential risk and a missed opportunity to provide holistic patient care. Such a lack of knowledge also constitutes a tremendous gap for NPs working in an outpatient health care setting to provide symptom management and comfort care to populations most in need of it, particularly palliative care patients. Methods: Leininger’s Theory of Cultural Care served as a sensitizing theory for the development of the two lines of inquiry of CAM education and utilization. A DNPprepared NP with substantive knowledge of CAM and extensive integrating CAM into a primary care outpatient practice who met Yin’s (2018) criteria for an embedded case study participated in an open-ended interview focusing on CAM as the phenomenon of interest. The six thematic steps developed by Braun and Clark (2006) were used in performing data analysis. These steps include data familiarization, generating initial codes, searching for themes, reviewing themes, defining/naming themes, and producing the report.

Findings: Five major themes emerged from the study’s two lines of inquiry. Line of inquiry one (perception of formal CAM education throughout the participant’s nursing education) yielded the three themes of: (1) Extreme deficiency in CAM education at all levels of nursing education (deficiency); (2) CAM education as imperative in NP-level education (imperative); and (3) opportunities for improved CAM education (opportunities). Line of inquiry two (utilization of CAM as an NP in a primary care outpatient setting) yielded two additional themes of: (4) CAM as life-altering for patients (life-altering) and (5) importance of cultural collaboration (cultural collaboration). Implications for Research: Data from this study support the need for future studies of level of CAM inclusion in nursing curricula, particularly at the NP level, and documentation of subsequent uptake of CAM interventions by practicing NPs. Key words: nursing education, complimentary therapy, alternative therapy

Document Type

Dissertation: Open Access