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Integrative oncology for palliative care nurses: pre–post training evaluation
  1. Eran Ben-Arye1,2,
  2. Yehudit Tapiro3,
  3. Ruth Baruch4,
  4. Ahuva Tal5,
  5. Bella Shulman2,
  6. Orit Gressel2,
  7. Pesi Israeli6,
  8. Jamal Dagash7,
  9. Alexander Yosipovich5,
  10. Ilanit Shalom Sharabi6,
  11. Patricia Zimmermann3 and
  12. Noah Samuels8
  1. 1Technion Israel Institute of Technology, Haifa, Israel
  2. 2Integrative Oncology Program, Oncology Service, Lin Medical Center, Haifa, Israel
  3. 3Clalit Health Services, Tel Aviv, Israel
  4. 4Nursing, Clalit Health Services, Tel Aviv, Israel
  5. 5Carmel Medical Center, Haifa, Israel
  6. 6LIN Medical Center, Haifa, Israel
  7. 7Clalit Health Services, Haifa, Israel
  8. 8Center for Integrative Complementary Medicine, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
  1. Correspondence to Professor Eran Ben-Arye, Technion Israel Institute of Technology, Haifa 3200003, Israel; eranben{at}


Objectives Integrative oncology (IO) is increasingly being incorporated in supportive and palliative cancer care. This study examined an IO-palliative care training programme for nurses from community and hospital settings.

Methods A 120-hour course, attended by 24 palliative care nurses without IO training, included precourse/postcourse questionnaires examining knowledge, attitudes and level of IO-palliative care skills. Qualitative analysis examined precourse and postcourse narratives.

Results Most (18; 75%) completed study questionnaires, with knowledge and attitudes towards IO changing only modestly and IO-related skills significantly for guidance on herbal medicine and lifestyle changes, manual-movement and mind-body modalities. Greater consultation skills were reported for fatigue, stomatitis, nausea, appetite, constipation/diarrhoea, insomnia, peripheral neuropathy and hot flashes. Trainees reported improved skills for pain (p=0.003), emotional (p<0.001) and informal caregiver-related concerns (p<0.001), with no change in palliative care-related skills. Qualitative analysis found both personal and professional attitude changes, with enhanced mindfulness and an expressed intent to implement the learnt skills in daily practice.

Conclusions The IO-palliative care nurse training programme increased IO-related and palliative care-related consultation skills for a wide range of quality of life-related concerns. Further research is needed to explore both short-term and long-term effects and the implementation of the learnt skills in clinical practice.

Trial registration number NCT03676153.

  • Pain
  • Complementary therapy
  • Education and training

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  • Contributors EB-A is the corresponding author.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.