Center for the Study of Complementary and Alternative Therapies (CSCAT) faculty members and collaborators are dedicated to exploring complementary health-enhancing approaches in the context of rigorous science; educating and training students at all levels; and disseminating evidence-based information to other professionals and to the public.
ESTABLISHMENT OF THE CENTER/HISTORICAL OVERVIEW
Given the explosion of technology in healthcare beginning in the 1980s, and its growth particularly within the past three decades in nursing, the founder of the CSCAT (Ann Gill Taylor) became most interested in the decline of comforting, caring touch by nurses when providing care for patients. Especially in the critical care units, nurses’ touch may be more often associated with carrying out procedures that inflict discomfort and pain to the patient as opposed to providing comfort, certainly in the short-term. Thus, whenever making rounds in the critical care settings two decades ago, Taylor and a graduate student began their interaction with patients (those who were conscious enough to speak and not intubated) with very basic questions such as, “What is going on as far as your (the patient) comfort enhancement/pain management?” and “Have you received comforting, caring touch from any nurse or other healthcare personnel since you have been hospitalized?” These questions were asked when Taylor and graduate students rounded in the 10 adult critical care units within University Hospital over a 30-day assessment period. The results from the data collected during this time revealed that only one patient—a male patient told us, “My back was hurting so badly the other night that my wife gave me a back rub, which helped a bit.” Upon exiting this patient’s room, the graduate student and Taylor spoke about the alarming and disappointing findings from their survey, although it confirmed Taylor’s perception that comforting, caring touch—foundational to the practice of nursing—was not prevalent in the delivery of care in our acute care setting.
Having gathered the 30-day survey data, Taylor and the critical care graduate students developed a protocol whereby comforting, caring touch could be reintroduced in these settings three times a day for about 10 minutes each time (procedural touch to be avoided during these 10-minute periods of time). The touch was to involve an independent nursing action such as a warm or cool cloth to the patient’s forehead; a gentle hand, foot, or back massage; or simply a gentle human touch to the patient’s hand or shoulder while compassionately communicating with the patient. The form of comforting, caring touch was guided by patients’ requests or the nurses’ perception of needs for those patients who could not communicate.
Near the time the graduate students and Taylor were completing the development of the protocol to reintroduce comforting, caring touch in the critical care settings within University Hospital, the Office of Alternative Medicine (created by NIH in 1991; became NCCAM in 1998) released a one-time, one-year call for grant applications to develop a foundation of scientific data that could lead to larger studies, as a first step to investigate and validate complementary and alternative treatments. Of the initial 42 one-year awards, the University of Virginia received an award for a massage protocol to reduce pain. Shortly thereafter came the NIH call to establish four CAM centers, two of which would be east of the Mississippi and two west of the Mississippi, with the focus of one center to be on CAM modalities related to cancer and other immune diseases and the focus of the other to be on pain and pain management, including cancer-related pain. With the advent of this call, Taylor refocused her attention to apply for one of these centers given that her professional career had been devoted to providing comforting, caring nursing to patients. She was the only nurse in the country to apply for one of these awards and, even more relevant, perhaps, she did so within the conservative environment of the University of Virginia. In the end, NIH funded 11 such centers, with Taylor and her center team receiving one of these initial center awards. Thus, the Center for the Study of Complementary and Alternative Therapies (CSCAT) was founded.
The Center’s mission has been to serve as a mechanism that stimulates research of rigorous scientific and technical merit related to complementary health-enhancing approaches to reduce pain and pain-related symptoms that often include anxiety, depressed mood, fatigue, and sleep disturbances, as well as a poor health-related quality of life. Populations in which studies are conducted are primarily chronic disease population, although Taylor had conceptualized the Center while working within the critical care setting. Over the past two decades, the research themes in the CSCAT have been pain and other symptom management, with particular attention given to persons with fibromyalgia and other chronic painful conditions. In summer 2000, the National Center for Complementary and Alternative Medicine (NCCAM) awarded two CSCAT collaborators (Skalak and Tuttle) support for two R01s under the Frontier Medicine category of bioelectromagnetics; in October 2000, the CSCAT received two NCCAM awards (T32 and K30 awards). The CSCAT continued to investigate static magnetic fields over the next 5 years with the Administrative Core supported through institutional support and philanthropic gifts. Taylor also received an R21 from the National Cancer Institute in 2003.
The CSCAT has promoted information exchange through seminars, generated new research ideas, and fostered interdisciplinary collaboration among students and faculty over the past two decades. Our goal has always been to bring together a critical mass of experienced researchers in a supportive, yet scientifically rigorous environment, to conduct quality clinical and biomedical research.
Given the work of the CSCAT research team and its collaborators, we believe that we offer others here at the University of Virginia a superb CAM clinical research training and career development environment; thus ensuring increased likelihood that efficacious therapeutic paradigms will continue to emerge as contributions to integrative, holistic healthcare. The University of Virginia provides an excellent environment for training with its state-of-the-art research facilities, basic science laboratories, engineering technologies, biostatistical support for our interdisciplinary teams’ research, and its prior history in the conduct of CAM-related research.