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Table of contents
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Document 1 of 1

Magnet therapy: What's the attraction

Author: Ratterman, Rebecca; Secrest, Janet; Norwood, Barbara; Ch'ien, Anne P
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Full text: Headnote
EVIDENCE-BASED PRACTICE
Headnote
Purpose
Headnote
To review the current state of the science of magnet therapy with respect to pain management
and to view magnet therapy from a nursing perspective.
Data Sources
Headnote
Extensive review of the world-wide scientific literature and of scientific peer-reviewed journals
regarding magnet therapy.
Conclusions
Headnote
Magnet therapy is gaining popularity; however, the scientific evidence to support the success of
this therapy is lacking. More scientifically sound studies are needed in order to fully understand
the effects that magnets can have on the body and the possible benefits or dangers that could
result from their use.
Implications for Practice
Headnote
Credibility for advanced practice will be established across disciplines as nurses demonstrate their
ability to critically evaluate practices. Alternative therapies are accepted and used by many
patients today. While magnet therapy is popular, the scientific evidence to support its use is
limited, at best. Advanced practice nurses have more effective treatment modalities in their
repertoire and are advised to avoid practices for which efficacy is unsupported.
Key Words
Headnote
Magnet therapy; Rogers' Science of Unitary Human Beings; complementary and alternative
therapies.
INTRODUCTION
An emerging trend in health care is the use of alternative therapies. Alternative therapy, or
unconventional therapy, can be defined as those practices "neither taught widely in the U.S.
medical schools nor generally available in U.S. hospitals" (Astin, 1998, p.1548). Examples include
acupuncture, herbal therapies, chiropractic, massage, and imagery.
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Alternative therapies have been used for years, yet only recently has the use of these therapies
significantly increased in Western cultures. Astin (1998) found that the majority of alternative
health care consumers were not dissatisfied with conventional care; however, they felt that
alternative care was more congruent with their own values, beliefs, and philosophical orientations
toward health and life. As health care providers, advanced practice nurses (APNs) need to assess
these values and beliefs in order to provide the care their patients prefer. Therefore, in order to
optimally serve their clients, APNs need to have an understanding of these therapies and their
scientific worth.
Magnet therapy is one such alternative therapy gaining increasing recognition. Kim (2000)
describes magnet therapy as "a natural, non-invasive health promoting modality" (p. 1) which
involves the external application of magnetic fields to an area of the body in order to heal.
Documentation suggests that the discovery of the first magnetic substance was approximately
1000 B.C. by the shepherd Magnes (Mourino, 1991). While walking on Mount Ida in Mysia (now
Turkey), he noticed that the tacks in his sandals were strongly drawn to the earth. Digging to
ascertain the cause, Magnes discovered magnitite, the mineral lodestone--a magnetic oxide of
iron. By 200 A.D., magnetic rings were sold as a cure for arthritis by Greek physicians. In Germany
during the 1600s, the use of magnetic salves, although controversial, was thought to "draw out"
headaches, gout, and venereal diseases.
Today, claims of magnet therapy vary greatly from accelerating the healing time of wounds, to
encouraging growth in preterm infants (Szor &Topp, 1998; Cody &Moran, 1999). Magnets have
been used to relieve stress, combat infections, prevent seizures, and accelerate the healing time
of bone fractures and post surgical wounds (Lawrence, Plowden, &Rosch, 1998; Magnetic Field
Therapy, 2000). The focus of this article is on pain management. Magnets are more commonly
used to treat pain and have been promoted for the following: headaches, carpal tunnel syndrome,
soft tissue sprains, joint pain, phantom limb pain, fibromyalgia, and chronic pelvic pain. There are
many claims of successful magnet therapy; however, evidence of the effectiveness of magnet
therapy is difficult to find in established scientific, peerreviewed journals. There are several
different ways to perform magnet therapy; the term here will refer to use of permanent, or static,
magnets in the management of pain.
MAGNETIC FIELDS AND THEIR EFFECTS
Magnetic fields are composed of the areas of energy produced by the permanent magnet and are
created by the motion of electrons in the atom of the magnet material, such as iron or nickel
(Whitaker &Adderly, 1998). These fields remain still and constant and are not pulsating in nature,
such as with electromagnetism, which combines constantly moving, or pulsating electric currents
with magnetism. The direction in which the electrons are spinning in the atom determines the
polarity, or charge of the magnet and are referred to as "positive" or "negative" and "north" or
"south" (Whitaker &Adderly). When electrons spin to the right, a northern polarity and negative
charge are created, and to the left, a southern polarity and positive charge (Kim, 2000).
All magnets consist of two poles in which similar poles repel one another, while opposing poles
attract (Lawrence et al., 1998). These poles are thought to have differing effects on the human
body (Importance of polarity, 2000). The northern pole is considered negative magnetic energy
and is believed to normalize and calm the body. Some of the many proposed actions of the
northern polarity include reducing fluid retention, increasing cellular oxygen, reducing
inflammation, and normalizing acid base balance. The southern pole is made up of positive
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magnetic energy and is credited for causing an overstimulation response. Effects of southern
polarity on the body are thought to oppose those of the northern polarity, such as increasing
intracellular edema, decreasing cellular oxygen, increasing inflammation, and causing more
acidity in pH levels.
Some believe that one or uni-poled magnets are superior to bipolar magnets (Magnetic Therapy
101, 2000; Importance of polarity, 2000). Because every magnet has two poles, unipoled magnets
simply refer to similar poles facing the body, whereas bipolar magnet use incorporates both poles
facing the body using multiple magnets. Alternating poles, or bipolar magnet use, is thought to
decrease the strength of the magnetic fields by canceling one another out (Ramey, 1998).
Whitaker and Adderly (1998) state that the designation of polarity is "historical and has no
particular significance except to define the direction of a magnet field" (p. 18).
The strength of a magnet is measured in units referred to as gauss, which represents "the number
of lines of magnetic force passing through an area of 1 square centimeter" (Whitaker &Adderly,
1998, p. 15). The earth's surface possesses a magnetic field of about 0.5 gauss, whereas a
refrigerator magnet usually measures from 35-200 gauss. Magnets used to treat pain range from
300-5,000 gauss (Magnetic field therapy, 2000; Vallbona, Hazlewood, &Jurida, 1997; Whitaker
&Adderly). Magnetic resonance imaging (MRI) machines use pulsating electromagnetic fields and
exert up to 200,000 gauss. Although research has been very limited regarding effects of exposure
to these strong magnetic fields, neither pain relief nor discomfort have been reported (Finegold,
1999; Livingston, 1998). Reports from the National Institutes of Health (NIH) have shown that
"MRIs strong magnetic fields have no harmful effects" (Lawrence et al., 1998, p.155).
There are several contraindications to magnet therapy use (Lawrence et al., 1998; Whitaker
&Adderly, 1998). Pregnant women should not use these devices because effects on fetuses are
unknown. Patients with cardiac pacemakers, defibrillators, or insulin pumps also should avoid the
use of magnets due to magnetically controlled features of these devices (Magnetic field therapy,
2000). Whitaker and Adderly also recommend that magnets should not be applied immediately
after the occurrence of sprains, inflammatory injuries, or fresh wounds based on the theory that
vasodilatation occurs with the application of a magnetic field, which could potentially cause an
increase of swelling, pain, or hemorrhage of the affected area. Therefore, if these types of injuries
have occurred, it is recommended that one wait one or two days before initiating magnet therapy.
Also, magnets should not be applied close to any transdermal drug delivery system or patch
(Whitaker &Adderly, 1998). This again is based on the theory that magnet-induced vasodilation
could potentially increase the amount of drug circulating in the body. Finally, patients are advised
to consult with a health care provider regarding any health problems or concerns prior to initiating
magnet therapy. There is a possibility that use of magnets to relieve pain could mask a serious
medical condition (Finegold, 1999).
Dizziness and lightheadedness have been reported as side effects when placing the magnet near
the carotid artery or when using the magnet anywhere on the body for longer than 24 hours
(Magnetic field therapy, 2000). Some patients have reported an increase in pain during the first
few applications of the magnetic device, while others have reported a warming sensation in the
effected area. Skin irritation has also been noted, leading many physicians to recommend using a
protective barrier between the skin and the magnet. Based on anecdotal reports and conjectures
of possible effects of magnet therapy, it is recommended by some practitioners to avoid using
magnetic mattress pads for longer than 8 hours and waiting at least 60 minutes after eating
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before applying magnets to the abdomen due to possible interference of normal contractions of
the digestive tract (Magnetic field therapy). Finally, the use of magnets is not recommended for
immune system disorders, digestive problems, fevers, kidney failure, liver failure, impotence, or
any life threatening disorder. None of these recommendations, however, have been systematically
studied.
Many people, including physicians and health care professionals, share conflicting views
concerning the effectiveness of magnet therapy. The scientific literature available on magnet
therapy is also conflicting. Some claim that magnets are credited for pain relief due to either the
placebo effect, or the mechanism of the device housing the magnet (Livingston, 1998). For
example, many senior golfers claim that magnetic back braces help ease their pain; however,
even without the magnets, the device itself provides mechanical support, localized warmth, and
serves as a constant reminder not to overexert their muscles. Popular publications regarding
magnet therapy, such as the one by Whitaker and Adderly (1998), include statements such as,
"two things about magnets are certain: They can lessen or eliminate many types of pain, and they
are safe" (p. 7). Bold statements such as this and pre-existing bias in reporting the existing
literature can be very misleading to the public.
THEORETICAL AND SCIENTIFIC BASIS OF MAGNET THERAPY
The NIH has established the National Center for Complementary and Alternative Medicine
(NCCAM) to investigate unconventional therapies. Currently, this Center has no consensus or
state-of-the-science statements on magnet therapy, and no clinical trials are underway. One study
addressing static magnet use with fibromyalgia is currently being funded (NCCAM, 2001).
Although the purported mechanism of action is not known, several theories have been proposed
regarding the effects of magnet therapy and pain relief. None, however, has widespread
acceptance in the scientific community. Indeed, it is at times difficult to ascertain appropriate
credentials of those proposing theories. A well known theory is that magnets increase blood flow
to the affected area by creating a pull on charged particles in bodily fluids, which in turn, boosts
the level of oxygen and nutrients to damaged muscles and joints (Magnetic field therapy, 2000).
Whitaker and Adderly (1998), a physician and health administrator, respectively, report that this
increase in blood flow "carries away toxins, and brings in white blood cells (leukocytes), which
work to reduce inflammation, reduce swelling, and speed a cure" (p.70). The Mayo Clinic Health
Letter reports that magnets may also work by blocking pain signals to the brain suggesting a gate
theory (Second Opinion, 1998).
Whitaker and Adderly (1998) write that Robert Holcomb, an assistant professor of neurology at
Vanderbilt University, reports that magnetic fields cause a shift in position of chromosomes within
cells causing relief of acute and chronic pain; a primary source for Holcomb was not found in the
scientific literature. Magnet therapy may prevent the accumulation of cholinesterase, an enzyme
present in nerve endings that can deactivate acetylcholine (Whitaker &Adderly). Acetylcholine is a
neurotransmitter that is essential for pain control. Yet another theory, the Hall effect, a principle of
physics, has been proposed. The Hall effect refers to positively and negatively charged ions in the
bloodstream that become activated while passing through a magnetic field and produce heat,
which causes vasodilatation and an increased blood supply in the treated area (Whitaker
&Adderly).

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A Dr. Bonlie reports that the earth's magnetic field has decreased about 90% in the past 4,000
years (Magnetic therapy 101, 2000). This field is felt to be an essential environmental factor for
life and the loss of this natural energy could cause "a corresponding loss of physiological vitality
and efficiency in all the functions of the body" (p.2). Magnet therapy is thought to replenish the
earth's depleted magnetic field and reverse the negative consequences on the body. Dr. Bonlie's
report of this theory was found on a magnetic product website, yet information regarding his
credentials was not provided. Finally, other biological elements such as "electrolytes, iron, the pH
balance, hormone production and enzyme activity" may also play a role in our response to
magnets (Whitaker &Adderly, 1998, p.78). Little research to support these theories is provided in
scientific, peer-reviewed journals.
Presently, the choices of magnets available for consumers are numerous. There are many claims
of which product is "best" and which has been found to "really work." Do they work, or is this a
huge placebo market? Is there enough research to provide a clear answer?
Supporters of magnet therapy have been criticized for making vague and unsupported claims
regarding effectiveness. The adage that "time heals all wounds" is another argument against the
claims of magnet therapy. The theory of localized vasodilation has also been questioned due to
the lack of redness and warmth in the affected area (Ramey, 1998). The scientific literature on
magnet therapy, while conflicting, is slowly growing (Table 1).
Vallbona, Hazlewood, and Jurida (1997) conducted a double-blind randomized clinical trial
involving patients (n=50) with postpolio syndrome using magnetic (300-500 gauss) or placebo
devices. The device was placed on a trigger point of pain for 45 minutes. Pain was rated before
and after the intervention with the previously validated McGill Pain Questionnaire. A significant
decrease in pain was defined as a 3-point drop in pain rating scores. The active device group
experienced a significant (p <.0001) decrease in pain scores post intervention. The placebo group
also experienced some pain relief, however, not to the degree of the active group. Seventy-six
percent of the group using the active magnetic device experienced significant pain relief (> 3point reduction), compared to only 19% of the placebo group.
This study was criticized for having questionable blinding; the devices were placed in envelopes,
which could differentiate the magnetic devices because the active magnets would stick together
and the placebos would not. Small sample size, lack of a crossover component, and the fact that
all patients experienced pain relief were also viewed as limitations to the study.
In two different studies, Weintraub (1998, 1999) investigated the use of magnets to treat
peripheral neuropathy in both diabetic and non-diabetic patients. The first study (1998) examined
eight diabetic patients and six patients without diabetes, all of whom had peripheral neuropathy.
Significant differences between groups were not reported. Magnetic (475 gauss) footpads were
worn for 24-hour periods for up to four months. No sham magnet controls were used. Baseline and
post treatment measurements of nerve conduction and somatosensory evoked potentials were
completed. Pain was measured by using a Visual Analog Scale (VAS) twice daily. Significant
(p<.05) improvements in pain scores were found among the diabetic group with a 75% reduction
or reversal of pain. Only 50% reduction of pain was noted in the non-diabetic group. No significant
changes were noted among the other variables. Weintraub noted that limitations of the study
included a small sample size, lack of blinding, short duration of follow-up, and the absence of
sham magnets as controls with crossover.
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The larger study conducted by

Weintraub (1999) was a randomized, double-placebo control, crossover trial (each group has
control/sham and active insole) testing the effectiveness of magnet therapy on peripheral
neuropathy pain. Nineteen subjects with peripheral neuropathy pain were examined, ten were
diabetic and nine were not. The VAS was used twice daily to measure pain. One placebo and one
active (475 gauss) magnetic foot pad was used 24 hours a day for 30 days (Phase I). Patients then
switched the foot pads for another 30 days (Phase II). Then, patients received two active insoles
and continued to grade their pain for the next eight weeks (Phase III).
Ninety percent of the diabetic cohort experienced a significant (p<.02) decrease in pain after the
four month course, whereas only 33% of the non-diabetic cohort experienced relief. No significant
changes were found in neurologic or electrodiagnostic data. Lack of a double-blind component
and the small sample size were limitations to the study.
Borsa and Liggett (1998) conducted a single-blind, placebo study using a repeated measures
design on 45 healthy subjects in whom muscle strain was measured by an isokinetic testing
device, followed by an active magnet (700 gauss), placebo, or nothing at all. Pain perception
(rated 0-10 on the VAS) and strength were repeatedly measured up to 72 hours following
treatment. No significant differences (>0.05) in pain perception scores or strength were found
when comparing pre- and posttreatment scores of the two groups. Magnet therapy made no
difference in relieving pain and/or increasing strength in these healthy participants.
Hong and colleagues (1982) conducted a double-blind experiment in which bipolar magnetic
(1300 gauss) and placebo necklaces were used. Volunteers (n= 101) with neck and shoulder pain
for at least one year were compared with individual without pain. Significant differences between

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groups were not mentioned. Pain frequency and intensity, nerve conduction, and nervous
excitation thresholds were assessed. The necklaces were worn 24 hours a day for 3 weeks.
Of those subjects who had experienced pain, significant pain relief was obtained by both active
and placebo groups (p<0.001), which is highly suggestive of a placebo effect. No significant
differences were found in the excitation threshold measurements among all the groups. A
significant (p<0.04) decrease in nerve conduction was found on the individuals who did not
experience pain and wore active magnets; however, this was not found in subjects who had
experienced pain. The researchers hypothesized that magnet therapy can alter nerve conduction
and excitability, and decrease the transmission of pain information as suggested by the gate
theory. Another possibility is that the placebo effect relaxed patients enough to decrease nerve
conduction. Future studies suggested by the authors include an increase of magnetic strength,
change in magnetic direction from perpendicular to parallel to the direction of nerve conduction,
and the use of unipolar magnets. Though this study was conducted in 1982, no additional
research conducted by these authors was found.
A randomized, double-blind, placebo controlled, crossover pilot study (Collacutt, Zimmerman,
White, &Rindone, 2000) involved patients (n=20) with stable low back pain, such as with
degeneration, for at least 6 months and the use of placebo and bipolar permanent magnets (300
gauss). Twenty subjects wore an abdominal binder for 6 hours per day, 3 days a week for 1 week,
followed by a week off. The devices were then switched for an additional week resulting in I week
with the active magnet, and 1 week with the sham. No significant (p>0.05) differences were
found between magnet and placebo use on VAS pain scores, range of motion (ROM), and Pain
Rating Index scores. Suggestions for further research by the authors include using unipolar
magnets, increasing magnet strength, and varying treatment times and patient populations. A
larger sample size would also enhance the power of the study.
Kim (2000) conducted a double blind, randomized study that examined the use of placebo and
northern polarity magnetic headbands (3,950 gauss) in patients (n=26) who suffered from chronic
headaches. A control group taking non-narcotic analgesics was used. Patients wore the device
headband 30 minutes daily for four weeks; quantitative VAS scores and qualitative information
was obtained. No significant findings (p>0.179) were noted between the different groups in
regards to pain relief however, all groups obtained some relief with the active magnet group
obtaining the most (60.2%), then placebo (47.9%), and control group (31.2%). The author
suggests that the small sample size and limited statistical power were issues that needed to be
addressed with future studies.
A double-blind randomized controlled trial (Colbert, Markov, Banerji, &Pilla, 1999) was conducted
with 25 female patients with fibromyalgia who were given a magnetic or sham mattress pad for a
16 week period. The mattress pad with northern polarity was measured at 1100 +/- 50 gauss;
however, the actual strength at the patients' skin was calculated to be between 200-600 gauss.
The measured variables included global wellbeing, pain, sleep, fatigue, and tiredness on
awakening by using 010 point VAS at the same time of day each week. Pain distribution was
measured by a tool created for this experiment. Interrater reliability for the tool was computed at
r=0.72. Physical functioning of daily tasks was measured by the Fibromyalgia Impact
Questionnaire (FIQ), which was validated.
The treatment group experienced a significant decrease in pain (p<0.05), fatigue (p<0.006), total
myalgic score (p<0.03), and pain distribution (p<0.02). These subjects also reported significant
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improvement in sleep (p<0.01) and physical functioning, or FIQ scores (p<0.04). The control
group experienced no significant changes in any of these variables. Both groups reported
improvement in scores of tiredness on wakening. The authors note that the firm surface of the
mattress pads could have contributed to this placebo effect. Neither group revealed any effect on
global well being. A limitation of the study is the lack of control and documentation of the duration
of time spent using the device and the positions used. A small sample size and the examination of
one gender are also limitations to this study, although fibromyalgia is a female-dominated
disorder.
Magnet therapy has been considered for use with plastic surgery, as well. Man, Man, and Harvey
(1998) conducted a double-blind, randomized study examining the use of magnets on postoperative patients (n=20) undergoing suction lipectomies. Pain, edema, and ecchymosis were
evaluated at 1, 2, 3, 4, 7, and 14 days postoperatively. Ecchymosis and edema were measured by
the same blinded observer on 0-10 scales. Pain was measured by the blinded observer while the
patient was in the hospital and by the patient once discharged home by using a VAS. One group
(n=10) used a magnetic patch (150-400 gauss with northern polarity) over the treated area, and
the control group (n= 10) used a sham patch. Patients' treatment areas were covered with a
compressive dressing for a total of 14 days. The treatment group demonstrated a significant
decrease (p<0.05) in ecchymosis (days 1-3), edema (days 1-4), and pain (days 1-7); results were
not found to be significant beyond those days. There was no significant difference between
groups after day 7. An obvious limitation to this study was the small sample size and lack of
gender demographics.

Scientific research regarding

magnet therapy and the treatment of pain is limited. The placebo effect has the potential to play
a role in the results, and in order to support the theory that magnets indeed relieve pain,
controlled, scientific experiments need to be conducted.
An important reason why these experiments are difficult to conduct is that participants can detect
whether the metal device is magnetized or not, thus eliminating objectivity. Also, in studies where
participants have more than one pain site and act as their own controls, it is not likely that the
same intensity of pain would be present at each location. Finally, animal experiments are difficult
to design because of the inability to access feedback and measure outcomes (Whitaker &Adderly,
1998).
There are many uncertainties that accompany the use of magnet therapy, such as what polarity,
direction, duration, and strength to use. The limited research available on magnet therapy is
conflicting and inconclusive. Some studies show promise and warrant further investigation in
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order to justify the use of magnet therapy. Currently, NCCAM has several clinical trials in progress
that review magnet therapy use with different illnesses; however, only electromagnetic therapy is
being used. No studies on the use of permanent magnet therapy are funded.
NURSING'S ROLE
The goals of magnet therapy are congruent with the discipline of nursing in many ways, such as
health promotion, and the relief of pain and suffering. One way of understanding magnetic
therapy is through Rogers' Science of Unitary Human Beings (Rogers, 1983). Rogers' theory has
changed over time, yet still remains relevant for nurses in today's health care system where the
focus is on holistic and continuous care.
Rogers views both humans and their environments as energy fields. Human energy fields and
their environmental energy fields are known (or are identified) by patterns that are unique. She
refers to humans as "human fields" or "unitary human beings." The human "field" is integral with
its environmental "field," meaning that one cannot be considered without the other. Both human
and environmental fields change continuously, creatively, and integrally.
Magnetic therapy can be interpreted through Rogers' theory. A magnetic field represents a pattern
of the humans environmental field. Combined, the human and environmental/magnetic fields
create a unique, integral pattern. The union of magnetic fields creates a pattern change that could
have an effect on the human, such as pain relief. Rogers' refers to this concept as "repatterning"
in which a new interaction causes a pattern change and the evolution of man and environment
continue (Rogers, 1970). Theoretically, then, a magnet placed on a patient would change the
environmental energy field. Magnet therapy can be viewed through a Rogerian perspective
following the theoretical and operational definitions cited in Table 2.
Rogers' theory supports that nursing's purpose is to promote health and well being for all persons;
the art of nursing is to creatively use the science of nursing for human betterment (Rogers, 1994).
Hence, an important role of the APN is to explore such treatments as magnet therapy, which can
be seen as a creative use of science. From Rogers' perspective, it is theoretically plausible for
magnet therapy to have an effect upon individuals through a process of repatterning. At this
point, however, the scientific evidence does not adequately support this theory.
SUMMARY
Nurses have an ethical responsibility to understand the scientific basis of therapies they may
prescribe. Advanced practice nurses are faced with clients who use, or may want to use,
alternative therapies. Viewing magnet therapy through a nursing model provides a theoretical
understanding of the phenomenon and offers a basis for future research. Magnet therapy may be
far from becoming a scientifically supported therapy; however, there have been some interesting
findings in the studies conducted previously. There is some indication that magnet therapy does
work in certain conditions, such as with the pain of peripheral neuropathy; however, there is
clearly a need for more scientifically sound studies. This critical review of the state of the science
of magnet therapy has not demonstrated adequate scientific support to justify its use in clinical
practice. Alternative therapies are accepted and used by many patients today, and while magnet
therapy is in popular use, the scientific evidence to support its use is limited, at best.
References
REFERENCES
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Cody, D.K., &Moran, J.D. (1999). Case study: Use of biomagnetic therapy to encourage growth in
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Weintraub, M.I. (1998). Chronic submaximal magnetic stimulation in peripheral neuropathy: Is
there a beneficial therapeutic relationship? American Journal of Pain Management, 8, 12-16.
Whitaker, J. &Adderly, B.A. (1998). The pain relief breakthrough: The power of magnets. Boston:
Little, Brown &Co.
AuthorAffiliation
Rebecca Ratterman, RN, MSN
Janet Secrest, RN, PhD
Barbara Norwood, RN, EdD
Anne P. Ch'ien, RN, MSN, FNP
AuthorAffiliation
Authors
Rebecca Ratterman, RN, FNP-C, is in clinical practice in Cleveland, TN. Janet Secrest, RN, PhD, is
UC Foundation Professor at University of Tennessee at Chattanooga. Barbara Norwood, RN, EdD, is
Assistant Professor at University of Tennessee at Chattanooga. Anne P Ch'ien, RN, MSN, FNP, is a
Clinical Associate Professor at University of Tennessee at Chattanooga. Contact Dr. Secrest by email at Janet-Secrest@utc.edu.

Publication title: Journal of the American Academy of Nurse Practitioners

Volume: 14
Issue: 8
Pages: 347
Number of pages: 7
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Publication year: 2002

Publication date: Aug 2002
Year: 2002
Publisher: Blackwell Publishing Ltd.
Place of publication: Austin
Country of publication: United Kingdom
Publication subject: Medical Sciences--Nurses And Nursing
ISSN: 10412972
Source type: Scholarly Journals
Language of publication: English
Document type: PERIODICAL
ProQuest document ID: 212876999
Document URL: http://search.proquest.com/docview/212876999?accountid=50268
Copyright: Copyright American Academy of Nurse Practitioners Aug 2002
Last updated: 2014-11-01
Database: ProQuest Nursing & Allied Health Source

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