Complimentary and Alternative Medicine
Complimentary Alternative Modalities Nursing 382 Holistic Nursing Assessment and Practice Dr. Laura Schwarz, DNP, RN, CNE, AHN-BC Mavis maveric Month, Date, Year
A comprehensive approach used to address health care needs to include the physical, emotional, psychological & spiritual aspects of a person (Blais & Hayes, 2011)
Practices or products used in addition to, or
as an alternative to, traditional Western
medicine. Not widely taught in medical schools
or readily available in heath care settings
(Dossey et al., 2015)
Becoming more popular, patients are more
aware
What is cam therapy?
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Biological-Based Therapies - Herbals medicine
- Vitamin supplements
- Whole, organic foods
Manipulative Body Therapies - Cranial-sacral therapy
- Massage therapy
- Osteopathic manipulation - Chiropractic therapy
Energy Therapies - Magnet therapy
- Therapeutic / healing touch
- Reiki
- Qi Gong
Mind-based Therapies - Prayer
- Guided self-healing
- Meditation
- Art, music and dance
(Blais & Hayes, 2011, p. 370)
Examples of CAM
Aromatherapy
Massage Therapy
Yoga / Meditation
Three Therapies experienced
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Photo courtesy of Microsoft Office PPT
Photo courtesy of Microsoft Office PPT
The use of essential oils, derived from plants, thought to work at the psychological, physiological and cellular levels in the body
Stimulants travel through the nose and
nerve impulses, to the limbic system of brain,
evoking an emotional response
May also be absorbed through the skin &
into blood stream through massage oils
bath salts
One of the oldest forms of CAM, dating back 6000 years
(Novey, 2000)
Aromatherapy – What is it?
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WHY:
I chose aromatherapy because we have started to use on my Mother Baby unit (nasal inhalers, oils & bath salts). I wanted to see if it would help me manage my stress, relax & sleep
HOW:
I used a lavender oil inhaler stick every day before bed (for 15 min) & used lavender bath salts 2 times a week for 2 weeks
RESULTS:
My tension, anxiety, stress level decreased & I was able to fall asleep faster. I was able to focus on my breathing, clear my mind and relax.
Aromatherapy – My experience
Patients experiencing pain, stress, anxiety, depression, insomnia, cancer treatment or in critical care
“Patients in the lavender group had less postoperative pain” after cesarean section (Olapour et al., 2013, p. 203)
“Aromatherapy in cancer patients suggests a short-term benefit to reduce anxiety and depression, improve sleep and increase overall wellbeing” (Boehm et al., 2012, p. 508)
Aromatherapy reduced anxiety, improved sleep, and stabilized the blood pressures of patients in the
ICU (Cho et al., 2013)
Aromatherapy - Who would benefit?
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We recently started using aromatherapy on our unit. I will now offer this to every patient by sharing what is available, how it works & how they could benefit. However, I will respect those who chose not to use it
Share research that post-op pain scores decreased for cesarean section patients who used aromatherapy, in addition to standard meds
Communicate how easy, cost effective, and empowering aromatherapy can be for use in the hospital or at home
A significant and increasing number of pregnant women use CAM, as if offers them greater control and choice in their holistic care (Hall et al., 2011)
Aromatherapy – How nurses could incorporate?
A systematic form of touch and pressure that manipulates soft tissues of the body to promote comfort and healing
Stimulates the circulation of blood &
lymph, to help remove metabolic
wastes and promote relaxation
Often used with aromatherapy, oils,
and music
Widely available, many different types,
prices vary
(Novey, 2000)
Massage Therapy – what is it?
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WHY:
I often have tight muscles, especially in my back and hamstrings. With work, exercise and a busy lifestyle, I often feel stressed. My doctor and others have recommended massages to me. I have had had one years ago, but can be expensive.
HOW:
I had a deep tissue (myofascial release) massage. The room was dimly lit, with soft music. I was on a comfortable table, with a sheet covering me, face down in a “donut”. The therapist used oil, heat packs and deep stroking pressure for 60 min.
RESULT:
After my session, my tension, knots, stress and muscle aches were relieved. The area under my eyes were swollen and I was very thirsty. I was told to drink lots of water. I felt absolutely fabulous. I vowed to schedule monthly appointments!
Massage Therapy– My experience
Patients experiencing pain, stress, anxiety, depression, pregnancy or chronic illness
For low back pain, “although traditional therapy showed slightly greater pain relief, the decline in pain using massage therapy was significant” (Melancon & Miller, 2005, p. 120)
“Back massage significantly reduced anxiety” in CHF patients (Chenet al., 2013, p. 464)
Massage therapy with pregnant women lowered anxiety and depression and women were less likely to deliver prematurely (Field et al., 2012)
Positive effects are seen on full term and preterm infants experiencing massage therapy (Abdallah et al., 2013).
Massage Therapy – Would would benefit?
Our hospital has an “Integrative Medicine” group that we can put a “consult” in for them to see our patient. Most patients do not stay long enough to have an IM massage, except for antepartum (bed rest) patients.
Encourage patients to utilize if they
have an extended stay.
Give hand, foot or neck massages
to patients or show their caregiver.
Offer aromatherapy oils to use
Encourage people to use at home, in
addition to traditional medication, heat and ice.
Practice what I preach and make appointments for monthly massages! Already found “Groupons” for cheaper options.
Massage Therapy– How nurses could incorporate?
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Consciously controlling breathing, while moving through a series of postures or asanas (Dossey et al., 2005)
“Control of the body through correct posture and breathing, control of the emotions and mind, and meditation and contemplation” (Novey, 2000, p. 141)
Involves mind, body and spirit in a relaxation response mechanism, by increasing blood flow and oxygen use, while reducing carbon dioxide and
respiration rate (Novey, 2000)
Popular activity, especially
among women
Widely available, prices vary
Various types & levels offered,
something for everyone
Yoga / Meditation – What is it?
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WHY:
I already run and strength train, but have never done yoga consistently or tried different types. My doctor & others have encouraged yoga to increase my flexibility, promote relaxation and manage my stress.
HOW:
Participated in five Bikram and five Hatha yoga sessions since January.
Bikram yoga is done in a 105 deg F room with 40% humidity. The 26 poses were very intense and invigorating. I felt detoxified due to the exorbitant amount of sweating. Sessions are 90 min and I need shower after. I had mild headache after one (perhaps dehydration?).
Hatha yoga was done in a dimly lit room, with soft music. The session was 60 min, with simple poses, done in a relaxing, calming manner. I did at night, then went straight to bed.
RESULT:
I enjoyed both, but liked to alternate depending upon my time & mood. Both offered the opportunity to “stretch, relieve stress, open the lungs, relax the heart, and clear the mind” (Novey, 2000, p. 146).
Yoga – My expereince
Patients experiencing pain, anxiety, stress, pregnancy, cancer treatment or chronic illness. Check with your doctor, as not all yoga is safe for everyone (i.e. Bikram)
Prenatal yoga provided optimism, power and well-being, while helping to relieve musculoskeletal issues during pregnancy (Reis & Alligood, 2014)
Systematic reviews show yoga to be beneficial for reducing fatigue in cancer patients (Sadja & Mills, 2013)
“Eight weeks of Bikram yoga improved mindfulness, perceived stress, cardiorespiratory endurance, flexibility and balance” (Hewlett al., 2011, p. 87)
Regular daily yoga improved sleep and quality of life in the elderly (Bankar et al., 2013)
Yoga – would would benefit?
Encourage patients to do yoga, offer resources, classes in area, as there are many offerings, including at our hospital
Share research that indicates yoga may help patients with relaxation, flexibility and stress relief.
Share my experiences and answer
patient questions (i.e. many post partum
patients ask about mom baby yoga classes)
I will continue to do yoga at least once a
week, and vary the type of yoga, depending
upon my time and mood
Yoga – How nurses could incorporate?
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CAM is becoming more mainstream - patients are more aware and asking about
Nurses need to be educated regarding options, benefits and be able to answer patient questions
Aromatherapy is a safe, effective addition
to traditional medication for pain control,
relaxation and sleep
Massage promotes relaxation, stress
reduction and muscle tension relief
Yoga can help improve meditative breathing,
flexibility and overall well-being.
All are cost effective, empowering and easy to offer patients
conclusion
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Abdallah, B., Badr, L. K., & Hawwari, M. (2013). The efficacy of massage on short and long term outcomes in preterm infants. Infant Behavior and Development, 36(4), 662-669.
Bankar, M., Chaudhari, S., & Chaudhari, K. (2013). Impact of long term Yoga practice on sleep quality and quality of life in the elderly. Journal of Ayurveda and Integrative Medicine, 4(1), 28.
Blais, K., & Hayes, J. S. (2015). Professional nursing practice: concepts and perspectives (7th ed.). Pearson.
Boehm, K., Bussing, A., & Ostermann, T. (2012). Aromatherapy as an Adjuvant Treatment in Cancer Care - A Descriptive Systematic Review. African Journal of Traditional, Complementary and Alternative Medicines, 9(4), 503-518.
References
Chen, W., Liu, G., Yeh, S., Chiang, M., Fu, M., & Hsieh, Y. (2013). Effect of Back Massage Intervention on Anxiety, Comfort, and Physiologic Responses in Patients with Congestive Heart Failure. The Journal of Alternative and Complementary Medicine, 19(5), 464-470.
Cho, M., Min, E. S., Hur, M., & Lee, M. S. (2013). Effects of Aromatherapy on the Anxiety, Vital Signs, and Sleep Quality of Percutaneous Coronary Intervention Patients in Intensive Care Units. Evidence-based Complementary and Alternative Medicine, 2013, 1-6.
Dossey, B. M., Keegan, L., & Guzzetta, C. E. (2005). Holistic nursing a handbook for practice (4th ed.). Jones and Bartlett.
Field, T., Diego, M., Hernandez-Reif, M., Medina, L., Delgado, J., & Hernandez, A. (2012). Yoga and massage therapy reduce prenatal depression and prematurity. Journal of Bodywork and Movement Therapies , 16(2), 204-209.
REFERENCES
Hall, H. G., Griffiths, D. L., & McKenna, L. G. (2011). The use of complementary and alternative medicine by pregnant women: A literature review. Midwifery, 27(6), 817-824.
Hewett, Z. L., Ransdell, L. B., Gao, Y., Petlichkoff, L. M., & Lucas, S. (2011). An Examination of the Effectiveness of an 8-week Bikram Yoga Program on Mindfulness, Perceived Stress, and Physical Fitness. Journal of Exercise Science & Fitness, 9(2), 87-92.
Melancon, B., & Miller, L. H. (2005). Massage Therapy Versus Traditional Therapy for Low Back Pain Relief. Holistic Nursing Practice, 19(3), 116-121.
Novey, D. (2000). Clinician's complete reference to complementary & alternative medicine. St. Louis: Mosby.
REFERENCES
Olapour, A., Behaeen, K., Akhondzadeh, R., Soltani, F., Razavi, F.A., & Bekhradi, R. (2013). The Effect of Inhalation of Aromatherapy Blend containing Lavender Essential Oil on Cesarean Postoperative Pain. Anesthesiology and Pain Medicine, 3(1), 203-7.
Reis, P. J., & Alligood, M. R. (2014). Prenatal Yoga in Late Pregnancy and Optimism, Power, and Well-Being. Nursing Science Quarterly, 27(1), 30-36.
Sadja, J., & Mills, P. J. (2013). Effects of Yoga Interventions on Fatigue in Cancer Patients and Survivors: A Systematic Review of Randomized Controlled Trials. EXPLORE: The Journal of Science and Healing, 9(4), 232-243.
References