practice sample

� No one single definition of CAM (Gadboury, April, & Verhoef, 2012).

� Best definition found: A group of therapies, products, or procedures that are present outside conventional medicine.

� Used in addition to, not instead of traditional medicine.

� China is largest user of CAM, but on the rise in the USA.

� Used increasingly by traditional providers and practitioners, including nurses (Li et al., 2011).

MASSAGE

YOGA

MEDITATION

� Definition: Use of hands to touch or rub the skin and muscles of another to create a positive effect.

� Technique examples: kneading, skin rolling and gliding.

� One of the fastest growing CAM therapies in USA.

� Usually not covered by insurance. (Smith et al., 2010)

� Wellness paradigm: Massage attends to the person’s physical, emotional and psychological needs.

� Benefits: lowers muscle tension, lowers blood pressure, improves mood, pain management, improves pain threshold and reduces fatigue.

� Contraindications: burns, skin injuries and DVT.

(Smith et al., 2010)

� Patients with neck, back and shoulder problems, muscle pain, fatigue, anxiety and depression, non-ill people looking for wellness, pregnancy and headaches (Smith et al., 2010).

� Improves lung function in children with asthma (Abdel Fattah & Hamdy, 2011).

� Immediate results with ill hospitalized psychiatric patients. Reduces anxiety and aggression (Garner et al., 2008).

I used a gift card from my 40th birthday for a massage. It was wonderful! I got the massage with hot rocks (as pictured). I felt relaxed and refreshed. I would not have gone without the gift card, and I am very thankful. Courtesy of Microsoft Office PPT

The feelings of well being lasted for 2 days. I choose the hot rocks to work on some tense spots in my upper back and it worked.

Almost any of our patients could benefit from massage. In most inpatient or nursing home settings, the nurse can give a patient a massage, with their permission. A neck or hand massage would be a great way to reduce anxiety about an upcoming procedure. In the psychiatric setting it could help with the stress of a commitment hearing. If the nurse is not able to give a massage, a referral to a local massage therapist is ideal.

� Definition: A practice of physical postures, breathing techniques and mind control.

� Mind-body form of CAM. � Encourages proper body alignment and

awareness. � Yoga breathing is a stress reliever. � Teaches good posture, (not just on the mat)

but all the time. (Krucoff, 2011)

� Used by many for overall health and fitness.

� Also used as a CAM therapy for specific aliments: physical and emotional.

� In USA, usually taught in a group class

(Kaley-Isley et al., 2010)

� Dates back 4000 years and has evolved. � Increases flexibility and strength. � Enhances muscle function. � Very few drawbacks, but must be done

correctly to avoid injury (Hart, 2008).

� “Pay attention to what their own bodies are saying” (Hart, p. 31, 2008).

� Patients with anxiety, depression, ADHD, obesity, eating disorders, pain, injury, asthma and irritable bowel syndrome (Kaley-Isley et al., 2010).

� Patients with chronic neck and shoulder pain (Krucoff, 2011).

� Patients with back pain, arthritis, fatigue, coronary artery disease, hypertension and carpal tunnel syndrome (Hart, 2008).

I have some old Yoga DVDs that I have not used it a while. I pulled them out and did one each day for 4 days. It felt great. My favorite pose is downward facing dog (pictured here). I could feel it strengthening and stretching my muscles. I feel that if I continue with Yoga, it will lessen my back pain. I also felt reduced stress those days. Courtesy of Microsoft Office PPT.

Some simple Yoga postures and stretches could be taught to patients by nurses. Yoga videos could be viewed in a patient room or in a general area of the healthcare intuition. With a small investment, Yoga mats could be provided. If Yoga instruction is not possible, the nurse could make a referral to local Yoga classes.

� Definition: The act of sitting up, focusing on your breath. When your mind wanders from breath, re-focus on breath and being in the present moment.

� Apply techniques to daily life. For example, mindful eating or driving (Brady, O’Connor, Burgermeister, & Hanson, 2012).

� Actually increases cerebral blood flow (Moss, Wintering et al., 2012).

� Practical and low-cost CAM.

� Techniques focus on management of attention and emotion.

� Spiritual element: improves feelings of well- being and spirituality.

(Moss et al., 2012)

� Mindfulness-based Stress Reduction (MBSR) › Training done in various institutions. › Group sessions and discussions. › Guided sitting meditation. › Numerous body postures.

(Olivio et al., 2009)

� Anyone feeling stressed or emotionally exhausted (Brady et al., 2012).

� Patients with anxiety, fatigue, anger, confusion along with memory loss or cognitive problems (Moss et al., 2012).

� Patients at risk for coronary artery disease, substance abuse, eating disorders and hostility (Olivio et al., 2009).

I am in a book club where 2 of the members meditate on a regular basis. I asked them for guidance. One of the women brought a guided meditation for the whole group to our meeting. We did it together, and I really liked it. I feel that focusing on the present moment lessens the stress of daily life. Meditation brings us to a place of realization that we can handle all that comes along in life. It will also take practice, but it’s worth it.

The first step would be for the nurse to educate about and encourage meditation to their patients. Written information can be distributed or left in common areas. Nurses could also keep a simple meditation card in their pocket to give to interested patients. The nurse can guide patients through a simple meditation of focusing on their breath. If that is not possible, a community referral could be made.

Many CAM therapies are meant to reduce stress and anxiety. This is true for massage, Yoga and meditation. Almost anyone can benefit from all three. Massage is more expensive and requires another person, but Yoga and meditation can be done low-cost and alone if need be. There is evidence to back up the many health benefits of these and other CAM therapies.

Abdel Fattah, M., & Hamdy, B. (2011). Pulmonary Functions of Children with Asthma Improve Following Massage Therapy.

Journal of Alternative & Complementary Medicine, 17(11), 1065-1068. https://doi.org/10.1089/acm.2010.0758

Brady, S., O'Connor, N., Burgermeister, D., & Hanson, P. (2012). The Impact of Mindfulness Meditation in Promoting a Culture

of Safety on an Acute Psychiatric Unit. Perspectives In Psychiatric Care, 48(3), 129-137.

https://doi.org/10.1111/j.1744-6163.2011.00315.x

Gaboury, I., April, K., & Verhoef, M. (2012). A qualitative study on the term CAM: is there a need to reinvent the wheel? BMC

Complementary & Alternative Medicine, 12(1), 131-137. https://doi.org/10.1186/1472-6882-12-131

Garner, B., Phillips, L., Schmidt, H., Markulev, C., O'Connor, J., Wood, S., & McGorry, P. (2008). Pilot study evaluating the effect

of massage therapy on stress, anxiety and aggression in a young adult psychiatric inpatient unit. Australian & New

Zealand Journal Of Psychiatry, 42(5), 414-422.

Hart, J. (2008). An overview of clinical applications of therapeutic yoga. Alternative & Complementary Therapies, 14(1), 29-32.

Kaley-Isley, L., Peterson, J., Fischer, C., & Peterson, E. (2010). Yoga as a complementary therapy for children and adolescents: a

guide for clinicians. Psychiatry (1550-5952), 7(8), 20-32.

Krucoff, C. (2011). Yoga for Neck and Shoulder Pain: As a mind-body practice, yoga offers powerful tools for physical and

emotional relief. IDEA Fitness Journal, 8(6), 88-90.

Li, X., Tao, K., Zhou, Q., & Ling, C. (2011). Scientific Publications from Mainland China, Taiwan, and Hong Kong in Integrative

and Complementary Medicine Journals: A Ten-Year Literature Survey. American Journal Of Chinese Medicine,

39(4), 639-649.

Moss, A., Wintering, N., Roggenkamp, H., Khalsa, D., Waldman, M. R., Monti, D., & Newberg, A. B. (2012). Effects of an 8-

Week Meditation Program on Mood and Anxiety in Patients with Memory Loss. Journal Of Alternative &

Complementary Medicine, 18(1), 48-53. doi:10.1089/acm.2011.0051

Olivo, E., Dodson-Lavelle, B., Wren, A., Fang, Y., & Oz, M. (2009). Feasibility and effectiveness of a brief meditation-based

stress management intervention for patients diagnosed with or at risk for coronary heart disease: a pilot study.

Psychology, Health & Medicine, 14(5), 513-523. doi:10.1080/13548500902890087

Smith, J., Sullivan, S., & Baxter, G. (2010). Massage therapy: more than a modality. New Zealand Journal Of Physiotherapy,

38(2), 44-51.

Yoga Journal. (2008). Ahimsa. [photograph]. Retrieved from http://blogs.yogajournal.com/slideshows/better-bone-health on

March 2, 2014.