Alternative Medicine.

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Chapter_014.ppt

Chapter 14

Complementary and Alternative Strategies

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Holistic Practice

  • Health defined as more than the absence of disease
  • Health: optimal wellness in all aspects of being
  • Goals
  • Support a person’s natural healing systems
  • Consider the whole person
  • Consider the environment surrounding person
  • Often considered complimentary or alternative
  • Moving into mainstream US practice
  • Useful adjuncts to nursing practice

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  • Holistic: encompasses emotional, spiritual, and relational well-being
  • Combine with the physical body
  • Together they define a whole person
  • Allopathic medicine: focus is on identifying and treating disease
  • Care by physician or midlevel provider
  • Drugs, surgery, procedures to ailments

Holistic Versus Allopathic

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Alternative Health Modalities

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Source: Nat’l Health Statistics Report # 79 – Nat’l Center for Health (2015)

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  • The American Holistic Nurses Association (AHNA) defines holistic nursing as nursing practice that heals the whole person
  • Per AHNA: “specialty practice that draws on nursing knowledge, theories, expertise and intuition to guide nurses in becoming therapeutic partners with people in their care.”

Holistic Nursing

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  • Biologically based practices
  • Mind and body techniques and practice
  • Manipulative body-based practices
  • Energy therapies
  • Ancient medical systems
  • Whole medical system (includes all domains)

Domains are neither mutually exclusive nor inclusive—considerable overlap

Types of Therapy

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  • Ayurvedic medicine (India)
  • Evolved over thousands of years
  • Herbs, massage, diet, drugs
  • Goal is mind-body harmony
  • Traditional Chinese Medicine (China)
  • Evolved over thousands of years
  • Herbs, CAM treatments, acupuncture
  • Balance yin and yang life forces
  • Describes organs via fire, earth, metal,H2O, wood

Whole Medical Systems

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  • Naturopathy:
  • Combo of traditional and 19th century European modalities based on healing power of nature
  • No RX, injections, x-rays or surgery
  • Healthy lifestyle, cleansing regimens, diets, manipulation, exercise
  • Homeopathy—founded by Hahnemann 1807
  • Administers small amounts of dilute pathogenic substances to stimulate body’s healing abilities
  • FDA hearings 2015—unfavorable findings

Whole Medical Systems

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  • Use of natural products—historic roots
  • Medicinal herbs found in prehistoric man
  • Botanical herbs inventoried in Middle Ages
  • Current modalities:
  • Nutritional counseling: good efficacy data
  • Herbs, vitamins, minerals (not multivitamins or CA++)
  • Probiotics (“friendly” bacteria)
  • Aromatherapy aka essential oil therapy

Uses naturally extracted plant oils to promote health

  • Hydrotherapy: ice, steam, sauna, compresses

Biologically Based Practices

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  • Spinal or bone manipulation
  • Application of controlled force on bone or joint
  • Performed by chiropractors, physical therapists, and osteopathic physicians
  • Chiropractic focuses as spinal alignment
  • Cranial and cranio-sacral therapy
  • Focus on skull and flow of CSF
  • Gentle pressure cranium, spine, sacrum
  • Goal to restore free movement of CSF

Manipulative and Body-Based
Modalities

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  • Physical therapy: variety of modalities
  • Manipulation, massage, heat or cold, movement, electrical impulse
  • Treat pain and restore function and ROM
  • Massage—various techniques
  • Manipulation of muscle and soft tissue
  • Reduce stress; enhance relaxation
  • Reflexology—manipulation and energy fields
  • Pressure to hands and feet
  • Pressure points correspond to body organs

Manipulative and Body-Based
Modalities (Cont.)

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  • Guided imagery: directs the imagination
  • Focuses on calming thoughts or experiences
  • Promotes sense of well-being, relaxation
  • Randomized controlled study shows improved quality of life and some impact on laboratory values
  • Meditation—focused attention, mindfulness
  • Quiets the mind, reduces stress
  • Part of some religions but not a religious activity
  • Variable formats: breath, chosen word, walking

Mind Body Medicine

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  • Hypnotherapy
  • Focused attention of unconscious mind
  • Recall of suppressed events and behavior change
  • Commonly used for tobacco cessation
  • Biofeedback—relaxation technique
  • Focus on vital functions: HR, BP, breathing rate
  • Visualizations to bring about change
  • Neurolinquistic programming (NLP)
  • Changes behavior via change in thinking/speaking

Mind Body Medicine

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Movement Arts

  • Qigong (Chinese)
  • Relaxed movement with meditation,
  • Controlled breathing to move qi energy and increase vital energy
  • Tai chi (from Chinese martial art)
  • Combined physical movement, breath control, meditation
  • Sequence of poses flows in unbroken rhythm to balance energy flow
  • Brings awareness moment-to-moment state of body
  • Produces meditative state

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Movement Arts

  • Yoga (Hindu)—many forms
  • Origins as spiritual practice
  • Hatha yoga—most familiar in Western culture
  • Involves positions and breath control
  • Positions relaxing or may require strength
  • Documented health benefits

Improves flexibility, promotes relaxation, decreased stress, improves pain management

  • Dance therapy—mind and body move in response to music

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Energy Therapy

  • Energy flows through the body
  • Energy nourishes organs/promotes optimal functioning
  • Goal: energy work releases blockages to energy flow, rebalances life energy
  • Cultural energy name variations
  • Chinese: Chi or qi
  • Japanese: Ki
  • East Indian: Prana
  • Western civilization: subtle energy, life energy, or universal energy

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Energy Therapy Modalities
Acupuncture

  • Manipulates chi or qi by stimulating (fine needles) precisely mapped points on the skin points overlie channels (meridians) through which chi travels
  • Acupuncture points act as valves in meridians
  • Valve opens/closes, corrects imbalance in chi
  • Stimulation via needles, electrostimulation, laser, light, burning herbs (moxibustion)
  • Effective: substance abuse, depression, insomnia, nausea/vomiting, pain

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Energy Therapy Modalities
Acupressure and Reflexology

  • Acupressure
  • Stimulation of meridian points by hand pressure
  • No oil needed; can be done with person clothed
  • Reflexology
  • Deeply applied pressure to mapped points on feet and/or hands
  • Pressure applied with thumbs
  • Pressure points correspond to organs of the body that will be stimulated by pressure

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Energy Therapy Modalities
Touch Therapies

  • Touch therapies fall under umbrella of energy therapies
  • Practitioners use their hands to direct energy (from environment) to individual
  • Goal is to restore balance and harmony
  • Examples: therapeutic touch reiki, attunement, Jin Shin Jyutsu, polarity therapy, healing touch

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Energy Therapy Modalities
Therapeutic Touch

  • Conceptualized by Martha Rogers
  • Human energy fields interact with environmental energy fields
  • TT involves three elements
  • Centering of practitioner (calm, present in moment, connected)
  • Assessment (sensing disturbances/imbalances by moving hands over body)
  • Treatment: methods to change patterns of energy field (unruffling), or direct energy to person/redistribute energy (modulation)

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Energy Therapy Modalities
Additional Modalities

  • Healing touch (similar to therapeutic touch)
  • Adds full-body techniques for moving energy and disorder-specific energy interventions to modulation phase
  • Qigong (Chinese)
  • Pranic (East Indian)
  • Reiki (Japanese): attunement opens energy channel; brings universal energy through body to recipient
  • Polarity therapy: Clearing energy blockages and rebuilding health
  • Jin Shin Jyutsu: finger pressure to healing points
  • )

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Prayer and Distant Healing

  • Prayer
  • Different meanings to different people
  • Common belief aids in recovery
  • Research mixed on therapeutic benefit
  • Distant healing
  • Prayer for others
  • Method: praying circle
  • Sharing of energy and sending of energy to person in need
  • Research did not validate this therapy

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Music Therapy and Pet Therapy

  • Music therapy
  • Use music/sounds to produce desired changes in behaviors, emotions, physiological processes
  • Influences limbic system (involved with emotions/feelings)
  • Pet therapy
  • Two-thirds of three US households have at least one pet
  • Half of older Americans have a pet
  • Pets may improve depression, loneliness
  • Improve physical activity

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Nursing Presence

  • Being available in a situation with the wholeness of one’s individual being
  • Nurse’s presence can contribute to healing
  • “Being with” rather than “being there” or “doing to”
  • Attention “focused” vs attentive
  • Touch “caring” vs task oriented
  • “Listen” vs merely hearing patient

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  • Most Complementary and Alternative Medicine (CAM) interventions lack a strong scientific evidence base, as many have not been studied with rigorous, well-designed clinical trials.
  • Some CAM providers are not credentialed in a standardized national system, credentialing regulations and standards vary nationally
  • Safety issues for some CAM; caution needed


Safety and Effectiveness

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