Alternative Medicine.
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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