Chapter 27: Complementary and Alternative Therapies Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

2 Hippocrates Renowned “father of medicine” followed four principles: 1. Observe all 2. Study patient not disease 3. Evaluate honestly 4. Assist nature Nightingale “the nurses role was to provide an environment that supported the patient’s healing process.”

3 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Traditional Model  Biomedical  Conventional  Allopathic medicine Focus is on disease rather than on perceiving the patient as a whole person and is based on the following assumptions: 1. Scientific methods identify the cause of disease 2. Germ theory defines infections 3. Prevention based on proper hygiene and lifestyle choices 4. Disease is tangible and measurable

4 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Holistic or Alternative Care Model  Strengthening inner resistance to disease  Enhancing body’s healing power  Have been used primarily for  Pain management  Treatment of chronic illness  Anxiety and depression  Disease prevention

5 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Ancient Cultural Beliefs  Illness = Punishment for sin or whim of gods  Healing via purification  Incantation  Herbs  Animal sacrifices  Laws to regulate  Hygiene  Sanitation  Food

6 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Hippocrates  Introduced beliefs that the Gods did not control health  Health dependent on balance of mind, body, and environment  Patient-centered approach

7 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Biomedicine Model Concepts  Separation of mind and body  Disease = Breakdown of parts  Treatment tailored to signs and symptoms  Physician-centered, evidence-based treatment regimes

8 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Holistic Model Concepts  Concerned with healing the total person  Considers entire background: cultural; genetic; past and current experiences; family structure  Persons perception of health and illness  Coping mechanisms  Multiple methods used in plan of care

9 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Psychoneuroimmunology  Concerned with influence of psychobiologic factors on stress response and health outcomes  HPA axis arousal affects immune system  Stress =  Immunity  Stress =  Resistance

10 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Current Issues  Changing complexion of health care  Costs, restrictions of managed care  Greater familiarity with alternative therapy  Concierge medicine  Barriers to acceptance of alternative therapies  Cost discourages research  No regulation for purity/dosage accuracy  Self-diagnosis  Interactions between alternative and conventional

11 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Current Issues, cont’d.  Impact of Healthy People 2010 report  Increase quality and years of a healthy life  Eliminate health disparities  Shift in emphasis from risk factors to definition of health over the life span

12 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Mind Body Interventions  Meditation  Prayer  Mindfulness-based therapy  Prayer  Yoga  Use of the arts  Humor  Exercise  Animal-assisted therapy  Psychotherapy and hypnosis

13 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Energy Therapies  Biofeedback  Bioelectromagnetics

14 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Alternative Therapies of Medical Practice  Traditional Chinese: accupuncture  Ayurveda/Ayurvedic: yoga, meditation  Homeopathic: substances produce disease  Naturopathic: ecclectic herb selection  Environmental: sensitivity and allergy  Culture-based community: folk medicine

15 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Manual Healing Methods  Osteopathy and chiropractic medicines  Massage  Acupressure  Hand and foot reflexology  Therapeutic touch

16 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Pharmacologic and Biologic Treatments  Vaccines and medicines not yet approved by mainstream medicine  Animal cartilage  Chelating chemicals

17 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Herbal Medicine  Chinese, European, American  Examples:  Ginkgo biloba  Echinacea  Saw palmetto  Prunus africanus  Ginseng  St. John’s wort

18 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Diet and Nutrition  Vitamins, minerals, supplements  Food elimination diets  Vegetarian  Ethnic-based diets  Antioxidant  Superfoods

19 Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Energy Therapies  Biofeedback  Bioelectromagnetics  Light therapy  Bone growth stimulation  Magnet therapy