Focus on Complementary and Alternative Therapies (Relates to Chapter 7, “Complementary and Alternative Therapies,” in the textbook) Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Most Common Types of CAM 2 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. eFig Most commonly used complementary and alternative therapies by Americans

3 Biomedical versus Integrative Health Care Model Biomedical Model Integrative Model Focus on physical body Focus on mind–body–spirit Focus on treatment of symptoms using drugs and surgery Focus on self-healing of body using herbs, nutrition, stress management Health care provider directs care Individual directs care; encourages personal responsibility for health Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

4 Biomedical versus Integrative Health Care Model Biomedical Model Integrative Model Focus on disease states Focus on health and wellness Technologic, invasive Noninvasive Increasing cost Lower cost Little focus on prevention Focus on prevention Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Whole Medical Systems Traditional Chinese medicine (TCM) Ayurveda Homeopathy Naturopathy 5 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Traditional Chinese Medicine (TCM) Interventions include  Acupuncture  Acupressure  Chinese herbology 6 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Acupuncture Treatment 7 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Fig Acupuncture. Placement of acupuncture needles for the treatment of numbness in the arms related to damage of neck vertebrae.

Conditions That May Benefit from Acupuncture Pain management Headache Insomnia Nausea/vomiting 8 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

In responding to a patient who comes to the clinic and requests an acupuncturist for treatment of asthma, the nurse recognizes that: 1. Asthma is a disorder that should not be treated with acupuncture because of the risk for respiratory complications. 2. Application of acupuncture needles stimulates or blocks specific superficial nerves to alter physiologic function. 3. Stimulation of specific acupoints can balance the energies of yin and yang to increase Qi and improve lung function. 4. Effective treatment of any disorder by acupuncture requires that the patient believe strongly in the concepts of Chinese medicine. Audience Response Question 9 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Mind–Body Interventions Prayer  Meditative  Ritualistic  Colloquial  Intercessory 10 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Mind–Body Interventions Relaxation breathing Meditation Biofeedback Imagery Hypnosis 11 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Mind–Body Interventions Music therapy Art therapy Journaling Animal-assisted therapy (AAT) 12 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Biologic-Based Therapies Herbal therapy Dietary supplements Nutritional therapy Aromatherapy 13 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Commonly Used Dietary Supplements Chondroitin sulfate Coenzyme Q 10 Fish oil/omega-3 fatty acids 14 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Commonly Used Dietary Supplements Glucosamine Probiotics Melatonin 15 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Manipulative and Body-Based Methods Chiropractic therapy Acupressure Massage therapy Yoga 16 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Hand Massage 17 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Fig Hand massage can be a helpful tool to calm down an agitated or nervous patient.

Energy Therapies Therapeutic touch (TT) Healing touch Reiki 18 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Gerontologic Considerations Herbs commonly used by older adults  Ginkgo biloba  Ginseng  St. John’s wort  Saw palmetto  Echinacea 19 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Gerontologic Considerations Safety concerns  Age-related changes  Polypharmacy 20 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nurse’s Role Assessment Promoting safety and serving as a resource Providing holistic self-care and holistic nursing practice 21 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nurse’s Role Serving as a provider Participating in research 22 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Assessment Questions What are you doing to maintain or improve your health and wellness? How involved are you in planning and carrying out your health- related care? 23 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Assessment Questions What is your view of the ideal relationship between yourself and your health care provider? Are you using any vitamin, mineral, dietary, or herbal supplements? 24 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Assessment Questions Do you have any conditions that have not responded to conventional medicine? If so, have you tried any other approaches? 25 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Assessment Questions Are you interested in obtaining information about alternative or complementary approaches? 26 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

When obtaining a health history, the nurse knows that it is most important to assess the patient’s use of herbs to: 1. Evaluate the effectiveness of the products. 2. Teach the patient about the safe use of herbs. 3. Determine the risk for drug-herb interactions. 4. Confirm the patient’s desire for more holistic health care. Audience Response Question 27 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Case Study 28 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Case Study 55-year-old woman was recently diagnosed with stage I infiltrating ductal carcinoma of the breast. Her diagnosis came following abnormalities seen on a routine mammogram. 29 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Case Study She is asymptomatic and states “she feels just fine.” She does not want to have a mastectomy and is concerned about the side effects of cancer treatments. 30 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Discussion Questions 1. What should the priorities of care be for her? 2. What patient teaching should you discuss with her before she begins treatment? 31 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Discussion Questions 3. She recently read an article about a celebrity who used alternative therapies for her cancer. She asks you what therapies you would recommend. ◦ How should you counsel her? 32 Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.