1. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 11 Complementary and Alternative Healing

2. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Use of Alternative Healing Methods  Use of alternative healing methods  Healing philosophies, practices, and products that fall outside what Western society considers mainstream medicine  Approximately 4 out of 10 Americans have visited an alternative health care practitioner.  Growing popularity of complementary and alternative medicine (CAM) has been consumer-driven.

3. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.  Factors that contribute to consumer’s desire for CAM: Dissatisfaction with the conventional health care system Dissatisfaction with the conventional health care system Unwillingness to “grin and bear” the effects of diseases Unwillingness to “grin and bear” the effects of diseases Shrinking world—The rapid pace and ease of information sharing have enabled individuals to learn about practices of people throughout the world Shrinking world—The rapid pace and ease of information sharing have enabled individuals to learn about practices of people throughout the world Use of Alternative Healing Methods

4. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Growing evidence of effectiveness—The body of research supporting the effectiveness of alternative therapies increases almost daily. People are hearing testimonials from friends and family about the ways they have been helped by acupuncture, herbs, and other forms of CAM. Growing evidence of effectiveness—The body of research supporting the effectiveness of alternative therapies increases almost daily. People are hearing testimonials from friends and family about the ways they have been helped by acupuncture, herbs, and other forms of CAM. Use of Alternative Healing Methods

5. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Principles Underlying Alternative Healing  The body has the ability to heal itself. Most of conventional medicine works from the premise that the elimination of sickness requires an intervention “done to” the body (e.g., giving medications, surgery). In CAM, it is assumed that the body heals itself. Alternative healing therapies enhance the body’s ability to self-heal.

6. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.  Health and healing are related to a harmony of mind, body, and spirit. The mind, body, and spirit are inseparable; what affects one affects all. Healing and the improvement of health demand that all of the facets of a person be addressed, not merely a single symptom or system. Principles Underlying Alternative Healing

7. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.  Basic, positive health practices build the foundation for healing. Good nutrition, exercise, rest, stress management, and avoidance of harmful habits (e.g., smoking) are essential ingredients in health maintenance and the improvement of health conditions. Principles Underlying Alternative Healing

8. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.  Approaches to healing are individualized. The unique composition and dynamics of each person are recognized in CAM. Practitioners of healing therapies explore the underlying cause of a problem and customize approaches accordingly. Principles Underlying Alternative Healing

9. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.  Individuals are responsible for their own healing. It is the responsibility of competent adults to seek health advice, make informed choices, gain necessary knowledge and skills for self- care, engage in practices that promote health and healing, and seek help when needed. Principles Underlying Alternative Healing

10. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. National Center for Complementary and Alternative Medicine (NCCAM)  A freestanding center within NIH; has categorized CAM into five fields of practice

11. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. National Center for Complementary and Alternative Medicine (NCCAM)  Five fields  Alternative medical systems  Mind/body interventions  Biologically based treatments  Manipulative and body-based methods  Energy therapies

12. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Overview of Popular Alternative Healing Therapies Alternative medical systems Alternative medical systems –Acupuncture –Ayurveda –Biofeedback –Chiropractic medicine – Dietary supplements – Herbs – Hypnotherapy – Imagery – Magnet therapy

13. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Biologically Based Treatments  Herbal therapies  Individual and orthomolecular biologic therapies  Special diets

14. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Manipulative and Body-Based Methods  Chiropractic  Massage and related techniques (e.g., manual lymph drainage, Alexander technique, Feldenkrais method, pressure point therapies, Trager psychophysical integration)  Osteopathy

15. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Energy Therapies  Qigong  Reiki  Therapeutic touch  Bioelectromagnetic-based therapies

16. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Acupuncture  Practiced in China for longer than 2000 years, acupuncture is a major therapy within traditional Chinese medicine. It is based on the belief that energy flows through invisible channels throughout the body that are called meridians. This energy is called Qi (pronounced chee), and it is considered the vital life force. It is believed that illness and symptoms develop when the flow of energy becomes blocked or imbalanced. Health is restored when the energy becomes unblocked. This is achieved by stimulating acupuncture points on the meridian(s) affected.

17. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Ayurveda  Although it recently has gained popularity through the writings and lectures of Deepak Chopra (1993), Ayurveda has existed in India for longer than 5000 years. Ayurveda means “the science of life”; it is a system of care that promotes spiritual, mental, and physical balance. Noninvasive approaches, including yoga, massage, diet, purification regimens, breathing exercises, meditation, and herbs, are used to achieve balance.

18. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Biofeedback  Biofeedback is a technique in which the client is taught to alter specific bodily functions (e.g., heart rate, blood pressure, muscle tension). The client uses various relaxation and imagery exercises to effect desired responses. Machinery such as electroencephalograms, electromyelograms, and thermistors is used to measure and offer feedback about the function that one is trying to alter.

19. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Chiropractic Medicine  Chiropractic medicine is based on the belief that misalignments of the spine, called subluxations, put pressure on the nerves, leading to pain and disruptions in normal bodily function. The misalignment is treated by manipulation and adjustment of the spine.

20. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Dietary Supplements  Past advice that vitamin and mineral supplements are unnecessary if one is eating well has been replaced by the recommendation that everyone should take a daily vitamin and mineral supplement. This shift in thinking has resulted from the realization that many people do not consume the proper nutrients in their diets.

21. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Herbs  In the 1960s, when the movement toward natural health began to swell, interest in herbal products increased. The use and sale of herbal remedies have grown significantly since then.

22. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Homeopathy Homeopathy  The origin of the word homeopathy helps to explain this therapy. In Greek, the word homios means similar, and pathos means suffering. The foundation of homeopathy, the Law of Similars, builds on the belief that remedies are prescribed that produce symptoms similar to those of the illness that is being treated.

23. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Hypnotherapy  This mind/body therapy is now widely and successfully used for a range of conditions, including chronic pain, migraine, asthma, smoking cessation, and irritable bowel syndrome.

24. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Imagery Imagery  The process of creating an image in the mind that can cause a specific bodily response

25. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Magnet Therapy Magnet Therapy  The technique is investigated to achieve the following:  Relieve pain by creating a slight electrical current that stimulates the nervous system and consequently blocks nerve sensations  Speed wound healing by dilating vessels and increasing circulation to an area  Explore additional claims about health benefits that have been put forth by distributors of magnet products  Improve attention deficit disorder  Boost the immune system

26. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Massage, Bodywork, and Touch Therapies  Massage is the manipulation of soft tissue through rubbing, kneading, rolling, pressing, slapping, and tapping movements.  Bodywork is the combination of massage with deep tissue manipulation, movement awareness, and energy balancing.  In touch therapy techniques, the hands of the nurse/therapist are near the body in the client’s energy field.

27. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Meditation and Progressive Relaxation  Meditation is the act of focusing on the present moment.  Progressive relaxation is another exercise in which the person learns to guide himself or herself through a series of exercises that relax the body, such as tightening and relaxing of various muscle groups.

28. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. N aturopathy N aturopathy  Built on the principle that the body has inherent healing abilities that can be stimulated to treat disease  Naturopathic doctors assess and treat the cause of the disease rather than merely alleviating the symptoms.

29. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Prayer and Faith  Many consider their faith an integral part of their total being—not a “therapy.” Now, scientific evidence supports the therapeutic benefits of faith and prayer in health and healing.  Hundreds of well-conducted studies have revealed that people who profess a faith, pray, and attend religious services are healthier, live longer, have lower rates of disability, recover faster, have lower rates of emotional disorders, and otherwise enjoy better health states than those who do not (Larson, Sawyers, and McCullough, 1998).

30. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Tai Chi Tai Chi  Used to stimulate the flow of Qi, the life energy  Combination of exercise and energy work that looks like a slow, graceful dance with continuous, controlled movements of the arms and legs

31. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Frequently Used Therapies  Yoga: A system of exercises that involve various postures, meditation, and deep breathing. The word yoga means union; union of body, mind, and spirit is achieved through yoga. This exercise has been found helpful for pain, anxiety, stress, high blood pressure, poor circulation, respiratory and digestive disorders, and carpal tunnel syndrome (Garfinkel et al, 2000).

32. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing and CAM Therapies  A holistic approach—Nurses have long realized that healing effectively occurs in ways not encompassed within the conventional biomedical system. Nursing also has promoted many of the same principles that are evident in CAM, particularly care of the body, mind, and spirit.

33. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing and CAM Therapies  Facilitating clients’ use of CAM—Nurses should assess the following:  CAM practices and products that are being used and their sources  Appropriateness of the use of CAM practices and products  Adverse effects and risks associated with the use of CAM  Conditions for which CAM currently is not used that could be improved by its use

34. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing and CAM Therapies  Integrating CAM into conventional settings  Meet with the interdisciplinary team to describe the need to better meet the emotional and spiritual needs of patients, families, and staff.  Coordinate with the staff development instructor the scheduling of classes on progressive relaxation, imagery, meditation, therapeutic touch, and stress reduction.  Begin including healing therapies in care plans.

35. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing and CAM Therapies  Arrange for the nutritionist to offer classes to staff on healthy eating; add healthy snacks to the break room.  Coordinate with the housekeeping and maintenance departments to introduce aromatherapy diffusers, plants, and piped-in music on the unit.  Develop a system for reminding staff members to use stress reduction measures throughout their shift.

36. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing and CAM Therapies  Collaborate with the nutritionist, social worker, spiritual care counselor, and nursing clinical resources department to provide group sessions for clients and their families on topics such as coping with illness, managing stress, and promoting healthy lifestyle habits.  Ask the quality improvement coordinator to measure and evaluate the effectiveness of CAM interventions.

37. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing and CAM Therapies  Using CAM competently  Maintain a resource library  Become familiar with helpful websites

38. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing and CAM Therapies  Legal considerations  Some of the healing therapies once considered part of nursing care may require separate licensure.  Consider the question of to whom the nurse is responsible when practicing CAM therapies: the acupuncturist, hypnotherapist, osteopath?

39. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing and CAM Therapies  Can these therapists delegate responsibilities to the nurse?  How does the nurse ensure that in such a practice setting, diagnoses are not made and treatments are not prescribed that are beyond the scope of CAM?