Complementary and Alternative Therapies

Chapter 17Chapter 17

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Complementary and Alternative TherapiesComplementary and Alternative Therapies

• Complementary Therapies Therapies used in addition to conventional treatment

recommended by the person’s health care provider Complement the conventional treatment Include exercise, massage, reflexology, prayer,

biofeedback, creative therapies, guided imagery, acupuncture, relaxation strategies, chiropractic therapy, therapeutic touch, and herbalism

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• Alternative Therapies May include the same interventions as

complementary therapy, but frequently become the primary treatment modality that replaces traditional or conventional medicine

Complementary and Alternative TherapiesComplementary and Alternative Therapies

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• Many alternative therapies do not interfere with those therapies prescribed by a physician, but some can have serious interactions.

• The nurse needs to project an open, nonjudgmental attitude when obtaining a health history so that the patient feels comfortable in providing all information about any therapies he or she is currently receiving.

Complementary and Alternative TherapiesComplementary and Alternative Therapies

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Herbal TherapyHerbal Therapy

• Many current medicines have their origins in herbs. Digitalis comes from the foxglove herb.

• Recently, there has been an increased interest among the general population about the use of herbs and natural supplements to treat illness and maintain health.

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Herbal TherapyHerbal Therapy

• Herbs vary from pharmaceuticals in several ways. Herbal preparations usually use the whole plant. One herb may be used for a variety of purposes and

is usually gentler than pharmaceuticals. Pharmaceuticals that are derived from herbs separate

the active ingredients and use only that part, thereby being stronger.

Herb manufacturers are not held to the same stringent standards as are manufacturers of pharmaceuticals.

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Herbal TherapyHerbal Therapy

• Many herbal medicines are sold as foods or food supplements in health food stores and through private companies because they have not received approval for use as drugs.

• The goal of herbal therapy is to restore balance within the individual by facilitating the person’s self-healing ability.

• Many herbs are potentially toxic if used incorrectly.

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Herbal TherapyHerbal Therapy

• Treatment can be provided in a variety of ways. Dried herbs can be taken orally in a capsule or tablet

form. Tinctures are made by placing herbs in alcohol or

vinegar until the liquid absorbs the properties of the herb; the liquid is then strained and used.

Tea may be made of an infusion of herbs and hot water and drunk, or a moist compress can be made from the tea and applied to the affected area.

Herbs can be applied topically by making a salve or ointment to be applied to the skin.

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Ginger RootGinger Root

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Chiropractic TherapyChiropractic Therapy

• Has been in existence since the late 1800s.• Doctors of chiropractic medicine undergo extensive

training in manipulation of the musculoskeletal system.

• It is based on holistic beliefs in the body’s ability to take care of itself.

• The chiropractic doctor adjusts the joints of the body through gentle manipulation to restore the area to proper alignment.

• A doctor of chiropractic medicine does not prescribe medications.

• Other treatments such as hot and cold packs may be used.

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Acupuncture and AcupressureAcupuncture and Acupressure

• Acupuncture A method of stimulating certain points on the body by

the insertion of special needles to modify the perception of pain, normalize physiological functions, or treat/prevent disease.

This is the primary treatment modality used by physicians of Chinese medicine.

The most common problems for which acupuncture is used include low back pain, myofascial pain, simple and migraine headaches, sciatica, shoulder pain, tennis elbow, osteoarthritis, whiplash, and musculoskeletal sprains.

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Figure 17-2Figure 17-2

Acupuncture uses fine needles inserted at specific points to open the meridians.

(From Leahy, J.M., Kizilay, P.E. [1998]. Foundations of nursing practice: a nursing process approach. Philadelphia: Saunders.)

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Acupuncture and AcupressureAcupuncture and Acupressure

• Acupressure This involves the use of gentle pressure at similar

points on the body. Pressure may be applied with a finger or a small blunt

object. It is used primarily for the prevention and relief of

symptoms of muscle tension. Acupressure reduces tension, increases circulation,

and enables the body to relax deeply. By relieving stress, acupressure increases resistance

to disease and promotes wellness.

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Figure 17-1Figure 17-1

Massage therapy can be used to relieve tension.

(From Potter, P.A., Perry, A.G. (2005). Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)

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Therapeutic MassageTherapeutic Massage

• Massage performed by training professionals manipulates the soft tissues of the body and assists with healing.

• Massage can either be relaxing or energizing.

• It should be conducted in a warm, relaxing atmosphere.

• Oils or lotions may be used during the massage.

• Massage is contraindicated for phlebitis or thrombosis and infectious skin diseases.

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AromatherapyAromatherapy

• Pure essential oils, produced from plants, are used to provide health benefits.

• The oils can be used for inhalation, or they may be applied topically.

• Scent may be dispersed into the air through the use of candles or oil dispersers.

• Oils can also be used in bathing.

• Different scents are thought to invoke different responses in the body. Relaxation, stimulation, improved digestion, increased

hormone production, and improved circulation or memory

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AromatherapyAromatherapy

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ReflexologyReflexology

• It is thought that the entire body can be reached by applying pressure to specific areas on the feet.

• Reflexology is based on the premise that there are zones and reflexes in different parts of the body that correspond to and and are relative to all parts, glands, and organs of the entire body.

• The manipulation of specific reflexes removes stress, placing the body in a parasympathetic healing state and enabling the disharmonies to be released by a physiological change in the body.

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ReflexologyReflexology

• Four Main Benefits Relaxation with the removal of stress Enhanced circulation Assisting the body to normalize metabolism naturally Complementing all other healing modalities

• Warnings, Contraindications, and Precautions Pressure on the corresponding reflex areas should be

decreased for patients with heart problems, blood problems, high blood pressure, epilepsy, and diabetes.

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Magnet TherapyMagnet Therapy

• Magnets have been used for thousands of years to help heal and improve overall health.

• They are thought to increase circulation to the affected area and to promote healing, as well as stimulate acupuncture points.

• Common physiologic responses Vasodilatation, analgesic action, anti-inflammatory

action, spasmolytic activity, healing acceleration, and antiedema activity

• Contraindications Pregnancy, pacemakers, insulin delivery systems,

cochlear implants, and defibrillators

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ImageryImagery

• Uses the conscious mind to create mental image to evoke physical changes in the body, improve perceived well-being, and enhance self-awareness

• Frequently combined with some form of relaxation training to facilitate the effect of the relaxation technique

• Can be self-directed or guided• Can evoke powerful psychophysiologic responses

such as an alteration in immune function

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Guided imageryGuided imagery

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Relaxation TherapyRelaxation Therapy

• Relaxation is the state of generalized decreased cognitive, physiological, or behavioral arousal.

• The process of relaxation elongates the muscle fibers, reduces the neural impulses sent to the brain, and thus decreases the activity of the brain and other body systems.

• It decreases heart and respiratory rates, blood pressure, and oxygen consumption.

• The long-term goal of relaxation therapy is for the person to continually monitor himself or herself for indications of tension and then consciously let go and release the tension.

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Animal-Assisted TherapyAnimal-Assisted Therapy

• 1994—first time used in the United States

• Therapeutic purposes

• Complementary therapy in acute and long-term settings

• Dogs used more than cats

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YogaYoga

• “The joining of the mind, body, and spirit to enrich the quality of one’s life and to enhance one’s health” (O’Hara et al., 1998)

• Basic principles Control of the body through correct posture and

breathing Control of the emotions and mind Meditation and contemplation

• Regular practice can tone the muscles that balance all parts of the body, including internal organs, heart, lungs, glands, and nerves. Flexibility of the spine is increased, and deep relaxation and reduction in stress are promoted.

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Figure 17-3Figure 17-3

Yoga is useful in control of the body through correct posture,

breathing, meditation, and contemplation.

(From Potter, P.A., Perry, A.G. (2005). Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)

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T’ai Chi/TaijiT’ai Chi/Taiji

• Fusion of martial arts and Daoist philosophical concepts

• Yin and yang

• Suited for people of various physical capabilities

• Benefits include improvement in balance, leg strength, cardiorespiratory function, range of motion, and arthritis.

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BiofeedbackBiofeedback

• Noninvasive

• Determines a patient’s neuromuscular and autonomic nervous system response

• Measures specific body functions

• Goal is for patients to become aware of their responses and, in conjunction with relaxation techniques, to be able to control their responses

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Nursing Role in Complementary and Alternative TherapiesNursing Role in Complementary and Alternative Therapies

• Nurses need to be aware of their state nurse practice act with regard to complementary therapies and to practice accordingly within the scope of the law.

• Nurses work closely with their patients and are in the unique position of becoming familiar with the patient’s religious and cultural viewpoints and existential issues.

• Nurses may be able to determine which CAM therapies would be more appropriately aligned with these beliefs and offer recommendations accordingly.