Chapter 17 Complementary and Alternative Therapies All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. Complementary and Alternative Therapies Complementary therapies Therapies used in addition to conventional treatment recommended by the person s health care provider Complement conventional treatment Include exercise, massage, reflexology, prayer, biofeedback, creative therapies, guided imagery, acupuncture, relaxation strategies, chiropractic therapy, therapeutic touch, and herbalism All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 2 Complementary and Alternative Therapies cont d Alternative therapies May include the same interventions as complementary therapy, but frequently become the primary treatment modality that replaces traditional or conventional medicine All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 3 1
Complementary and Alternative Therapies cont d 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 All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 4 Question 1 Which therapy frequently becomes the primary treatment modality that replaces traditional medicine? 1. Alternative therapy 2. Herbal therapy 3. Complementary therapy 4. Conventional therapy All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 5 Herbal 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 All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 6 2
Herbal Therapy cont d 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 All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 7 Herbal Therapy cont d 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 All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 8 Herbal Therapy cont d 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 All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 9 3
Chiropractic 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 belief 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 All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 10 Chiropractic https://www.youtube.com/watch?v=douplft -HfQ https://www.youtube.com/watch?v=74fwkigv W3g All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 11 Acupuncture 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 physiologic 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 All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 12 4
Acupuncture and Acupressure cont d Acupressure This involves the use of gentle pressure at certain points on the body Pressure may be applied with 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 All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 13 Therapeutic Massage Massage performed by trained 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 All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 14 Aromatherapy 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 evoke different responses in the body Relaxation, stimulation, improved digestion, increased hormone production, and improved circulation or memory All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 15 5
Reflexology It is thought that the entire body can be treated 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 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 physiologic change in the body All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 16 Question 2 Reflexology is used as an alternative therapy because: 1. the reflexologist manipulates specific reflexes to relieve stress. 2. reflexology is relaxing. 3. pure oils are used with reflexology to provide health benefits. 4. reflexology is contraindicated for infectious skin diseases All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 17 Reflexology cont d 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 All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 18 6
Magnet 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, antiinflammatory action, spasmolytic activity, healing acceleration, and antiedema activity Contraindications Pregnancy, pacemakers, insulin delivery systems, cochlear implants, and defibrillators All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 19 Imagery 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 All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 20 Relaxation Therapy Relaxation is the state of generalized decreased cognitive, physiologic, 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 him- or herself for indications of tension and then consciously let go and release the tension All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 21 7
Animal-Assisted Therapy 1994 first time used in the United States Therapeutic purposes Complementary therapy in acute and longterm settings Dogs used more than cats All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 22 Didjeridoo Paws For Healing Therapy Dog All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 23 Question 3 There are a variety of reasons why magnet therapy may be used either intermittently or continuously. Magnet therapy is contraindicated in which patient? 1. A 39-year-old female with hyperthyroidism 2. A 68-year-old male with a pacemaker 3. A 48-year-old male with a decubitus ulcer 4. A 58-year-old female with thrombophlebitis All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 24 8
Yoga 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 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 of stress are promoted All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 25 T 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 All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 26 Biofeedback Noninvasive Determine 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 All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 27 9
Nursing 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 All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 28 Question 4 When caring for patients with various religious beliefs and cultural concerns, which of the following would be the role of the nurse? (Select all that apply.) 1. The nurse should become familiar with viewpoints and religious beliefs of patients. 2. The nurse does not determine complementary and alternative therapies that might be used with western medicine. 3. It is not important for the nurse to know the nurse practice act in the state which she/he is employed. 4. The nurse does not need to familiarize him- or herself with any of the therapies a patient may use because they will not be contraindicated with western medicine. All items and derived items 2015, 2011, 2006 by Mosby, Inc., an imprint of Elsevier Inc. All rights reserved. 29 10