Monday, November 30, 2009

Reflection & Assimilation


Course Outcomes:

1. Describe the history and background surrounding complementary and alternative medicine / therapy (CAM).

2. Enhance understanding of how safe and effective CAM interventions are integrated with non-cam interventions abroad and in the United States.

3. Determine how CAM services affect the health care marketplace.

4. Enhance understanding of the social, cultural, and economic factors relating to the use of CAM.

5. Describe the advantages and disadvantages of each of the modalities of alternative therapies.

6. Define and address ethical and legal issues related to the use of CAM in the traditional health care systems of today.

7. Evaluate the essential issues in alternative therapies in relation to research and nursing applications.

Final Questions:

As you complete your work in the course and reflect upon the course outcomes, consider the following questions:

1. Do you feel you have met the course outcomes as they are listed above?

2. Is there any outcome for which you feel you still need support or assistance? Are there any you would like to explore further?

3. What helped you meet the outcomes?

4. How do you plan on applying the knowledge you have learned?

5. Do you now feel that you have a better understanding of complementary and alternative therapies?

6. Do you have any final questions that were not answered during the semester?

I thank all of you for your hard work and dedication throughout the semester! I hope you all have enjoyed learning about complementary and alternative therapies and will use the knowledge you have gained to make positive changes in your practice settings. If you need any assistance at any time, please do not hesitate to contact me. Good luck to all in completing your degree and in meeting your career goals!
 
Sincerely,
Kathy Getchel
Time to Talk


Providing Information To and For
Patients and Health Care Providers




Patients and their health care providers need to talk openly about all their health care practices including any and all complementary and alternative therapies they use. The National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health has launched an educational campaign—Time to Talk—to encourage the discussion of CAM use. As the Federal Government's lead agency for scientific research on CAM, NCCAM is committed to providing evidence-based CAM information to help health professionals and the public make health care decisions.

Why should we ask patients about their CAM use?

• Most patients do not proactively disclose use of CAM to their physicians.

• Patients with chronic and acute medical conditions—including cancer, diabetes, back pain, and depression—turn to CAM in large numbers.

• As more patients use CAM therapies, practitioners need a full picture of all conventional and CAM practices they are using so that they can effectively manage their care.

Respondents of the NCCAM/AARP national survey cited the most common reasons why doctor-patient dialogue is lacking as:

• The physician never asked (42%)

• They did not know they should (30%)

• There was not enough time during the office visit (19%).

Why patients should tell their health care providers about CAM use?

• Giving their health care providers a full picture of what they do to manage their health helps them stay in control.

• Some CAM approaches can have an effect on conventional medicine. Talking to your health care providers about CAM use will help ensure coordinated and safe care.

• Talking to your providers about CAM use helps them to be fully informed and your partners in health care.

How can an organization get involved and make a difference?

• Download or order the Time To Talk materials from the web site

• Distribute Time To Talk materials at meetings, health fairs, and/or community functions

• Post available materials and information on Time to Talk to increase communication: ideas include newsletters, e-mail alerts, Web sites, blogs, etc.

• Keep in touch with the Time to Talk campaign. Network with other facilities and let them know how the materials have effectively been used in education outreach efforts.

Resources for Providers

1. National Center for Complementary and Alternative Medicine: nccam.nih.gov

2. CAM on PubMed

3. Journal citations specific to CAM: nccam.nih.gov/camonpubmed/

4. Online Continuing Education Series -

Video lectures available for CME/CEU credits: nccam.nih.gov/videolectures


Resources for Patients

1. National Center for Complementary and Alternative Medicine: nccam.nih.gov

Toll-free clearinghouse: 1-888-644-6226

2. Medline Plus: medlineplus.gov


CAM Resources from the National Institutes of Health

1. National Center for Complementary and Alternative Medicine: nccam.nih.gov

Toll-free clearinghouse: 1-888-644-6226

2. Medline Plus: medlineplus.gov

3. NIH Office of Dietary Supplements: ods.od.nih.gov

4. NCI Office of Cancer Complementary and Alternative Medicine:cancer.gov/cam/

Questions?

Do you ask your patients about their use of complementary and alternative medicine (CAM) during your initial patient assessment? What can you do differently when capturing the data you need and educating patients and family members to ensure patient safety yet allow the autonomy patients are seeking in making decisions regarding their health care? In the end, why talk about CAM? Is it necessary in your opinion?

According to a recent national survey conducted by the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health in partnership with AARP, two-thirds of people aged 50 and older are using some form of CAM, but 69 percent are NOT discussing use with their physicians. Full disclosure of all health care therapies is essential to every health care provider’s evaluation and ensures safe, coordinated care for the patient.

Tips for discussing CAM use with patients:

• Include a question about CAM use on medical history forms

• Ask patients to bring a list of all therapies they use, including prescription and over-the-counter medications, herbal therapies, and other CAM practices

• Have a nurse, nurse practitioner, or physician assistant initiate the conversation.

• When completing patient history forms, be sure to include all therapies and treatments in use. Have patients make a list in advance if possible.

• Encourage patients to tell their health care providers about all therapies or treatments—including over-the-counter and prescription medicines, as well as herbal and dietary supplements.

• Educate patients and family members to be proactive - don't wait for the provider to ask about CAM use, safety and effectiveness.

• Reinforce with patients that it is essential when considering a new CAM therapy to ask their health care providers about safety, effectiveness, and possible interactions with medications (both prescription and nonprescription).

Reference:

National Center for Complementary and Alternative Medicine. (2009). Time to talk. Retrieved November 30, 2009, from http://nccam.nih.gov/timetotalk/

Sunday, November 29, 2009

Other Complementary and
Alternative Therapies of Interest


Tai Chi

Tai chi, which originated in China as a martial art, is a mind-body practice in complementary and alternative medicine (CAM). Tai chi is sometimes referred to as "moving meditation"—practitioners move their bodies slowly, gently, and with awareness, while breathing deeply. Tai chi incorporates the Chinese concepts of yin and yang (opposing forces within the body) and qi (a vital energy or life force). Practicing tai chi is said to support a healthy balance of yin and yang, thereby aiding the flow of qi. Many people practice tai chi to improve their health and well-being. Scientific research is under way to learn more about how tai chi may work, its possible effects on health, and chronic diseases and conditions for which it may be helpful (Tai, 2009).

Video of Tai Chi: http://www.youtube.com/watch?v=ARyIqrUD2rY




Yoga

Yoga is a mind-body practice in complementary and alternative medicine (CAM) with origins in ancient Indian philosophy. The various styles of yoga that people use for health purposes typically combine physical postures, breathing techniques, and meditation or relaxation. There are numerous schools of yoga. Hatha yoga, the most commonly practiced in the United States and Europe, emphasizes postures (asanas) and breathing exercises (pranayama). Some of the major styles of hatha yoga include Iyengar, Ashtanga, Vini, Kundalini, and Bikram yoga. People use yoga for a variety of conditions and to achieve fitness and relaxation. The 2002 National Health Interview Survey found that yoga is one of the top 10 CAM modalities used. Nearly 8 percent of those surveyed (more than 15.2 million adults) had ever used yoga for health purposes (About, 2009).

Power Yoga Video: http://www.veoh.com/browse/videos/category/sports/watch/v3993945RxBaNeZ9




Aromatherapy

Aromatherapy is the use of essential oils from plants to support and balance the mind, body, and spirit. Patients with cancer use aromatherapy mainly to improve their quality of life. Essential oils like Roman chamomile, geranium, lavender, and cedar wood are the basic materials of aromatherapy. Interest in aromatherapy grew in the late 20th century as a form of complementary medicine. Aromatherapy may work by sending chemical messages to the part of the brain that affects moods and emotions. Essential oils are most often used by inhaling them or by applying them to the skin. Laboratory studies and animal studies have shown that certain essential oils have antibacterial, calming, or energizing effects. Aromatherapy research with cancer patients has studied its effects on symptoms, anxiety, and stress. Safety testing on essential oils has found very few bad side effects. Lavender and tea tree oils have been found to have some hormone -like effects. Aromatherapy products do not need approval by the U.S. Food and Drug Administration because no specific medical claims are made (Cancer, 2009).

Aromatherapy Videos:

http://www.howcast.com/videos/164134-How-To-Use-Aromatherapys-Essential-Oils-To-Improve-Your-Life

http://www.ehow.com/video_4400086_nighttime-aromatherapy-medicine.html

After exploring about the various complementary and alternative therapies available for patients and for yourself, what do you think are the best alternatives to traditional modern medicine? Will you be beginning any of these as a result of your reading and research this semester? Share some of your thoughts with your classmates. 

 Kathy


References

National Cancer Institute. (2009). Aromatherapy and essential oils: Overview. Retrieved November 29, 2009, from http://www.cancer.gov/cancertopics/pdq/cam/aromatherapy/patient

National Center for Complementary and Alternative Medicine. (2009). About yoga. Retrieved November 29, 2009, from http://nccam.nih.gov/health/yoga/

National Center for Complementary and Alternative Medicine. (2009). Tai chi: An introduction. Retrieved November 29, 2009, from http://nccam.nih.gov/health/taichi/

Tuesday, November 24, 2009



Music Therapy

It seems as though we have just begun this semester and we are almost coming to a close. This week we will be researching music therapy and the effects on health and wellness. Please reflect on past experiences with music and how it may or may not have affected your health in positive or negative ways. This week we will begin an online journal of our own health and wellness and how our lifestyles have an effect on outcomes. Please see the course assignments for the specifics of the project to be better prepared for this 2 week long initiative. There is also a sample journal for which to refer. Please let me know if you have any questions!

Description

Music therapy is the use of music by health care professionals to promote healing and enhance quality of life for their patients. Music therapy may be used to encourage emotional expression, promote social interaction, relieve symptoms, and for other purposes. Music therapists may use active or passive methods with patients, depending on the individual patient's needs and abilities.

Music Therapy History

"Music has been used in medicine for thousands of years. Ancient Greek philosophers believed that music could heal both the body and the soul. Native Americans have used singing and chanting as part of their healing rituals for millennia. The more formal approach to music therapy began in World War II, when U.S. Veterans Administration hospitals began to use music to help treat soldiers suffering from shell shock. In 1944, Michigan State University established the first music therapy degree program in the world"
(American, 2008).

Use of Music Therapy

"Music therapists work with a variety of physical, emotional, and psychological symptoms. Music therapy is often used in cancer treatment to help reduce pain, anxiety, and nausea caused by chemotherapy. Some people believe music therapy may be a beneficial addition to the health care of children with cancer by promoting social interaction and cooperation. There is evidence that music therapy can reduce high blood pressure, rapid heart beat, depression, and sleeplessness. There are no claims music therapy can cure cancer or other diseases, but medical experts do believe it can reduce some symptoms, aid healing, improve physical movement, and enrich a patient's quality of life" (American, 2008).

Evidence

"Scientific studies have shown the value of music therapy on the body, mind, and spirit of children and adults. Researchers have found that music therapy, when used with anti-nausea drugs for patients receiving high-dose chemotherapy, can help ease nausea and vomiting. A number of clinical trials have shown the benefit of music therapy for short-term pain, including pain from cancer. Some studies have suggested that music may help decrease the overall intensity of the patient's experience of pain when used with pain-relieving drugs. Music therapy can also result in a decreased need for pain medicine in some patients. In hospice patients, one study found that music therapy improved comfort, relaxation, and pain control. Another study found that quality of life improved in cancer patients who received music therapy, even as it declined in those who did not. Other clinical trials have revealed a reduction in heart rate, blood pressure, breathing rate, insomnia, depression, and anxiety with music therapy. No one knows all the ways music can benefit the body, but studies have shown that music can affect brain waves, brain circulation, and stress hormones. These effects are usually seen during and shortly after the music therapy" (American, 2008).

Music Therapy Example

“Prepare to Relax” provides introductory music and instructions for setting up your environment for maximum relaxation. This music is for relaxation, pain relief, stress relief and therapy. This specially composed piano music with Hope Young’s gentle and relaxing voice guides you into a state of peace and serenity. The music takes you into deeper healing and relaxation.

Literature for Review

American Cancer Society. (2008). Music therapy. Retrieved November 24, 2009, from http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Music_Therapy.asp

Clark, M., Isaacks-Downton, G., Wells, N. (2006). Use of preferred music to reduce emotional distress and symptom activity during radiation therapy. J Music Ther., 43, 247-265.

Ezzone, S., Baker, C., Rosselet, R., Terepka, E. (1998). Music as an adjunct to antiemetic therapy. Oncol Nurs Forum, 25, 1551-1556.

Hilliard, R.E. (2003). The effects of music therapy on the quality and length of life of people diagnosed with terminal cancer. J Music Ther., 40, 113-137.

Krout, R.E. (2001). The effects of single-session music therapy interventions on the observed and self-reported levels of pain control, physical comfort, and relaxation of hospice patients. Am J Hosp Palliat Care, 18, 383-390.

Lane, D. (1993). Music therapy: Gaining an edge in oncology management. J Oncol Manag., 2, 42-46.

Watkins, G.R. (1997). Music therapy: Proposed physiological mechanisms and clinical implications. Clin Nurse Spec., 11, 43-50.

Thursday, November 19, 2009



USE OF CAM IN NURSING PRACTICE

I. CLASSIFICATION OF CAM THERAPIES
                        
Alternative Medical Systems
Definition: Complete medical systems of theory and practice.
Examples: Ayurveda, homeopathy, indigenous healing practices, naturopathy, osteopathy, and traditional Chinese medicine.

Mind-Body Interventions
Definition: Enhance the mind’s capacity to affect bodily functions.
Examples: Art therapy, behavioral medicine, biofeedback, dance, dream therapy, humor, hypnotherapy, imagery, intuition, meditation, prayer, music/sound therapy, support groups and yoga.

Biologically Based Therapies
Definition: Use of substances found in nature.
Examples: Herbs, aromatherapy, diet, flower essence, nutritional supplements, vitamins, and pharmacological/biological treatments.

Manipulative and Body-Based Methods
Definition: Manipulation and/or movement of one or more parts of the body.
Examples: Acupressure, Alexander technique, chiropractic, craniosacral, Feldenkrasis, massage, osteopathy, reflexology, rolfing, and Trager method.

Energy Therapies
Definition: Use of electromagnetic fields or energy fields around the body.
Examples: Qigong, prayer, reiki, therapeutic touch, full spectrum light, electromagnetic field, and transcutaneous electrical nerve stimulation.

NCCAM (2003)

II. POSITION STATEMENT:

Each institution should develop a unique position statement that reflects their viewpoint and policy on CAM therapy for all practitioners. The following is an example of a position statement from the New York Nurses Association:

1. Complementary and alternative therapies are an adjunct to conventional medical regimes, and the RN has an integral role in the coordination and facilitation of such therapies.

2. RNs can, and often use, holistic nursing therapies that can be described as complementary or alternative in nature.

3. RNs should obtain and maintain appropriate education and clinical experience in order to maintain competency in CAM.

4. RNS should be familiar with Nurse Practice Act and perform only those therapies inherent in the RN’s scope of practice.

5. RNs have an ethical and professional responsibility to support an individual’s choice regarding health care and educate the patient about various therapeutic options and the risk and benefits associated with each.

III. NURSING RECOMMENDATIONS:

1. Provide full disclosure when offering CAM to patients, including discussing the pros and cons of all therapeutic options available to the patient.

2. Be cognizant of the ethical and cultural issues and considerations surrounding CAM in order to fully function as an advocate for quality, comprehensive care of patients.

3. Discuss with the patient, and family when appropriate, available options regarding CAM and support the patient’s choice.

4. Incorporate the Holistic Nurses Association’s Standards of Holistic Nursing Practice and the American Nurses Association’s Code for Ethics for Nursing into their practice.

5. Continually seek avenues to raise community awareness about the benefits of CAM in wellness and preventative medicine.

6. Conduct, support and/or participate in research to study the effectiveness of CAM as nursing interventions.

7. Support continued funding of the federal Office of Alternative Medicine and urge professional nursing organizations to work collaboratively with that office.

8. Advocate for the adequate coverage and access of CAM by federal, state and insurance programs.

9. Advocate that health care practitioners and health care facilities provide the patient with the opportunity to obtain conventional and CAM by accepting and integrating the availability of such therapies into the health care delivery system.

10. Advocate that nursing programs integrate CAM concepts and information into their existing curricula.

**Adapted from the New York State Nurses Association Board of Directors Position Statement and Nursing Recommendations on CAM.

References:

American Holistic Nurses’ Association. Position on the role of nurses in the practice of complementary and alternative therapies. Retrieved, November 19, 2009, from http://www.ahna.org/about/statements.html#role

Hawks, J. H., & Moyad M. A. (2003). Complementary and preventive medicine. CAM: Definition and classification overview. Urologic Nursing, 23(3), 221-223.

National Center for Complementary and Alternative Medicine. Take charge of your health. Retrieved November 19, 2009, fromhttp://nccam.nih.gov/

Nurse’s handbook of alternative & complementary therapies. (1999). Springhouse , PA: Springhouse Corporation. (pp. 28-60).

Silva, M. C., & Ludwick, R. (2001, November 1). Ethical issues in complementary/alternative therapies. Online Journal of Issues in Nursing. Retrieved July 7, 2006, from http://www.nursingworld.org/ojin/ethicol/ethics_7.htm

**Nurses have a unique opportunity to provide services that facilitate wholeness. They need to understand all aspects of CAM, including costs, patient knowledge, and drug interactions, if they are to promote holistic strategies for patients seeking to achieve a higher quality of life.

Assignment:

Using the most current research on CAM and your area of practice currently; formulate 2 new additions to the position statement and nursing recommendations listed that you feel strongly should be included to ensure patient safety and optimal outcomes. Work with your peers in order to prepare a diverse list of suggestions and recommendations that we will post later on in the semester. Please let me know if you need any help with this assignment. This assignment will be due by: November 30th. Please submit to the drop box under "Position Statement". Thank you!!

Tuesday, November 17, 2009



Reiki Therapy


(pronounced Ray-Key) is a method of natural healing based on the application of Universal Life Force Energy (the name literally means Universal Life Force Energy).

Today we will be talking about Reiki one of the more widely known forms of energy healing. “Energy Healing involves direct application of Chi for the purpose of strengthening the client’s energy system (aura). Chi is the term used by the Chinese mystics and martial artists for the underlying force the Universe is made of. Mystics in all cultures have talked about the physical universe being made of an underlying form of something, much as modern physics research is now coming to understand the Universe is made of energy which is subject to (or affected by) thought. Just as modern physics says this energy is affected by thought the mystics also say this underlying form is affected by thought, going so far as to claim we create our own reality from our thinking and the thoughts we share between each of us every day”.

A Reiki healing is very simply performed. The practitioner places his or her hands upon the person to be healed with the intent for healing to occur, and then the energy begins flowing. The Reiki energy is smart since the Universe is a very smart place indeed. The energy knows where to go, and what to do once it gets there, or else is being directed by a higher intelligence. The energy manages its own flow to and within the recipient. It draws through the healer exactly that amount of energy which the recipient needs. All this happens without direct conscious intervention by the healer. The healer’s job is to get out of the way, to keep the healing space open, and to watch/listen for signs of what to do next.

Video- Hands On Reiki Session: http://www.youtube.com/watch?v=MYA3Hlkx094

1. How could you use Reiki in your practice?

2. Has anyone seen Reiki in their health care setting?

3. Describe a case in which Reiki has made a positive difference in the life of a  client in your community.

Monday, November 16, 2009



Guided Imagery

What is Guided Imagery?

“Guided imagery can be defined as a mental image, ‘a thought with sensory qualities’. It is something we mentally see, hear, taste, smell, touch, or feel. The term “guided imagery” refers to a wide variety of techniques, including simple visualization and direct suggestion using imagery, metaphor and story-telling, fantasy exploration and game playing, dream interpretation, drawing, and active imagination where elements of the unconscious are invited to appear as images that can communicate with the conscious mind. Once considered an 'alternative or complementary' approach, guided imagery is now finding widespread scientific and public acceptance, and it is being used to teach psychophysiological relaxation, alleviate anxiety and depression, relieve physical and psychological symptoms, overcome health-endangering habits, resolve conflicts, and help patients prepare for surgery and tolerate procedures more comfortably. Mental images, formed long before we learn to understand and use words, lie at the core of who we think we are, what we believe the world is like, what we feel we deserve, what we think will happen to us, and how motivated we are to take care of ourselves. These images strongly influence our beliefs and attitudes about how we fall ill, and what will help us to get better. All healing rituals involve manipulation of these images, either overtly or covertly, and thus guided imagery can be considered one of the oldest and most ubiquitous forms of medicine. The healing rituals of various cultures that have persisted over time all have a certain level of clinical efficacy, and while we may attribute these therapeutic benefits to ‘placebo effects’, they have real and measurable effects with important implications for our understanding of the healing process”(Academy, 2009).

Patients in acute care settings often have emotional and physical stresses that are also experienced by family and significant others. Guided imagery, one of the most well-studied integrative therapies, is used increasingly to improve patients' experiences and healthcare outcomes. More and more, patients are relying on the use of guided imagery to provide a significant source of strength, support, and courage as they prepare for a procedure or manage the stresses of a hospital stay.

“The research team led by Linda Halpin at the Inova Heart Center of Inova Fairfax Hospital compared cardiac surgical outcomes between two groups of heart patients - with the use of Diane Tusek's guided imagery tapes. and the group receiving standard of care. Analysis of the data revealed that patients who completed the Tusek's guided imagery program had a shorter average length of stay, a decrease in average direct pharmacy costs, and a decrease in average direct pain medication costs while maintaining high overall patient satisfaction with the care and treatment provided. Guided imagery is now used as a standard, complementary therapy to help reduce anxiety, pain, and length of stay among the cardiac surgery patients at all of the centers in Inova Hospital Center in Fairfax” (Halpin, 2002, p.133).

Academy for Guided Imagery. (2009). What is guided imagery. Retrieved November 16, 2009, from http://www.academyforguidedimagery.com/whatisguidedimagery/index.html

Halpin, L.S., Speir, A.M., CapoBianco, P., Barnett, S.D. (2002).Guided imagery in cardiac surgery: Outcomes in management & nursing practice, 6(3) 132-7.

Holden-Lund, C. (1998). Effects of relaxation with guided imagery on surgical stress and wound healing: Research in nursing and health, 11(4) 235-244.

Mannix L, Tusek D., (1999). Solomon G.: Effect of guided imagery on quality of life for patients with chronic tension-type headache. Headache: The Journal of Head and Face Pain, 39(5).

Tusek, D. (2000). AACN clinical issues advanced practice in acute and critical care: Strategies for implementing a guided imagery program to enhance patient experience, 2(34).

How can you envision guided imagery in your life?

How can you utilize this unique therapy in your practice?

This week, you will explore the world of guided imagery through your research  of the ways in which guided imagery has changed the life of one patient. In a 3-5 page paper, describe how guided imagery has improved the outcome of a patient, what standard of care was being provided for the patient, the current providers opinion on the use of guided imagery and the education provided to the patient prior to the procedure. Feel free to elaborate on other issues that you feel are important to the care of the patient undergoing guided imagery and how it has improved their state of wellness. The patient chosen can be one you have cared for, one you have researched or a fictitious patient. When completed, submit your project to the Unit 2 dropbox under "Guided Imagery Project". The project is due no later than November 23th. Please feel free to let me know if you have any questions.

Sunday, November 15, 2009

Web Field Trip

Part of the experiences in this course will be to examine various complementary and alternative therapy treatment modalities as it relates to traditional modern medicine. Explore the following web sites and discover the fascinating facts and research now available with the multiple therapies options involved with CAM. Also, take the time to view the videos that accompany the web sites to allow for a better understanding of CAM techniques. I hope you enjoy the learning – there is some great material on the web!! Be prepared to answer the following:

Questions:

1. What did you learn about CAM therapies that you did not already know?

2. What advantages / disadvantages did you find in selected CAM therapies?

3. What information did you find lacking in these web sites that would have been helpful?

4. Would you refer clients to this web site as a means of patient education?

5. Did you find any information / research that you might find helpful for your own health benefits?

6. How would this new information allow you to practice patient care differently?

Websites:

Mayoclinic.com. (2009). Complementary and alternative medicine: What is it? Retrieved November 15, 2009, from http://www.mayoclinic.com/health/alternative-medicine/PN00001

National Center for Complementary and Alternative Medicine. Take charge of your health. Retrieved November 15, 2009, from http://nccam.nih.gov/

National Network of Libraries of Medicine. (2007). Complementary and alternative medicine. Retrieved November 15, 2009, from http://nnlm.gov/outreach/consumer/chcam.html

Wholehealthmd.com. (2007). The new approach to healing. Retrieved November 15, 2009, from http://www.wholehealthmd.com/ME2/Default.asp

Videos:


Thursday, November 12, 2009

Questions for Discussion:

How do nurses rate their knowledge, perceived efficacy and utilization of complementary therapies on self and their clients? Are nurses able to safely refer their patients to nontraditional therapies and practitioners?

While health care literature reflects an interest in the use of complementary therapies, there are a limited number of studies in the nursing literature addressing the use of therapies by nurses for self-care or use with clients. If significantly more Americans are using some form of complementary therapy, it is imperative that nurses have a knowledge base of a variety of therapies in order to assist clients with decision making related to the therapies. Many complementary therapies have limited scientific research support resulting in little data about rationale for use, action, effects, and side effects. Since some therapies may be unsubstantiated by science, nurses must be alert to the increasing use of these therapies and include questions about them as a routine part of the assessment interview.

“Nurses need to assess the client's use of therapies, including why the therapies are used, the source of the therapy, as well as the client's knowledge of side effects. Nurses must be aware of the positive and negative effects that complementary therapies have, as well as any interactions with traditional medical treatments. This knowledge base will aid the nurse in assisting the client with appropriate health decisions. Although some nurses may hold a cautious regard for complementary therapies, recognizing the power of the mind-body-spirit interface and the nurse's therapeutic value of bedside presence can be extremely significant in many illnesses” (Lynn, 1996).

The nurse becomes a significant resource in assisting the client with decision making regarding choice of complementary therapies. Nurses must determine which interventions are appropriate to integrate into their practice and which require referral to credentialed providers.

Journal Readings:
Baileys, K. (2009). Complementary therapies can have benefits for nurses. ONS Connect, 24(5), 19.

Fountouki, A., & Theofanidis, D. (2009). Nurses' attitude towards complementary therapies. Health Science Journal, 3(3), 149-157.

Lynn, J. (1996). Using complementary therapies: Reflexology. Professional Nurse, 11(5), 321-22.

Rojas-Cooley, M., & Grant, M. (2009). Complementary and alternative medicine: Oncology nurses' knowledge and attitudes. Oncology Nursing Forum, 36(2), 217-224.

Wednesday, November 11, 2009


Course Number / Title
NU208: Complementary and Alternative Therapies

Definition
Complementary and Alternative Medicine
(KOM-pleh-MEN-tuh-ree... all-TER-nuh-tiv MEH-dih-sin)

Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices generally are not considered standard medical approaches. Standard treatments go through a long and careful research process to prove they are safe and effective, but less is known about most types of CAM. CAM may include dietary supplements, megadose vitamins, herbal preparations, special teas, acupuncture, massage therapy, magnet therapy, spiritual healing, and meditation. Also called CAM (Cancer, 2009).

Course Description

"Today, there is evidence that patients faced with chronic and even terminal illnesses–particularly conditions like heart disease and cancer–can learn and employ a variety of mind-body practices to achieve a level of symptom relief and a better quality of life, and in some cases, improvements in health outcomes. Importantly, the clinical reports of these effects are supported by a growing body of basic and clinical research, much of it in the neurosciences, psychoneuroimmunology, and behavioral medicine. Such tools have been used to document the ability of people skilled in yoga or various forms of meditation and stress management approaches to lower heart rate and blood pressure, and of tai chi to enhance immunity.

In addition, new methods to establish the magnitude of physiological functioning during the meditative state can assist in identifying the biological mechanisms of action of mind-body techniques. Mindfulness meditation has also been shown to improve antibody response to a flu vaccine, with the magnitude of measured brain activity in the meditative state predictive of the level of immune response. Innovative monitoring strategies have established that specific psychological characteristics like optimism and positive affect are linked to faster recovery following heart transplant surgery and to greater longevity. The latter investigations have underscored the apparent value of resilience and positive emotions to health and well-being"
(Center, 2005, p.19).

This course will focus on the common and specific features of widely used mind-body medicine practices and explore mind-body interventions such as relaxation, meditation, tai chi, and yoga, to name a few, looking for specific commonalities as these are related to positive health outcomes.

Course Outcomes
By the end of the course, the student will be able to -

1. Describe the history and background surrounding complementary and alternative medicine / therapy (CAM).

2. Enhance understanding of how safe and effective CAM interventions are integrated with non-cam interventions abroad and in the United States.

3. Determine how CAM services affect the health care marketplace.

4. Enhance understanding of the social, cultural, and economic factors relating to the use of CAM.

5. Describe the advantages and disadvantages of each of the modalities of alternative therapies

6. Define and address ethical and legal issues related to the use of CAM in the traditional health care systems of today.

7. Evaluate the essential issues in alternative therapies in relation to research and nursing applications

Textbook
Yuan, C.-S., Bieber, E. J., & Bauer, B. (2006). Textbook of complementary and alternative medicine (2nd Ed.). London, UK: Informa Healthcare.

References
National Cancer Institute. (2009). Complementary and alternative medicine in cancer treatment: Overview. Retrieved November 11, 2009,from http://www.cancer.gov/cancertopics/pdq/cam/cam-cancer-treatment

National Center for Complementary and Alternative Medicine. (2005). Expanding horizons of health care: Strategic plan 2005-2009. Retrieved November 11, 2009, from http://nccam.nih.gov/about/plans/2005/strategicplan.pdf

Monday, November 9, 2009


Week 2 Conference Call:

Dear Class,
     On Sunday November 15th, 2009 from 6pm EST - 7pm EST I would like to conduct a conference call for those who would like to meet and discuss class expectations, questions regarding the course, grading, etc... This is a totally voluntary opportunity available for those who feel they have questions regarding the course after reading the information provided on the website. Please feel free to call in at the following number to join us:

(712) 451 - 6050
Participant Access Code: 393229#

You will then be joined into conference!!
See you in conference!!!

Kathy

Introduction:
Katherine M. Getchel, BSN, RN

Hello and Welcome to Complementary and Alternative Therapies!

As a new instructor to Kaplan, I am thrilled to be teaching this semester and sharing this time with all of you! I received my diploma from nursing in 1982 and graduated from Kaplan with my BSN in 2008. I will be graduating in 2010 with my Masters in Nursing Education and will be continuing on for my PhD in the fall of 2010.

I have been married for 25 years now and have one 19 year old son named Michael who just graduated as an electrician. I live in a small city in Connecticut where I have lived all my life and hope to retire someday in Vermont where my husband and I have plans to build a log cabin. One of my true loves is online teaching and I hope that you also enjoy learning in this exciting learning environment.

Complementary and alternative therapies have always been an interest of mine since my days working in oncology with cancer patients. I have learned and witnessed so much related to many of the therapies we will study including: stress reduction, guided imagery, therapeutic healing / touch, as well as nutrition, music therapy and prayer. Complementary and alternative medical therapies are emerging as a significant force shaping the delivery of health care in the United States. However, the remains much debate as to their place in modern medicine as well as their benefit in relation to traditional medicine. Hopefully, after this course has been completed, you will be able to formulate your own position as it relates to complementary and alternative therapies and be more knowledgeable to allow you to better educate your patients.

I look forward to our class and sharing ideas, experiences and clinical scenarios with each other. Please do not hesitate to contact me if you have any questions or concerns during the course. I hope you enjoy our time together and will take away as much information as possible for your individual practice settings.

Kathy