COMPLEMENTARY AND ALTERNATIVE THERAPIES

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COMPLEMENTARY AND ALTERNATIVE THERAPIES Powered By Docstoc
					Complementary and
Alternative Therapy
    C. Matthews MSN, RN
    Marilee Elias, MSN, RN
         Spring 2012

 Please make phones silent & visible
                          Reading
       Required:
            – Wilkinson-Ch. 40
            – Ignatavicius – Ch. 2
       Suggested Additional reading:
            – Lilley – Ch. 8 “Over the counter drugs and
              Herbal products”
            Some references in this presentation will be
              from pages in your textbooks other than
              required chapters – highly recommended
              reading.
                            C. Matthews RN, MSN
7/26/2012                      M. Elias RN, MSN            2
             Course Outcomes
   1. Identify the roles of the nurse in a variety of
     community settings to maintain optimal level of
     wellness.
   2. Client - centered teaching.
   3. Apply the nursing process to meet the
     physiological and psychosocial needs of clients
     and their families at the end of life.
   4. Standards of safe medication administration.



                      C. Matthews RN, MSN
7/26/2012            M.Elias RN, MSN SP10           3
             UNIT OUTCOMES
1. Integrate complementary therapies into health promotion
   activities for the well client.
2. Assess client need for Complementary or Alternative
   therapy.
3. Identify use of Complementary or Alternative therapy.
4. Evaluate outcomes of Complementary or Alternative
   therapy practices.
5. Provide non-pharmacological measures for pain relief.
6. Identify quackery or unscrupulous practitioners.




                       C. Matthews RN, MSN
7/26/2012             M.Elias RN, MSN SP11               4
CONTENT FOR ALTERNATIVE THERAPIES

               I. Systems of Health Care
                – Traditional Chinese Medicine
                – Native American medicine
                – Homeopathy
               II. Mind-Body Therapies
                – A. Journaling
                – B. Imagery
                – C. Meditation
               III. Manipulative Therapies
                – D. Massage
                – E. Tai Chi



                                   C. Matthews RN, MSN
7/26/2012                         M.Elias RN, MSN SP11   5
CONTENT FOR ALTERNATIVE THERAPIES

   IV. Biologic Based Therapies
     – A. Aromatherapy
     – B. Herbal preparations
   V. Energy Therapies
     – Healing touch
     – Therapeutic touch
     – Reiki




                             C. Matthews RN, MSN
7/26/2012                   M.Elias RN, MSN SP10   6
       History of Western Medicine




                  C. Matthews RN, MSN
7/26/2012        M.Elias RN, MSN SP11   7
  Ancients -- Myths & Religion –
  Basis For Medical Practice




                 C. Matthews RN, MSN
7/26/2012       M.Elias RN, MSN SP11   8
     History of Western Medicine:
        Ancient Greece & Rome
                            Hippocrates




                            Galen

                C. Matthews RN, MSN
7/26/2012      M.Elias RN, MSN SP11        9
       History of Western Medicine

                               Early Christian era
                                ushers in hospitals
                                and health care
                                similar to
                                established Arab
                                Medicine




                  C. Matthews RN, MSN
7/26/2012        M.Elias RN, MSN SP11                 10
       History of Western Medicine
                                Middle Ages
                                  – Midwives
                                  – Witches
                                  – Physicians




                  C. Matthews RN, MSN
7/26/2012        M.Elias RN, MSN SP11            11
       History of Western Medicine
                                Renaissance




                  C. Matthews RN, MSN
7/26/2012        M.Elias RN, MSN SP11          12
       History of Western Medicine

                                   – Lister
                                   – Nightingale




                  C. Matthews RN, MSN
7/26/2012        M. Elias RN, MSN SP11             13
       History of Western Medicine


                                   20th and 21st
                                    Centuries




                  C. Matthews RN, MSN
7/26/2012        M. Elias RN, MSN SP11              14
           Integrative Health Care is
A Concept of Coordinated Health Care that
  Includes ALL the Treatments
  (Conventional and CAMs) and Health
  Practices that Your Patient uses in their
  Life.

How do We get our Patients to Tell us about
 the CAMs they use?
Course outcome #1    C. Matthews RN, MSN
Unit outcome #1     M. Elias RN, MSN SP11     15
                    What is Holism?
 Concept focused on Relationships among
  all living things.
 Therapeutic Encounters include:
     – Enhancing Resistance to Illness
     – Reducing aggravating behaviors
     – Stress Management
     – Goal is Optimal state of Wellness for each
       unique person

Course outcome #1        C. Matthews RN, MSN
Unit outcome #1         M. Elias RN, MSN SP11       16
RNs must be familiar with C. A. M.

“The 2007 National Health Interview
  Survey (NHIS), which included a
  comprehensive survey of CAM use by
  Americans, showed that approximately
  38 percent of adults use CAM.” NCCAM

retrieved 3/16/11 from http://nccam.nih.gov/health/whatiscam/



Course outcome #1          C. Matthews RN, MSN
Unit outcome #1           M. Elias RN, MSN SP11                 17
                  What is CAM?
 Complementary     modalities
    (therapies): used in conjunction with
    conventional medical practice.
    (Wilkinson, p. 1019)


 Alternative  Modalities(therapies):
    used instead of traditional care.
    (Wilkinson, p.1019)


                            C. Matthews RN, MSN
Unit outcome #3            M. Elias RN, MSN SP11   18
                      RN must:
1.Be non-judgmental despite personal opinions
2. Build rapport by showing client respect – if
  not, he may be afraid to tell about CAM use
3. Understand that C.A.M. can be beneficial,
  when used correctly
4. Be aware that C.A.M. can be dangerous if it
  interacts or interferes with conventional
  treatment

  Course outcome #1     C. Matthews RN, MSN
  Unit outcome #1      M. Elias RN, MSN SP11   19
                      RN must:
5. Be willing to teach the public about the
  positive and negative information
  regarding C.A.M.
6. Be aware that use of C.A.M. is popular
  and increasing and must be included in
  the history & physical
7. Know that Herbals, in particular, can
  have significant effect on prescription
  drugs and body function


Course outcome #1,2     C. Matthews RN, MSN
Unit outcome #1        M. Elias RN, MSN SP11   20
National Center for Complementary
and Alternative Medicine
 National Institutes of Health established
  NCCAM.
 Purposes:
     – Fund studies evaluating effectiveness of
       C.A.M.
     – Advance health professional knowledge re:
       C.A.M.
     – Serve as a clearinghouse for information
       about these therapies
                      C. Matthews RN, MSN
7/26/2012            M. Elias RN, MSN SP11         21
     NCCAM Domains of C.A.M.
                  Ignatavicius pg 8; Wilkinson p. 1020


   National Center for Complementary and
    Alternative Medicine – 5 categories
      – Systems of Health Care
      – Mind-body therapies
      – Manipulative and body-based therapies
      – Biologically based therapies
      – Energy therapies


                            C. Matthews RN, MSN
Unit outcome #3            M. Elias RN, MSN SP11         22
                          Mind-Body
    Meditation
       – Stress relief/ reduce anxiety
       – Relaxation
       – Reduced levels of lactic acid
       – Decreased oxygen consumption
       – Slowed heart rate
       – Decreased blood pressure
       – Improved function of immune system
       – Reduce pain
       – Relieve symptoms of psoriasis
       – Improve health
              (References: Ignativicius; Wilkinson)

                              C. Matthews RN, MSN
Unit outcomes #1-5           M. Elias RN, MSN SP11     23
                     Relaxation
 Used post-operatively (Ignatavicius, p. 299)
 Relaxation techniques (Ignatavicius, p. 56-57)
  – To reduce anxiety, tension & emotional
    tension which can exacerbate pain
 Relaxation (Wilkinson Vol 2, p. 967; Vol 1, pg 806-807)
 Progressive             muscle relaxation (PMR)
    (Wilkinson p. 807)
             Promoting sleep
             Can be taught in home setting
             Nurses can use for reduction of pain & stress.


                              C. Matthews RN, MSN
Unit outcomes #1-5           M. Elias RN, MSN SP11             24
                          Guided Imagery
       – Distraction when confronting pain, discomfort
         or fear
       – Making decisions and altering behavior
       – Caution: not recommended for emotionally
         unstable or cognitively impaired client
       – Helps reduce pain.
       – Reduction of nausea & vomiting.
       – Decreasing anxiety
       – Promoting comfort during cancer treatment
                     – Ignatavicius, 6th ed. p. 9


                                      C. Matthews RN, MSN
Unit outcomes #1-5                   M. Elias RN, MSN SP11   25
                     Mind - Body
 Biofeedback         (see Wilkinson text p. 1027)

 Journaling
      – Provides a vehicle for expressing feelings
   Hypnosis
      – Advanced training is NECESSARY
   Humor
      – Biochemical Responses?
      – Physiologic Responses?


                         C. Matthews RN, MSN
Unit outcomes #1-5      M. Elias RN, MSN SP11        26
                            Spiritual
   Life force beliefs found in most cultures.
    (Wilkinson, p 1020)

   Faith healing         (Wilkinson page 260)




                              C. Matthews RN, MSN
7/26/2012                    M. Elias RN, MSN SP11   27
                              Spiritual
 spiritual            beliefs – how they affect health

         Longer life span
         Predictors of health outcomes
         Effects on specific diseases
              – Page 249 Wilkinson




                                C. Matthews RN, MSN
  Unit outcomes #1-5           M. Elias RN, MSN SP11      28
                       Prayer
   Most Widely Used CAM in U.S.
      (NCCAM, 2004)
 C.A.M. interventions            (Wilkinson page 257)
 Prayer
      – For Self
      – For Others
      – Healing Prayer Services
      – Prayer Groups

                        C. Matthews RN, MSN
Unit outcomes #1-5     M. Elias RN, MSN SP11             29
                           Spiritual
 Intercessory            prayer
      – An organized and regular form of prayer in
        which someone communicates with his or
        her higher power on behalf of another who
        is in need.
 Healing            prayer
      – Studies showing evidence of improvement
             Wilkinson, p 259-260


                               C. Matthews RN, MSN
Unit outcomes #1-5            M. Elias RN, MSN SP11   30
                       Spiritual
   Nurses should expect to work in
    collaboration with others, particularly
    ministers, pastors and chaplains, to meet
    the complex spiritual needs of all patients.

   Potential problem: the nurse and patient
    have different views of spirituality
      – Respect patient’s wishes
      – If patient asks for spiritual intervention that is
        inconsistent with the nurse’s beliefs, seek
        assistance from another nurse or chaplain.
                          C. Matthews RN, MSN
Unit outcomes #1-5       M. Elias RN, MSN SP11           31
Manipulative and body-based methods
  Movement           & exercise
       – Strengthens circulatory & respiratory
         function
       – Endorphins
       – Helps regulate metabolism
       – Enhances Immune system




                          C. Matthews RN, MSN
 Unit outcomes #1-5      M. Elias RN, MSN SP11   32
Manipulative and Body-based Therapies
      Yoga
         – “life forces in correct balance and flow
         – Concentration, strength, flexibility, symbolic
           movements
         – Breathing, movement & posture
      Tai Chi
         – Promotes the flow of qi or energy throughout the
           body
                     – Ignatavicius, p. 11
         – Reduces sx. of fibromyalgia
         – Used in cardiac rehab programs, can lower BP

                                        C. Matthews RN, MSN
Unit outcomes #1-5                     M. Elias RN, MSN SP11   33
        Other Movement Therapies
   Dance Therapy




                      C. Matthews RN, MSN
Unit outcomes #1-5   M. Elias RN, MSN SP11   34
       Chiropractic and Osteopathy
   Chiropractic
      – Relationship between Body Structure and
        Function
      – Subluxation & Adjustment
   Osteopaths D.O. vs. M.D.
      – Includes Osteopathic Manipulation




                       C. Matthews RN, MSN
Unit outcomes #1-5    M. Elias RN, MSN SP11       35
Massage
      – Muscles & Soft Tissues
      – Benefits of Massage
      – Contraindications for Massage
      – Can we (nurses) do Massage?




                        C. Matthews RN, MSN
Unit outcomes #1-5     M.Elias RN, MSN SP10   36
          Energy – Based Therapies
   “A group of techniques
    that work with the
    body’s energy field by
    the use of the hands to
    direct or redirect the
    energy to enhance
    balance within the field.”
    (see Wilkinson page 1033-34)

                                                   alternativecancer.us/aura.jpg


                            C. Matthews RN, MSN
Unit outcomes #1-5         M. Elias RN, MSN SP11                            37
    Energy – Based Therapies
    Energy fields                                                    www.windsofchange.eu.com/chakra.

     http://images.google.com/images?hl=en&q=layers+of+body+energy+field&btnG=Se
                                                                      html


     arch+Images&gbv=2

       – Layers
       – Chakras
       – Reflexology ‘zones’
          http://images.google.com/images?gbv=2&hl=en&q=reflexology+zones&btnG=S
          earch+Images

       – Traditional Chinese Medicine – 12 Meridians
          (Ignatavicius, 6th ed., page 9)
       – Acupressure ‘meridians’ (Wilkinson figure 40-3 page 1024)
       – Acupuncture chi/blockages

                                     CC. Matthews RN, MSN
    Unit outcomes #1-5               M. Elias RN, MSN SP11                                38
          Energy – Based Therapies
   Therapeutic massage
      – Precaution –   Wilkinson p. 1033

   Therapeutic touch
      – Caution for touch –       Ignatavicius 6th ed., page 13

 Healing touch
 Reiki
 Acupressure
 Reflexology
                           C. Matthews RN, MSN
Unit outcomes #1-5        M. Elias RN, MSN SP11                   39
          Energy – Based Therapies
   TT (Therapeutic Touch)
      – Integral to assessment
      – Bonding
      – Communication
      – Soothing, calming, comfort
      – orientation
   Contraindications
      – When NOT to touch –         Ignatavicius pg. 13

                        C. Matthews RN, MSN
Unit outcomes #1-5     M. Elias RN, MSN SP11              40
Reiki
 Create Energy Balance
 Patient draws Energy
 Reiki Masters & Training

                          “Reiki is a Japanese technique for stress
                          reduction and relaxation that also
                          promotes healing. It is administered by
                          "laying on hands" and is based on the idea
                          that an unseen "life force energy" flows
                          through us and is what causes us to be
                          alive.”
                     http://www.centurylink.net/search/index.php?q=google&context=www.centurylink.net




                                       C. Matthews RN, MSN
Unit outcomes #1-5                    M. Elias RN, MSN SP11                                             41
             Reflexology/Acupressure
    Reflexology
       – Ancient Egypt
       – Energy Zones Top to Bottom
       – Pressure Points
       – What conditions benefit from it?
    Acupressure
       – Meridians & Pressure Points



                         C. Matthews RN, MSN
Unit outcomes #1-5      M. Elias RN, MSN SP11   42
                     Acupuncture
 Derived from traditional Chinese medicine
  and other countries and alternative
  systems
 Qi (chi) Energy travels through 72
  Meridians in the body
 Needles are applied to Acupoints on the
  Meridians to restore the flow of qi


                        C. Matthews RN, MSN
Unit outcomes #1-5     M. Elias RN, MSN SP11   43
            Acupuncture – uses for
       Migraine headache – Ignatavicius, p. 953
       Pain and Anesthesia – Ignatavicius p. 57




                         C. Matthews RN, MSN
7/26/2012               M.Elias RN, MSN SP10      44
     The dreaded nausea and vomiting which commonly
      occurs in some patients undergoing chemotherapy
      and inevitably, with the use of certain classes of
      agents, can often be worse than the disease itself.
      Most oncologists have experienced the patients
      who start vomiting at the thought of their next clinic
      visit. At the University of Los Angeles (UCLA)
      School of Medicine, a well-controlled study
      completed over two Years ago, the authors of the
      published paper reported significant reduction of
      nausea and vomiting when pre-treated with. It is
      now routinely administered before, after and in
      between chemotherapy treatment sessions for
      control or nausea and emesis. Such treatments are
      relatively simple and easily executed in an
      outpatient setting. Its effectiveness helps in
      minimizing the use of standard, expensive multi-
      drug anti-nausea regimens with their attendant side
      effects, given along with the chemotherapeutic
      agents.
     Acupuncture in Cancer Treatment by Eugene Mak, MD@
      http://www.medicalacupuncture.org/acu_info/articles/cancertreatment.html
                                       C. Matthews RN, MSN
7/26/2012                             M.Elias RN, MSN   SP10                     45
       Biologically Based Therapies
 Dietary Therapies
 Herbs
 Vitamins
 Aromatherapy




Course outcome #2, 3 & 4    C. Matthews RN, MSN
Unit outcomes #1-5         M. Elias RN, MSN SP11   46
                           Dietary Therapies
    Nutraceuticals and phytonutrients
    Protective or healing agents found in plant
     and animal foods.
    Free radicals: unstable molecules that alter
     genetic codes and trigger the development of
     cancer growth in cells.
    Antioxidants: react with free radicals,
     preventing their damaging effects
      – Sources of antioxidants: vitamin C, beta-
        carotene, vitamin E

Course outcome #2, 3 & 4         C. Matthews RN, MSN
Unit outcomes #1-5              M. Elias RN, MSN SP11   47
                           Dietary Therapies
   Macrobiotic Diets
     – Yin/ yang of foods
     – Balanced foods
     – Foods to avoid: processed and treated foods,
       red meat, sugar, dairy products, eggs,
       caffeine
     – Caution: children and pregnant women may
       have deficiency in Vitamins D and B12

Course outcome #2, 3 & 4         C. Matthews RN, MSN
Unit outcomes #1-5              M. Elias RN, MSN SP11   48
                           Aromatherapy –
                             Wilkinson page 1030


 Essences from oils extracted from plants &
  flowers.
 Conditions responsive to aromatherapy:
     – Stress and anxiety
     – Muscular and rheumatic pains
     – Digestive disorders
     – Skin conditions


Course outcome #2, 3 & 4        C. Matthews RN, MSN
Unit outcomes #1-5             M. Elias RN, MSN SP11   49
              Aromatherapy
   Can be used for sense of smell, but also
    as compresses, baths or topical




                    C. Matthews RN, MSN
7/26/2012          M. Elias RN, MSN SP11       50
Aromatherapy
(Ignativicius, p.12)

 Lavender – promotes relaxation & sleep
 Peppermint – stimulation, concentration
 Sandalwood – ease depression
 Tea tree – treating MRSA?
 Chamomile – relaxation
 Lemon – promotes sleep/ tx for insomnia
  and/or digestive disorders


Course outcome #2, 3 & 4    C. Matthews RN, MSN
Unit outcomes #1-5         M. Elias RN, MSN SP11   51
                           Herbals
Cherokee story
 “…humans were without diseases until the
  animals created them in retribution for the
  lack of respect humans had shown them.
  The plants, however, felt that the animals
  were much too harsh and volunteered
  themselves to provide a cure for every
  disease the animals had created.”
             Cavendar, p. 55

Course outcome # 3 & 4       C. Matthews RN, MSN
Unit outcomes #1-5          M. Elias RN, MSN SP11   52
    HERBALS – what RN needs to know
   Major drawback: May delay important diagnosis
    and treatment.
   Nursing Intervention: Make certain MD or ARNP
  is aware of client’s use of herbals.
 Nursing action: What to assess & instruct pre-
  op client regarding herbal therapy.



    Course outcome #2, 3 & 4    C. Matthews RN, MSN
    Unit outcomes #1-5         M. Elias RN, MSN SP11   53
HERBALS – what RN needs to know
   FDA categorized herbals as food and nutritional
    supplements not as drugs

   The Dietary Supplement Health & Education Act
    (DSHEA) of 1994 allowed herbs to be sold as
    dietary supplements as long as there are no
    health claims written on labels

   DSHEA requires no proof of safety or efficacy
    and sets no standards for products labeled as
    supplements, i.e. no guarantee the herb is
    properly prepared
Course outcome #2, 3 & 4    C. Matthews RN, MSN
Unit outcomes #1-5         M. Elias RN, MSN SP11      54
                 Commonly used Herbals
                           Ignatavicius page 12 – table 2-3

 Know intended uses for each
 Know Caution & adverse effects of each
     – Gingko bilboa
     – Garlic
     – Echinacea
     – Ginseng
     – St. John’s Wort


Course outcome #2, 3 & 4             C. Matthews RN, MSN
Unit outcomes #1-5                  M. Elias RN, MSN SP11     55
                           Ginko Biloba
 Reduce Memory Problems, Dementia,
  Peripheral Vascular Disease
 Antioxidant & Vasodilatory Properties
 BUT can cause BLEEDING when used
  with Anticoagulants
 Avoid before surgery
 Also cause Headache, GI Upset



Course outcome #2, 3 & 4      C. Matthews RN, MSN
Unit outcomes #1-5           M. Elias RN, MSN SP11   56
                            Garlic
 Lowers Cholesterol, Lowers BP, Natural
  Antibiotic,
 Natural Anti-platelet Agent
 BUT Causes BLEEDING with other Anti-
  platelet Drugs
 Potentiates Anti-diabetic Drugs
 Avoid before Surgery



Course outcome #2, 3 & 4    C. Matthews RN, MSN
Unit outcomes #1-5         M. Elias RN, MSN SP11   57
                           Echinacea
 Builds Immunity, Helps Wound Healing
 Use > 8 Weeks & Possible Immune
  Function Suppression
 NOT Recommended for People with
  Immune Diseases




Course outcome #2, 3 & 4     C. Matthews RN, MSN
Unit outcomes #1-5          M. Elias RN, MSN SP11   58
                           Ginseng
 Asian Ginseng- Diabetes, Erectile
  Dysfunction, “Unclear” Thinking
 American Ginseng- Diabetes,
  Prevention of Colds & Flu
 Siberian Ginseng- Prevent Colds & Flu,
  reduce Severity of Herpes Simplex type 2
  Infections
 BUT, BUT, BUT, BUT…



Course outcome #2, 3 & 4    C. Matthews RN, MSN
Unit outcomes #1-5         M. Elias RN, MSN SP11   59
            Ginseng and the Big Buts




                     C. Matthews RN, MSN
7/26/2012           M. Elias RN, MSN SP11   60
           Ginseng & The BIG BUTS
 Insomnia, Headache, Agitation, GI Upset,
  Unusual Menstrual Bleeding, Breast Pain,
  Dizziness, Increase or Decrease BP,
  Hypoglycemia,
  Fast/Pounding/Irregular Heartbeat;
  Severe Allergic Reaction
 Not with Immune System Disorders,
  Schizophrenia, Endometriosis, Fibroids
 NOT FOR Long-term Use

Course outcome # 2, 3 & 4    C. Matthews RN, MSN
Unit outcomes #1-5          M. Elias RN, MSN SP11   61
                           St. John’s Wort
 Ease Mild to Moderate Depression
 BUT causes Photosensitivity
 DO NOT use in Major Depression
 DO NOT use with Other Antidepressants




Course outcome #2, 3 & 4        C. Matthews RN, MSN
Unit outcomes #1-5             M. Elias RN, MSN SP11   62
                           Herbals
 Alert: “Natural” does not always mean
  harmless.
 Plants used improperly can be poisonous.
 Chemicals within herbs can strengthen the
  immune system, alter blood chemistry, or
  protect specific organs against disease
 Caution: some individuals may have
  allergies

Course outcome #2, 3 & 4    C. Matthews RN, MSN
Unit outcomes #1-5         M. Elias RN, MSN SP11   63
                           Herbals
   Special precaution with pregnant or
    lactating women and children – should not
    use without physician’s knowledge
         Rationale:
         Unpredictable biologic effects
         Possible allergies
         Side effects
         Herbs have chemical composition
         Little or no regulation of production/ quality
         Possible herb/drug or herb/herb interaction
         Possible delay of treatment is dangerous
Course outcome #2, 3 & 4    C. Matthews RN, MSN
Unit outcomes #1-5         M. Elias RN, MSN SP11          64
                           Herbals & the RN
 Teach    about signs of allergic
    reactions

 Teach    that herbs can be dangerous
    even if they are not Rx and are
    “natural”


Course outcome #2, 3 & 4        C. Matthews RN, MSN
Unit outcomes #1-5             M. Elias RN, MSN SP11   65
                             Herbals & the RN
       Always ask about use of herbals when
        getting medication history

       “What is the story of why the patient is
        using the plant medicine or therapy?”
                           – Libster, p. 809


       Teach clients to look for products labeled
        ‘standardized’ – these more likely to have
        accurate amounts of herb and less likely
        to have contamination
Course outcome #2, 3 & 4                  C. Matthews RN, MSN
Unit outcomes #1-5                       M. Elias RN, MSN SP11   66
    Frankincense and Myrrh* medicinal use

   Have had spiritual significance since ancient
    times and they also were adopted as medicines
    for physical ailments.

   In modern Chinese Materia Medica, these two
    resins are classified as herbs for vitalizing
    circulation of blood and are utilized for treating
    traumatic injury, painful swellings, masses, and
    other disorders related to stasis syndromes.
    –   MYRRH AND FRANKINCENSE by Subhuti Dharmananda, Ph.D., May 2003 @
        http://www.itmonline.org/arts/myrrh.htm




    Course outcome #2, 3 & 4          C. Matthews RN, MSN
    Unit outcomes #1-5               M. Elias RN, MSN SP11   *Will not be on the test!   67
   Pain in the epigastrum, abdomen, hypochondria, and/or
    heart due to qi and blood stasis, and stagnation in the
    viscera and bowels or the channels (jing) and network
    vessels (luo).

   Amenorrhea, dysmenorrhea, or postpartum abdominal
    pain due to blood stasis.
   Rheumatic complaints due to wind damp causing qi and
    blood stagnation and stasis in the network vessels.
   Wounds, scars, and skin inflammation with blood stasis
    and necrotic tissue.

   Traumatic injuries with pain, swelling, and redness due
    to qi stagnation and blood stasis.
     –      MYRRH AND FRANKINCENSE by Subhuti Dharmananda, Ph.D., May 2003 @
            http://www.itmonline.org/arts/myrrh.htm

                                                  C. Matthews RN, MSN
7/26/2012                                        M. Elias RN, MSN SP11         68
                           Folk Medicine
                      (Ignatavicius, 6th ed., page 32-33)

 Learned from experience
 Passed from generation to generation
 Preservation of heritage/ culture
 Some have been scientifically proven (ex.
  Garlic)
 Plants/herbs
 Hot/cold
   “Evil Eye” (Mal de Ojo)
Course outcome #2, 3 & 4          C. Matthews RN, MSN
Unit outcomes #1-5               M. Elias RN, MSN SP11      69
             C. Matthews RN, MSN
7/26/2012   M. Elias RN, MSN SP11   70
                           Folk Medicine
   Own terminology: (Feel free to ask the meaning)
     –   “high blood”          “low blood”                    “thin blood”
     –   “Thick blood”         conjure                        water
     –   “fall out”            gimpy                          dropsy
     –   risin’                sugar                        cut pain
     –   Weeded breasts
     –   “snuffing the mother”
     –   “the itch”
                 – Cavendar, 2003



Course outcome #2, 3 & 4             C. Matthews RN, MSN
Unit outcomes #1-5                  M. Elias RN, MSN SP11                71
Course outcome #2    C. Matthews RN, MSN
Unit outcome #6     M. Elias RN, MSN SP11   72
                    What is Quackery?
 A pretender
 Questionable products & services
 Overpromotion vs fraud
 Misinformation
 Useful for some purposes, not others




Course outcome #2         C. Matthews RN, MSN
Unit outcome #6          M. Elias RN, MSN SP11   73
                How to spot Quackery
    Tell only part of the story
    Overpromotes nutritional insurance
    Play on fears about chemicals
    ‘Everyone needs supplements’
    Promise quick, dramatic, miraculous results
    Anecdotes & testimonials
    Questionable credentials
    Claim persecution
    Promote distrust
    Take claims directly to the media, not peers
    Resist peer review

Course outcome #2       C. Matthews RN, MSN
Unit outcome #6        M. Elias RN, MSN SP11        74
          Nurses Educate the Public
 Teach signals of fraudulent practice
 Avoid ‘healers’ who:
     – Promise immediate relief or success
     – State that their way is the only sure therapy
     – Refuse to work with other health care
       providers
     – Claim to have all the answers
     – Use testimonials that claim amazing results

Course outcome #2      C. Matthews RN, MSN
Unit outcome #6       M. Elias RN, MSN SP11            75
            One Minute Paper
Now is the time to write short answers
  to:
1. What is something you heard today that
   is new to you?
2. How do you plan to approach your
   clients about CAM?
3. List one thing that surprised you.
4. List one thing that reinforced something
   you already believed.

                  C. Matthews RN, MSN
7/26/2012        M. Elias RN, MSN SP11    76
                     References
   Cavender, A.(2003) Folk Medicine in Southern
    Appalachia. The University of North Carolina Press,
    Chapel Hill, N.C.
   Ignatavicius, D.D. & Workman, M.L. (2010) Medical-
    Surgical Nursing. 6th ed. Elsevier Saunders, St. Louis,
    Missouri.
   Libster, M.L. (2002) Delmar’s Integrative Herb Guide for
    Nurses. Delmar Thomson Learning. United States.
   Wilkinson, J.M. & Treas, L.S. (2011) Fundamentals of
    nursing, 2nd ed. FA Davis Company, Philadelphia, PA.

                          C. Matthews RN, MSN
7/26/2012                M. Elias RN, MSN SP11             77

				
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