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Original PDF Complementary and Alternative Therapies For Nursing Practice 5th PDF
Original PDF Complementary and Alternative Therapies For Nursing Practice 5th PDF
Original PDF Complementary and Alternative Therapies For Nursing Practice 5th PDF
Complementary
& Integrative
Therapies for
Nursing Practice
Karen Lee Fontaine
CONTENTS
Preface xi
Acknowledgments xv
vii
viii Contents
*
“Try This” features throughout the chapters, provides you with examples of how you can integrate
these practices into your own life, and also gives you ideas for client education. A list of resources is
also included in every chapter.
ix
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PREFACE
xi
xii Preface
may be new to us, many of these traditions are hundreds or even thousands of
years old and have long been part of the medical mainstream in other cultures.
I have titled this book Complementary & Integrative Therapies for Nursing
Practice because I believe we need to merge complementary approaches with
Western-based nursing practices resulting in integrative therapies. I have
tried to provide enough information about these therapies to help guide prac-
tice decisions. This text, as an overview and practical guide for nurses, does
not pretend to be an exhaustive collection of all the facts and related research,
nor does it offer meticulous documentation for all claims made by the various
therapies. The goal of the text is to motivate you, the reader, to explore these
approaches, increase your knowledge about factors that contribute to health
and illness, and expand your professional practice appropriately.
It is possible to classify alternative practices in any number of ways. I have
chosen to present more than 40 approaches categorized into seven units. In Unit 1,
I introduce the philosophical approaches to both Western biomedicine and
complementary and integrative medicine, as well as evidence-based health care
in these therapies. Concepts common to many approaches are defined and
discussed, such as energy, breath, spirituality, and healing. Unit 2 presents a
number of health-care practices that have been systematized throughout the
centuries worldwide. These typically include an entire set of values, attitudes,
and beliefs that generate a philosophy of life, not simply a group of remedies.
The chapters cover Traditional Chinese medicine, Ayurvedic medicine, and
Native American healing and curanderismo. Unit 3 comprises chapters relating
to botanical healings used by 80% of the world’s population. Chapters cover
herbs and nutritional supplements, aromatherapy, homeopathy, and naturopa-
thy. Unit 4 presents manual healing methods—some from ancient times and
some developed in the latter half of the 20th century. The chapters discuss chi-
ropractic, massage, pressure point therapies, hand-mediated biofield therapies,
and combined physical and biofield therapies. The chapters in Unit 5 cover
types of mind–body techniques for healing and include yoga, meditation, hyp-
notherapy and guided imagery, dreams, intuition, music as a therapeutic tool,
biofeedback, and movement-oriented therapies. Unit 6 presents two spiritual
approaches to therapeutic intervention: working with shamans and the use of
faith and prayer. Unit 7 includes two chapters on miscellaneous practices: bioel-
ectromagnetics and animal-facilitated therapy.
The appendix provides specific information on managing the types of
common health problems that respond well to alternative therapies and life-
style modification.
This book does not recommend treatments but, rather, describes alterna-
tive practices, their backgrounds and claims, preparation of practitioners, con-
cepts, diagnostic methods, treatments, and evidence from research studies.
“Integrated Nursing Practice” is an important section of every chapter
designed to help you, the nurse, expand your practice by providing you with
specific information and suggestions.
In this fifth edition, I have continued the “Considering the Evidence”
feature with all new research relating to the chapter topic. Seven of these
Preface xiii
I would like to express thanks to the many people who have inspired, com-
mented on, and in other ways assisted in the writing and publication of the
fifth edition of this book. On the publishing and production side at Pearson, I
was most fortunate to have an exceptional team of editors and support staff.
My thanks go to Julie Levin Alexander, Publisher, and Neha Sharma, Content
Producer, who provided support and guidance throughout this project.
Sadika Rehman, Project Manager, kept this book on schedule and dedicated
her time and skills to its completion.
xv
REVIEWERS
xvi
1
UNIT
Healing Practices:
Complementary
and Integrative
Therapies for
Nurses
M
ost of nursing education in the United States, Canada, the
United Kingdom, Europe, and Australia—often referred
to as Western countries—has been under the umbrella of
biomedicine, and thus Western nurses are familiar and comfort-
able with its beliefs, theories, practices, strengths, and limitations.
Fewer nurses have studied alternative medical theories and prac-
tices and as a result may lack information or even harbor misinfor-
mation about these healing practices. Unlike the profession of
medicine in general, however, the profession of nursing has tradi-
tionally embraced two basic concepts embodied by alternative
therapies—holism and humanism—in its approach with clients.
Nurses have long believed that healing and caring must be
approached holistically and that biological, psychological, emo-
tional, spiritual, and environmental aspects of health and illness
are equally important. This humanistic perspective includes prop-
ositions such as the mind and body are indivisible, people have the
power to solve their own problems, people are responsible for the
patterns of their lives, and well-being is a combination of personal
satisfaction and contributions to the larger community. This theo-
retical basis gives nurses a solid foot in each camp and places them
in the unique position to help create a bridge between biomedicine
and alternative medicine (Buchan, Shakeel, Trinidade, Buchan, &
Ah-See, 2012; Dossey & Keegan, 2016; Peplau, 1952; Quinn, 2000).
BACKGROUND
Many interesting exchanges around the world have debated the
appropriate terminology of various healing practices. Some peo-
ple become vested in the use of particular terms and have diffi-
culty getting past the language limitations. For example, many
3
4 Unit 1 • Healing Practices
people view the term alternative medicine as being too narrow or misleading
and are concerned that the term lacks a full understanding of traditional heal-
ing practices. It would be helpful for a common language to be developed
without these constraints. As language evolves, the terms used today may be
quite different from those that will be in use 20 years from now. For consistency,
the terms chosen for this text are conventional medicine or biomedicine to
describe Western medical practices, and the terms alternative medicine or
complementary medicine to describe other healing practices. Traditional
medicine refers to indigenous medical systems such as Traditional Chinese
Medicine (TCM). Integrative medicine embodies conventional and comple-
mentary and alternative medicine. There are no universally accepted terms.
The following list presents commonly used words and their counterparts:
Mainstream Complementary/Alternative
Modern Ancient
Western Eastern
Allopathic Homeopathic; holistic
Conventional Unconventional
Orthodox Traditional
Biomedicine Natural medicine
Scientific Indigenous healing methods
The line between conventional medicine and complementary and alter-
native medicine is imprecise and frequently changing. For example, is the use
of megavitamins or diet regimens to treat a disease considered medicine, a
lifestyle change, or both? Can having one’s pain lessened by massage be con-
sidered a medical therapy? How should spiritual healing and prayer—some
of the oldest, most widely used, and least studied traditional approaches—be
classified? Although the terms alternative and complementary are frequently
used, in some instances they represent the primary treatment modality for an
individual. Thus, conventional medicine sometimes assumes a secondary role
and becomes a complement to the primary treatment modality.
Conventional Medicine
Biomedical or Western medicine is only about 200 years old. It was founded
on the philosophical beliefs of René Descartes (1596–1650)—that the mind and
body are separate—and on Sir Isaac Newton’s (1642–1727) principles of physics—
that the universe is like a large mechanical clock in which everything operates
in a linear, sequential form. This mechanistic perspective of medicine views
the human body as a series of body parts. It is a reductionist approach that
converts the person into increasingly smaller components: systems, organs,
cells, and biochemicals. People are reduced to patients, patients are reduced
to bodies, and bodies are reduced to machines. Health is viewed as the absence
of disease or, in other words, nothing is broken at present, and sick care is
focused on the symptoms of dysfunction. Physicians are trained to fix or
Chapter 1 • Integrative Healing 5
repair broken parts through the use of drugs, radiation, surgery, or replacement
of body parts. The approach is aggressive and militant—physicians are in a
war against disease, with a take-no-prisoners attitude. Both consumers and
practitioners of biomedicine believe it is better to
• do something rather than wait and see whether the body’s natural pro-
cesses resolve the problem.
• attack the disease directly by medication or surgery rather than try to
build up the person’s resistance and ability to overcome the disease.
Biomedicine views the person primarily as a physical body, with the
mind and spirit being separate and secondary or, at times, even irrelevant. It
is a powerful medicine in that it has virtually eliminated some infectious
diseases, such as smallpox and polio. It is based on science and technology,
personifying a highly industrialized society. As a “rescue” medicine, the
biomedical approach is appropriate. It is highly effective in emergencies,
traumatic injuries, bacterial infections, and some highly sophisticated sur-
geries. In these cases, treatment is fast, aggressive, and goal oriented, with
the responsibility for cure falling on the practitioner.
The priority of intervention is on opposing and suppressing the symp-
toms of illness. This approach is evidenced in many medications with prefixes
such as an- or anti-, as in analgesics, anesthetics, anti-inflammatories, and anti-
pyretics. Biomedicine characterizes each disease in terms of its mechanisms of
action, based on the belief that most individuals are affected in the same way.
There is minimal consideration for how the disease affects the person or how
the person affects the disease (Maitland, 2016). Thus, treatment is basically the
same for most people. Because conventional medicine is preoccupied with
parts and symptoms and not with whole working systems of matter, energy,
thoughts, and feelings, it does not do well with long-term systemic illnesses
such as arthritis, heart disease, and hypertension. Despite higher per capita
spending on health care in the United States than in all other nations, in 2013,
U.S. life expectancy ranked only 37th, and the infant mortality rate ranked 56th
among the 225 nations studied (World Factbook, 2013–2014; World Health
Rankings, 2016). In comparison of 19 developed countries, the United States
had the highest rate of preterm births. Sadly, the United States has failed to be
a world leader in providing a healthier quality of life (Raheim, 2015).
BOX 1.1
Paradigms of Medicine
Integrative Medicine
Integrative medicine embodies conventional and complementary and alterna-
tive medicine, making use of the best available evidence of both approaches to
healing. It is a multidisciplinary, collaborative, holistic approach that encom-
passes mind, body, and spirit. It stresses the relationship between the client
and the practitioner as well as the human capacity for healing. Integrative
practitioners believe that clients have the right to make informed choices
about their health-care options. The focus is on “using the least invasive, least
toxic, and least costly methods to help facilitate health” (Willison, 2006,
p. 255). The goal of integrative medicine is to find new solutions to prevention
and treatment of health-care problems.
Dr. Andrew Weil has been the driving force for integrative medicine in
the United States and hopes to reform the entire medical delivery system by
changing the way we look at health and disease and by modifying the edu-
cation of physicians. His program at the Arizona Center for Integrative
Medicine at the University of Arizona College of Medicine was the first to
adopt this new curriculum. Currently, more than 60 medical schools have
adopted this integrative approach. In 2008, the World Health Organization
(WHO) stressed the importance of integrative medicine and advocated the
inclusion of complementary and alternative therapies in biomedical health-
care education.
8 Unit 1 • Healing Practices
Nursing must also be open to change to meet the goal of true integrative
care. Holistic nursing is an advanced specialty practice focusing on health and
wellness, assisting with the healing process, supporting individuals, and eas-
ing suffering. Colleges of nursing must integrate the principles and skills of
holistic nursing throughout all the levels of nursing curricula if we are to be a
force in the changing health-care systems.
ASSUMPTIONS
In understanding conventional and alternative medicine, it is helpful to study
the assumptions basic to their theories, practices, and research. These assump-
tions include the origin of disease, the meaning of health, the curative process,
and health promotion.
Origin of Disease
Biomedicine and alternative medicine have widely divergent assumptions
regarding the origin of disease. Biomedicine was shaped by the observations
that bacteria were responsible for producing disease and pathological damage
and that antitoxins and vaccines could improve a person’s ability to ward off
the effects of pathogens. Armed with this knowledge, physicians began to
conquer a large number of devastating infectious diseases. As the science
developed, physicians came to believe that germs and genes caused disease,
and once the offending pathogen, metabolic error, or chemical imbalance was
found, all diseases would eventually yield to the appropriate vaccine, antibi-
otic, or chemical compound.
Conventional medicine has also been influenced by Darwin’s concept of
survival of the fittest; that is, all life is a constant struggle, and only the most
successful competitors survive. Applied to medicine, this notion means that
humans live under constant attack by the thousands of microorganisms that,
in the Western view, cause most diseases. People must defend themselves and
counterattack with treatments that kill the enemy. Based on this assumption,
symptoms are regarded as harmful manifestations and should be suppressed.
For example, a headache is an annoyance that should be eliminated, and a
fever should be reduced with the use of medications.
Complementary and alternative medicine is based on the belief of
a life force or energy that flows through each person and sustains life.
Balance refers to harmony among organs in the body and among body
systems, and in relationships to other individuals, society, and the
environment. A balanced organism presents a strong defense against
external insults such as bacteria, viruses, and trauma. When the life force
or energy is blocked or weakened, the vitality of organs and tissues is
reduced, oxygen is diminished, waste products accumulate, and organs
and tissues degenerate. Symptoms are the body’s way of communicating
that the life force has been blocked or weakened, resulting in a compro-
mised immune system. Disease is not necessarily a surprise encounter
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— Mies, kuka oletkin, astu syrjään, sillä minulla on asiaa
jumalanaiselle.
— Anna minun mennä, sanoi hän. Hän tunsi, pikemmin kuin näki,
pitkän keihään, joka oli ojennettu hänen rintaansa vastaan
pimeässä. — Anna minun olla, niin minä annan sinulle monta säkkiä
suolaa ja putkia enemmän kuin metsässä on puita.
Hän oli vahva kuin nuori leijona, mutta hänen kurkkuunsa tarttuva
käsi ei myöskään ollut heikko. Hetkisen he kamppailivat, ja sitten he
kaatuivat kierien toistensa yli polulla.
*****
Ngombilaisten joukossa oli nainen, jolla oli suloinen kieli. Kun hän
puhui, miehet kuuntelivat innokkaasti, sillä sensukuinen hän oli,
syntymästään asti voimakaspuheinen.
Koko päivän hän makasi maassa ympärillään koko kylän väki, jolle
hän puhui työmiesten sahatessa poikki messinkirengasta hänen
kaulastaan. Päivän mentyä rengas saatiin pois ja päällikkö lähetti
hänet takaisin vanhempansa luo, jolta hän oli tytön ostanut suurella
summalla. Hänen toimenpiteensä kohtasi suurta vastustusta, sillä
nainen oli käyttänyt aikansa hyödyllisesti, ja koko kylä oli niin
kuohuksissaan, että se oli valmis kapinaan.
— Miksi minä puhuisin, kun sinä olet puhunut liikaa? kysyi Otapo
kylmästi. — Kiroan sen päivän, jolloin sinut näin, Mfasimbi, sillä
erehdykseni on maksanut minulle kalaverkon, joka oli kylän paras, ja
palan uutta kangasta, jonka ostin kauppamieheltä; ne on herramme
päällikkö ottanut.
— Jos sinulla olisi ollut miehen mieli, niin Namani, mieheni, olisi
nyt kuollut, ivasi nainen.
— Toivon, että äitini olisi synnyttänyt tytön, kun hän synnytti minut,
sanoi Otapo, — silloin en olisi joutunut häpeään.
Hän sai pian siitä tiedon, sillä nainen juoksi rinnettä hänen
luokseen ja polvistui syleillen hänen jalkojaan.
Päällikkö oli vihainen, sillä hän oli Namania korkeampi herra ja sitä
paitsi valvoi seudun rauhaa komissaarin puolesta.
— Jos sinä olisit ottanut hänet, Muhamed, sanoi vaimo, joka oli
kanonainen ja harras uskovainen, — olisit tullut surulliseksi.
Bosambo oli mies, jolla oli eläimen vaistot. Hän tunsi ilmassa
levottomuutta. Jokainen väräjävä hermosäie toi hänelle viestin:
hänen miehensä olivat luisumassa pois hänen vallastaan. Hän ei
epäröinyt.
Hiu-ii!
Kiiltävä kärki suhahti ilman läpi nopeammin kuin katse voi seurata.
*****
Abibu oli jätetty kylään, josta Mfasimbi oli karkoitettu. Hänet oli
jätetty selvittämään Otapon kuoleman salaisuutta, eikä häntä
helposti säikytetty.
Nyt hän näki selvästi. Yksi joukko oli astunut maihin, ja siellä kävi
kiivas käsirysy.
*****
Ja he tulivat myöskin.
RUKOILEVA MAURILAINEN
Mies nyökkäsi.