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Using complementary therapies: acupuncture.

Acupuncture is a traditional Chinese healing system designed to achieve and maintain harmony. Needles are applied to points in 12 meridians, each of which links to an organ. Nurses are often asked about complementary therapies and need to be familiar with the theory.

Acupuncture Therapy↗

Complementary therapy and obstetrics and gynaecology: a time to integrate.

PURPOSE OF REVIEW: The purpose of this review is to assess the evidence and role of complementary and alternative medicine in obstetrics and gynaecology. There is increasing patient interest and use of complementary and alternative medicine therapies and there is thus a need for health practitioners to be appropriately informed of different complementary therapies. RECENT FINDINGS: This article reviews the background to complementary and alternative medicine and the evidence although limited for its introduction into mainstream obstetrics and gynaecology; the difficulty in obtaining good evidence is also discussed. SUMMARY: The conclusions drawn are that we need to develop an integrated approach to healthcare and this is particularly relevant and important in obstetrics and gynaecology. With this integration, clinical research is essential and needs encouragement from all levels.

Complementary Therapies↗

The effectiveness of osteopathic manipulative treatment as complementary therapy following surgery: a prospective, match-controlled outcome study.

CONTEXT: Osteopathic manipulative treatment has been reported to relieve a variety of conditions, but no studies have examined the outcome effects of osteopathic manipulative treatment as a complementary modality for treating musculoskeletal problems during postoperative recovery. OBJECTIVE: To assess osteopathic manipulative treatment as a complementary therapy for patients undergoing elective knee or hip arthroplasty. DESIGN: Prospective, single-blinded, 2-group, match-controlled outcome study. SETTING: Osteopathic teaching hospital. PATIENTS: Of 166 eligible patients, 38 were assigned to a treatment group and matched with 38 control subjects. INTERVENTION: The treatment group received osteopathic manipulative treatment on postoperative days 2 through 5. MAIN OUTCOME MEASURES: Days to independent negotiation of stairs, distance ambulated, supplemental intramuscular analgesic use, length of hospital stay, and patients' perceptions of treatment. RESULTS: Compared to control subjects, the intervention group negotiated stairs 20% earlier (mean = 4.3 postoperative days, SD = 1.2; control subjects 5.4, SD = 1.6, P = .006) and ambulated 43% farther on the third postoperative day (mean = 24.3 m, SD = 18.3; controls = 13.9, SD = 14.4, P = .008). The intervention group also required less analgesia, had shorter hospital stays, and ambulated farther on postoperative days 1, 2, and 4. CONCLUSIONS: Patients receiving osteopathic manipulative treatment in the early postoperative period negotiated stairs earlier and ambulated greater distances than did control group patients.

Aged↗

Alternative and complementary therapies: integration into cancer care.

1. Cancer survivors and caregivers in the workplace are using complementary and alternative therapies and expect nurses to know about them. 2. Therapies such as acupuncture, acupressure, homeopathy, herbal preparations, imagery, and Therapeutic Touch among others may help with cancer symptoms or treatment effects. 3. Specific strategies, e.g., staff stress management programs, inservice or continuing education, inclusion of therapies on assessment forms, can be used to begin integrative efforts. 4. The ideal health care system is one that integrates alternative and complementary healing therapies into conventional care.

Complementary Therapies↗

Surveys of complementary and alternative medicine: Part V. Use of alternative and complementary therapies for psychiatric and neurologic diseases.

Surveys of general complementary and alternative medicine (CAM) use have suggested an association with high levels of depression and anxiety. This raises the question of whether anxious or depressed people seek CAM, or whether there are underlying factors associated with long-term chronic illness. There is no clear indication from four surveys of psychiatric patients. These are summarized and presented. A separate table summarizes three studies of patients with neurologic diseases, two of patients with multiple sclerosis, and one of a mixed patient population. More studies are amassing in specific disease areas, although it is difficult to detect clear trends because of methodological and terminological incompatibilities.

Complementary Therapies↗

Complementary therapy and cardiac surgery.

Mind-body techniques and complementary care may assist people who are undergoing surgery and those recovering from cardiac surgery to cope with the event, the process of recovery, and accompanying lifestyle changes. These approaches can provide cardiac patients with nonpharmacologic tools that may prevent further coronary artery disease and the development of dysrhythmias. The Complementary Care Center at Columbia-Presbyterian Medical Center was developed to clinically apply and research the use of nonallopathic, complementary modalities with patients receiving care at the medical center, including those undergoing cardiac surgery.

Adaptation, Psychological↗

Complementary therapies in pediatrics: a legal perspective.

Increasing use of complementary and alternative medicine (CAM) therapies such as chiropractic, massage therapy, and herbal medicine, raises questions about the clinically appropriate use of CAM in pediatrics. Nonjudicious use of CAM therapies may cause either direct harm or, by creating an unwarranted financial and emotional burden, indirect harm. When advising patients concerning CAM therapies, pediatricians face 2 major legal risks: medical malpractice and professional discipline. Pediatricians can incorporate these considerations into advising and clinical decision-making about CAM therapies to address the best interest of the pediatric patient while helping to manage potential liability risk. This article provides a suggested framework, including asking the following questions: (1) Do parents elect to abandon effective care when the child's condition is serious or life-threatening? (2) Will use of the CAM therapy otherwise divert the child from imminently necessary conventional treatment? (3) Are the CAM therapies selected known to be unsafe and/or ineffective? (4) Have the proper parties consented to the use of the CAM therapy? (5) Is the risk-benefit ratio of the proposed CAM therapy acceptable to a reasonable, similarly situated clinician, and does the therapy have at least minority acceptance or support in the medical literature? Such an approach ideally can help guide the pediatrician toward clinical conduct that is clinically responsible, ethically appropriate, and legally defensible.

Child↗

An account of nurses' role using complementary therapies.

Nurses are showing a clear and increasing interest in complementary medicine. This article outlines their potential for future development in the context of both general practice and hospital-based medicine. Specific reference is made to the Centre for the Study of Complementary Medicine, Southampton, UK where we have trained effective nurse practitioners to work within the practice team, delivering both advice and treatment to patients.

Complementary Therapies↗

Use of complementary therapies by patients with IBD may indicate psychosocial distress.

BACKGROUND: Complementary and alternative medicine (CAM) is used increasingly by patients with chronic diseases. We have assessed the use of CAM in general medicine and gastrointestinal outpatients focusing particularly on factors predisposing to its use in patients with inflammatory bowel disease (IBD). METHODS: 239 consecutive patients attending gastrointestinal and general medical outpatient clinics answered a questionnaire about their use of CAM: patients with IBD also completed a validated disease-specific quality of life (QOL) inflammatory bowel disease questionnaire (IBDQ). RESULTS: 26% of all patients used CAM, most commonly herbal remedies (43%). CAM was used significantly more by younger than older patients and by single than married or widowed ones. There were no differences by gender or ethnicity. More patients with irritable bowel syndrome used CAM than those with other diagnoses. In IBD patients, CAM users had significantly poorer QOL scores for emotional and social factors than nonusers. 53% of users stated that CAM alleviated their symptoms. CONCLUSIONS: Use of CAM is common in gastroenterological outpatients, particularly if they are young, single, or have irritable bowel syndrome (IBS). Most patients deem it helpful. In IBD, poor QOL predisposes to use of CAM. Conversely, use of CAM may serve as a marker of emotional or social unease in these patients. Physicians need to be aware of widespread usage of CAM by their patients.

Adult↗