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[Does non-conventional complementary therapies improve the quality of life of cancer patients? A critical literature review].

Despite substantial progress in biomedicine, a majority of advanced cancer diseases currently cannot be cured. In addition to conventional medical symptom management (palliation) and improvement of quality of life, methods of complementary medicine and supportive psychotherapy are increasingly applied. Whereas the efficacy of biomedical and psychotherapeutic interventions has been documented, controlled investigations of complementary methods are rare and their efficacy is poorly documented or is viewed controversially. Complementary methods are defined as methods applied by conventionally trained physicians and are based on tradition, or the perspective of human arts, which are not investigated or taught at universities. As an example of the latter, anthroposophic medicine is presented. Finally, we present a project developed within the scope of NFP 34, where the efficacy of a routine biomedical treatment is compared with an additional anthroposophic and psychotherapeutic intervention respectively.

Anthroposophy↗

Role of nurses in promoting complementary therapies.

The decline in the caring aspects of medicine has made technology appear cold and inhuman and has turned medicine into a physical, restorative profession. Because practitioners are disillusioned by the shortcomings of scientific medicine, a desire to explore alternative approaches to health has appeared. Many complementary methods are similar to nursing in that they centre on the concept of holism. The lack of research in complementary methods and the need for legal regulation of their practitioners have a potential to discredit this area of health care. Nurses are among the most suitable professional groups to help complementary health care methods to attain their rightful place. The role of the nursing profession in this process will be seen as an indication of its standing as an independent research-based profession.

Complementary Therapies↗

Complementary therapy in practice.

Dorothy Crowther describes the evolution of the Wirral Holistic Care Services, a company dedicated to helping people cope with cancer. Based on a recognition that such patients want more than the standard NHS fare, initial evaluations suggest that the company is going some way to meeting the extra needs of this group. Available therapies include aromatherapy, kinesiology, reflexology and meditation, incorporating a model of care which endorses putting the patient first.

Adaptation, Psychological↗

The integration of complementary therapies into conventional medicine focuses primarily upon symptomatic care of the body with scant attention given to any interrelationship of the spirit and mind upon health and well-being.

We are pleased to continue our series of debates addressing topical issues currently under scrutiny in the field of complementary medicine. In selected issues, two people are invited to argue the case for or against a specific statement. In certain instances the position taken may not necessarily reflect the personal views of the authors. They have been asked to take a specific stance in order to stimulate debate and reflection about particular aspects of complementary and alternative medicine.

Attitude of Health Personnel↗

Qigong Yangsheng as a complementary therapy in the management of asthma: a single-case appraisal.

OBJECTIVES: Qigong Yangsheng, the health-promoting method of traditional Chinese medicine that combines movement, mental exercise, and breathing technique, is used in China for the therapy of bronchial asthma, and for some time now has been enjoying an ever-widening acceptance in the Western world as well. This pilot study investigates if Qigong Yangsheng could be used as a complementary therapeutic measure to treat asthma patients in a Western industrialized country. DESIGN: Thirty asthma patients, with varying degrees of illness severity, were taught Qigong Yangsheng under medical supervision. They were asked to exercise independently, if possible, on a daily basis and to keep a diary of their symptoms for half a year including peak-flow measurements three times daily, use of medication, frequency and length of exercise as well as five asthma-relevant symptoms (sleeping through the night, coughing, expectoration, dyspnea, and general well-being). The concept of this study was based on a single-case research design series with baseline, one teaching phase, a phase of self-practice and a refresher teaching course. A 4-week follow-up period was carried out in the same season as the original baseline phase 52 weeks later. RESULTS: An improvement was indicated if subjects showed a decrease of at least 10 percent in peak-flow variability between the 1st and the 52nd week. This occurred more frequently in the group of the exercisers (n = 17) than in the group of nonexercisers (n = 13) (p < 0.01 chi-square with Yates correction). When comparing the study year with the year before the study, there was improvement also in reduced hospitalization rate, less sickness leave, reduced antibiotic use and fewer emergency consultations resulting in reduced treatment costs. CONCLUSION: Qigong Yangsheng is recommended for asthma patients with professional supervision. An improvement in airway capability and a decrease in illness severity can be achieved by regular self-conducted Qigong exercises.

Adult↗

The use of complementary therapies by cancer patients.

Since the beginning of time, persons with acute or chronic diseases have sought added control over their fates in the form of whatever therapies offered hope. Although conventional treatments for cancer have been proven to lower mortality rates significantly, patients continue to look for more ways to combat their illnesses. Little in the literature supports the actual frequency of use of such therapies, nor do we have published data to support the general assumption that their popularity is growing. This group of researchers reanalyzed data from the Cancer Survivorship Questionnaire of the 1992 National Health Interview Survey to compare the use of self-healing and psychosocial techniques before and after 1987. Using Martha Roger's conceptual framework of the Science of Unitary Human Beings, these therapies were viewed as unitary field practice modalities. Results of the secondary analysis of data from 2970 patients revealed that use of additional therapies increased by 63.9% after 1987.

Adult↗

Use of complementary therapies in patients with cardiovascular disease.

Previous studies have suggested that patients with chronic medical conditions use complementary and alternative medicine (CAM) at a higher rate than the general population. Despite recent interest in CAM for cardiovascular disease, few data are available regarding patterns of use in patients with cardiovascular disease in the United States. This study used the 2002 National Health Interview Survey and analyzed data on CAM use in 10,572 respondents with cardiovascular disease. Among those with cardiovascular disease, 36% had used CAM (excluding prayer) in the previous 12 months. The most commonly used therapies were herbal products (18%) and mind-body therapies (17%). Among herbs, echinacea, garlic, ginseng, ginkgo biloba, and glucosamine with or without chondroitin were most commonly used. Among mind-body therapies, deep-breathing exercises and meditation were most commonly used. Overall, CAM was used most frequently for musculoskeletal complaints (24% of respondents who used mind-body therapies, 22% who used herbs, 45% who used any CAM). Mind-body therapies were also used for anxiety or depression (23%) and stress or emotional health and wellness (16%). Herbs were commonly used for head and chest colds (22%). Fewer respondents (10%) used CAM specifically for their cardiovascular conditions (5% for hypertension, 2% for coronary disease, 3% for vascular insufficiency, < 1% for heart failure or stroke). Most, however, who used CAM for their cardiovascular condition perceived the therapies to be helpful (80% for herbs, 94% for mind-body therapies). CAM use was more common in younger respondents, women, Asians, and those with more education and greater incomes. In conclusion, CAM use, particularly herbs and mind-body therapies, is common in the United States in patients with cardiovascular disease and mirrors use in the general population. CAM use specifically to treat cardiovascular conditions, however, is less common.

Adult↗

Shamanism and complementary therapy.

Shamanism is an ancient tradition which may offer profound insights into the healing process and to our whole understanding of health. It has an extensive historical and geographical distribution, and may contain elements essential to our understanding of humanity. This paper outlines the origin and nature of shamanic practice, and considers its implications for a number of current healing issues. Several areas of potential relevance to complementary practitioners are explored. These include the shamanic concepts of illness, change and growth; illness and healing as rites of passage; death and dying; and the use of imagery in healing. This paper suggests that complementary practitioners may find some shamanic principles highly congruent with their own practice.

Attitude to Death↗

Shamanism and complementary therapy.

Shamanism is an ancient tradition which may offer profound insights into the healing process and to our whole understanding of health. It has an extensive historical and geographical distribution, and may contain elements essential to our understanding of humanity. This paper outlines the origin and nature of shamanic practice, and considers its implications for a number of current healing issues. Several areas of potential relevance to complementary practitioners are explored. These include the shamanic concepts of illness, change and growth; illness and healing as rites of passage; death and dying; and the use of imagery in healing. This paper suggests that complementary practitioners may find some shamanic principles highly congruent with their own practice.

Attitude to Death↗

Using complementary therapies: reflexology.

Reflexology is a treatment based on massage of the feet to relieve symptoms in other parts of the body. Reflexology is slowly gaining acceptance by some practitioners of conventional medicine. Several training courses and registered bodies for reflexology exist.

Complementary Therapies↗

So you fancy a career in complementary therapies?

This interview highlights key issues nurses should be aware of when deciding whether or not to set up in private practice. Fiona Mantle raises a number of generic issues nurses may need to consider before choosing the pathway to private practice. Whilst the issues she highlights are not exhaustive, her aim is to direct potential practitioners to seek advice and guidance in order to make informed decisions about future careers in clinical practice with complementary and alternative medicines.

Career Choice↗

Use of complementary therapies, adherence, and quality of life in lung transplant recipients.

PURPOSES: The purpose of this study was to describe complementary and alternative medicine (CAM) use by lung transplant patients and to determine whether CAM users differ from nonusers with respect to health status, quality of life, or medical adherence. METHODS: A mailed survey seeking CAM, quality of life, and adherence information was sent to 145 lung transplant recipients, and 99 responded. RESULTS: The majority (88%) used at least 1 form of CAM (median, 2; range, 0-17). Prayer (68%), support groups (43%), and relaxation techniques (31%) were the most common. Only 44% of users reported discussing CAM with their providers. CAM users were adherent to their transplant regimen. Few differences were found between CAM users and nonusers. Education, high symptom burden, female sex, and depression symptoms were associated with various types of CAM use. CONCLUSION: Most lung transplant recipients are using CAM. Providers must explore potential for interaction or enhancement between CAM and standard therapy to optimize care.

Adolescent↗

The use of complementary therapies in inner-city asthmatic children.

Use of complementary/alternative medicine (CAM) has been increasing, especially among patients with a chronic illness. Although asthma is the most common chronic illness affecting children in the United States, very little is known about the use of CAM in children with asthma. Our objective was to determine the prevalence and correlates of CAM use among inner-city children with asthma. A cross-sectional survey of parents of children with asthma attending an urban health center was performed. Parents were surveyed regarding CAM use over the past year, perceived efficacy of CAM, severity of child's asthma symptoms and demographic information. Differences in proportions were tested by chi-square or Fisher's exact test as appropriate. Three hundred ten parents participated, of whom 61% were Hispanic and 37% were African American. Parental mean age was 33 years and the mean age of the child was 7.2 years; 89% of parents had treated their child in the past year with some form of CAM. However, only 18% had informed a physician of doing so. The most common forms of CAM used were as follows: prayers (53%), rubs (53%), and massage (45%). Of those who used CAM, 59% perceived it to be at least as effective as pharmacotherapy, and 44% used CAM as first treatment of an asthma attack. Mild and moderate persistent asthmatics had significantly higher rates of CAM use than did mild intermittent and severe persistent asthmatics. We found a very high rate of CAM use among children with asthma in this inner-city population. Most importantly, a very high proportion of parents perceived the therapies to be effective, used them as first treatment of an acute exacerbation, and did not inform a physician of doing so. These findings have implications for the care of asthmatic children by pediatricians practicing in urban settings.

Adult↗

Complementary therapy. The use of touch in nursing practice.

Touching patients seems a natural and integral part of nursing care, but do nurses really understand the potential benefits and potential harm touch can cause patients? The authors look at the importance of touch in nursing care, and suggest that greater awareness of how touch affects patients would be of benefit to nurses.

Complementary Therapies↗

Traditional and complementary therapies used together in the treatment, relief and control of Chron's disease and polyarthritis.

A diagnosis of polyarthritis and later Chron's disease was initially treated by traditional treatments and medicines, which was later supported by aromatherapy and acupuncture, but the turning point to a full recovery followed from a visit to a naturopath and the commencement of an individual/personal diet regime. Over the months of the acute phase of the illness, a valuable insight was gained to the challenges of a physical disability and the difficulties of immobility, and the loss of independence. Also, the experience of being a patient rather than a nursing practitioner, gave first hand experience of the different situations patients meet on a daily basis throughout the health care services, both traditional and complementary, from a patient's perspective rather than from a nursing point of view. The following paper will hopefully help others to consider a fresh individual situations, reflect on the collaboration of traditional and complementary treatments, and treatment of underlying cause as well as symptoms.

Arthritis↗