1-What is Complementary and Alternative Health? Flashcards
Within all health models, medicine can be classified as ?
- safe and effective
- not safe, nor effective
CAM
complementary and alternative medicine
How do most CAM therapies envision the body?
- The body is an entity with its own self-healing energy reservoir
- Emphasize “wellness” and engage the individual as an active participant in his or her own health
- Individual will achieve optimal health not because of a CAM therapy, but with the aid of the therapy (and by extension the practitioner)
What are the forms of patient participation in their treatment?
- Mind-body-spirit practice (meditation)
- Use of atural products (herbology)
- Use of manipulative or body-based practices (osteopathy, chiropractic)
- Use of movement therapies (Feldenkrais)
- Use of energy manipulation (reiki)
According to the World Health Organization (WHO, 2013), ____% of the population depend on traditional medicine for primary health care in some Asian and African countries.
80%
*“traditional” medicine in Asian and African countries would be considered CAM in North America
According to the World Health Organization (WHO, 2013), up to ___% of the population has used some form of alternative or complementary medicine
80%
T&CM
Traditional Medicine’ and ‘Complimentary Medicine -WHO
Merges the terms TM and CM, encompassing products, practices and practitioners.
What is the importance of the WHO strategy document?
This document is a huge undertaking which will shape the accessibility of T&CM worldwide over the next 10 years
TM
Traditional medicine -WHO
The sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness
CM
Complementary medicine -WHO
Or “alternative medicine”
Refer to a broad set of health care practices that are not part of that country’s own tradition or conventional medicine and are not fully integrated into the dominant health-care system. They are used interchangeably with traditional medicine in some countries
In North America CAM is divided into what 2 categorizations of practice?
- Centuries-old practices; well-developed clinical knowledge; embedded within the cultural society; large numbers of practitioners (ex: traditional medicine in China)
- Therapies only recently developed by a small number of practitioners and have not been validated by scientific testing (ex: mind-body medicine, natural product nutrition)
Allopathic medicine
- Considered the “scientific” healing art of disease care and prevention
- Used to describe modern conventional medical methods derived from “Western” thinking
- Also referred to as conventional medicine and is the dominant form of medicine used in North America
- ex: a surgeon working in cardiology
Alternative/complementary medicine
- Refers to practices used for the purpose of medical intervention, health promotion, or disease prevention not routinely taught at Western medical schools
- Used in conjunction with or as an adjunct to, but not a replacement for, conventional allopathic forms of medicine
- May or may not be considered ‘unscientific’ in nature
- Indicates a compatibility between the utilization of such practices and allopathic medicine
- ex: naturopathy
Biomedical model/Biomedicine
- Same as allopathy, however, the focus is on reductive biology and science including the study of tissue cells, components, and chemicals to understand life processes and to combat disease
- Conceptionally, this model used Newtonian physics (ex: nuclear medicine) and pre-evolutionary biology (ex: oncology)
Integrated medicine
- Implies an active, conscious effort by the health professions to seek evidence for using various CAM modalities in order to appropriately incorporate them into the continuum of the current health care system
- This meaning has been rarely achieved
Unconventional medicine
Any health care practice that is not considered conventional nor allopathic, (ex: reiki)
What are the 5 important characteristics common to both types of CAM?
- A wellness orientation
- A reliance on self-healing
- An inference that bioenergetic mechanisms play a role in healing
- The use of nutrition and natural products
- An emphasis on individuality including humility
Describe the wellness orientation characteristic common to both types of CAM
- Goal of preventing disease
- More than the prevention of disease
- Focus on engaging inner resources of individual as an active and conscious participant in the maintenance of their own health
- Healthy = balance of internal resources with external natural and social environment
- For the “mainstream”, it is the use of drugs and surgery to prevent disease in those at risk (not for treating disease) - medicalization of prevention
Describe the reliance on self-healing characteristic common to both types of CAM
- Body heals itself
- External manipulations mobilize the body’s inner healing resources
Describe the bioenergetic mechanisms characteristic common to both types of CAM
- Body has energy
- Body is an energetic system
- Disruptions in balance and flow of energy cause illness
- Body can make itself sick (ex: fever)
Describe the use of nutrition and natural products characteristic common to both types of CAM
- Fundamental
- nutrients and plant products are taken into the body and incorporated
- Provide energy in calories witht eh material resources to stay healthy and get well
- Basic plan of the body evolves and exists in an ecological context, what the body needs it obtains from the environment in which it grew
- Best to obtain nutrients from their natural forms
Describe the individuality and humility characteristic common to both types of CAM
- The whole person as a unique individual with own inner resources
- Normalization, standardization, generalization difficult to apply to research and clinical practice
- may be better than standardization (nothing lost in translation)
- focus on the healed (not the healer)
- humbling to the role of practitioner as heroic healer
- healer is not sole source of healing
Why is CAM generally considered holistic and vitalist in nature?
CAM is also based on the concept that “the body heals itself, has its own [vital] energy, and is uniquely individual
Holism
- Refers to the totality of a living system
- This system cannot be reduced, observed, or measured at a level below that of the whole organism
Vitalism
- Refers to the nonmaterial “energy” of a living organism
- Across cultures, numerous names given to define these energies
- Traditional Chinese medicine (TCM) uses the term Qi (“chi”)
In comparison to alternative helath, allopathic medicine is considered ________ and _______.
materialist and reductionist
Materialism defined by Merriam-Webster
a theory that physical matter is the only or fundamental reality and that all being and processes and phenomena can be explained as manifestations or results of matter
Reductionism
refers to complex phenomena which can be explained more easily when broken down into simpler component phenomena
Describe the four bodies model
The four intersecting circles depict a simplified version of an individual
How does the Western allopathic/biomedicine system approache treatment?
through the physical body
How does CAM approache treatment?
from the energy flow within the individual
How is the futur or health care changing?
- Postulates that “postmodern medicine might permit translation of the biomedical model back to the realm of the whole, vital organism”
- If so, there is potential to create a strong web of integrative medicine encompassing the best of both biomedicine and CAM therapies
According to Health Canada, ___% of Canadians aged 12 or older— ______people —reported using some type of CAM care in the 12 months before the survey interview.
20%
5.4 million people
The Fraser Institute reports that ____% of the Canadian population has used a CAM therapy at least once in their lifetime.
74%
A more recent survey done by Ipsos Reid shows “____% of Canadians regularly take natural health products (NHPs) like vitamins and minerals, herbal products, and homeopathic medicines.
73%
Under the Natural Health Products Regulations, which came into effect on January 1, 2004, natural health products (NHPs) are defined as?
- Vitamins and minerals
- Herbal remedies
- Homeopathic medicines
- Traditional medicines such as traditional Chinese medicines
- Probiotics
- Other products like amino acids and essential fatty acids
What is Health Canada’s role reguarding Natural Health Products?
- Assures all Canadians have ready access to a wide range of natural health products that are safe, effective and high quality
- Assess all natural health products before letting them be sold in Canada
- Check that NHPs are properly manufactured (without contamination or incorrect ingredients)
- Conduct post-market monitoring to make sure that NHP Regulations are being followed
NCCAM
National Center for Complementary and Alternative Medicine, a division of the National Institutes of Health (United States)
Complementary
(according to NCCAM)
A non-mainstream practice that is used together with conventional medicine
Alternative
(according to NCCAM)
A non-mainstream practice that is used in place of conventional medicine
True alternative medicine is uncommon
Integrative Medicine
(according to NCCAM)
- bringing conventional and complementary approaches together in a coordinated way
- Integrative Approaches for Pain Management for Military Personnel and Veterans
- Integrative Approaches for Symptom Management in Cancer Patients and Survivors
- Integrative Approaches and Health-Related Behaviors
What specific term does the NCCIH (NCCAM) use?
- Complementary health approaches for practices and products of non-mainstream origin
- Integrative health for incorporating complementary approaches into mainstream health care
What are the types of Complementary Health Approaches?
(according to NCCAM)
- Natural products
- Mind body practices
- Other (traditional healers, Ayurvedic medicine, traditional Chinese medicine, homeopathy, and naturopathy)
Natural products
(according to NCCAM)
herbs (also known as botanicals), vitamins and minerals, and probiotics
Mind and Body practices
(according to NCCAM)
Include a large and diverse group of procedures or techniques administered or taught by a trained practitioner or teacher
List examples of Mind and Body practices
(according to NCCAM)
- yoga
- chiropractic
- osteopathic manipulation
- meditation
- massage therapy
- acupuncture
- relaxation techniques (breathing exercises, guided imagery, and progressive muscle relaxation)
- tai chi
- healing touch
- hypnotherapy
- movement therapies (Pilates, Rolfing Structural Integration, and Trager psychophysical integration)
What are the 10 most common complementary health approaches amon adults in 2012
(according to NCCAM)
- Natural products: 17.7 %
- Deep breathing: 10.9 %
- Yoga, tai chi, or qi gong: 10.1 %
- Chiropractic or osteopathic manipulation: 8.4 %
- Meditation: 8.0 %
- Massage: 6.9 %
- Special diets: 3.0 %
- Homeopathy: 2.2 %
- Progressive relaxation: 2.1 %
- Guided imagery: 1.7 %
What is the difference between chiropractic in Canada vs in the US?
Canadian chiropractic:
- an alternative to allopathic medical treatment but yet still has been widely accepted as mainstream by our medical community
- more conventional in nature
US:
- practitioners have “scaled many walls of the health care establishment…while at the same time maintaining strong roots in the CAM communitylisted among some of the most commonly used CAM therapie
What is the difference between kinesiology in Canada and in the US?
Canada:
- profession represented by the Canadian Kinesiology Alliance
- associated with the assessment of movement, performance, and function; and the rehabilitation, prevention, and management of disorders to maintain, rehabilitate, and enhance movement, performance, and function in the areas of sport, recreation, work, exercise, and general ADLs
- recently regulated as health care providers only by Ontario
US:
- American Kinesiology Association and American Kinesiotherapy Association are similar in scope of practice
- kinesiology is not utilized as a professional designation
- no overarching national organization
- public confusion between “kinesiology” and kinesiotherapy
- Some suggestion that applied kinesiology is an extension of chiropractic treatments
What is the College of Kinesiologists of Ontario?
- Regulatory body that governs the profession of kinesiology in Ontario
- Receives its authority from the Kinesiology Act, 2007 and the Regulated Health Professions Act, 1991
- Is mandated by the Ontario government to protect the public
What is applied kinesiology?
- A true CAM therapy
- Determine health imbalances in the body’s organs and glands by identifying weakness in specific muscles
- Diagnoses and treatments are believed to be performed by stimulating or relaxing these specific muscles
Cultural relativity
- Technique that health care providers should adopt
- While you may know the values of another person, you neither adopt nor reject them
- Acknowledge that your own beliefs are not exclusively correct
- Allows you to be open minded and allow beliefs and ideas to be open to interpretation
As many CAM therapies use nutrient or herbal remedies and supplements (e.g., Ayurveda, naturopathy), it is imperative that these substances be?
- of the highest quality
- practitioners have accurate information regarding them,
- they are prescribed appropriately
How are herbal and nutritional medicine regulated in the US?
Based on similar criteria that are made to apply to pharmaceuticals, except:
- Herbal supplements are regulated under the Dietary Supplement Health and Education Act (DSHEA) of the US Food and Drug Administration (FDA) -DSHEA requires particular labeling and packaging guidelines to be followed however marketing is allowed prior to approval
How are natural health products regulated in Canada?
- Health Canada states that they must have a product licence in order to be legally sold in Canada
- Health Canada collects detailed information about the product
- Health Canada also issues an eight-digit Natural Product Number (NPN) or Homeopathic Medicine Number (DIN-HM)
- There are exceptions (cause confusion)
What detailed information does Health Canada collect about natural products?
- medicinal ingredients
- source
- dose
- potency
- non-medicinal ingredients
- recommended uses
What does having to have a product license do?
Ensures that standards for labelling, packaging, and manufacturing practices are met
Ensures that evidence of product safety and efficacy is provided
What does the Natural Product Number (NPN) or Homeopathic Medicine Number (DIN-HM) do?
- Must appear on the label
- Shows that it has been reviewed and approved by Health Canada
What are the exceptions to natural procust regulations?
- Requirements do not apply to health care practitioners who themselves create or compound products for individual patients, or to retailers of natural health products
- Exemption number (EN-XXXXXX) means Health Canada not yet evaluated
What are the 6 general guidelines for the use of herbal medicines?
- Careful patient history of herb and supplement use
- Accurate medical diagnosis
- Natural not equal safe. Watch quality, dosage, adverse effects, interactions
- Avoid during pregnancy and lactation
- Care with children (dosage based on weight)
- Record adverse effects, dosage, discontinue
Invasive modalities
Enter the physical body by cutting (e.g., surgery), insertion (e.g., injection), or ingestion (e.g., eating)
Less invasive modalities
Involve only touching the surface of the body or not touching the skin at all
Use some key words to show how our Western culture has viewed CAM in the past and the opposing outlook for the present and future
