Integrative Therapies Flashcards
1
Q
Define: Conventional therapies
A
Mainstream community medical practice
2
Q
Define: Complementary therapies
A
Not meant to replace conventional therapy, but use in addition to in order to achieve wellness
3
Q
Define: Alternative therapies
A
A more “natural” approach; outside accepted medical theory
4
Q
Define: Integrative therapies
A
Best of conventional and complementary therapies
5
Q
Define: Holistic nursing
A
Treating the entire individual because they are interconnected (mind, body, etc.)
6
Q
What is the main difference between medicine and holistic paradigms?
A
- Illness vs. wellness
- Illness model tells patients what to do, whereas wellness model empowers people to take responsibility for this health
7
Q
What is holistic health?
A
- A context or philosophy of care that embraces the whole person
- Not a particular set of specific therapies
- State of well-being characterized by optimal integration of body, mind and spirit
- An imbalance in one does affect the other two
8
Q
What are the principles of holistic health?
A
- Human beings are living energy systems rather than an arrangement of parts
- Every illness of body reflects a corresponding disturbance in mind and spirit
- Recognize one’s physical, mental and spiritual potential
- Healing is a natural process
- Natural, low-risk methods quicken individual’s health resources and take precedence over other invasive therapies when possible (e.g. drugs, surgery)
- Personal responsibility is fundamental
- A holistic practitioner engages in ongoing learning process and “walks the walk”
9
Q
What is the role of the Canadian Holistic Nurses Association?
A
- Develops standards for practice for holistic nursing, education and research
- Just in addition to code of ethics and CRNBC, does NOT replace!
10
Q
Describe Canadian’s and their use of
A
- 74% have used at least one form of CAM’s (complementary and alt medicine) in their lifetime
- Will be spend approx. 7.8 annually on CAM products and practitioners
- 31.4%-91% of all Ca patient’s use CAM therapies for some periods, often in conjunction with standard medical treatment
- Growing #’s of people with chronic/incurable conditions
- Concern for healthcare costs
- Increasing cultural diversity; exposure to different models of health beliefs and healing
11
Q
Why do people use CAM’s?
A
- Holistic philosophy
- Empowerment - being able to feel in control of well-being
- Improve quality of life
12
Q
What are the common goals of CAM use?
A
- Manage/minimize side effects of conventional tx and/or symptoms
- Promote feelings of well-being
- Enhance immune system, relaxation response decreases stress
- Enhance efficacy of conventional tx
- Promote sense of self control
- Augment hope
13
Q
What are major categories of CAM’s?
A
- Whole medical systems
- Mind-body interventions
- Nutrition as medicine
- Biologically based therapies (natural health products)
- Manipulative and body-based therapies
- Energy therapies
14
Q
What are Whole Medical Systems?
A
- Complete systems of diagnosis and practice; many practices that focus on a philosophy (e.g. presence of “energy” in the body”)
- Traditional Aboriginal medicine
- Naturopathic medicine (focus on non-invasive treatments and facilitating the body to heal)
- Traditional Chinese medicine
- Latin American practices
- Ayurveda (life force, emotional/physical/spiritual, focus on balance)
15
Q
What are mind-body interventions?
A
- Aromatherapy
- Art Therapy
- Biofeedback
- Breathwork
- Dance Therapy
- Imagery
- Meditation
- Hypnotherapy
- Yoga
- Music
- Prayer
- Psychotherapy
- Storytelling
- Journaling
- Humor
- Animal-Assisted Therapy
16
Q
What is aromatherapy?
A
- Use of essential oils for therapeutic purposes that encompass mind, body and spirit
- Obtained from a variety of plants t/o the world
- Oils may be found in flowers, bark, leaves, wood, roots, seeds or peels
- Inhaled/topically applied/ingested
- Psychological and physical effects
17
Q
What is biofeedback?
A
- Uses instruments and teaches self-regulation strategies to help people increase voluntary control over internal physiological and mental processes.
- Measures muscle tension, skin temp, cardiac activity, and brainwaves and then provides immediate feedback in the form of visual and/or auditory signals=increased awareness of internal processes
- Uses: pain, DM, headaches, cessation of urinary incontinence, GI disorders
18
Q
What is imagery?
A
- Guided, clinical hypnosis, or self hypnosis
- Formation of a mental representation of an object, place, event, or situation that is perceived through the senses
- Imagery, by inducing deep relaxation and reprocessing of stressful triggers, interrupts or alters the stress response and support the immune system
- Uses: asthma, HTN, arthritis, IBS, MS, PMS, anxiety, decrease stress, pain, Ca tx
19
Q
What is meditation?
A
- Self directed practice for relaxing the body and calming the mind; another form of relaxation therapy
- Types: Mindfulness meditation, Transcendental meditation, Centering prayer, Relaxation Response, Walking the labyrinth, Breath awareness
- Uses: stress reduction, anxiety, insomnia, depression, chronic fatigue, chronic pain, substance use, HTN, irritability, HIV, cancer, asthma, PTSD
- Side effects: hallucinations, cardiovascular complications (e.g. they lower their BP but we still give them a HTN agent and put them into hypotension)
20
Q
What are some biologically based CAM’s?
A
- Herbal Remedies
- Homeopathic medicines
- Vitamins and Minerals (megavitamin therapy)
- Traditional medicines (Ayurvedic remedies) (traditional Chinese herbal remedies)
- Probiotics
- Amino acids, essential fatty acids, and antioxidant supplements
21
Q
Describe nutrition as medicine:
A
- Gerson therapy: used primarily in Ca patients, includes nutritional supplements, low salt, high potassium, lots of veggies, fruit juices, etc.
- Macrobiotic diet: fish, fruit, seeds, nuts, etc.
- Mediterranean diet: full grains, nuts, veggies
22
Q
What are manipulative and body based therapies?
A
- Acupressure
- Chiropractic
- Feldenkrais method
- Tai chi
- Massage Therapy
- Simple Touch
23
Q
What is acupressure and acupuncture?
A
- Acupressure: Uses the fingers to press certain points on the body to stimulate the body’s self-curative abilities
- Acupuncture: 1-20 hair-thin needles inserted into your skin for 10-30 min. May apply electrical stimulation or heat to needles
- TCM: restore balance in the body ‘yin’ and ‘yang’
- Uses: COPD, dysmenorrhea, low-back pain, agitation/stress/anxiety, pain
24
Q
What is Feldenkrais?
A
- Based on establishing good self-image through awareness and correction of body movements
- Integrates the impact of physics on body movement patterns with how people move, behave and interact
- Movement explorations which bring you back to your center, improve freedom of movement, etc.
25
What is Tai Chi?
- Traditional Chinese martial art and mind-body exercise
- Chen , Yang, Wu, Sun styles
- Promotes free flow of energy throughout the body which improves health of an individual
- Good for strengthening muscle, improving flexibility and decreasing stress
26
What is massage therapy?
- Application of manual techniques and adjunctive therapies with the intention of positively affecting health and well-being
- Produce friction and pressure on cutaneous and subcutaneous tissues
- Various different types (e.g. deep tissue)
- Promotes relaxation, reduce pain, promote sleep, lessen anxiety and improve mobility
27
What are examples of energy and bio-field therapies?
- Qigong
- Reiki
- Healing Touch/Therapeutic Touch
- Acupressure/Acupuncture (see body based)
- Reflexology
- Light Therapy
- Magnet Therapy (all living things live in a magnetic field [the earth] and we have our own magnetic field)
28
What is Qigong?
- Practice of breathing, movement, and meditation and involves the assuming of basic postures
- Promotes strength, balance and optimal functioning
- Cross-over with Tai Chi
29
What is Reiki therapy?
- Intended to affect the energy fields that purportedly surround and penetrate the body
- Practitioner places a hand on or above the body and transfers “universal life energy” to the patient, the energy from this therapy provides strength, harmony and balance
- E.g. modern family, the homeless man living in their backyard was a "Reiki" therapist
30
What is healing touch?
- Uses gentle touch to influence and support the human energy system within the body (energy centers) and surrounding the body (energy fields)
- Differences exist in how touch is used throughout the world based on philosophical and cultural differences
- Focuses on creating an energetic balance of the whole body at the physical, emotional, mental and spiritual levels
- Hands influence the flow of energy to promote balance and healing
- Uses: pain, anxiety, stress, relaxation, depression
31
What is reflexology?
- Specific pressure technique that works on precise reflex points of the feet that correspond to other body parts
- Have to be cautious in patients with impaired CV function or other feet problems (e.g. DM)
32
Which CAM is within a nurses scope for our patient's?
- Relaxation Therapy
- Meditation/Breathing
- Imagery
- Simple Touch
33
What are the benefits of relaxation therapy?
- Decreased muscle tension/tension headaches
- Improved well-being
- Reduce symptoms of distress and pain
- Decrease anxiety related to diagnoses (e.g. HIV, PTSD)
- Allow individuals control over health and lives
- Can be used alone or in combination with deep-breathing, imagery, yoga, music and/or art therapy
34
What are limitations to relaxation therapy?
- Fear loss of control
- Anxiety
- Physiological and psychological status
35
What are the benefits of meditation/breathing?
- Improved breathing patterns
- Manages stress/decrease anxiety
- Manage symptoms of depression
- Lowers BP
- Manage chronic pain
- Increase productivity
- Improves mood
- Decreases irritability
- Limited by feared loss of control and can augment certain drugs
36
What areas require training/certification?
- Biofeedback
- Chiropractic
- TCM
- Acupuncture
- Therapeutic Touch
37
Describe drug-herb interactions:
- 25000 plant species used medicinally throughout the world!
- Oldest form of medicine
- 1/3 of modern drugs were developed from plants
- Herbs are potent products which when taken concurrently with drugs can cause potential interaction(s)
- Interaction knowledge limited
38
What do we need to know when assessing drug-herb interactions?
- Pharmacokinetics (metabolism, excretion, etc.)
- Absorption; some herbs bind to other drugs and inhibit absorption or reduce action of drugs with narrow therapeutic index (e.g. digoxin, warfarin)
39
What are some safe, common NPH's?
- Echinacea (not for longer than 8 weeks; anti-inflammatory effects, but contradicted for Ca, lupus, asthma, etc.)
- Evening Primrose Oil (anti-inflammatory, contraindicated for seizure disorders and GI troubles)
- Fish Oil (can increase INR)
- Garlic (stimulate immune system, but inhibits platelet aggregation)
- Ginger (n/v, anti-inflammatory, may enhance effect of NSAID's)
- Ginkgo biloba
- Glucosamine (can help with joint pain, arthritis)
- Milk Thistle (anti-inflammatory, chronic hepatitis and cirrhosis or GI upset)
- Saw palmetto (anti-inflammatory, BPH/urinary problems, increase risk of bleeding)
- St. John’s wort* (can help with depression/menopause, inhibit uptake of serotonin; careful with anti-depressants and lots of other meds)
- Valerian (taken for restlessness, movement disorders, etc., not to be used with other sedatives)
- Chamomile (anti-inflammatory, anti-estrogenic, difficulty sleeping; can impact CNS depressants)
- Black cohosh (not recommended for breast Ca history)
40
What are unsafe NHP's?
- Comfrey (impairs wound healing, can lead to Cancer)
- Ephedra (banned in US d/t causing liver failure)
- Kava
- Lobelia (overstimulate CNS, especially CV system)
41
Before choosing CAM's, what do we need to know?
- Balance hopes and beliefs with resources
- Look for accurate information about therapy
- Ask about adverse effects with conventional tx
- What are goals for the therapy?
- Time commitment? Cost?
- Talk with family physician and family
42
What is the nursing role in CAM's?
- Know scope of practice
- Possess appropriate knowledge and skill
- Understand and practice within provincial and territorial legislation
- Keep abreast in current research on CAM's
- Advise of appropriate times to initiate traditional vs/ CAM
- Be aware of cultural and spiritual beliefs
- Perform comprehensive med rec with each admission, transfer and discharge
- Document accordingly
