Integrative Therapies Part I Flashcards

1
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 wellbeing characterized by optimal integration of body, mind and spirit
An imbalance in one does affect the other two

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2
Q

What are “conventional therapies”?

A

Conventional therapies – the use of mainstream medical/community therapies.

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3
Q

What are “complementary therapies”?

A

Complementary therapies – using things in addition to the traditional/conventional therapies.

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4
Q

What are “alternative therapies”?

A

Alternative therapies – “doing your own thing”. Using it instead of conventional therapies. (These aren’t always scientifically/medically accepted)

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5
Q

What are “integrative therapies/integrated medicine”?

A

Integrative therapies (“medicine”) – A blend of the conventional and complementary therapies.

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6
Q

What is “holistic nursing” in a nutshell?

A

Holistic Nursing – All-encompassing care, looking at the big picture.

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7
Q

What are the principles of holistic health? (7)

A

Human beings are living energy systems rather than an arrangement of parts.
Every illness of body reflects a corresponding disturbance in the mind and spirit.
Recognize one’s physical, mental and spiritual potential.
Healing is a natural process.
Natural, low-risk methods quicken the individual’s healing resources and take precedence over drugs, surgery, other invasive therapies whenever possible.
Personal responsibility is fundamental.
Holistic practitioner: engaged in ongoing learning processes; networking with others and “walks the talk”

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8
Q

What organization develops standards for practice for holistic nursing, education and research?

A

Canadian Holistic Nurses Association

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9
Q

How many canadians have used at least one form of complimentary alternative medicine in their lifetime?

A

74% (Potter and Perry, 5th ed, 2014)

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10
Q

How much do Canadians spend on complimentary alternative medicine on an annual basis?

A

$7.8 million (Truant, Balneaves & Fitch, 2015)

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11
Q

How many cancer patients use complimentary alternative medicine theories?

A

31.4% to 91% of all cancer patients use complimentary alternative medicine therapies for some periods, often in conjunction with standard medical treatment (Gross, Cromwell, Matulonis & Hayman 2013)

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12
Q

What are three reasons people choose to use complimentary alternative medicine?

A

Holistic philosophy
Empowerment
Quality of life

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13
Q

What are some common goals of complimentary alternative medicine use?

A

Manage/minimize side effects of conventional Tx
Manage/minimize symptoms
Promote feelings of well-being ->QOL
Enhance immune system -> relaxation response
Enhance efficacy of conventional Tx
Promote sense of self control
Augment hope
Growing numbers of people with chronic and incurable conditions
Boost immune system
Concern for health care costs
Increasing cultural diversity

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14
Q

What are the major domains/categories of conventional alternative medicine?

A

Whole Medical Systems

Mind-body Interventions

Nutrition as Medicine

Biologically Based Therapies (Natural Health Products)

Manipulative and Body-Based Therapies

Energy Therapies

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15
Q

What are some whole medical systems?

A

Ayurveda

Latin American Practices

Traditional Aboriginal Medicine

Naturopathic Medicine

Traditional Chinese Medicine

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16
Q

What are some examples of mind-body interventions?

A
Aromatherapy
Art Therapy
Biofeedback
Breathwork
Dance Therapy
Imagery
Meditation
Hypnotherapy
Yoga
Music
Prayer 
Psychotherapy
Storytelling
Journaling
Humor
Animal-Assisted Therapy
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17
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

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18
Q

What are some uses for aromatherapy??

A

Uses: pain, nausea, sleeplessness, agitation, smoking cessation, treatment of infections, prevention of infectious diseases (MRSA)

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19
Q

What are some examples of oils used for aromatherapy?

A

Common oils: basil, chamomile, ginger, lavender, lemon, sage, rosemary, tea tree, peppermint, eucalyptus

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20
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

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21
Q

What are some uses for biofeedback?

A

Pain, DM, headaches, cessation of urinary incontinence, GI disorders

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22
Q

What is imagery therapy?

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 Fitzgerald & Langevin (2010). Complementary and Alternative Therapies in Nursing.

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23
Q

What are some uses for imagery therapies?

A

Uses: asthma, hypertension, arthritis, IBS, MS, PMS, anxiety, decrease stress, pain cancer

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24
Q

What is meditation?

A

Self directed practice for relaxing the body and calming the mind

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25
Q

What are some types of meditation?

A

Mindfulness meditation, Transcendental meditation, Centering prayer, Relaxation Response, Walking the labyrinth, Breath awareness

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26
Q

What are some uses for meditation? (Which problems does it help)

A

stress reduction, anxiety, insomnia, depression, chronic fatigue, chronic pain, substance use, hypertension, irritability HIV, cancer, asthma, PTSD

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27
Q

What are some side effects of meditation?

A

Side effects: hallucinations, cardiovascular compromise

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28
Q

What are some biologically based complimentary alternative medicine

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

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29
Q

What are three diets that can be used as “nutrition as medicine”?

A

Gerson Therapy

Macrobiotic Diet

Mediterranean Diet

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30
Q

What are some manipulative and body based complimentary alternative medicine therapies?

A

Acupressure

Chiropractic

Feldenkrais method

Tai chi

Massage Therapy

Simple Touch

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31
Q

What is acupressure?

A

Uses the fingers to press certain points on the body to stimulate the body’s self-curative abilities

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32
Q

What is acupuncture?

A

1-20 hair-thin needles inserted into your skin for 10-30 min. May apply electrical stimulation or heat to needles

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33
Q

What is the goal of traditional Chinese medicine of acupressure and acupuncture?

A

To restore balance in the body - “yin” and “yang”

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34
Q

What are some uses for acupressure and acupuncture?

A

COPD, dysmenorrhea, low back pain, agitation, pain, stress, ansiety

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35
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

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36
Q

What is tai chi?

A

Traditional Chinese martial art and mind-body exercise

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37
Q

What are the styles of tai chi?

A

Chen , Yang, Wu, Sun styles

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38
Q

What are the benefits of tai chi?

A

Promotes free flow of energy throughout the body which improves health of an individual
Strengthens muscles
Improves flexibility
Decreases stress

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39
Q

What is massage therapy?

A

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

40
Q

What are some benefits of massage therapy?

A

Promotes relaxation, reduces pain, promote sleep, lessen anxiety, improve mobility

41
Q

What are some energy and biofield therapies?

A
Qigong
Reiki 
Healing Touch/Therapeutic Touch
Acupressure/Acupuncture (see body based) 
Reflexology
Light Therapy
Magnet Therapy
42
Q

What is qigong?

A

Practice of breathing, movement, and meditation and involves the assuming of basic postures
Promotes strength, balance, and optimal functioning

43
Q

What is reiki therapy?

A

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

44
Q

What are some uses of reiki therapy?

A

Uses: pain, relaxation, depression, palliative care, cancer, HIV, pre and post op, stroke rehabilitation, PTSD, enhancing immune function

45
Q

What is healing touch therapy?

A

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

46
Q

What are some uses for healing touch therapy?

A

Pain, anxiety, stress, relaxation, depression, cancer, side effects, post procedural recovery

47
Q

What is reflexology?

A

Specific pressure technique that works on precise reflex points of the feet that correspond to other body parts

48
Q

What complimentary alternative medicine therapies are within our scope?

A

Relaxation therapy
Meditation/breathing
Imagery
Simple touch

49
Q

What are some benefits of relaxation therapy?

A

Decreased muscle tension, improved well-being, reduce symptoms of distress, pain, alleviate tension headaches, decrease anxiety related to diagnoses i.e. HIV PTSD improves cognition
Allows individuals control over health/lives

50
Q

What are some therapies that can be used in combination with relaxation therapy?

A

Can be used alone or in combination with deep breathing, imagery, yoga, music and/or art therapy

51
Q

What are some limitations of relaxation therapy?

A

Fear loss of control, anxiety physiological and psychological status

52
Q

What are some benefits of meditation/breathing therapy?

A

Improved breathing patterns, manages stress, decrease anxiety, manage symptoms of depression. Lowers BP, manage chronic pain, increases productivity, improves mood, decreases irritability

53
Q

What are some limitations of meditation/breathing therapy?

A

Fear loss of control, augments certain drugs

54
Q

What are some complimentary alternative medical therapies that require training or certification? (Not in our scope)

A

Biofeedback

Chiropractic

TCM

Acupuncture

Therapeutic Touch

55
Q

How many plants are used medically throughout the world?

A

25000

56
Q

How many modern drugs are developed from plants?

A

1/3 of modern drugs were developed from plants.

57
Q

What are herbs?

A

potent products i.e. chamomile, fish oil

58
Q

What piece of legislature regulates herbal/natural products?

A

Canadian Food and Drug Act (2004) regulates all OTC Natural Health products -> DIN, DN-HM, NPN

59
Q

What are some things nurses should be aware off regarding herbal/natural products regarding absorption of other medications?

A

Herbs e.g. gums/mucilage (psyllium, rhubarb, flaxseed) bind to other drugs, inhibit absorption or reduce actions of drugs with narrow therapeutic index* i.e. digoxin, warfarin
Need to discourage using herbal products if taking drugs that interact or, give Rx drug 1hour before or 2 hours after these herbals.

60
Q

What are some safe common NPH’s

A

Echinacea

Evening Primrose Oil

Fish Oil

Garlic

Ginger

Ginkgo biloba

Glucosamine

Milk Thistle

Saw palmetto

St. John’s wort*

Valerian

Chamomile

Black cohosh

61
Q

What is echinacea used for?

A

for respiratory infections, colds, boosts immune system

62
Q

What are some contraindications of echinacea?

A

contra-indicated for cancer patients, auto-immune disorders like lupus, contra-indicated in diabetes

63
Q

What is evening primrose oil used for?

A

anti-inflammatory effects, rheumatoid arthritis, hot flashes

64
Q

What are some contraindications for evening primrose oil?

A

contra-indicated in patients with seizure disorders, can cause loose stools and abdominal pain if taking too much

65
Q

What are fish oils used for?

A

for heart, preventing development of CAD, anti-inflammatory properties, rheumatoid arthritis, preventative for cancer

66
Q

What are some contraindications/interactions for fish oil?

A

Possible increase in INR with coumadin

67
Q

What is garlic used for?

A

stimulates the immune system, used for hypertension, athletes foot, flu prevention

68
Q

What are contra-indications of garlic?

A

can have anti-coagulant properties (don’t take with anticoagulant meds, NSAIDS)

69
Q

What is ginkgo biloba used for?

A

dementia, poor memory

70
Q

What are contra-indications of ginkgo biloba

A

Contra-indicated with anticoagulants, in high doses can induce seizures

71
Q

What is glucosamine used for?

A

Joint disorders

72
Q

What are contraindications/interactions of glucosamine?

A

Has anticoagulant properties, shouldn’t take with anticoagulants

73
Q

What is milk thistle used for?

A

decreases toxicity to the liver, decreases inflammation

Used in chronic hepatitis, cirrhosis, GI upset

74
Q

What are contraindications of milk thistle?

A

Can interacts with anticoagulants

75
Q

What is saw palmetto used for?

A

Used for BPH, urinary issues

76
Q

What are interactions of saw palmetto?

A

Can interact with anticoagulants

77
Q

What is St. John’s wort used for?

A

Depression

78
Q

What are the interactions of St. John’s wort?

A

Many interactions, including SSRIs and other antidepressants

79
Q

What is valerian used for?

A

used as a hypnotic/sedative for sleep disorders

Used for muscle spasms

80
Q

What are interactions with valerian?

A

Use caution when using other sedatives with valerian

81
Q

What is chamomile used for?

A

used for sleep, has anti-inflammatory effects, used for menstrual disorders

82
Q

What are some interactions of chamomile?

A

Can interact with anticoagulants and CNS depressants

83
Q

What is black cohosh used for?

A

Estrogen-like effect, used for PMS

84
Q

What is a contraindication of black cohosh?

A

Contraindicated in breast cancer

85
Q

What are four unsafe NHP’s?

A

Comfrey

Ephedra

Kava

Lobelia

86
Q

What is comfrey used for?

A

Wound healing

87
Q

What is the “unsafe” thing about comfrey?

A

Can cause cancer

88
Q

What is ephedra used for?

A

Weight loss

89
Q

What is the unsafe thing about ephedra?

A

Can cause cardiovascular issues

Interacts with synthroid

90
Q

What is kava used for?

A

Used for anxiety, stress, sleep

91
Q

What is the unsafe thing about kava?

A

Banned because of hepatotoxicity and liver failure

92
Q

What is lobelia used for?

A

Used for asthma

93
Q

What is the unsafe thing about lobelia?

A

Can cause death

Overstimulation of the CNS (tachycardia, hypertensive, etc)

94
Q

What are some considerations that should be made before choosing complimentary alternative medical therapies?

A

“You’ve got to balance your hopes and your beliefs with your resources.” Lynda Balneaves (complementary therapy expert and researcher)

Look for info about the therapy
Ask about side effects with conventional treatment
What are your goals for the therapy?
Time commitment? Cost?
Talk to your doctor
Talk to your family
95
Q

What are some nursing roles in complimentary alternative medical therapies?

A

Know scope of practice
Possess appropriate knowledge and skill
Understand and practice within provincial and territorial legislation
Keep abreast in current research on CAMs
Advise patients of appropriate tunes to initiate allopathic/traditional therapy vs. CAM
Be aware of patient’s cultural and spiritual beliefs
Perform comprehensive medication reconciliation with admission, transfer, and discharge
Document accordingly

96
Q

What are some questions to ask when choosing a complementary practitioner?

A

What are specific goals of therapy? i.e. cure, symptom palliation
Is there scientific research evidence that therapy is effective in achieving stated goals?
Expected benefits?
Risks?
Side effects of therapy?
Does therapy interfere or augment effects of other therapy?
Costs? Covered by client’s insurance?
Practitioner qualifications i.e. certified/practice license/member of professional organization? Carry malpractice insurance?
Client receiving therapy as part of clinical trial?