CH. 29 Complementary and Integrative Health

Complementary Health Approaches (CHA):

• interventions that can be used with conventional medicine interventions

  • most CHAs have been used much longer than modern medicine, but nursing and medical schools only recently incorporated CHA into their curriculums

• the divide between “Western” medicine and CHA has softened in recent years

• important terminology:

  • allopathic medicine

  • holism

  • integrative care

Prevalence of CHAs:

• ~30% of adults and ~12% of children use some form of CHAs

• CHAs are more prevalent among women, adults aged 30-69, adults with higher levels of income and education

• most prevalent in non-Hispanic Whites (37.9%), Hispanics (22%), non-Hispanic Blacks (19.3%)

Reasons of Using CHAs:

to improve health, relieve symptoms associated with chronic illnesses, to treat side effects of conventional treatments, wanting greater control over one’s health, adopting a holistic health philosophy

Most Frequently Used CHAs:

natural products, deep breathing exercises, yoga, chiropractic manipulation, meditation, and massage

Mind-Body Practices:

based on the belief that there is a strong mind-body connection

Natural Products:

herbs and nutritional supplements that are ingested with the hope of achieving a therapeutic goal; readily available and becoming increasingly popular

Other CHAs:

whole/alternative medical systems and consist of a philosophy and theory about health and illness, along with specific types of treatment; generally culturally-based

Mind-Body Practices:

• relaxation

• meditation

• guided imagery

• yoga

• Qi Gong and Tai Chi

• chiropractic health care

• healing touch (HT)

Relaxation:

• promote parasympathetic nervous system activity

  • goal: reduce sympathetic activity and restore balance of these two systems

Meditation:

• a group of techniques that train the person to focus attention

  • goal: achieve a state of greater calmness and both physical and psychological relaxation

Guided Imagery:

• focuses on evoking pleasant images to replace negative or stressful feelings

  • goal: promote relaxation

Yoga:

• practice that combines physical movement, breathing practices, and relaxation practices

  • promote strength/flexibility, increase endurance, promote relaxation, and reduce one’s response to stress

Qi Gong and Tai Chi:

• system of postures, exercises, breathing techniques, and visualizations

  • goals: restore the healing system so the body knows how to correct and heal itself

Chiropractic Health Care:

• focuses on the relationship between the body’s structure (mainly the spine) and its functioning

  • goal: through adjustments (manipulations) to the spine and other parts of the body, one is able to correct alignment problems, alleviate pain, improve functioning, and support the body’s natural ability to heal itself

Health Touch (HT):

• a type of energy healing therapy that uses a collection of energy techniques to assess and treat the human energy system; requires a certification to perform

  • goal: to restore wholeness through harmony and balance, facilitating self-healing

What are botanicals and nutritional supplements?

products often made from plants or natural ingredients that people use to support health or manage symptoms

How are herbal supplements regulated in the United States?

• classifies herbs as food, not drugs, therefore they are NOT regulated by the FDA

  • in many countries herbal products are heavily regulated and available through the primary health care system (ex: Germany)

Examples of botanicals and nutritional supplements:

• echinacea

• goldenseal

• ginki biloba

• senna

• St. John’s wort

• melatonin

• glucosamine

although “natural”, may interact with prescribed medications

CBD - cannabinoids:

compounds with medicinal properties that are not considered intoxicating

THC:

the compound that makes humans “high”

What schedule does the lesson assign to FDA-approved cannabis-derived CBD medication containing no more than 0.1% THC?

schedule V

When is hemp considered legal under federal law?

when it meets applicable federal and state requirements and contains no more than 0.3% THC by dry weight

What does the lesson say about synthetic cannabinoid medications?

the FDA has legalized 3 prescription meds that are synthetic cannabinoids - prescription only

Cannabis Legalities:

• know your state laws

• keep in mind your facility may be governed by federal laws

• educate your out-of-state patients on laws in your state

Ayurveda:

• originated in India and is one of the world’s oldest medical system

  • aim: integrate and balance the mind’, body, and spirit

Traditional Chinese Medicine:

• originated in China; views humans as microcosms of the larger surrounding universe; interconnected with nature and subject to its forces; body is composed of different parts with their own functions that are interdependent on each other

  • aim: balance these functions to achieve optimal health

Shamanism:

most widely practiced medical system in the world; though that disease and illness originate in the spirit world; the “shaman” is a medical person who possesses the ability to access the spirit world, done on behalf of a person or a while community, and return to “reality” with information regarding the proper treatment

Homeopathy:

originated by a German physical ~200 years ago; believes when one suppresses their symptoms, the condition goes deeper into the body (ex: antipyretics for a fever); uses remedies derived from substances that come from plants, minerals, animals to cause similar symptoms

Naturopathy:

originated from what was traditional medicine in Europe during the 19th century; believes that health is a dynamic state of being that provides abundant energy for people to cope with life in our society; treatment focuses heavily on dietary and lifestyle changes, stress reduction, herbs and supplements, manipulative therapies, and detoxification

Nursing Implications for CHAs:

• many patients are turning to CHAs after being unsatisfied with allopathic medical treatments

  • nursing programs are responding to this trend by incorporating information regarding CHAs into their cirriculums

• patient education regarding CHAs is essential, specifically related to their safety and effectiveness

• certification for holistic nursing is an option