Complementary, Alternative, and Integrative Therapies

Allopathic Medicine (Biomedicine)

  • Traditional western medicine effective at treating physical ailments.
  • Less effective in decreasing stress, managing symptoms of chronic disease, caring for emotional/spiritual needs, and improving quality of life.

Complementary Therapies

  • 33.2%-50.6% of US population integrates non-traditional therapies.
  • Motivators include desire for less invasive treatments, dissatisfaction with biomedical treatments, desire for an active role in treatment.
  • Common approaches: massage, chiropractic/osteopathic manipulation, herbal supplements, yoga, acupuncture.

Defining Therapies

  • Complementary: Used with conventional treatment.
  • Alternative: Used in place of conventional pharmacology or medical procedures.
    • Examples: Traditional Chinese medicine, Ayurveda, naturopathy

Integrative Nursing

  • Advances health and wellbeing through caring-healing relationships.
  • Uses evidence to inform traditional and emerging interventions.
  • Goals: Weigh risks and benefits of interventions, evaluate therapy goals (pain and stress relief).

Relaxation Therapy

  • Reduces tension and stress, promotes well-being.
  • Techniques:
    • Deep Breathing (Diaphragmatic Breathing)
    • Progressive Muscle Relaxation (PMR)
    • Guided Imagery
    • Meditation & Mindfulness
    • Aromatherapy
    • Music Therapy
  • Clinical Applications: Labor & Delivery, Postoperative Care, Mental Health Nursing, Chronic Illness Management

Meditation

  • Limits stimulus input to increase self-awareness.
  • Clinical Applications: Reduces blood pressure, relapses in alcohol treatment programs, depression, anxiety, and increases quality of life in cancer patients.
  • Limitations: May induce anxiety, hypertension, and require medication changes.

Guided Imagery

  • Uses mental images to stimulate physical changes and improve well-being.
  • Clinical Applications: Controls pain, reduces stress, improves sleep.
  • Limitations: May increase airway constriction in COPD/asthma patients, cause anxiety in PTSD/social anxiety.

Traditional Chinese Medicine (TCM)

  • Views health as "life in balance."
  • Disease occurs with imbalances in vital energy (qi).
  • Limitations: Not regulated in most states with concerns over herbal treatments and interactions with allopathic medicine.

Acupuncture

  • Regulates qi through meridians.
  • Clinical Applications: Effective for pain, hot flashes, headaches, sinusitis, gastrointestinal disorders.
  • Limitations: Contraindicated for bleeding disorders and skin infections; caution with pregnancy, hepatitis, or HIV.

Cupping (TCM)

  • Uses heated cup on skin for light suction.
  • Commonly used for muscle pain.

Coining (TCM)

  • Uses rubbing a metal object along the skin
  • Often used for respiratory conditions

Therapeutic Touch (Reiki)

  • Affects energy fields to promote healing.
  • Clinical Applications: may be effective in treating pain, dementia, trauma, and anxiety during acute and chronic illness
  • Limitations: Contraindicated for those sensitive to touch, pregnant women, neonates, cardiac/neurological instabilities.

Chiropractic Therapy

  • Normalizes relationship between structure and function through joint manipulations.
  • Clinical applications: vertebral subluxation, low back pain, osteoarthritis joint pain, pediatric asthma, headaches, dysmenorrhea, vertigo, tinnitus, and visual disorders
  • Limitations: Contraindicated with bone/joint infections, fractures, rheumatoid arthritis, and osteoporosis.

Herbal Therapies

  • Natural products, not regulated by the FDA.
  • Clinical Applications: Depression, pain.
  • Limitations: “Natural” does not equal “safe”; may interact with medications, cause bleeding, cardiac effects, or liver failure.
  • Look for U.S. Pharmacopeia (USP)-verified dietary supplement mark.

Remedies by Ailment:

  • Anxiety: Chamomile, Kava, Lavender, Valerian Root
  • Depression: Rhodiola Rosea, Ashwagandha, Saffron, St. Johns Wort
  • Sinus/Stuffiness: Chamomile, Rose Petal, Yerba Santa
  • Skin: Grape Seed, Shea Nut, Witch Hazel, Chamomile, Calendula, Lavender
  • Headache: Skullcap, Sage, Licorice, Ginger
  • Digestion: Aloe Vera, Ginger, Fennel, Dandelion, Lemon Verbena
  • Arthritis: Yerba Santa, Turmeric
  • Inflammation: Aloe Vera, Birch Bark, Turmeric
  • Circulation: Red Yeast Rice, Cayenne, Garlic
  • Nausea: ginger, aloe vera, basil, mint

Aromatherapy

  • Uses essential oils for physical and psychological wellbeing.
  • Limitations: Could cause allergies or respiratory complications, skin irritation.
  • Ex: peppermint for nausea; lavender can promote relaxation.

Animal Therapy

  • Offers support in acute care settings, retirement communities, and among veterans.
  • Commonly used for PTSD, seizure awareness, diabetes, and to enhance muscle strength
  • Be cautious if the patient has fears of animals or allergies

Music Therapy

  • Can alter behaviors, emotions, and physiologic processes.
  • Can improve sleep, movement, communication, and pain

Integrative Nursing Role

  • Nurses align therapies with patient beliefs and provide accurate information.