Complementary and Integrative Health

Complementary and Integrative Health (CIH) Basics

• Complementary Health Approaches (CHA):

  • Refers to interventions not typically part of conventional medical care but used together with it.

• Integrative Health (IH):

  • Refers to the combination of complementary health and conventional health approaches in a coordinated way.

• Allopathic Medicine (Biomedicine):

  • Treats symptoms and diseases using drugs, radiation, or surgery.

  • Belief that illness occurs in either the mind or body, which are separate entities.

  • Health is defined as the absence of disease.

  • Main causes of illness are perceived as pathogens.

  • Curing aims to destroy invading organisms or repair affected parts.

  • Emphasis is on disease and high technology, utilizing drugs, surgery, and radiation as primary tools.

• Holism:

  • A theory and philosophy focusing on connections and interactions between parts of the whole.

  • Views all living organisms, including humans, as continuously connecting and interacting with their environment.

  • Parts of an organism (systems, subsystems, cells) are also continuously interacting and changing.

  • This continuous interaction means the body is not merely the sum of its parts (reductionism) but a unified, dynamic whole.

• Holistic Nursing:

  • A practice built on a holistic philosophy, with the goal of healing the whole person.

• Integrative Health Care:

  • The combination of allopathic and complementary and alternative modalities.

Why Nurses Need to Know About CHA

• Patient and Institutional Expectations:

  • Patients, families, physicians, and institutions increasingly expect practicing nurses to be knowledgeable about CHA.

• Continuity of Care:

  • Many patients use these therapies as outpatients and wish to continue their use as inpatients.

• Administration of Supplements:

  • Patients and family members may expect nurses to administer herbal preparations or nutritional supplements.

• Expanding Nursing Practice:

  • Many nurses are expanding their clinical practice by incorporating CHA.

• Integrative Health Care Provision:

  • Many institutions now provide complementary therapies to inpatients as part of total patient care in an effort to provide integrative health care.

Reasons for Using Complementary Health Approaches

• Seeking ways to improve health and well-being.

• Relieving symptoms associated with chronic, even terminal illnesses.

• Alleviating side effects of conventional treatments.

• Holding a holistic health philosophy or experiencing a transformational event that changes one's worldview.

• Desiring greater control over one's own health.

Three Categories of Complementary Health Approaches

1. Mind–Body Practices

2. Natural Products

3. Other CHAs

Complementary and Integrative Health Approaches for Pain Management

• Mind–body practices that are movement-based.

• Natural products, including nutritional and herbal remedies.

• Other mind–body approaches.

• Energy healing.

• Physical manipulation.

• Lifestyle changes.

Specific Complementary Health Approaches

Mind-Body Practices

• Relaxation:

  • Benefits for Patients:

    • Reduces anxiety.

    • Reduces muscle tension and pain.

    • Improves immune system function.

    • Enhances sleep and rest.

    • Improves sense of well-being.

• Meditation

• Guided Imagery

• Yoga

• Qi Gong and Tai Chi

• Acupuncture

• Chiropractic Health Care

• Aromatherapy

Natural Products

• Botanical Agents

• Nutritional Supplements

• Medical Cannabis:

  • Marijuana

  • Cannabidiol (CBD)

  • Hemp oil

• Nutritional Therapy

Other Complementary Approaches

• Ayurveda

• Traditional Chinese Medicine (TCM):

  • Theoretical Framework:

    • Yin-yang theory: Focuses on the balance of opposing yet complementary forces.

    • Qi: The vital life force or energy.

    • 8 Principles to Analyze Symptoms and Categorize Conditions:

      • Cold/heat

      • Interior/exterior

      • Excess/deficiency

      • Yin/yang

    • Theory of Five Elements:

      • Fire

      • Earth

      • Metal

      • Water

      • Wood

• Shamanism

• Homeopathy

• Naturopathy

Energy-Healing Therapies

• Therapeutic Healing Touch (Therapeutic Touch):

  • Four Scientific Premises:

    1. A human being is an open energy system.

    2. Anatomically, a human being is bilaterally symmetrical.

    3. Illness is an imbalance in an individual's energy field.

    4. Human beings have a natural ability to transform and transcend their conditions of living.

• Sound Healing

Manipulative and Body-Based Practices

• Therapeutic Massage:

  • Involves an assortment of techniques that manipulate soft tissues of the body through pressure and movement.

  • Goals:

    • To break up tension held in body structures.

    • To promote communication between mind–body structures.

    • To promote detoxification.

    • To generally improve body functioning.

• Chiropractic Health Care:

  • Techniques and Services:

    • Spinal adjustment.

    • Application of heat and ice.

    • Electrical stimulation.

    • Relaxation techniques.

    • Rehabilitative and general exercise.

    • Counseling about diet, weight loss, and other lifestyle factors.

    • Dietary supplements.

Educating Patients About CHAs

• Safety and Efficacy:

  • Patients need to be informed about the safe and effective use of CHA.

  • Awareness of inconsistencies among preparation methods is important.

• Available Resources:

  • Resources exist to educate healthcare professionals (HCPs) and the public.

• Encourage Disclosure:

  • Nurses should encourage patients to list all CHA practices during medical visits.

  • This includes over-the-counter (OTC) and prescription medications, as well as dietary and herbal supplements.

  • Instruct patients to inquire about new CHA practices they might be considering before starting them.