Q1The Fifth Amendment protect individuals against self- incrimin

Q1
The Fifth Amendment protect individuals against self-
incrimination. The Sixth Amendment affords individuals
protections in the criminal process.
This discussion asks you to examine the rights afforded to
individuals under the Fifth and Sixth Amendment.
Please thoroughly discuss each of the following:
1. Discuss the difference between an arrest and a custodial
interrogation. When must Miranda be given to an individual?
2. Discuss how the court determines if a confession should be
admissible or not. What does the court look for to determine if a
confession is voluntarily given?
Q2
Describe the basic field of Ethnomethodolgy – what are the
main concerns of this perspective and how do they differ from
traditional sociological concerns? How do Garfinkel’s
Breaching Experiments relate to the main concern of
Ethnomethodology? Also share an example of an informal
breaching experiment and the response (for example, a time that
someone did not follow a social norm or a video portraying
norm-breaking, including a link).
Q3
create a gap analysis of one area of your business venture where
you see a “gap” between where your business is and where you
want it to be. Explain what is creating the gap and some of the
factors that contribute to it, then discuss how you will develop
strategies to bridge the gap.
Q4
Define temperament. Describe how temperament can play a role
in a child’s behaviors.

Complementary Alternative Modalities
Nursing 382 - Holistic Nursing Assessment and Practice
Dr. Laura Schwarz, DNP, RN, CNE, AHN-BC
Student Name
March, 17th 2020
Complementary Alternative Modalities
Complementary Alternative Modalities (CAM) are holistic
health promoting therapies used in conjunction with
conventional medicine. (National Institutes of
Health. 2013).
Conventional medicine consists of traditional, mainstream
medical treatment such as surgeries, procedures or medications.
(National Institutes of Health. 2013).
Holistic health embraces one’s spiritual, emotional, and
psychological well-being.
Image Courtesy of Microsoft Office Clip Art.
Examples of Complementary Alternative Modalities:
Images Courtesy of Microsoft Office Clip Art.

Acupuncture
Guided Meditation
Yoga
Aromatherapy
Healing Touch
Music Therapy
Massage
Vitamins/Herbal Supplements

Holistic Nursing Practice
“Holistic nursing practice takes into account the
interconnectedness of body, mind, emotion, spirit,
social/cultural, relationship, context, and environment and its
impact on health and healing”(Blais & Hayes, 2011, p. 364).
Patient Well-being
Spiritual
Emotional

Cultural
Environmental
Physical
Physiological
Therapies Personally Experienced
Aromatherapy
Hand Massage
Guided Meditation
5
Aromatherapy
Stimulation of the basic sense of smell is used to promote
feelings of well-being, relaxation, and connection.

(Liwidjaja-Kuntaraf et al.., 2011)
Figure 1: Photograph of Aromatherapy. Achieving Health.
http://www.achievinghealth.com.au/change-mood-
aromatherapy
Mechanisms of Action:
“Aromatherapy is the use of essential oils from plants for
healing. In general, it seems to relieve pain, improve mood, and
promote a sense of relaxation” (University of Maryland Medical
Center, 2013).
“Aromas hit the nose and go directly to the most primitive parts
of the brain, effecting our emotions and nervous system before
our higher cortex is even aware of them” (Kemper, 2010).
“The scent of essential oils from flowers, herbs, and trees is
inhaled to promote a sense of health and well-being”
(Liwidjaja-Kuntaraf et al., 2011).
“A systematic review of the use of aromatherapy and massage
for symptom relief in patients with cancer revealed some
support for the relief of both physical and psychological
symptoms” (Williams et al.

2009).
Essential Oils
Can be applied to skin or inhaled by diffuser.
Essential oils that help achieve a state of relaxation include:
Chamomile
Jasmine
Lavender
Rose
(University of Maryland Medical Center, 2013)
Essential Oil Contraindications
Contraindicated for patients with:
Asthma
Heart conditions
Hypertension
Epilepsy
Allergic reactions
Avoid using essential oils on anyone less than 5 years of age.
Why Aromatherapy?

I enjoy the scent of essential oils and feel they are
complimentary to other CAM’s.
I have previously taken a day course on massage with essential
oils called the Raindrop Technique by Young Living Essential
Oils.
I wanted to find out if I could incorporate this therapy into my
everyday routine to help balance stress and anxiety for both
myself and my patients.
Need to include how/why these were chosen.
10
Aromatherapy Experience
Description
Using Young Living Essential oils nightly for one week, I
diffused the scent of lavender to relax and unwind before I went
to bed.
I also applied lavender infused lotion to my hands and feet
before going to sleep.
Additionally, I included aromatherapy during my hand massage
experience.
Thoughts
Many times after a long day of work, I find myself continually
thinking about what I need to get done the next day.
After the first night of using aromatherapy, I found that I was
able to clear my mind and relax before bed.
I also had an easier time falling asleep without my mind racing
about my work.

Describe experience, including what I thought
11
Practice Implementation
Who would Benefit?
Nursing Application Strategies:
Offer lavender essential oil patches to patients who would
benefit from this therapy.
Educate patients about the benefits of aromatherapy.
Take breaks in the staff renewal room.
Use the essential oil diffuser to create a sense of relaxation and
well-being during my breaks.
What patient’s will benefit?? Use peer reviewed sources to
back up information Include how nurses could incorporate this
into practice
12
Aromatherapy
Cancer Patients
Dementia Patients
Patients with insomnia
Patients with chronic illness
Nurses

Patients with Anxiety or Depression
Hand Massage
Light pressure on the soft tissues of the hands is used to
promote relaxation, along with a sense of well-being and
connection. Hand massage can also be used in conjunction with
aromatherapy.
Figure 2: Photograph of Hand Massage. Tips for Massage.
http://www.tipsformassage.com/hand-and-arm-massage-
techniques/
(Liwidjaja-Kuntaraf et al. 2011)
“Massage therapy encompasses many techniques, using oil or
lotion to reduce friction on the skin while the therapist presses,

rubs, and otherwise manipulates the muscles and other soft
tissue of the body” (Liwidjaja-Kuntaraf et
al. 2011).
Hand Massage helps relieve muscle tension, reduce stress, and
evoke feelings of calmness. (University of Maryland Medical
Center, 2013)
“Hand massage helped to reduce stress and anxiety in terminally
ill patients, based on psychological and endocrinological
measurements”(Osaka et al., 2009).
Massage Contraindications Include:
Inflammation
Bruising
Skin conditions
Burns
Cancer
Blood clots
Image Courtesy of Microsoft Office Clip Art.
Why Hand Massage?
Massage is one of the most easily applied CAM therapy for
nursing.
To assess a simple massage type’s effectiveness on reducing
stress.

I am uncomfortable getting a massage at a spa; with hand
massage I could test the benefits of this therapy without feeling
self-conscious.
Hand Massage Experience
Description
Through our spiritual care department I trialed hand massage
and aromatherapy from the healing services menu.
This menu is offered to patients and staff from 8am to 8pm
Monday – Friday.
I made two 15 minute appointments with a therapist to receive
hand massage supplemented by aromatherapy.
Thoughts
I was much less apprehensive and self-conscious with hand
massage and felt able to relax.
During the massage I felt calm and with less tension.
The addition of the essential oil tangerine helped stimulate my
senses and reduce my nervousness.
17
Who would Benefit?
Offer hand massage to hospitalized patients in pain or feeling
anxious.
Review the benefits of massage with patients and help them
develop additional coping skills to decrease stress and anxiety
outside of the hospital.
Utilize our healing services menu offered through our spiritual
care team.

Hand Massage
Pregnant Women
Hospice Patients
Elderly
Patients with Chronic Pain
Nurses

Guided Meditation
Relaxation of the mind and body through focused concentration
to promote mental, emotional, and physical healing in addition
to stress relief.
Figure 3: Photograph of Meditation. Corporate Wellness
Magazine. http://www.corporatewellnessmagazine.com/article-
detail.php?issue=issue-15&article=focus-on-fascia-
“The goal of mind-body techniques is to get the body and mind
to relax and to reduce the levels of stress hormones in the body,
so that your immune system is better able to fight off
illness”(University of Maryland Medical Center, 2013).
“Meditation is a method of relaxation that has been associated
with a number of positive effects and shown to decrease pain
and other symptoms such as anxiety and pain”
(Williams et al., 2009).
“It is designed to guide patients toward a relaxed state of mind
and to promote gentle, hypnotic-like suggestions to bring the
resources of the relaxed mind back to daily life”
(Toth et al., 2007, p.197).

Why Guided Meditation?
I can remember being a child and my mother using this to help
me fall asleep. With her voice she would soothingly stimulate
my imagination by saying “pretend that you are on a soft cloud,
floating high up in the air”. I remember feeling so comforted,
peaceful, and able to relax my mind.
I wanted to try this therapy with the help of a trained coach.
The goals of this trial were to assess it’s effectiveness on stress
reduction and the efficacy of using this in nursing practice.
Need to include how/why these were chosen.
21
Guided Meditation Experience
Description:
Every Tuesday and Thursday spiritual services offers guided
meditation from 12:00 to 12:15.
I attended both days during one week in our hospital chapel.
During this session, you are guided through your imagination to
places of tranquility and relaxation.
Thoughts:
Both times I left feeling relaxed, centered, and less anxious.
I was able to return to work feeling less emotionally fatigued
and more mentally focused.
This experience was very helpful to reduce stress through
meditation.

22
Who would Benefit?
Educate patients on the benefits of guided meditation and
services offered while in the hospital.
Utilize guided meditation for patients in pain or having anxiety.
Call a “Code Lavender” for patients or family in emotion or
spiritual distress.
Guided Meditation
Nurses
Pregnant Women
Patients with Chronic Conditions
Patient with Insomnia

Patients Experiencing Pain
Calling a “Code Lavender”
Courtesy of Park Nicollet Spiritual Care Services, 2013.
Conclusion
CAM therapies are beneficial for both nurses and patients in
any stage of health promotion.
Teaching patients about CAM therapy provides additional

coping mechanisms to help support primary health promotion.
“With proper advice and an open approach towards its usage,
CAM can safely and effectively complement conventional
medicine” (Buchan et al. 2012, p.675).
Review’s major points
25
Conclusion
My research findings have shown me that holistic patient care
involves treating patients entire state of well-being.
Implementing CAM therapy into nursing practice promotes
holistic nursing care.
CAM therapies together with Traditional Medicine form a
holistic treatment plan for patients.
Conclusion
I truly enjoyed my experience with these CAM therapies and
found that I felt less stress and anxiety.
I plan to incorporate CAM therapies into my current nursing
practice by learning more about hand massage techniques and
providing patients with the spiritual care healing services menu.
I also plan to make time to utilize our Staff Renewal Rooms and
educate other staff members on the benefits to CAM therapy.
In the future, I would personally like to try other CAM
therapies such as Yoga or Acupuncture.

References
Blais, K. & Hayes, J.K. (2015). In Pearson (Ed.), Professional
nursing practice: Concepts and perspectives (7th Edition ed.).
New Jersey: Prentice Hall, Inc.
Blythman, R., & Vialls, K. (2012). Relaxation and conventional
medicine go hand-in-hand. Australian Nursing Journal,
19(8), 44-45.
Buchan, S., Shakeel, M., Trinidade, A., Buchan, D., & Ah-See,
K. (2012). The use of complementary and alternative
medicine by nurses. British Journal of Nursing, 21(11),
672-675.
Corporate Wellness Magazine. (2010). [Photograph of
Meditation]. Retrieved from
http://www.corporatewellnessmagazine.com/article-
detail.php?issue=issue15&article=focus-on- fascia-
Cleveland Clinic. (2014, January). Health Hub. Retrieved from
Cleveland Clinic:
http://my.clevelandclinic.org/wellness/integrative-
medicine
References
Kemper, K. J. (2010). How aromatherapy works. Nutrition
Health Review: The Consumer's Medical Journal, (102), 3-3.
Liwidjaja-Kuntaraf, K., Handysides, A., & Landless, P. (2011).
Your guide to complementary alternative medicine. Vibrant
Life, 27(5), 30-35.
National Institutes of Health. (2013, May). Retrieved from
National Center for Complementary and Alternative Medicines:
http://nccam.nih.gov/health/whatiscam
Osaka, I., Kurihara, Y., Tanaka, K., Nishizaki, H., Aoki, S., &
Adachi, I. (2009). Endocrinological evaluations of brief hand
massages in palliative care. Journal of Alternative &

Complementary Medicine, 15(9), 981-985.
https://doi.org/10.1089/acm.2008.0241
Schwantes, M. (2011). DETOX your mind. Vibrant Life, 27(5),
16-19.
Toth, M., Wolsko, P. M., Foreman, J., Davis, R. B., Delbanco,
T., Phillips, R. S., & Huddleston, P. (2007). A pilot study
for a randomized, controlled trial on the effect of guided
imagery in hospitalized medical patients. Journal of
Alternative & Complementary Medicine, 13(2), 194-197.
https://doi.org/10.1089/acm.2006.6117
Williams, A. M., Davies, A., & Griffiths, G. (2009). Facilitating
comfort for hospitalized patients using non- pharmacological
measures: Preliminary development of clinical practice
guidelines. International Journal of Nursing Practice, 15(3),
145-155. https://doi.org/10.1111/j.1440-172X.2009.01739.x
University of Maryland Medical Center. (2013, May). Medical
Reference Guide.
http://umm.edu/health/medical/altmed/treatment/aromatherapy
Reference Guide.
http://umm.edu/health/medical/altmed/treatment/mindbody-
medicine#ixzz2vntOlNK9
Reference Guide.
http://umm.edu/health/medical/altmed/treatment/massa ge
References
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Complimentary
Alternative
Modalities
Nursing 382
Holistic Nursing Assessment and Practice
Mavis maveric
Month, Date, Year
A comprehensive approach used to address health care needs to
include the physical, emotional, psychological & spiritual
aspects of a person (Blais & Hayes, 2011)
Practices or products used in addition to, or
as an alternative to, traditional Western
medicine. Not widely taught in medical schools
or readily available in heath care settings
(Dossey et al., 2015)
Becoming more popular, patients are more
aware
What is cam therapy?

Photo courtesy of Microsoft Office PPT
Biological-Based Therapies - Herbals medicine
- Vitamin supplements
- Whole, organic foods
Manipulative Body Therapies - Cranial-sacral therapy
- Massage therapy
- Osteopathic manipulation
- Chiropractic therapy
Energy Therapies - Magnet therapy
- Therapeutic / healing touch
- Reiki
- Qi Gong
Mind-based Therapies - Prayer
- Guided self-healing
- Meditation
- Art, music and dance
(Blais & Hayes, 2011, p. 370)
Examples of CAM
Aromatherapy
Massage Therapy

Yoga / Meditation
Three Therapies experienced
The use of essential oils, derived from plants, thought to work
at the psychological, physiological and cellular levels in the
body
Stimulants travel through the nose and
nerve impulses, to the limbic system of brain,
evoking an emotional response
May also be absorbed through the skin &
into blood stream through massage oils
bath salts
One of the oldest forms of CAM, dating back 6000 years
(Novey, 2000)
Aromatherapy – What is it?
WHY:
I chose aromatherapy because we have started to use on my

Mother Baby unit (nasal inhalers, oils & bath salts). I wanted to
see if it would help me manage my stress, relax & sleep
HOW:
I used a lavender oil inhaler stick every day before bed (for 15
min) & used lavender bath salts 2 times a week for 2 weeks
RESULTS:
My tension, anxiety, stress level decreased & I was able to fall
asleep faster. I was able to focus on my breathing, clear my
mind and relax.
Aromatherapy – My experience
Patients experiencing pain, stress, anxiety, depression,
insomnia, cancer treatment or in critical care
“Patients in the lavender group had less postoperative pain”
after cesarean section (Olapour et al., 2013, p. 203)
“Aromatherapy in cancer patients suggests a short-term benefit
to reduce anxiety and depression, improve sleep and increase
overall wellbeing” (Boehm et al., 2012, p. 508)
Aromatherapy reduced anxiety, improved sleep, and stabilized
the blood pressures of patients in the
ICU (Cho et al., 2013)
Aromatherapy - Who would benefit?
We recently started using aromatherapy on our unit. I will now
offer this to every patient by sharing what is available, how it

works & how they could benefit. However, I will respect those
who chose not to use it
Share research that post-op pain scores decreased for cesarean
section patients who used aromatherapy, in addition to standard
meds
Communicate how easy, cost effective, and empowering
aromatherapy can be for use in the hospital or at home
A significant and increasing number of pregnant women use
CAM, as if offers them greater control and choice in their
holistic care (Hall et al., 2011)
Aromatherapy – How nurses could incorporate?
A systematic form of touch and pressure that manipulates soft
tissues of the body to promote comfort and healing
Stimulates the circulation of blood &
lymph, to help remove metabolic
wastes and promote relaxation
Often used with aromatherapy, oils,
and music
Widely available, many different types,
prices vary
(Novey, 2000)
Massage Therapy – what is it?

WHY:
I often have tight muscles, especially in my back and
hamstrings. With work, exercise and a busy lifestyle, I often
feel stressed. My doctor and others have recommended
massages to me. I have had had one years ago, but can be
expensive.
HOW:
I had a deep tissue (myofascial release) massage. The room was
dimly lit, with soft music. I was on a comfortable table, with a
sheet covering me, face down in a “donut”. The therapist used
oil, heat packs and deep stroking pressure for 60 min.
RESULT:
After my session, my tension, knots, stress and muscle aches
were relieved. The area under my eyes were swollen and I was
very thirsty. I was told to drink lots of water. I felt absolutely
fabulous. I vowed to schedule monthly appointments!
Massage Therapy– My experience
Patients experiencing pain, stress, anxiety, depression,
pregnancy or chronic illness
For low back pain, “although traditional therapy showed
slightly greater pain relief, the decline in pain using massage
therapy was significant” (Melancon & Miller, 2005, p. 120)
“Back massage significantly reduced anxiety” in CHF patients
(Chenet al., 2013, p. 464)

Massage therapy with pregnant women lowered anxiety and
depression and women were less likely to deliver prematurely
(Field et al., 2012)
Positive effects are seen on full term and preterm infants
experiencing massage therapy (Abdallah et al., 2013).
Massage Therapy – Would would benefit?
Our hospital has an “Integrative Medicine” group that we can
put a “consult” in for them to see our patient. Most patients do
not stay long enough to have an IM massage, except for
antepartum (bed rest) patients.
Encourage patients to utilize if they
have an extended stay.
Give hand, foot or neck massages
to patients or show their caregiver.
Offer aromatherapy oils to use
Encourage people to use at home, in
addition to traditional medication, heat and ice.
Practice what I preach and make appointments for monthly
massages! Already found “Groupons” for cheaper options.
Massage Therapy– How nurses could incorporate?
Consciously controlling breathing, while moving through a
series of postures or asanas (Dossey et al., 2005)
“Control of the body through correct posture and breathing,

control of the emotions and mind, and meditation and
contemplation” (Novey, 2000, p. 141)
Involves mind, body and spirit in a relaxation response
mechanism, by increasing blood flow and oxygen use, while
reducing carbon dioxide and
respiration rate (Novey, 2000)
Popular activity, especially
among women
Widely available, prices vary
Various types & levels offered,
something for everyone
Yoga / Meditation – What is it?
WHY:
I already run and strength train, but have never done yoga
consistently or tried different types. My doctor & others have
encouraged yoga to increase my flexibility, promote relaxation
and manage my stress.
HOW:
Participated in five Bikram and five Hatha yoga sessions since
January.
Bikram yoga is done in a 105 deg F room with 40% humidity.
The 26 poses were very intense and invigorating. I felt
detoxified due to the exorbitant amount of sweating. Sessions
are 90 min and I need shower after. I had mild headache after
one (perhaps dehydration?).
Hatha yoga was done in a dimly lit room, with soft music. The
session was 60 min, with simple poses, done in a relaxing,
calming manner. I did at night, then went straight to bed.

RESULT:
I enjoyed both, but liked to alternate depending upon my time &
mood. Both offered the opportunity to “stretch, relieve stress,
open the lungs, relax the heart, and clear the mind” (Novey,
2000, p. 146).
Yoga – My expereince
Patients experiencing pain, anxiety, stress, pregnancy, cancer
treatment or chronic illness. Check with your doctor, as not all
yoga is safe for everyone (i.e. Bikram)
Prenatal yoga provided optimism, power and well-being, while
helping to relieve musculoskeletal issues during pregnancy
(Reis & Alligood, 2014)
Systematic reviews show yoga to be beneficial for reducing
fatigue in cancer patients (Sadja & Mills, 2013)
“Eight weeks of Bikram yoga improved mindfulness, perceived
stress, cardiorespiratory endurance, flexibility and balance”
(Hewlett al., 2011, p. 87)
Regular daily yoga improved sleep and quality of life in the
elderly (Bankar et al., 2013)
Yoga – would would benefit?
Encourage patients to do yoga, offer resources, classes in area,

as there are many offerings, including at our hospital
Share research that indicates yoga may help patients with
relaxation, flexibility and stress relief.
Share my experiences and answer
patient questions (i.e. many post partum
patients ask about mom baby yoga classes)
I will continue to do yoga at least once a
week, and vary the type of yoga, depending
upon my time and mood
Yoga – How nurses could incorporate?
CAM is becoming more mainstream - patients are more aware
and asking about
Nurses need to be educated regarding options, benefits and be
able to answer patient questions
Aromatherapy is a safe, effective addition
to traditional medication for pain control,
relaxation and sleep
Massage promotes relaxation, stress
reduction and muscle tension relief
Yoga can help improve meditative breathing,
flexibility and overall well-being.
All are cost effective, empowering and easy to offer patients
conclusion

Abdallah, B., Badr, L. K., & Hawwari, M. (2013). The efficacy
of massage on short and long term outcomes in preterm
infants. Infant Behavior and Development, 36(4), 662-669.
Bankar, M., Chaudhari, S., & Chaudhari, K. (2013). Impact of
long term Yoga practice on sleep quality and quality of life in
the elderly. Journal of Ayurveda and Integrative Medicine,
4(1), 28.
Blais, K., & Hayes, J. S. (2015). Professional nursing practice:
concepts and perspectives (7th ed.). Pearson.
Boehm, K., Bussing, A., & Ostermann, T. (2012). Aromatherapy
as an Adjuvant Treatment in Cancer Care - A Descriptive
Systematic Review. African Journal of Traditional,
Complementary and Alternative Medicines, 9(4), 503-518.
References
Chen, W., Liu, G., Yeh, S., Chiang, M., Fu, M., & Hsieh, Y.
(2013). Effect of Back Massage Intervention on Anxiety,
Comfort, and Physiologic Responses in Patients with
Congestive Heart Failure. The Journal of Alternative and
Cho, M., Min, E. S., Hur, M., & Lee, M. S. (2013). Effects of
Aromatherapy on the Anxiety, Vital Signs, and Sleep

Quality of Percutaneous Coronary Intervention Patients in
Intensive Care Units. Evidence-based Complementary and
Alternative Medicine, 2013, 1-6.
Dossey, B. M., Keegan, L., & Guzzetta, C. E. (2005). Holistic
nursing a handbook for practice (4th ed.). Jones and
Bartlett.
Field, T., Diego, M., Hernandez-Reif, M., Medina, L., Delgado,
J., & Hernandez, A. (2012). Yoga and massage therapy
reduce prenatal depression and prematurity. Journal of
Bodywork and Movement Therapies , 16(2), 204-209.
REFERENCES
Hall, H. G., Griffiths, D. L., & McKenna, L. G. (2011). The use
of complementary and alternative medicine by pregnant
women: A literature review. Midwifery, 27(6), 817-824.
Hewett, Z. L., Ransdell, L. B., Gao, Y., Petlichkoff, L. M., &
Lucas, S. (2011). An Examination of the Effectiveness of an 8-
week Bikram Yoga Program on Mindfulness, Perceived Stress,
and Physical Fitness. Journal of Exercise Science & Fitness,
9(2), 87-92.
Melancon, B., & Miller, L. H. (2005). Massage Therapy Versus
Traditional Therapy for Low Back Pain Relief. Holistic
Nursing Practice, 19(3), 116-121.
Novey, D. (2000). Clinician's complete reference to
complementary & alternative medicine. St. Louis: Mosby.

REFERENCES
Olapour, A., Behaeen, K., Akhondzadeh, R., Soltani, F., Razavi,
F.A., & Bekhradi, R. (2013). The Effect of Inhalation of
Aromatherapy Blend containing Lavender Essential
Oil on Cesarean Postoperative Pain. Anesthesiology and Pain
Medicine, 3(1), 203-7.
Reis, P. J., & Alligood, M. R. (2014). Prenatal Yoga in Late
Pregnancy and Optimism, Power, and Well-Being. Nursing
Science Quarterly, 27(1), 30-36.
Sadja, J., & Mills, P. J. (2013). Effects of Yoga Interventions
on Fatigue in Cancer Patients and Survivors: A Systematic
Review of Randomized Controlled Trials. EXPLORE: The
Journal of Science and Healing, 9(4), 232-243.
References
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Complementary Alternative Medicine
Nancy Nurse, RN
Minnesota State University: Mankato
Nursing 382
Holistic Nursing Assessment and Practice
Month, day, year
Definition of CAM Therapy
No one single definition of CAM (Gadboury, April, & Verhoef,
2012).
Best definition found: A group of therapies, products, or
procedures that are present outside conventional medicine.
Used in addition to, not instead of traditional medicine.
China is largest user of CAM, but on the rise in the USA.
Used increasingly by traditional providers and practitioners,
including nurses (Li et al., 2011).
CAM Therapies Researched
MASSAGE
YOGA
MEDITATION

Massage Figure 1. Photo of massage. Massage
Envy Spa. www.massageenvy.com.
Definition: Use of hands to touch or rub the skin and muscles of
another to create a positive effect.
Technique examples: kneading, skin rolling and gliding.
One of the fastest growing CAM therapies in USA.
Usually not covered by insurance.
(Smith et al., 2010)
Massage
Wellness paradigm: Massage attends to the person’s physical,
emotional and psychological needs.
Benefits: lowers muscle tension, lowers blood pressure,
improves mood, pain management, improves pain threshold and
reduces fatigue.
Contraindications: burns, skin injuries and DVT.
(Smith et al., 2010)
Who benefits from massage?
Patients with neck, back and shoulder problems, muscle pain,
fatigue, anxiety and depression, non-ill people looking for
wellness, pregnancy and headaches (Smith et al., 2010).
Improves lung function in children with asthma (Abdel Fattah &
Hamdy, 2011).
Immediate results with ill hospitalized psychiatric patients.
Reduces anxiety and aggression (Garner et al., 2008).

My experience with massage
I used a gift card from my 40th birthday for a massage. It was
wonderful! I got the massage with hot rocks (as pictured).
I felt relaxed and refreshed.
I would not have gone without
the gift card, and I am very
thankful. Courtesy of Microsoft Office
PPT
The feelings of well being lasted for 2 days. I choose the hot
rocks to work on some tense spots in my upper back and it
worked.
Massage as a nursing tool
Almost any of our patients could benefit from massage. In most
inpatient or nursing home settings, the nurse can give a patient
a massage, with their permission. A neck or hand massage
would be a great way to reduce anxiety about an upcoming
procedure. In the psychiatric setting it could help with the
stress of a commitment hearing.
If the nurse is not able to give a massage, a referral to a local
massage therapist is ideal.
Yoga Figure 2. Photo of Yoga. Yoga Journal.
http://blogs.yogajournal.com/slideshows/better-bone-
health
Definition: A practice of physical postures, breathing

techniques and mind control.
Mind-body form of CAM.
Encourages proper body alignment and awareness.
Yoga breathing is a stress reliever.
Teaches good posture, (not just on the mat) but all the time.
(Krucoff, 2011)
Yoga
Used by many for overall health and fitness.
Also used as a CAM therapy for specific aliments: physical and
emotional.
In USA, usually taught in a group class
(Kaley-Isley et al., 2010)
Yoga
Dates back 4000 years and has evolved.
Increases flexibility and strength.
Enhances muscle function.
Very few drawbacks, but must be done correctly to avoid injur y
(Hart, 2008).
“Pay attention to what their own bodies are saying” (Hart, p. 31,
2008).

Who benefits from Yoga?
Patients with anxiety, depression, ADHD, obesity, eating
disorders, pain, injury, asthma and irritable bowel syndrome
(Kaley-Isley et al., 2010).
Patients with chronic neck and shoulder pain (Krucoff, 2011).
Patients with back pain, arthritis, fatigue, coronary artery
disease, hypertension and carpal tunnel syndrome (Hart, 2008).
My experience with Yoga
I have some old Yoga DVDs that I have not used it a while. I
pulled them out and did one each day for 4 days. It felt great.
My favorite pose is downward facing dog (pictured here).
I could feel it strengthening and
stretching my muscles. I feel that
if I continue with Yoga, it will
lessen my back pain. I also felt
reduced stress those days. Courtesy of Microsoft Office
PPT.
Yoga as a nursing tool
Some simple Yoga postures and stretches could be taught to
patients by nurses. Yoga videos could be viewed in a patient
room or in a general area of the healthcare intuition. With a
small investment, Yoga mats could be provided.
If Yoga instruction is not possible, the nurse could make a
referral to local Yoga classes.

Meditation Figure 3. Photo of meditatio n.
www.themeditationcenter.org.
Definition: The act of sitting up, focusing on your breath.
When your mind wanders from breath, re-focus on breath and
being in the present moment.
Apply techniques to daily life. For example, mindful eating or
driving (Brady, O’Connor, Burgermeister, & Hanson, 2012).
Actually increases cerebral blood flow (Moss, Wintering et al.,
2012).
Meditation
Practical and low-cost CAM.
Techniques focus on management of attention and emotion.
Spiritual element: improves feelings of well-being and
spirituality.
(Moss et al., 2012)
Meditation training
Mindfulness-based Stress Reduction (MBSR)
Training done in various institutions.
Group sessions and discussions.
Guided sitting meditation.
Numerous body postures.

(Olivio et al., 2009)
Who benefits from meditation?
Anyone feeling stressed or emotionally exhausted (Brady et al.,
2012).
Patients with anxiety, fatigue, anger, confusion along with
memory loss or cognitive problems (Moss et al., 2012).
Patients at risk for coronary artery disease, substance abuse,
eating disorders and hostility (Olivio et al., 2009).
My experience with meditation
I am in a book club where 2 of the members meditate on a
regular basis. I asked them for guidance. One of the women
brought a guided meditation for the whole group to our meeting.
We did it together, and I really liked it. I feel that focusing on
the present moment lessens the stress of daily life. Meditation
brings us to a place of realization that we can handle all that
comes along in life. It will also take practice, but it’s worth it.
Meditation as a nursing tool
The first step would be for the nurse to educate about and
encourage meditation to their patients. Written information can
be distributed or left in common areas. Nurses could also keep a
simple meditation card in their pocket to give to interested

patients. The nurse can guide patients through a simple
meditation of focusing on their breath. If that is not possible, a
community referral could be made.
Conclusion
Many CAM therapies are meant to reduce stress and anxiety.
This is true for massage, Yoga and meditation. Almost anyone
can benefit from all three.
Massage is more expensive and requires another person, but
Yoga and meditation can be done low-cost and alone if need be.
There is evidence to back up the many health benefits of these
and other CAM therapies.
References
Abdel Fattah, M., & Hamdy, B. (2011). Pulmonary Functions of
Children with Asthma Improve Following Massage Therapy.
Journal of Alternative & Complementary Medicine, 17(11),
1065-1068. https://doi.org/10.1089/acm.2010.0758
Brady, S., O'Connor, N., Burgermeister, D., & Hanson, P.
(2012). The Impact of Mindfulness Meditation in Promoting a
Culture of Safety on an Acute Psychiatric Unit. Perspectives
In Psychiatric Care, 48(3), 129-137.
https://doi.org/10.1111/j.1744-6163.2011.00315.x
Gaboury, I., April, K., & Verhoef, M. (2012). A qualitative
study on the term CAM: is there a need to reinvent the wheel?
BMC Complementary & Alternative Medicine, 12(1), 131-
137. https://doi.org/10.1186/1472-6882-12-131
Garner, B., Phillips, L., Schmidt, H., Markulev, C., O'Connor,
J., Wood, S., & McGorry, P. (2008). Pilot study evaluating the
effect of massage therapy on stress, anxiety and aggression
in a young adult psychiatric inpatient unit. Australian & New
Zealand Journal Of Psychiatry, 42(5), 414-422.

Hart, J. (2008). An overview of clinical applications of
therapeutic yoga. Alternative & Complementary Therapies,
14(1), 29-32.
References
Kaley-Isley, L., Peterson, J., Fischer, C., & Peterson, E. (2010).
Yoga as a complementary therapy for children and adolescents:
a guide for clinicians. Psychiatry (1550-5952), 7(8), 20-32.
Krucoff, C. (2011). Yoga for Neck and Shoulder Pain: As a
mind-body practice, yoga offers powerful tools for physical and
emotional relief. IDEA Fitness Journal, 8(6), 88-90.
Li, X., Tao, K., Zhou, Q., & Ling, C. (2011). Scientific
Publications from Mainland China, Taiwan, and Hong Kong in
Integrative and Complementary Medicine Journals: A Ten-
Year Literature Survey. American Journal Of Chinese Medicine,
39(4), 639-649.
References
Moss, A., Wintering, N., Roggenkamp, H., Khalsa, D.,
Waldman, M. R., Monti, D., & Newberg, A. B. (2012). Effects
of an 8- Week Meditation Program on Mood and Anxiety in
Patients with Memory Loss. Journal Of Alternative &
doi:10.1089/acm.2011.0051
Olivo, E., Dodson-Lavelle, B., Wren, A., Fang, Y., & Oz, M.
(2009). Feasibility and effectiveness of a brief meditation-based
stress management intervention for patients diagnosed with
or at risk for coronary heart disease: a pilot study. Psychology,

Health & Medicine, 14(5), 513-523.
doi:10.1080/13548500902890087
Smith, J., Sullivan, S., & Baxter, G. (2010). Massage therapy:
more than a modality. New Zealand Journal Of Physiotherapy,
38(2), 44-51.
Yoga Journal. (2008). Ahimsa. [photograph]. Retrieved from
http://blogs.yogajournal.com/slideshows/better-bone-
health on March 2, 2014.
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1
2
Prayer, Guided Imagery and Music Therapies for Control of
Pain or Stress
Peter Nurse, RN
[email protected]
Minnesota State University, Mankato
NURS382 Holistic Nursing Assessment and Practice
Dr. Laura Schwarz, DNP, RN, CNE
Date

Abstract
Pain and stress are problems that are common among
hospitalized patients. These problems are also common among
hospital nursing staff. Prayer, guided imagery and music
therapies are some complementary and alternative medicine
(CAM) therapies that may provide relief from pain and stress.
These treatments were studied using literature research and
personal implementation to determine their potential efficacy.
Numerous peer-reviewed studies were reviewed supporting the
use of all these therapies for stress and/or pain management,
either alone or as adjuncts. Personal experience also
recommends the use of these therapies. These therapies are
easily implemented by the nurse and deliver benefit to patients
at low cost. These therapies may improve overall patient
satisfaction with hospital services.
Objectives, after participating in this session, the learner will be
able to
1. Describe selected CAM therapies, indications for use, and
potential benefits.
2. Provide patients with practical strategies for implementation
of selected CAM therapies for use in the hospital setting.
1
2Aromatherapy, Hand Massage, and Guided Meditation for
Stress Reduction
Student name, RN
[email protected]
Nursing 382 Holistic Nursing Assessment and Practice
Abstract
Hospitalized patients along with nurses providing their care are
subject to increased stress as a result of managing and treating
acute illness. Therefore, aromatherapy, hand massage, and
guided meditation therapies were examined for their

effectiveness on stress reduction in these individuals. A critical
review of literature together with a personal trial of these
therapies were used to evaluate their definition, mechanism of
action, practice implementation practicality, and effectiveness.
Individuals who benefit from receiving these therapies were
also recognized. The literature and personal assessment of
these therapies provides robust evidence to support the
effectiveness and use of these therapies for stress reduction.
The type of evidence obtained included qualitative and
quantitative research studies. Additional benefits demonstrated
by these therapies were also identified. Recommendations for
nursing practice implementation include education of therapy
methods and effectiveness on stress reduction in combination
with nursing practice integration strategies. Patient
recommendations include teaching complementary therapy
benefits and efficacy to reduce stress through relaxation.
Objectives: After participating in this presentation, the learner
will be able to:
1. describe complementary therapy methods, mechanisms of
action, effectiveness, and individual benefits.
2. apply complementary alternative modality practice
integration strategies to promote stress reduction.
3. educate patients on the benefits and effectiveness of
complementary therapy.

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