Complementary Therapies Seminar

Complementary and
Alternative Therapy
C. Matthews MSN, RN
Marilee Elias, MSN, RN
Spring 2012
Please make phones silent & visible

Reading
 Required:
– Wilkinson-Ch. 40
– Ignatavicius – Ch. 2
 Suggested Additional reading:
– Lilley – Ch. 8 “Over the counter drugs and
Herbal products”
Some references in this presentation will be
from pages in your textbooks other than
required chapters – highly recommended
reading.
10/5/2023 2
C. Matthews RN, MSN
M. Elias RN, MSN
SEMINAR
ON
ALTERNATIVE AND
COMPLEMENTARY THERAPY
PRESENTED BY-
Smrutirekha parida
MSC NURSING 1ST YR

C. Matthews RN, MSN
M.Elias RN, MSN SP10 3
Course Outcomes
10/5/2023
Introduction
Complementary and alternative medicines (CAMs) are treatments that
are not used in the practice of conventional western medicine. CAMs
can be used to treat the disease itself, lessen the side effects of
another treatment, or improve a patient's quality of life. These
treatments have either not gone through the process of scientific
testing or have been tested and found to be ineffective. There is also a
branch of medicine referred to as integrativecare because it involves a
treatment plan designed by a health professional that utilizes both
conventional western medicine and less proven complementary
methods.

CONTENT FOR ALTERNATIVE THERAPIES
10/5/2023 4
C. Matthews RN, MSN
M.Elias RN, MSN SP11
DEFINITION:
Complementary Therapy:
It refers to use together with conventional medical
treatment
Alternative Therapy: Alternative Therapy is the
term for medical products and practices that are not
part of standard care.They are use instead of
conventional medical treatment.

CONTENT FOR ALTERNATIVE THERAPIES
10/5/2023
C. Matthews RN, MSN
CLASSIFICATION OF COMPLEMENTARY AND
ALTERNATIVE THERAPY

History of Western Medicine
6
C. Matthews RN, MSN
10/5/2023
Whole medical system-

Ancients -- Myths & Religion –
Basis For Medical Practice
7
C. Matthews RN, MSN
10/5/2023
Homeopathic-
It is the form of alternative medicine in which practitioners
treat patient using highly diluted preparations. The basic
principle of homeopathy known as “law of minimum dose”,
“let like cure by like”.It was first stated by Germen physician
Samuel Hahnemann in 1976.

History of Western Medicine:
Ancient Greece & Rome
 Hippocrates
 Galen
8
C. Matthews RN, MSN
10/5/2023
Naturopathic-
According to British Naturopathic Association,”It is a
system of treatment which recognises the existence of the
vital curative force with in the body “.It therefore
advocates aiding human system to remove the cause of
disease i.e toxins by expelling the unwanted and unused
matters from human body for curing disease.

 Early Christian era
ushers in hospitals
and health care
similar to
established Arab
Medicine
9
C. Matthews RN, MSN
10/5/2023
Traditional Chinese medication-
Traditional Chinese medicine originated in ancient
china and has envolved over thousands of years.TCM
practitioners use herbal medicines and various mind
and body practices such as acumpuncture to treat
health problem

 Middle Ages
– Midwives
– Witches
– Physicians
10
C. Matthews RN, MSN
10/5/2023
Ayurvedic Treatment-
Ayurvedic medicine -- also known as Ayurveda -- is one of
the world's oldest healing systems. It was developed
thousands of years ago in India. According to Ayurvedic
theory, everything in the universe -- living or not -- is
connected. Good health is achieved when your mind, body,
and spirit are in harmony with the universe. A disruption of
this harmony can lead to poor health and
sickness.Interventions are diet,breathing
exercise,meditation and yoga etc. Some animal products
may also used as intervention

 Renaissance
11
C. Matthews RN, MSN
10/5/2023
Mind body intervention

– Lister
– Nightingale
12
C. Matthews RN, MSN
M. Elias RN, MSN SP11
10/5/2023
Mindbodyintervention–
Meditation-
It involves attending to a specific focal point.
Reduced levels of lactic acid
Decreased oxygen consumption
Slowed heart rate
Decreased blood pressure
Improved function of immune system
Reduce pain
Relieve symptoms of psoriasis
Improve health
Stress relief/ reduce anxiety

Integrative Health Care is
Course outcome #1
Unit outcome #1 14
C. Matthews RN, MSN
Relaxation-
–To reduce anxiety, tension & emotional tension
which can exacerbate pain
–Promoting sleep
Basic elements of relaxation techniques are-
•A quiet environment
•A comfortable position

What is Holism?
Course outcome #1
Unit outcome #1 15
C. Matthews RN, MSN
Yoga-
Yoga is a good practice if one does in daily
life. It helps to live healthy life style and better
life forever.It is traditional physical and mental
discipline in india.out side india it is a typical
form of exercise. Yoga is a practice to bring
body parts together to make a balance of body,
mind and soul. It is very useful to reducing the
stress and anxiety

RNs must be familiar with C. A. M.
Course outcome #1
Unit outcome #1
C. Matthews RN, MSN
M. Elias RN, MSN SP11 16
imagery-
A technique of using the imagination to visualize
pleasant image. Benefits of this technique
include decrease anxiety and tension, decrease
adverse effect of chemotherapy.

C. Matthews RN, MSN
What is CAM?
 Complementary modalities
(therapies): used in conjunction with
conventional medical practice.
(Wilkinson, p. 1019)
 Alternative Modalities(therapies):
used instead of traditional care.
(Wilkinson, p.1019)
Unit outcome #3
Hypnosis-
It induces an altered state of consciousness
resembling sleep during which the person is
more receptive to suggestion.It also enhances the
client’s ability to form images.
Uses-
•Pain management
•Skin disease
•Habit control

C. Matthews RN, MSN

C. Matthews RN, MSN
RN must:
1.Be non-judgmental despite personal opinions
2. Build rapport by showing client respect – if
not, he may be afraid to tell about CAM use
3. Understand that C.A.M. can be beneficial,
when used correctly
4. Be aware that C.A.M. can be dangerous if it
interacts or interferes with conventional
treatment
Course outcome #1
Unit outcome #1
Biological based therapy

C. Matthews RN, MSN
RN must:
5. Be willing to teach the public about the
positive and negative information
regarding C.A.M.
6. Be aware that use of C.A.M. is popular
and increasing and must be included in
the history & physical
7. Know that Herbals, in particular, can
have significant effect on prescription
drugs and body function
Course outcome #1,2
Unit outcome #1
Diet therapy-
According to this therapy the food must be taken in natural
form.Fresh seasonal fruits ,fresh green leafy vegetables and
sprouts are excellent.These are classified into 3 types.

National Center for Complementary
and Alternative Medicine
10/5/2023
C. Matthews RN, MSN
AyurvedicHerbs
Traditional Hindu system of herbs used for
over 2000 year. These could be a single
herb or a mixture of many herbal products,
depending on the diseases and the
treatment required. Some common herbal
remedies include the following:
•Garlic
•Peppermint
•Chamomile

C. Matthews RN, MSN
NCCAM Domains of C.A.M.
Ignatavicius pg 8; Wilkinson p. 1020
 National Center for Complementary and
Alternative Medicine – 5 categories
– Systems of Health Care
– Mind-body therapies
– Manipulative and body-based therapies
– Biologically based therapies
– Energy therapies
Unit outcome #3
Antioxidants and Free radicals
•Antioxidant:
Substances that prevents oxidation,a chemical
process where by a substances is joined to oxygen.
•Free radicals:
•Antioxidants prevent tissue damage related to
these,which are unstable molecules that alter
genetic codes and trigger the development of cancer
growth.

C. Matthews RN, MSN
Mind-Body
Unit outcomes #1-5
Manipulative and body based methods

C. Matthews RN, MSN
Relaxation
 Used post-operatively (Ignatavicius, p. 299)
 Relaxation techniques (Ignatavicius, p. 56-57)
– To reduce anxiety, tension & emotional
tension which can exacerbate pain
 Relaxation (Wilkinson Vol 2, p. 967; Vol 1, pg 806-807)
 Progressive muscle relaxation (PMR)
(Wilkinson p. 807)
 Promoting sleep
 Can be taught in home setting
 Nurses can use for reduction of pain & stress.
Unit outcomes #1-5
Chiropathic
This treatment includes exercises and health and
life style counselling.Also include manipulation of
spine and other joints.

C. Matthews RN, MSN
Guided Imagery
Unit outcomes #1-5
Massage
It is use of the hands direct or redirect the flow
of the body’s energy field and enhance balanced
with in these field. It includes touch. The
means of perceiving through the tactile
sensation.

C. Matthews RN, MSN
Mind - Body
 Biofeedback (see Wilkinson text p. 1027)
 Journaling
– Provides a vehicle for expressing feelings
 Hypnosis
– Advanced training is NECESSARY
 Humor
– Biochemical Responses?
– Physiologic Responses?
Unit outcomes #1-5
Energy therapies

Spiritual
 Life force beliefs found in most cultures.
(Wilkinson, p 1020)
 Faith healing (Wilkinson page 260)
10/5/2023
C. Matthews RN, MSN
•Bio fieldtherapy
This field has not yet been scientifically
proven. Some form of this therapy by
applying pressure and manipulate the body
by placing hands. Example - therapeutic
touch

Prayer
 Most Widely Used CAM in U.S.
(NCCAM, 2004)
 C.A.M. interventions (Wilkinson page 257)
 Prayer
– For Self
– For Others
– Healing Prayer Services
– Prayer Groups
Unit outcomes #1-5 29
C. Matthews RN, MSN
Alternative/Complimentary modalities and Nursing-

C. Matthews RN, MSN
Spiritual
 Intercessory prayer
– An organized and regular form of prayer in
which someone communicates with his or
her higher power on behalf of another who
is in need.
 Healing prayer
– Studies showing evidence of improvement
 Wilkinson, p 259-260
Unit outcomes #1-5
With increasing consumer and professional interest in
alternative and complementary care,Registered Nurses
are incorporating alternative /complementary modalities
into their practices.while these modalities give nurses
additional tools to meet client needs.For the theory of
human care ,the very basis of nursing is interaction and
connection between two human beings.The modality of
healing presence is a significant,important technique to
provide trust,support and to initiate the caring encounter
necessary for nursing to take place.With nation wide
interest in complimentary health care ,nurses have
actively incorporated alternative modalities into their
practice.

•To provide comfort to the patient nurse can use
Acupressure
•To develop the sleeping pattern of patient Nurse can use
Massage
•Guided imagery ,relaxation therapy can provide to the
patient when patient will be in anxiety
In psychiatric nursing ,alternative therapies have been
included as
•Meditation
•Naturopathy
NURSING CONCERN ALTERNATIVE AND
COMPLEMENTARY INTERVENTION

C. Matthews RN, MSN
Spiritual
 Nurses should expect to work in
collaboration with others, particularly
ministers, pastors and chaplains, to meet
the complex spiritual needs of all patients.
 Potential problem: the nurse and patient
have different views of spirituality
– Respect patient’s wishes
– If patient asks for spiritual intervention that is
inconsistent with the nurse’s beliefs, seek
assistance from another nurse or chaplain.
Unit outcomes #1-5
•To provide comfort to the patient nurse can use
Acupressure
•To develop the sleeping pattern of patient Nurse can
use Massage
•Guided imagery ,relaxation therapy can provide to the
patient when patient will be in anxiety
In psychiatric nursing ,alternative therapies have been
included as
•Meditation
•Naturopathy

C. Matthews RN, MSN
Manipulative and body-based methods
Unit outcomes #1-5
SUMMERIZATION

C. Matthews RN, MSN
Manipulative and Body-based Therapies
 Yoga
– “life forces in correct balance and flow
– Concentration, strength, flexibility, symbolic
movements
– Breathing, movement & posture
 Tai Chi
– Promotes the flow of qi or energy throughout the
body
– Ignatavicius, p. 11
– Reduces sx. of fibromyalgia
– Used in cardiac rehab programs, can lower BP
Unit outcomes #1-5
ANY DOUBT?

Acupuncture
C. Matthews RN, MSN
Conclusion
We thus observe that the people are shifting their
allegiance to the Indian alternative therapies,because
these therapies are natural and have no side
effects.The western medecines has failed to deal with
the chronic diseases as well as new,antibiotic
resistant bacteria.Ancient therapies by contrast ,have
an excellent record of curing the chronic diseases that
donot respond well to western medicine.

C. Matthews RN, MSN
Acupuncture – uses for
Migraine headache – Ignatavicius, p. 953
Pain and Anesthesia – Ignatavicius p. 57
10/5/2023
BIBLIOGRAPHY-
Basheer.P.Shebeer &Khan S.Yaseen ;A Concise Textbook of
Advance Nursing Practice; First Edition;,Emmess Medical
publicers,Bangalor; page no-
(925-935)
Wilkinson, J.M. & Treas, L.S. (2011) Fundamentals of nursing,
2nd ed. FA Davis Company, Philadelphia, PA.
Internet resources

10/5/2023
C. Matthews RN, MSN
 The dreaded nausea and vomiting which commonly
occurs in some patients undergoing chemotherapy
and inevitably, with the use of certain classes of
agents, can often be worse than the disease itself.
Most oncologists have experienced the patients
who start vomiting at the thought of their next clinic
visit. At the University of Los Angeles (UCLA)
School of Medicine, a well-controlled study
completed over two Years ago, the authors of the
published paper reported significant reduction of
nausea and vomiting when pre-treated with. It is
now routinely administered before, after and in
between chemotherapy treatment sessions for
control or nausea and emesis. Such treatments are
relatively simple and easily executed in an
outpatient setting. Its effectiveness helps in
minimizing the use of standard, expensive multi-
drug anti-nausea regimens with their attendant side
effects, given along with the chemotherapeutic
agents.
 Acupuncture in Cancer Treatment by Eugene Mak, MD@
http://www.medicalacupuncture.org/acu_info/articles/cancertreatment.html

Biologically Based Therapies
 Dietary Therapies
 Herbs
 Vitamins
 Aromatherapy
Course outcome #2, 3 & 4
C. Matthews RN, MSN

C. Matthews RN, MSN
Dietary Therapies
 Nutraceuticals and phytonutrients
 Protective or healing agents found in plant
and animal foods.
 Free radicals: unstable molecules that alter
genetic codes and trigger the development of
cancer growth in cells.
 Antioxidants: react with free radicals,
preventing their damaging effects
– Sources of antioxidants: vitamin C, beta-
carotene, vitamin E
Unit outcomes #1-5

C. Matthews RN, MSN
Dietary Therapies
 Macrobiotic Diets
– Yin/ yang of foods
– Balanced foods
– Foods to avoid: processed and treated foods,
red meat, sugar, dairy products, eggs,
caffeine
– Caution: children and pregnant women may
have deficiency in Vitamins D and B12
Unit outcomes #1-5

C. Matthews RN, MSN
Aromatherapy –
Wilkinson page 1030
 Essences from oils extracted from plants &
flowers.
 Conditions responsive to aromatherapy:
– Stress and anxiety
– Muscular and rheumatic pains
– Digestive disorders
– Skin conditions
Unit outcomes #1-5

Aromatherapy
 Can be used for sense of smell, but also
as compresses, baths or topical
10/5/2023
C. Matthews RN, MSN

C. Matthews RN, MSN
Aromatherapy
(Ignativicius, p.12)
 Lavender – promotes relaxation & sleep
 Peppermint – stimulation, concentration
 Sandalwood – ease depression
 Tea tree – treating MRSA?
 Chamomile – relaxation
 Lemon – promotes sleep/ tx for insomnia
and/or digestive disorders
Unit outcomes #1-5

C. Matthews RN, MSN
Herbals
Cherokee story
 “…humans were without diseases until the
animals created them in retribution for the
lack of respect humans had shown them.
The plants, however, felt that the animals
were much too harsh and volunteered
themselves to provide a cure for every
disease the animals had created.”
 Cavendar, p. 55
Course outcome # 3 & 4
Unit outcomes #1-5

C. Matthews RN, MSN
HERBALS – what RN needs to know
 Major drawback: May delay important diagnosis
and treatment.
 Nursing Intervention: Make certain MD or ARNP
is aware of client’s use of herbals.
 Nursing action: What to assess & instruct pre-
op client regarding herbal therapy.
Unit outcomes #1-5

C. Matthews RN, MSN
HERBALS – what RN needs to know
 FDA categorized herbals as food and nutritional
supplements not as drugs
 The Dietary Supplement Health & Education Act
(DSHEA) of 1994 allowed herbs to be sold as
dietary supplements as long as there are no
health claims written on labels
 DSHEA requires no proof of safety or efficacy
and sets no standards for products labeled as
supplements, i.e. no guarantee the herb is
properly prepared
Unit outcomes #1-5

C. Matthews RN, MSN
Commonly used Herbals
Ignatavicius page 12 – table 2-3
 Know intended uses for each
 Know Caution & adverse effects of each
– Gingko bilboa
– Garlic
– Echinacea
– Ginseng
– St. John’s Wort
Unit outcomes #1-5

Ginko Biloba
 Reduce Memory Problems, Dementia,
Peripheral Vascular Disease
 Antioxidant & Vasodilatory Properties
 BUT can cause BLEEDING when used
with Anticoagulants
 Avoid before surgery
 Also cause Headache, GI Upset
C. Matthews RN, MSN

Garlic
 Lowers Cholesterol, Lowers BP, Natural
Antibiotic,
 Natural Anti-platelet Agent
 BUT Causes BLEEDING with other Anti-
platelet Drugs
 Potentiates Anti-diabetic Drugs
 Avoid before Surgery
C. Matthews RN, MSN

Echinacea
 Builds Immunity, Helps Wound Healing
 Use > 8 Weeks & Possible Immune
Function Suppression
 NOT Recommended for People with
Immune Diseases
C. Matthews RN, MSN

Ginseng
 Asian Ginseng- Diabetes, Erectile
Dysfunction, “Unclear” Thinking
 American Ginseng- Diabetes,
Prevention of Colds & Flu
 Siberian Ginseng- Prevent Colds & Flu,
reduce Severity of Herpes Simplex type 2
Infections
 BUT, BUT, BUT, BUT…
C. Matthews RN, MSN

Ginseng and the Big Buts
10/5/2023
C. Matthews RN, MSN

Ginseng & The BIG BUTS
 Insomnia, Headache, Agitation, GI Upset,
Unusual Menstrual Bleeding, Breast Pain,
Dizziness, Increase or Decrease BP,
Hypoglycemia,
Fast/Pounding/Irregular Heartbeat;
Severe Allergic Reaction
 Not with Immune System Disorders,
Schizophrenia, Endometriosis, Fibroids
 NOT FOR Long-term Use
Course outcome # 2, 3 & 4
C. Matthews RN, MSN

St. John’s Wort
 Ease Mild to Moderate Depression
 BUT causes Photosensitivity
 DO NOT use in Major Depression
 DO NOT use with Other Antidepressants
C. Matthews RN, MSN

C. Matthews RN, MSN
Herbals
 Alert: “Natural” does not always mean
harmless.
 Plants used improperly can be poisonous.
 Chemicals within herbs can strengthen the
immune system, alter blood chemistry, or
protect specific organs against disease
 Caution: some individuals may have
allergies
Unit outcomes #1-5

C. Matthews RN, MSN
Herbals
 Special precaution with pregnant or
lactating women and children – should not
use without physician’s knowledge
Rationale:
Unpredictable biologic effects
Possible allergies
Side effects
Herbs have chemical composition
Little or no regulation of production/ quality
Possible herb/drug or herb/herb interaction
Possible delay of treatment is dangerous
Unit outcomes #1-5

C. Matthews RN, MSN
Herbals & the RN
 Teach about signs of allergic
reactions
 Teach that herbs can be dangerous
even if they are not Rx and are
“natural”
Unit outcomes #1-5

C. Matthews RN, MSN
Herbals & the RN
 Always ask about use of herbals when
getting medication history
 “What is the story of why the patient is
using the plant medicine or therapy?”
– Libster, p. 809
 Teach clients to look for products labeled
‘standardized’ – these more likely to have
accurate amounts of herb and less likely
to have contamination
Unit outcomes #1-5

C. Matthews RN, MSN
 Have had spiritual significance since ancient
times and they also were adopted as medicines
for physical ailments.
 In modern Chinese Materia Medica, these two
resins are classified as herbs for vitalizing
circulation of blood and are utilized for treating
traumatic injury, painful swellings, masses, and
other disorders related to stasis syndromes.
– MYRRH AND FRANKINCENSE by Subhuti Dharmananda, Ph.D., May 2003 @
http://www.itmonline.org/arts/myrrh.htm
*Will not be on the test!
Unit outcomes #1-5
Frankincense and Myrrh* medicinal use

 Pain in the epigastrum, abdomen, hypochondria, and/or
heart due to qi and blood stasis, and stagnation in the
viscera and bowels or the channels (jing) and network
vessels (luo).
 Amenorrhea, dysmenorrhea, or postpartum abdominal
pain due to blood stasis.
 Rheumatic complaints due to wind damp causing qi and
blood stagnation and stasis in the network vessels.
 Wounds, scars, and skin inflammation with blood stasis
and necrotic tissue.
 Traumatic injuries with pain, swelling, and redness due
to qi stagnation and blood stasis.
– MYRRH AND FRANKINCENSE by Subhuti Dharmananda, Ph.D., May 2003 @
http://www.itmonline.org/arts/myrrh.htm
10/5/2023
C. Matthews RN, MSN

C. Matthews RN, MSN
Folk Medicine
(Ignatavicius, 6th ed., page 32-33)
 Learned from experience
 Passed from generation to generation
 Preservation of heritage/ culture
 Some have been scientifically proven (ex.
Garlic)
 Plants/herbs
 Hot/cold
 “Evil Eye” (Mal de Ojo)
Unit outcomes #1-5

10/5/2023
C. Matthews RN, MSN

C. Matthews RN, MSN
Folk Medicine
 Own terminology: (Feel free to ask the meaning)
– “high blood” “low blood” “thin blood”
– “Thick blood” conjure water
– “fall out” gimpy dropsy
– risin’ sugar cut pain
– Weeded breasts
– “snuffing the mother”
– “the itch”
– Cavendar, 2003
Unit outcomes #1-5

Course outcome #2
Unit outcome #6
C. Matthews RN, MSN

C. Matthews RN, MSN
What is Quackery?
 A pretender
 Questionable products & services
 Over promotion vs. fraud
 Misinformation
 Useful for some purposes, not others
Course outcome #2
Unit outcome #6

C. Matthews RN, MSN
How to spot Quackery
 Tell only part of the story
 Over promotes nutritional insurance
 Play on fears about chemicals
 ‘Everyone needs supplements’
 Promise quick, dramatic, miraculous results
 Anecdotes & testimonials
 Questionable credentials
 Claim persecution
 Promote distrust
 Take claims directly to the media, not peers
 Resist peer review
Course outcome #2
Unit outcome #6

C. Matthews RN, MSN
Nurses Educate the Public
 Teach signals of fraudulent practice
 Avoid ‘healers’ who:
– Promise immediate relief or success
– State that their way is the only sure therapy
– Refuse to work with other health care
providers
– Claim to have all the answers
– Use testimonials that claim amazing results
Course outcome #2
Unit outcome #6

One Minute Paper
Now is the time to write short answers
to:
1. What is something you heard today that
is new to you?
2. How do you plan to approach your
clients about CAM?
3. List one thing that surprised you.
4. List one thing that reinforced something
you already believed.
10/5/2023 68
C. Matthews RN, MSN

C. Matthews RN, MSN
References
 Cavender, A.(2003) Folk Medicine in Southern
Appalachia. The University of North Carolina Press,
Chapel Hill, N.C.
 Ignatavicius, D.D. & Workman, M.L. (2010) Medical-
Surgical Nursing. 6th ed. Elsevier Saunders, St. Louis,
Missouri.
 Libster, M.L. (2002) Delmar’s Integrative Herb Guide for
Nurses. Delmar Thomson Learning. United States.
 Wilkinson, J.M. & Treas, L.S. (2011) Fundamentals of
nursing, 2nd ed. FA Davis Company, Philadelphia, PA.
10/5/2023

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