1. Complementary and alternative medicine in the management of pain, dyspnea, and nausea and vomiting near the end of life. A systematic review.

Pan CX, Morrison RS, Ness J, Fugh-Berman A, Leipzig RM.

http://www.ncbi.nlm.nih.gov/pubmed/11068159

 

Source

Department of Geriatrics and Adult Development, The Mount Sinai School of Medicine, New York, NY 10029-6574, USA.

Abstract

To review the evidence for efficacy of complementary and alternative medicine (CAM) modalities in treating pain, dyspnea, and nausea and vomiting in patients near the end of life, original articles were evaluated following a search through MEDLINE, CancerLIT, AIDSLINE, PsycLIT, CINAHL, and Social Work Abstracts databases. Search terms included alternative medicine, palliative care, pain, dyspnea, and nausea. Two independent reviewers extracted data, including study design, subjects, sample size, age, response rate, CAM modality, and outcomes. The efficacy of a CAM modality was evaluated in 21 studies of symptomatic adult patients with incurable conditions. Of these, only 12 were directly accessed via literature searching. Eleven were randomized controlled trials, two were non-randomized controlled trials, and eight were case series. Acupuncture, transcutaneous electrical nerve stimulation, supportive group therapy, self-hypnosis, and massage therapy may provide pain relief in cancer pain or in dying patients. Relaxation/imagery can improve oral mucositis pain. Patients with severe chronic obstructive pulmonary disease may benefit from the use of acupuncture, acupressure, and muscle relaxation with breathing retraining to relieve dyspnea. Because of publication bias, trials on CAM modalities may not be found on routine literature searches. Despite the paucity of controlled trials, there are data to support the use of some CAM modalities in terminally ill patients. This review generated evidence-based recommendations and identified areas for future research.

PMID: 11068159

[PubMed - indexed for MEDLINE]

 

2. Complementary and alternative medicine (CAM) among hospitalised patients: an Australian study.

Shorofi SA, Arbon P.

http://www.ncbi.nlm.nih.gov/pubmed/20347839

 

 

Source

School of Nursing and Midwifery, Flinders University, GPO Box 2100, Adelaide 5001, Australia. shorofi@yahoo.com

Abstract

PURPOSE:

To identify patients' report of complementary and alternative medicine (CAM) use, along with their knowledge, their attitudes, and their use/willingness to use CAM.

METHODS:

A total of 353 patients were recruited through a 'convenience' sampling method in four metropolitan hospitals in Adelaide. Data were collected by means of questionnaires with open- and close-ended questions.

RESULTS:

The prevalence of CAM use among patients was 90.4%; although a considerable proportion of patients using CAM did not disclose this information to nurses/doctors (39.9%) and 20.7% said they would report it as "only when needed/or if asked to". A high proportion of patients reported using non-herbal supplements (60.3%) and massage therapy (45%) while most forms of therapies were mainly used "only when needed". The CAM domain most frequently used was biologically based therapies (68.8%). Patients rated themselves as having "none" (24.4%) or "very little" (42.5%) knowledge about most CAM, although nearly half (46.4%) of them had a positive attitude towards CAM. Use, knowledge, and attitudes towards CAM were also associated with diverse socio-demographic variables. This study provides a comprehensive analysis of the use of CAM by patients.

Crown Copyright 2009. Published by Elsevier Ltd. All rights reserved.

PMID: 20347839

[PubMed - indexed for MEDLINE]

 

3. Reflection of a 7-year patient care program: implementing and sustaining an integrative hospital program.

Ernst LS, Ferrer L.

http://www.ncbi.nlm.nih.gov/pubmed/20009019

 

Source

Saint Barnabas Health Care System, Saint BarnabasMedical Center, 94 Old Short Hills Road, Livingston, NJ 07039, USA. lernst@sbhcs.com

Abstract

Integrative alternative therapies, also known as holistic therapies, have many applications in hospitals and health centers. These may include relaxation therapies, meditation, massage, reflexology, and Reiki or healing touch. Patients today are looking for these services, and institutions continue to explore ways to provide them without affecting their bottom line. The Integrative Cardiac Wellness Program is such a service, and its growth and longevity comes out of the personal investment of the staff to the program and to their patients. The literature review on the permanence of caring practice shows that caring about your work with patients, not just the job, is critical in longevity (Graber & Mitcham, 2004). The holistic nurses' and staff 's commitment to their professional growth within their specialty and their personal spiritual practice as experts in the field forms the backbone of the Integrative Wellness Program's success. It has been in existence for 7 years, providing integrative healing therapies to more than 7,000 patients, making it one of the most experienced. The program now serves cardiac surgery patients, and patients who have been diagnosed with cancer.

PMID: 20009019

[PubMed - indexed for MEDLINE]

 

4. Complementary medicine in the primary care setting: Results of a survey of gender and cultural patterns in Israel.

Ben-Arye E, Karkabi S, Shapira C, Schiff E, Lavie O, Keshet Y.

http://www.ncbi.nlm.nih.gov/pubmed/19682666

 

Source

Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. eranben@netvision.net.il

Abstract

OBJECTIVE:

The purpose of this study was to examine the use of complementary and alternative medicine (CAM) in a primary care practice in Israel to determine prevalence and patterns of use.

METHODS:

Trained research assistants invited all patients attending the administrative, medical, pharmaceutical, or nursing services of 7 clinics in urban and rural areas of northern Israel over a 16-month period, from April 1, 2005, through August 1, 2006, to complete a 13-item written questionnaire about CAM use and beliefs about CAM safety and efficacy. CAM was defined as therapies often referred to as alternative, complementary, natural, or folk/traditional medicine, and which are not usually offered as part of the medical treatment in the clinic, including herbal medicine, Chinese medicine (including acupuncture), homeopathy, folk and traditional remedies, dietary/nutritional therapy (including nutritional supplements), chiropractic, movement/manual healing therapies (including massage, reflexology, yoga, and Alexander and Feldenkrais techniques), mind-body techniques (including meditation, guided imagery, and relaxation), energy and healing therapies, and other naturopathic therapies. The Pearson chi(2) test and multivariate logistic regression were used to assess univariate associations with the odds ratios of CAM use among Arab and Jewish women. A t test was performed to determine whether there were any differences in the continuous variables between the 2 groups.

RESULTS:

Of 3972 consecutive patients who received the questionnaire, 3447 responded; 2139 respondents (62%) were women. Of the female respondents, 2121 reported their religion (1238 respondents [58%] self-identified as being Arab, and 883 [41.6%] as being Jewish). Compared with men, more women used CAM during the previous year (46.4% vs 39.4%; P < 0.001). Women were more likely to use CAM and to be interested in receiving CAM at primary care clinics. Arab women reported less CAM use than Jewish women but were more interested in experiencing CAM, had a higher degree of confidence in CAM efficacy and safety, and more frequently supported the integration of CAM practitioners in primary care clinics.

CONCLUSIONS:

In this study, women visiting primary care clinics in northern Israel used CAM more often than men did. Arab women reported less use of CAM than did Jewish women but also reported greater confidence in CAM efficacy and safety.

PMID: 19682666

[PubMed - indexed for MEDLINE]

 

5. Facilitating comfort for hospitalized patients using non-pharmacological measures: preliminary development of clinical practice guidelines.

Williams AM, Davies A, Griffiths G.

http://www.ncbi.nlm.nih.gov/pubmed/19531072

 

Source

The Western Australian Centre for Cancer and Palliative Care, Curtin University of Technology, Perth, Western Australia, Australia. anne.m.williams@health.wa.gov.au

Abstract

Nurses often use non-pharmacological measures to facilitate comfort for patients within the hospital setting. However, guidelines for use of these measures are commonly inadequate or absent. This paper presents 12 clinical practice guidelines that were developed from the findings of a literature review into non-pharmacological measures that are thought to facilitate patient comfort. The non-pharmacological measures addressed in these guidelines are: Aromotherapy, Distraction, Guided Imagery, Laughter, Massage, Music, Reiki, Heat or Cold, Meditation, Reflexology, Reposition and Transcutaneous Electrical Nerve Stimulation. These are preliminary guidelines for the use of non-pharmacological measures and further research and development of such guidelines is recommended.

PMID: 19531072

[PubMed - indexed for MEDLINE]

 

6. Integrative therapies in hospice and home health: introduction and adoption.

Johnson EL, O'Brien D.

http://www.ncbi.nlm.nih.gov/pubmed/19212218

 

Source

Pathways Home Health & Hospice, Sunnyvale, California 94085, USA. ejohnson@pathwayshealth.org

Abstract

Integrative therapies comprise a variety of nonpharmacologic methods that provide pain and symptom management. These therapies are increasingly gaining acceptance in the healthcare community as complementary to traditional treatments for pain. This article details the introduction, scope, and challenges healthcare organizations face when incorporating integrative therapies into their care plans.

PMID: 19212218

[PubMed - indexed for MEDLINE]

 

7. Nurses' experiences of practicing the HeartTouch technique for one month.

Jelonek Walker M.

Source

Lauterstein-Conway School of Massage, Austin, TX 78736, USA. walkerj@io.com

Abstract

Stress plays a significant role in almost every aspect of health. Appraisal (thoughts and feelings) of a situation determines the level of stress experienced.

PURPOSE:

To describe the nurses' experiences of practicing the HeartTouch (HRTT) technique, an internal tool designed to help nurses change their thoughts and feelings, especially in stressful situations.

METHOD:

After an education session discussing the effects of thoughts and feelings on stress and health, nurses learn HRTT. After practicing HRTT for 1 month during their daily life, 48 nurses answer 7 open-ended questions about their experience. Content analysis is used to analyze the data.

FINDINGS:

Nurses notice physical, mental, and emotional benefits for themselves, patients, colleagues, and family members. Nurses feel less stressed and experience an increased sense of control and ability to notice and change their thoughts and feelings. Nurses also discuss meaningful connections with self, others, and a Higher Power and greater work satisfaction.

PMID: 19126880

[PubMed - indexed for MEDLINE]

 

8. Insomnia among hospitalized older persons.

Flaherty JH.

http://www.ncbi.nlm.nih.gov/pubmed/18035231

 

Source

Geriatric Research, Education and Clinical Center, St. Louis Veteran's Affairs Medical Center, St. Louis, MO, USA. flaherty@slu.edu

Abstract

Among hospitalized older persons, rates of insomnia are alarmingly high, as is evident by the high rates of use of sedative-hypnotic drugs, ranging from 31% to 88%. Insomnia among hospitalized patients may represent undiagnosed sleep disorders, underlying medical problems, and underlying psychiatric problems. Causes of insomnia can be intrinsic or extrinsic. In the intensive care unit, which is one of the most studied areas of the hospital related to insomnia, most studies using polysomnography monitoring have shown that although sleep times seem normal (about 7&8 hours per night), no patients have normal sleep patterns. There is evidence supporting the use of nonpharmacologic interventions, which are preferable to the use of sedating drugs because of the risk associated with their use.

PMID: 18035231

[PubMed - indexed for MEDLINE]

 

9. The conjoint use of music therapy and reflexology with hospitalized advanced stage cancer patients and their families.

Magill L, Berenson S.

http://www.ncbi.nlm.nih.gov/pubmed/18662423

 

Source

School of Music, Faculty of Arts and Social Sciences, University of Windsor, Windsor, Ontario, Canada. lucannem@uwindsor.ca

Abstract

Advanced stage cancer patients experience debilitating physical symptoms as well as profound emotional and spiritual struggles. Advanced disease is accompanied by multiple changes and losses for the patient and the family. Palliative care focuses on the relief of overall suffering of patients and families, including symptom control, psychosocial support, and the meeting of spiritual needs. Music therapy and reflexology are complementary therapies that can soothe and provide comfort. When used conjointly, they provide a multifaceted experience that can aid in the reduction of anxiety, pain, and isolation; facilitate communication between patients, family members, and staff; and provide the potential for a more peaceful dying experience for all involved. This article addresses the benefits of the combined use of music therapy and reflexology. Two case studies are presented to illustrate the application and benefits of this dual approach for patients and their families regarding adjustment to the end of life in the presence of anxiety and cognitive impairment.

PMID: 18662423

[PubMed - indexed for MEDLINE

 

10. Use of complementary and alternative medicine (CAM) by Washington State hospices.

Kozak LE, Kayes L, McCarty R, Walkinshaw C, Congdon S, Kleinberger J, Hartman V, Standish LJ.

http://www.ncbi.nlm.nih.gov/pubmed/19106280

 

Source

Bastyr University Research Center, 14500 Juanita Drive NE, Kenmore, WA 98028, USA. leilak@bastyr.edu

Abstract

PURPOSE:

To assess the use of complementary and alternative medicine in hospice care in the state of Washington.

METHODS:

Hospices offering inpatient and outpatient care in Washington State were surveyed by phone interview.

RESULTS:

Response rate was 100%. Results indicated that 86% of Washington State hospices offered complementary and alternative services to their patients, most frequently massage (87%), music therapy (74%), energy healing (65%), aromatherapy (45%), guided imagery (45%), compassionate touch (42%), acupuncture (32%), pet therapy (32%), meditation (29%), art therapy (22%), reflexology (19%), and hypnotherapy (16%). Most hospices relied on volunteers with or without small donations to offer such services.

CONCLUSIONS:

Complementary and alternative therapies are widely used by Washington State hospices but not covered under hospice benefits. Extensive use of these therapies seems to warrant the inclusion of complementary and alternative providers as part of hospice staff, and reimbursement schedules need to be integrated into hospice care.

PMID: 19106280

[PubMed - indexed for MEDLINE]

 

11. Spiritual care as a dimension of holistic care: a relational interpretation.

Bush T, Bruni N.

http://www.ncbi.nlm.nih.gov/pubmed/19060804

 

Source

Royal Melbourne Institute of Technology University, Australia. tony.bush@rmit.edu.au

Abstract

This article reports on a phenomenological study undertaken to explore the meaning of spiritual care as described by a group of palliative care professionals. The research process was informed by van Manen's (1990) hermeneutic phenomenological approach. Eight palliative care professionals (nurses, complementary therapists and pastoral carers) were recruited from a community palliative care agency in Melbourne, Victoria, which provided home-based palliative care. All participants were female and came from diverse ethnic backgrounds. Data were collected by in-depth conversational interviews and were analyzed thematically. Two themes emerged: 'a living nexus between spiritual care, spirituality and holism' and 'a world of relationships'. The findings of the study point to the need for healthcare professionals to incorporate spiritual care guidelines into practice in order for palliative care to be truly representative of holistic health care.

PMID: 19060804

[PubMed - indexed for MEDLINE]

 

12. Complementary and alternative medicine use among primary care patients in west Texas.

Zhang Y, Jones B, Ragain M, Spalding M, Mannschreck D, Young R.

http://www.ncbi.nlm.nih.gov/pubmed/19005448

 

Source

Department of Family and Community Medicine (Lubbock and El Paso), Texas Tech University Health Science Center, Lubbock, TX, USA. yan.zhang@ttuhsc.edu

Abstract

BACKGROUND:

This study explored factors related to practitioner-based complementary and alternative medicine (CAM) usage among primary care clinic patients in rural West Texas areas, including physicians' awareness of their patients' CAM use.

METHODS:

A convenience sample was drawn from nine clinics that served low-income populations. Surveys were distributed to patients during a 6-week period in the winter of 2006. The analytical sample included 1731 participants. Logistic regressions were conducted to explore the factors related to CAM use.

RESULTS:

Of 1731 subjects, 52.0% (900) reported that they were currently using or had used CAM. The main types of CAM practitioners were chiropractor (42.7%) followed by massage therapist (33.3%) and herbalist (8.3%). Those who had discussed the use of alternative medicine with their physicians and those who had more days where they felt worried in the past 30 days were more likely to use CAM than their counterparts. Patients whose healthcare was covered by nonprivate insurance, those who rated their healthcare providers more highly, and those who agreed that their doctor visits were obtainable were less likely to use CAM.

CONCLUSIONS:

CAM use is clearly not uncommon among primary care patients in rural areas, with more than half of patients reporting some type of use. This study suggests that further research should elicit opinions on CAM among people who do not regularly access a conventional primary care provider, as well as assess the relationship between CAM and conventional medical treatment in terms of cost and health benefits.

PMID:

19005448

[PubMed - indexed for MEDLINE]

 

13. Personal use and professional recommendations of complementary and alternative medicine by Hong Kong registered nurses.

Xue CC, Zhang AL, Holroyd E, Suen LK.

http://www.ncbi.nlm.nih.gov/pubmed/18382017

 

Source

Division of Chinese Medicine, School of Health Sciences, The WHO Collaborating Centre for Traditional Medicine, RMIT University, Melbourne, Australia.

Abstract

OBJECTIVE:

To provide an understanding of Hong Kong registered nurses' personal and professional use of complementary and alternative medicine.

DESIGN:

Cross-sectional questionnaire study.

PARTICIPANTS:

Registered nurses who were members of the Hong Kong College of Nursing were invited to participate.

MAIN OUTCOME MEASURES:

Demographic data of the respondents, prevalence of personal and professional use of complementary and alternative medicines, including their use for detailed clinical conditions.

RESULTS:

A total of 187 nurses participated in this study. Nearly four fifths (80%; 95% confidence interval, 74-86%) of the participants had used at least one form of complementary/alternative medicine. In addition to the personal use of such treatment, over two fifths (41%; 95% confidence interval, 34-48%) had recommended at least one form of complementary/alternative medicine to their patients. These included bone-setting (20%), Chinese remedial massage (tuina, 19%), and meditation (19%). Specifically, registered nurses recommended acupuncture or acupressure to patients with musculoskeletal disorders, chronic pain, or headaches/migraines.

CONCLUSIONS:

Personal use and professional recommendations for complementary and alternative medicine by registered nurses in Hong Kong is substantial. Registered nurses played an active role in advising such treatment for their patients based on their personal knowledge of perceived benefit in specific conditions. Further investigations with a larger sample size should focus on registered nurses' educational needs in respect of complementary and alternative medicine and the advice they recommended.

PMID: 18382017

[PubMed - indexed for MEDLINE]

Free full text

Climacteric. 2008 Apr;11(2):124-34.

 

14. Self-management strategies to reduce pain and improve function among older adults in community settings: a review of the evidence.

Reid MC, Papaleontiou M, Ong A, Breckman R, Wethington E, Pillemer K.

http://www.ncbi.nlm.nih.gov/pubmed/18346056

 

Source

Department of Medicine, Weill Cornell Medical College, New York, New York, USA. mcr2004@med.cornell.edu

Abstract

CONTEXT:

Self-management strategies for pain hold substantial promise as a means of reducing pain and improving function among older adults with chronic pain, but their use in this age group has not been well defined.

OBJECTIVE:

To review the evidence regarding self-management interventions for pain due to musculoskeletal disorders among older adults.

DESIGN:

We searched the Medline and Cumulative Index to Nursing and Allied Health Literature databases to identify relevant articles for review and analyzed English-language articles that presented outcome data on pain, function, and/or other relevant endpoints and evaluated programs/strategies that could be feasibly implemented in the community. Abstracted information included study sample characteristics, estimates of treatment effect, and other relevant outcomes when present.

RESULTS:

Retained articles (N = 27) included those that evaluated programs sponsored by the Arthritis Foundation and other programs/strategies including yoga, massage therapy, Tai Chi, and music therapy. Positive outcomes were found in 96% of the studies. Proportionate change in pain scores ranged from an increase of 18% to a reduction of 85% (median = 23% reduction), whereas change in disability scores ranged from an increase of 2% to a reduction of 70% (median = 19% reduction). Generalizability issues identified included limited enrollment of ethnic minority elders, as well as non-ethnic elders aged 80 and above.

CONCLUSIONS:

Our results suggest that a broad range of self-management programs may provide benefits for older adults with chronic pain. Research is needed to establish the efficacy of the programs in diverse age and ethnic groups of older adults and identify strategies that maximize program reach, retention, and methods to ensure continued use of the strategies over time.

PMID: 18346056

[PubMed - indexed for MEDLINE]

 

15. Complementary/alternative medicine use among chronic pain clinic patients.

Konvicka JJ, Meyer TA, McDavid AJ, Roberson CR.

http://www.ncbi.nlm.nih.gov/pubmed/18226781

 

Source

Department of Anesthesiology, Scott & White Memorial Hospital and Clinic, 2401 S. 31st St, Temple, TX 76508, USA.

Abstract

Complementary and alternative therapies have enjoyed increasingly widespread use in recent years. Because of this trend, we were eager to obtain a better grasp on the actual number of people in our hospital's pain clinic who have used these modalities. In an effort to explore the use of complementary/alternative medicine (CAM) by patients seen in an anesthesiology chronic pain clinic, we conducted a study using a questionnaire. This questionnaire contained two sections, one covering complementary/alternative modalities and the other dealing with herbals or nutraceuticals. More than 400 patients were surveyed, 41% of whom were male and 59% of whom were female. Comparing alternative therapies by gender revealed no statistical difference in males versus females. The most commonly chosen modalities overall were nutraceuticals, massage therapy, and acupuncture. In terms of age, we found that the patients surveyed who were older than 60 years of age preferred nutraceuticals, and that the younger age group preferred more interactive relaxation techniques, such as meditation and massage.

PMID: 18226781

[PubMed - indexed for MEDLINE]

 

16. Creation of a healing enhancement program at an academic medical center.

Cutshall SM, Fenske LL, Kelly RF, Phillips BR, Sundt TM, Bauer BA.

http://www.ncbi.nlm.nih.gov/pubmed/17950176

 

Source

Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.

Abstract

There has been a growing emphasis on evaluating and improving the experience of the hospitalized patient. In 2004, the Cardiovascular Surgery team at Mayo Clinic Rochester, though achieving a high level of technical expertise and clinical outcomes, recognized that patients were not rating their overall hospital experience as highly as was expected. After a systematic evaluation of the hospital experience, tension, stress, pain, and anxiety were identified as key challenges for patients. A multidisciplinary team was created to evaluate pain management practices and explore methods for reducing pain, anxiety, and tension. An extensive review of the literature and site visits to other institutions provided the foundation for the program. The term "Healing Enhancement" was coined to identify the goals of this emerging paradigm that focused on all aspects of the patient's experience-mind, body, and spirit. Integrated therapies such as music, massage, guided imagery, and relaxation training were explored to measure their role in patient care.

PMID: 17950176

[PubMed - indexed for MEDLINE]

 

17. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter.

Cooke M, Holzhauser K, Jones M, Davis C, Finucane J.

http://www.ncbi.nlm.nih.gov/pubmed/17727588

 

Source

School of Nursing & Midwifery, Research Centre for Clinical Practice Innovation, Griffith University, QLD, Australia. m.cooke@griffith.edu.au

Abstract

AIMS AND OBJECTIVES:

This research aimed to evaluate the use of aromatherapy massage and music as an intervention to cope with the occupational stress and anxiety that emergency department staff experience. The study also aimed to compare any differences in results between a summer and winter 12-week massage plan.

BACKGROUND:

Emergency nurses are subjected to significant stressors during their work and it is known that workloads and patient demands influence the role stress has on nurses. The perception that winter months are busier for emergency departments has long been held and there is some evidence that people with cardiac and respiratory dysfunction do present more frequently in the winter months. Massage has been found to decrease staff anxiety.

DESIGN:

The study used a one-group pre-test, post-test quasi-experimental design with random assignment.

METHOD:

Staff occupational stress was assessed pre- and post- 12 weeks of aromatherapy massage with music and anxiety was measured pre and post each massage session. Sick leave was also measured. Comparisons of summer and winter data were undertaken.

RESULTS:

A total of 365 massages were given over two 12-week periods, one during summer and the other during winter. Analysis identified that aromatherapy massage with music significantly reduced anxiety for both seasonal periods. Premassage anxiety was significantly higher in winter than summer. No differences in sick leave and workload were found. There was no difference in the occupational stress levels of nurses following the two 12-week periods of massage.

CONCLUSION:

Emergency nurses were significantly more anxious in winter than summer but this cannot be attributed to increased sick leave or workloads. Aromatherapy massage with music significantly reduced emergency nurses' anxiety.

RELEVANCE TO CLINICAL PRACTICE:

High levels of anxiety and stress can be detrimental to the physical and emotional health of emergency nurses and the provision of a support mechanism such as on-site massage as an effective strategy should be considered.

PMID: 17727588

[PubMed - indexed for MEDLINE]

 

18. Use of complementary and alternative medicine in pediatric otolaryngology patients attending a tertiary hospital in the UK.

Shakeel M, Little SA, Bruce J, Ah-See KW.

http://www.ncbi.nlm.nih.gov/pubmed/17714796

 

Source

Department of Otolaryngology, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, Scotland, UK. drshakeel@doctors.org.uk

Abstract

OBJECTIVE:

Little data is available on complementary and alternative medicine (CAM) use in children attending otolaryngology services. We investigated the prevalence and pattern of CAM use among children attending the pediatric otolaryngology department in a tertiary pediatric teaching hospital in Scotland.

DESIGN:

A cross-sectional survey conducted by administering an anonymous questionnaire to the parents accompanying patients attending the pediatric otolaryngology department. Elective admissions and clinic attendees were included over a 3-month period in 2005/2006.

SETTING:

Academic tertiary care referral centre in North-East Scotland.

PATIENTS:

Five hundred and fifty-four consecutive patients aged less than 16 years were eligible. The response rate was 59% (n=327).

MAIN OUTCOME MEASURES:

Prevalence of CAM use in children. Secondary measures include types of CAM used, indications for use and communication with family physicians.

RESULTS:

Based on 327 responses, 93 patients (29%) had ever used CAM, 20% within the last year. Commonly used CAM preparations were cod-liver oil, echinacea, aloe vera, cranberry, primrose oil and herbal vitamin supplements. The popular non-herbal CAM included homeopathy, massage, aromatherapy, chiropractic, yoga and reiki. Nineteen percent used CAM for their admission illness. Sixty-one percent of parents thought that CAM was effective and 65% would recommend it to others. Fifty-one percent of parents stated that the family physician was unaware of CAM use by the child.

CONCLUSIONS:

Despite concerns regarding the efficacy, safety and cost effectiveness of complementary and alternative medicine, its use among the pediatric otolaryngology population is more common than many providers may realize. This has implications for all healthcare workers involved in their care.

PMID: 17714796

[PubMed - indexed for MEDLINE]

 

19. Complementary therapies for cancer pain.

Cassileth B, Trevisan C, Gubili J.

http://www.ncbi.nlm.nih.gov/pubmed/17686389

 

Source

Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. gubilij@mskcc.org

Abstract

Pharmacologic treatment of pain does not always meet patients' needs and may produce difficult side effects. Complementary therapies, which are safe, noninvasive, and generally considered to be relatively free of toxicity, may be used adjunctively with standard pain management techniques to improve outcome and reduce the need for prescription medication. Approaches such as acupuncture, massage therapy, mind-body interventions, and music therapy effectively reduce pain, enhance quality of life, and provide patients with the opportunity to participate in their own care. Such therapies have an important role in modern pain management.

PMID: 17686389

[PubMed - indexed for MEDLINE]

 

20. The status of complementary therapy services in Canadian palliative care settings.

Oneschuk D, Balneaves L, Verhoef M, Boon H, Demmer C, Chiu L.

http://www.ncbi.nlm.nih.gov/pubmed/17609996

 

Source

Division of Palliative Medicine, Department of Oncology, University of Alberta, Edmonton Palliative Medicine Program, Grey Nuns Hospital, 1100 Youville Drive W, Edmonton, Alberta, Canada. doreen.oneschuk@capitalhealth.ca

Abstract

GOAL OF WORK:

Little is known about complementary therapy services (CTs) available in Canadian palliative care settings.

MATERIALS AND METHODS:

An online survey was e-mailed to multiple Canadian palliative care settings to determine the types and frequency of CTs provided and allowed, who are the CT providers, funding of CT services, and barriers to the provision of CTs.

MAIN RESULTS:

The response rate was 54% (74/136). Eleven percent of surveyed palliative care settings provided CTs, and 45% allowed CTs to be brought in or to be used by patients. The three most commonly used CTs were music (57%), massage therapy (57%), and therapeutic touch (48%). Less than 25% of patients received CTs in the settings that provided and/or allowed these therapies. CTs were mostly provided by volunteers, and at most settings, limited or no funding was available. Barriers to the delivery of CTs included lack of funding (67%), insufficient knowledge of CTs by staff (49%), and limited knowledge on how to successfully operate a CT service (44%). For settings that did not provide or allow CTs, 44% felt it was important or very important for their patients to have access to CTs. The most common reasons not to provide or allow CTs were insufficient staff knowledge of CTs (67%) and lack of CT personnel (44%).

CONCLUSIONS:

Overall, these findings were similar to those reported in a US-based hospice survey after which this survey was patterned. Possible reasons for these shared findings and important directions regarding the future of CT service provision in Canadian palliative care setting are discussed.

PMID: 17609996

[PubMed - indexed for MEDLINE]

 

21. Literature review: should nursing take aromatherapy more seriously?

Buckle J.

http://www.ncbi.nlm.nih.gov/pubmed/17353823

 

Source

Centre for Complementary Healthcare and Integrative Medicine (CCHIM), Faculty of Health and Human Science, Thames Valley University, London.

Abstract

Aromatherapy is often misunderstood and consequently somewhat marginalized. Because of a basic misinterpretation, the integration of aromatherapy into UK hospitals is not moving forward as quickly as it might. Aromatherapy in UK is primarily aimed at enhancing patient care or improving patient satisfaction, and it is frequently mixed with massage. Little focus is given to the real clinical potential, except for a few pockets such as the Micap/South Manchester University initiative which led to a Phase 1 clinical trial into the effects of aromatherapy on infection carried out in the Burns Unit of Wythenshawe Hospital. This article discusses the expansion of aromatherapy within the US and follows 10 years of developing protocols and policies that led to pilot studies on radiation burns, chemo-induced nausea, slow-healing wounds, Alzheimers and end-of-life agitation. The article poses two questions: should nursing take aromatherapy more seriously and do nurses really need 60 hours of massage to use aromatherapy as part of nursing practice?

PMID: 17353823

[PubMed - indexed for MEDLINE]

 

22. What do clinicians want? Interest in integrative health services at a North Carolina academic medical center.

Kemper KJ, Dirkse D, Eadie D, Pennington M.

http://www.ncbi.nlm.nih.gov/pubmed/17291340

 

Source

Department of Pediatrics, Wake Forest University Baptist Medical Center, Winston-Salem, NC 27157, USA. kkemper@wfubmc.edu

Abstract

BACKGROUND:

Use of complementary medicine is common, consumer driven and usually outpatient focused. We wished to determine interest among the medical staff at a North Carolina academic medical center in integrating diverse therapies and services into comprehensive care.

METHODS:

We conducted a cross sectional on-line survey of physicians, nurse practitioners and physician assistants at a tertiary care medical center in 2006. The survey contained questions on referrals and recommendations in the past year and interest in therapies or services if they were to be provided at the medical center in the future.

RESULTS:

Responses were received from 173 clinicians in 26 different departments, programs and centers. There was strong interest in offering several specific therapies: therapeutic exercise (77%), expert consultation about herbs and dietary supplements (69%), and massage (66%); there was even stronger interest in offering comprehensive treatment programs such as multidisciplinary pain management (84%), comprehensive nutritional assessment and advice (84%), obesity/healthy lifestyle promotion (80%), fit for life (exercise and lifestyle program, 76%), diabetes healthy lifestyle promotion (73%); and comprehensive psychological services for stress management, including hypnosis and biofeedback (73%).

CONCLUSION:

There is strong interest among medical staff at an academic health center in comprehensive, integrated services for pain, obesity, and diabetes and in specific services in fitness, nutrition and stress management. Future studies will need to assess the cost-effectiveness of such services, as well as their financial sustainability and impact on patient satisfaction, health and quality of life.

PMID:

17291340

[PubMed - indexed for MEDLINE]

PMCID: PMC1802091

Free PMC Article

 

23. Nursing students' willingness to use complementary and alternative therapies for cancer patients: Istanbul survey.

Oztekin DS, Ucuzal M, Oztekin I, Işsever H.

http://www.ncbi.nlm.nih.gov/pubmed/17202772

 

Source

Florence Nightingale College of Nursing, Istanbul University, Kadikoy, 34726 Istanbul, Turkey. dnzoztekin@hotmail.com

Abstract

It is important for student nurses to be knowledgeable of the complementary and alternative therapies and to provide accurate information to both cancer patients and other health care professionals. This study examined the nursing students' willingness to use these therapies, availability of sources of information, use of the therapies for self care, opinions about the integration of these therapies into nursing curriculum, and analyzed the differences among the responses. A self-administered questionnaire was offered to 640 nursing students in Istanbul, descriptive statistics were used, and comparisons among responses were made with chi-square test. Willingness to use for cancer patients was highest for nutritional therapy (76.1%), breathing therapies (74.5%), and massage and manipulation-Tui Na, in which pressure and touch are applied to the body (71.9%). Use of information sources was highest for nutritional therapy (75.6%), breathing therapies (71.9%), and massage and manipulation-Tui Na (62.3%). Over half of the nursing students used music therapy (54.2%), and massage and manipulation-Tui Na (53.6%) for self-care. Breathing therapies (87.2%) were the most desired therapy chosen to be included in nursing curriculum. The statistically significant differences were found among the responses related to use five therapies for care and related to desired three therapies to be included in nursing curriculum. Although students had not previously been exposed to these therapies use with oncology patients, many of students expressed a desire to integrate therapies learning into nursing curriculum. The more student nurses document high risk patients, the more effective strategies will be developed by other health care professionals.

PMID:

17202772

[PubMed - indexed for MEDLINE]

Free full text

 

24. The supply of complementary and alternative medicine in Swiss hospitals.

Widmer M, Dönges A, Wapf V, Busato A, Herren S.

http://www.ncbi.nlm.nih.gov/pubmed/17200610

 

Source

Institute for Evaluative Research in Orthopaedic Surgery, University of Bern, Switzerland. marcel.widmer@MEMcenter.unibe.ch

Abstract

OBJECTIVES:

Over the past few years, a considerable increase in complementary and alternative medicine (CAM) has been observed, particularly in primary care. In contrast little is known about the supply of CAM in Swiss hospitals. This study aims at the investigation of amount and structure of CAM activities of Swiss hospitals.

MATERIALS AND METHODS:

We designed a cross-sectional survey using a 2-step, questionnaire- based approach acquiring overview information form hospital managers in a first questionnaire leading to detailed information on CAM usage at medical department level (head of department). This second questionnaire provides data of physician-based and non-physician-based CAM supply.

RESULTS:

The size of hospitals was significantly associated with the provision of CAM. 33% of the hospital managers indicated 1 or more medical doctor (MD) using CAM in their hospital compared to 37% of confirmation on department level (Kappa value 0.5). Mostly different CAM methods were applied. Acupuncture was used most frequently. However only 13 hospitals (11%) occupied more than 3 CAM MDs and only 5 hospitals had more than 2 full-time equivalents for MDs. Furthermore, 74.7% of these personnel resources were dedicated for outpatient care. In terms of CAM methods anthroposophic medicine accounted for more than half of the total personnel costs. On the other hand usage of non-physician based CAM accounted for 41% according to hospital managers compared to 64% of CAM usage according to medical departments (Kappa values 0.31). Reflexology of the foot was used most frequently.

CONCLUSION:

Total supply of CAM in Swiss hospitals is low and concentrates on few hospitals. Acupuncture is the widest spread discipline but anthroposophic medicine spends the most resources. The study shows that a high patient demand for CAM faces low supply in hospitals.

PMID: 17200610

[PubMed - indexed for MEDLINE]

 

25. Yoga for patients and carers in a palliative day care setting.

McDonald A, Burjan E, Martin S.

http://www.ncbi.nlm.nih.gov/pubmed/17170669

 

Source

aileenmedusa@googlemail.com

Abstract

This study suggests that yoga can be of benefit to patients (and carers) in palliative care settings. Complementary therapies have been employed in our day care unit for several years--aromatherapy, reflexology and massage--and have grown in popularity, enabling relaxation and a feeling of well-being. For patients striving to remain physically fit and, in consultation with our physiotherapist, we felt there may be a role for a gentle form of yoga. A study of the literature yielded information on yoga and cancer but little evidence of its use in palliative care. Having identified a form of yoga that could be adapted for those with physical frailties-- Dru yoga--a 12-week pilot project was introduced into the day care unit. This proved to be highly successful and has now been incorporated as part of our therapeutic service.

PMID: 17170669

[PubMed - indexed for MEDLINE]

  

26. Complementary medicine in palliative care and cancer symptom management.

Mansky PJ, Wallerstedt DB.

http://www.ncbi.nlm.nih.gov/pubmed/17034678

 

Source

National Center for Complementary and Alternative Medicine, National Institutes of Health, DHHS, Bethesda, Maryland 20892, USA. manskyp@mail.nih.gov

Abstract

Complementary and alternative medicine (CAM) use among cancer patients varies according to geographical area, gender, and disease diagnosis. The prevalence of CAM use among cancer patients in the United States has been estimated to be between 7% and 54%. Most cancer patients use CAM with the hope of boosting the immune system, relieving pain, and controlling side effects related to disease or treatment. Only a minority of patients include CAM in the treatment plan with curative intent. This review article focuses on practices belonging to the CAM domains of mind-body medicine, CAM botanicals, manipulative practices, and energy medicine, because they are widely used as complementary approaches to palliative cancer care and cancer symptom management. In the area of cancer symptom management, auricular acupuncture, therapeutic touch, and hypnosis may help to manage cancer pain. Music therapy, massage, and hypnosis may have an effect on anxiety, and both acupuncture and massage may have a therapeutic role in cancer fatigue. Acupuncture and selected botanicals may reduce chemotherapy-induced nausea and emesis, and hypnosis and guided imagery may be beneficial in anticipatory nausea and vomiting. Transcendental meditation and the mindfulness-based stress reduction can play a role in the management of depressed mood and anxiety. Black cohosh and phytoestrogen-rich foods may reduce vasomotor symptoms in postmenopausal women. Most CAM approaches to the treatment of cancer are safe when used by a CAM practitioner experienced in the treatment of cancer patients. The potential for many commonly used botanical to interact with prescription drugs continues to be a concern. Botanicals should be used with caution by cancer patients and only under the guidance of an oncologist knowledgeable in their use.

PMID: 17034678

[PubMed - indexed for MEDLINE]

 

27. Taiwanese nurses' attitudes towards and use of complementary and alternative medicine in nursing practice: a cross-sectional survey.

Chu FY, Wallis M.

http://www.ncbi.nlm.nih.gov/pubmed/16997305

 

Source

Nursing Department, Tzu Chi College of Technology, Taiwan, ROC. sylvia@tccn.edu.tw

Abstract

BACKGROUND:

Increasingly, nurses in Western countries express positive attitudes to complementary and alternative medicine (CAM) but lack knowledge, access to education and organisational policy to guide practice. It is unclear whether nurses in developed Asian countries mirror or differ from this profile.

OBJECTIVES:

To determine the attitudes towards and use of CAM by registered nurses in Taiwan.

DESIGN:

Cross sectional survey.

SETTING:

A Nursing College in eastern Taiwan.

PARTICIPANTS:

Registered nurses (N=170) working in various clinical settings who were studying a post registration Bachelor of Nursing conversion course.

METHODS:

Questionnaire distributed to nurses during class time.

RESULTS:

Most nurses had positive attitudes to CAM and most used therapies, like massage, occasionally in practice. However, none had formal qualifications in CAM and most perceived that there were insufficient resources or organisational policy to facilitate practice.

CONCLUSIONS:

Taiwanese nurses need more formal education about CAM and require access to clear policies regarding the safe use of CAM in nursing practice.

PMID: 16997305

[PubMed - indexed for MEDLINE]

 

28. Patient visits to a hospital-based alternative medicine clinic from 1997 through 2002: experience from an integrated healthcare system.

Bracha Y, Svendsen K, Culliton P.

http://www.ncbi.nlm.nih.gov/pubmed/16781496

 

Source

Berman Center for Outcomes and Clinical Research, Minneapolis Medical Research Foundation, Minnesota 55404, USA. ybracha@bermancenter.org

Abstract

OBJECTIVE:

Efforts to integrate complementary and alternative medicine (CAM) into conventional healthcare systems raise questions about expected levels of CAM use and its cost in an integrated system. This paper documents actual patient usage of a hospital-based alternative medicine clinic that has been operating on a conventional healthcare campus since 1993.

SETTING:

Hennepin Faculty Associates (HFA) is a multispecialty physician organization serving the Hennepin County Medical Center (HCMC), a public teaching hospital in downtown Minneapolis. In 1993, HFA opened an alternative medicine clinic, primarily providing acupuncture. The clinic has since expanded services to offer chiropractic, massage/bodywork, and herbs. Administrative claims data showing visit dates, treatment received, payment source, charges, and patient complaints are available from 1997 through 2002.

RESULTS:

Of all HFA patients who received conventional care on the HCMC campus every year (1997-2002), 6.5% also received care at the Alternative Medicine Clinic (AMC). Nearly 80% of AMC patients received third-party reimbursement for AMC services. Averaged over 6 years, self-pay patients had 3.2 visits per year and incurred $173 in charges per year; patients with a mixture of third-party payment sources had 8.0 visits per year and incurred $634 in charges per year. Number of visits per patient per year remained relatively constant over the 6 years, except for patients aged 65 or older, who showed an increase in number of visits, particularly for acupuncture.

CONCLUSIONS:

This report contributes a new perspective on use of CAM in the general population. Results from this perspective differ markedly from those provided by published survey data, showing a lower prevalence of use and lower charges incurred. Concern that insurance coverage for CAM would increase healthcare costs dramatically are not substantiated by these data.

PMID: 16781496

[PubMed - indexed for MEDLINE]

 

29. Evaluating CAM treatment at the end of life: a review of clinical trials for massage and meditation.

Lafferty WE, Downey L, McCarty RL, Standish LJ, Patrick DL.

http://www.ncbi.nlm.nih.gov/pubmed/16765848

 

Source

University of Washington, School of Public Health and Community Medicine, Department of Health Services, Seattle, WA 98195, USA. billlaf@u.washington.edu

Abstract

BACKGROUND:

There is a pressing need for improved end-of-life care. Use of complementary and alternative medicine (CAM) may improve the quality of care but few controlled trials have evaluated CAM at the end of life.

OBJECTIVES:

To determine the strength of evidence for the benefits of touch and mind-body therapies in seriously ill patients.

METHODS:

Systematic review of randomized controlled trials of massage and mind-body therapies. A PubMed search of English language articles was used to identify the relevant studies.

RESULTS:

Of 27 clinical trials testing massage or mind-body interventions, 26 showed significant improvements in symptoms such as anxiety, emotional distress, comfort, nausea and pain. However, results were often inconsistent across studies and there were variations in methodology, so it was difficult to judge the clinical significance of the results.

CONCLUSIONS:

Use of CAM at the end of life is warranted on a case-by-case basis. Limitations in study design and sample size of the trials analyzed mean that routine use of CAM cannot be supported. There are several challenges to be addressed in future research into the use of CAM in end-of-life patients.

PMID: 16765848

[PubMed - indexed for MEDLINE]

 

30. Evaluating the effectiveness of aromatherapy in reducing levels of anxiety in palliative care patients: results of a pilot study.

Kyle G.

http://www.ncbi.nlm.nih.gov/pubmed/16648093

 

Source

Thames Valley University, Slough, SL1 1YG, UK. gayekyle@tiscali.co.uk

Abstract

Results of the pilot study of the four counties randomised controlled trial to evaluate the effectiveness of aromatherapy massage with 1% Santalum album (Sandalwood) (group A) when compared with massage with Sweet Almond Carrier oil, (group B) or Sandalwood oil via an aromastone (group C), in reducing levels of anxiety in palliative care. The aims of the pilot study were to evaluate the effectiveness of aromatherapy in reducing anxiety in patients receiving palliative care in four counties. The primary end points of the research were to report a statistically significant difference in anxiety scores between experimental group (B) and comparison groups (A and C) and to influence the integration of aromatherapy into all aspects of palliative care. The limited data of the pilot study (N=34) tested the logistics of the research, particularly the 25% attrition rate and the robustness of the data collection tools. The results were not substantial enough to generate coherent statistics. Therefore no assumptions could be drawn from these results due to the inconsistencies that were bound to occur in such a small sample. However, the results do seem to support the notion that Sandalwood oil is effective in reducing anxiety.

PMID: 16648093

[PubMed - indexed for MEDLINE]

 

31. Palliative in-patient cancer treatment in an anthroposophic hospital: I. Treatment patterns and compliance with anthroposophic medicine.

Heusser P, Braun SB, Ziegler R, Bertschy M, Helwig S, van Wegberg B, Cerny T.

http://www.ncbi.nlm.nih.gov/pubmed/16645289

 

Source

Institute for Complementary Medicine KIKOM, University of Bern, Switzerland. peter.heusser@kikom.unibe.ch

Abstract

BACKGROUND:

Complementary and alternative medicine (CAM) and most of all anthroposophic medicine (AM) are important features of cancer treatment in Switzerland. While the number of epidemiological investigations into the use of such therapies is increasing, there is a distinct lack of reports regarding the combination of conventional and CAM methods.

PATIENTS AND METHODS:

144 in-patients with advanced epithelial cancers were enrolled in a prospective quality-of-life (QoL) study at the Lukas Klinik (LK), Arlesheim, Switzerland. Tumor-related treatment was assessed 4 months prior to admission, during hospitalization and 4 months after baseline.

OBJECTIVE:

We aimed at giving a detailed account of conventional, AM and CAM treatment patterns in palliative care, before, during and after hospitalization, with emphasis on compliance with AM after discharge.

RESULTS:

Certain conventional treatments featured less during hospitalization than before but were resumed after discharge (chemotherapy, radiotherapy, sleeping pills, psychoactive drugs). Hormone therapy, corticosteroids, analgesics WHO III and antidepressants remained constant. AM treatment consisted of Iscador? (mistletoe), other plant- or mineral-derived medication, baths, massage, eurythmy, art therapy, counseling and lactovegetarian diet. Compliance after discharge was highest with Iscador (90%) and lowest with art therapy (14%). Many patients remained in the care of AM physicians. Other CAM and psychological methods were initially used by 39.9% of patients. After 4 months, the use had decreased with few exceptions.

CONCLUSION:

During holistic palliative treatment in an anthroposophic hospital, certain conventional treatments featured less whereas others remained constant. After discharge, chemotherapy returned to previous levels, AM compliance remained high, the use of other CAM therapies low.

Comment in

PMID: 16645289

[PubMed - indexed for MEDLINE]

 

32. The Sh-h-h-h Project: nonpharmacological interventions.

Robinson SB, Weitzel T, Henderson L.

http://www.ncbi.nlm.nih.gov/pubmed/16269944

 

Source

Southern Illinois University School of Medicine, Springfield, Ill 62794, USA. srobinson3@siumded.edu

Abstract

Promoting rest and sleep is integral to the profession of nursing. The Sh-h-h-h Project, a nonpharmacological program designed to enhance rest and sleep, was implemented on a hospital medical unit. Nursing assistants provided patients with various modalities to improve sleep, including back rubs, warm drinks, blankets warmed in a blanket warmer, aromatherapy, relaxation music, and earplugs. Additional interventions were taken to reduce noise. The outcomes of the Sh-h-h-h Project are reported here, with patients indicating improved sleep quality and quantity.

PMID: 16269944

[PubMed - indexed for MEDLINE]

 

33. Using Bowen technique in a health service workplace to improve the physical and mental wellbeing of staff.

Dicker A.

http://www.ncbi.nlm.nih.gov/pubmed/19175262

 

Source

Ballina Community Health.

Abstract

A six week program using Bowen Technique treated 31 Hospital and Community Health Service staff in a group setting providing an innovative way to reduce stress and improve physical health. Quantitative and qualitative data indicated that Bowen Technique was successful in reducing pain, improving mobility, reducing stress, and improving energy, well being and sleep.

PMID: 19175262

[PubMed - indexed for MEDLINE]

 

34. Survey of complementary and alternative medicine use at a tertiary children's hospital.

Lim A, Cranswick N, Skull S, South M.

http://www.ncbi.nlm.nih.gov/pubmed/16101976

 

Source

Department of General Medicine, University of Melbourne, and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia. alissa.lim@rch.org.au

Abstract

OBJECTIVE:

The use of complementary and alternative medicine (CAM) within the Australian community is common. The objective of this study was to determine the prevalence and pattern of CAM usage in children attending a tertiary children's hospital.

METHODS:

We conducted a cross-sectional survey of children attending the Royal Children's Hospital, Melbourne. Children were identified by consecutive acute admissions and attendance at outpatient clinics. A structured questionnaire with items about the use of CAM in the preceding year was administered by means of a face-to-face interview.

RESULTS:

Based on the 503 children surveyed, 51% reported CAM use in the preceding year. Forty-three percent had used at least one CAM medication. The most common medicinal CAM used were multivitamins, vitamin C, herbal remedies and homeopathic treatments. Non-medicinal CAM was used by 23% of the participants. The most commonly used therapies were chiropractic, naturopathy, aromatherapy, therapeutic massage and dietary restriction. The main reasons stated for CAM usage included promotion of general health and treatment of colds. Sixty-three percent of those reporting CAM use had not discussed this with their treating doctor.

CONCLUSION:

The use of CAM by children is common. Complementary and alternative medicine is particularly used for the treatment of common illnesses and conditions of childhood. Importantly, use is not always conveyed to treating physicians. Given the potential risk of adverse events associated with the use of CAM or interactions with conventional management, doctors should ask about their use as a part of routine history taking.

PMID: 16101976

[PubMed - indexed for MEDLINE]

 

35. Aromatherapy in nursing practice].

[Article in Chinese]

Tseng YH.

http://www.ncbi.nlm.nih.gov/pubmed/16088776

 

Source

School of Nursing, Chung-Shan Medical University, No. 110 Chien-Kuo N. Road Sec. 1, Taichung 40201, Taiwan, ROC. yhtseng@csmu.edu.tw

Abstract

Aromatherapy is the use of essential oils which are distilled from aromatic plants to obtain holistic effects on the mind, body, and spirit. Among nurses, aromatherapy is the second most commonly used complementary therapy. The chemical components of essential oils, such as ketones, aldehydes, and esters, determine the specific effects of the essential oils. Essential oils may be administered by inhalation, bathing, or massage to decrease anxiety, pain, and fatigue, and improve wound healing. As neuronal, liver, and kidney toxicity, as well as skin allergies may occur, it is recommended not to use essential oils on a regular basis. Research has provided evidence on the effects of essential oils, but further research is needed to identify the effects of their interaction with medications, and whether there are any side effects or contraindications. Consequently, it will provide a scientific base on the use of essential oils and enhance the possibilities for the use of essential oils in health care.

PMID: 16088776

[PubMed - indexed for MEDLINE]

 

36. Complementary and alternative pain therapy in the emergency department.

Dillard JN, Knapp S.

http://www.ncbi.nlm.nih.gov/pubmed/15829396

 

Source

Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032, USA.

Abstract

One primary reason patients go to emergency departments is for pain relief. Understanding the physiologic dynamics of pain, pharmacologic methods for treatment of pain, as well CAM therapies used in treatment of pain is important to all providers in emergency care. Asking patients about self-care and treatments used outside of the emergency department is an important part of the patient history. Complementary and alternative therapies are very popular for painful conditions despite the lack of strong research supporting some of their use. Even though evidenced-based studies that are double blinded and show a high degree of interrater observer reliability do not exist, patients will likely continue to seek out CAM therapies as a means of self-treatment and a way to maintain additional life control. Regardless of absolute validity of a therapy for some patients, it is the bottom line: "it seems to help my pain." Pain management distills down to a very simple endpoint, patient relief, and comfort. Sham or science, if the patient feels better, feels comforted, feels less stressed, and more functional in life and their practices pose no health risk, then supporting their CAM therapy creates a true wholistic partnership in their health care.CAM should be relatively inexpensive and extremely safe. Such is not always the case, as some patients have discovered with the use of botanicals. It becomes an imperative that all providers be aware of CAM therapies and informed about potential interactions and side effects when helping patients manage pain and explore adding CAM strategies for pain relief. The use of regulated breathing, meditation, guided imagery, or a massage for a pain sufferer are simple but potentially beneficial inexpensive aids to care that can be easily employed in the emergency department. Some CAM therapies covered here, while not easily practiced in the emergency department, exist as possibilities for exploration of patients after they leave, and may offer an improved sense of well-being and empowerment in the face of suffering and despair. The foundations of good nutrition, exercise, stress reduction, and reengagement in life can contribute much to restoring the quality of life to a pain patient. Adding nondrug therapies of physical therapy, cognitive-behavioral therapy, TENS, hypnosis, biofeedback, psychoanalysis, and others can complete the conventional picture. Adding in simple mind/body therapies, touch therapies, acupuncture, or others may be appropriate in select cases, and depending on the circumstances, may effect and enhance a conventional pain management program. Armed with an understanding of pain dynamics and treatments, practitioners can better meet patient needs, avoid serious side effects, and improve care when addressing pain management in the emergency department.

PMID: 15829396

[PubMed - indexed for MEDLINE]

 

37. Use of alternative therapies by patients presenting to a pediatric emergency department.

Losier A, Taylor B, Fernandez CV.

http://www.ncbi.nlm.nih.gov/pubmed/15769566

 

Source

Department of Emergency Medicine, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.

Abstract

Complementary and alternative medicine (CAM) is used by some patients to supplement their health care. Information on the use of CAM in children who are not chronically ill is sparse. We conducted a survey of caregivers presenting to a tertiary pediatric Emergency Department to determine CAM use in this population. Six hundred twenty questionnaires (77.6% of those distributed) were available for analysis. Approximately 13% of caregivers reported using CAM for their child. The most common CAM therapies used were homeopathy (20%), prayer/spiritual approaches (19.7%), and massage therapy (16.7%). Age of child greater than 1 year was associated with CAM use (p < 0.05), as was parental higher education (p < 0.0001). Income, ethnicity, parental age, and chronic illness were not correlated with CAM use. CAM therapies are infrequently used in pediatric patients presenting to the Emergency Department.

PMID: 15769566

[PubMed - indexed for MEDLINE]

 

38. Policies pertaining to complementary and alternative medical therapies in a random sample of 39 academic health centers.

Cohen MH, Sandler L, Hrbek A, Davis RB, Eisenberg DM.

http://www.ncbi.nlm.nih.gov/pubmed/15712764

 

Source

Harvard Medical School Osher Institute, Boston, Mass, USA.

Abstract

This research documents policies in 39 randomly selected academic medical centers integrating complementary and alternative medical (CAM) services into conventional care. Twenty-three offered CAM services-most commonly, acupuncture, massage, dietary supplements, mind-body therapies, and music therapy. None had written policies concerning credentialing practices or malpractice liability. Only 10 reported a written policy governing use of dietary supplements, although three sold supplements in inpatient formularies, one in the psychiatry department, and five in outpatient pharmacies. Thus, few academic medical centers have sufficiently integrated CAM services into conventional care by developing consensus-written policies governing credentialing, malpractice liability, and dietary supplement use.

PMID: 15712764

[PubMed - indexed for MEDLINE]

 

39. Complementary therapy use by women's health clinic clients.

Pettigrew AC, King MO, McGee K, Rudolph C.

http://www.ncbi.nlm.nih.gov/pubmed/15624349

 

Source

University of Cincinnati College of Nursing, USA.

Abstract

CONTEXT:

While it is known that more women than men use complementary and alternative therapies, it is important to look at women who are pregnant or possibly receiving hormonal therapy, as side effects and consequences of these therapies may have a significant effect on their health status.

OBJECTIVE:

To assess women's knowledge, perceived effectiveness and use of 20 complementary and alternative therapies.

DESIGN:

Descriptive four-page questionnaire to obtain data on the use, reason for use, knowledge, perceived effectiveness, and sources of information of twenty complementary and alternative therapies.

SETTING:

Women's Health Center at a large Midwestern hospital.

PARTICIPANTS:

A convenience sample of 250 women waiting to be seen by either a nurse midwife or obstetrician/gynecologist at an outpatient clinic.

RESULTS:

Sixty-nine percent of the participants used one or more complementary therapy. The most frequently used therapies included prayer, vitamins, massage, diet, and aromatherapy. The best predictor of use of each therapy was the participant's knowledge of the therapy. Participants generally rated the efficacy of the therapies higher than their knowledge level. Frequently cited sources of information were popular media and family. The least common information sources were nurse-midwives, drug stores, Internet, and other professional healthcare providers.

CONCLUSIONS:

Women in this setting use complementary therapies at a rate greater than the general population. The participants obtained a great deal of their information about the therapies from popular press, media, friends, and family members rather than from licensed healthcare providers.

PMID: 15624349

[PubMed - indexed for MEDLINE]

 

40. A survey of complementary therapy services provided by hospices.

Demmer C.

http://www.ncbi.nlm.nih.gov/pubmed/15353094

 

Source

Department of Health Services, Lehman College, City University of New York, Bronx, New York 10468, USA. cdemmer@lehman.cuny.edu

Abstract

A questionnaire was mailed to 300 randomly selected hospices in the United States, to gather preliminary data on the nature of complementary therapy services provided by hospices. Information included types of complementary therapies offered, utilization, staffing, obstacles, as well as suggestions for improving hospice complementary therapy services. Of a total of 169 responding hospices, 60% offered complementary therapies to patients. The most popular therapies were massage therapy and music therapy. Only a portion of patients in these hospices received complementary therapy. Many hospices were limited in the amount of complementary therapy services they could provide because of program constraints, such as funding problems, lack of qualified complementary staff, inadequate knowledge of complementary therapies and how to offer these services, and resistance to complementary therapies by some staff and patients. A crucial challenge for hospices interested in providing complementary therapies to patients is to find ways to overcome these obstacles.

PMID: 15353094

[PubMed - indexed for MEDLINE]

 

41. Aromatherapy practice in nursing: literature review.

Maddocks-Jennings W, Wilkinson JM.

http://www.ncbi.nlm.nih.gov/pubmed/15347415

 

Source

Universal College of Learning, and Nurse Clinician/Trainee Nurse Practitioner, Acute Pain Services, Midcentral Health, Palmerston North, New Zealand. w.maddocks-jennings@ucol.ac.nz

Abstract

BACKGROUND:

The use of aromatherapy in nursing care continues to be popular in many settings. Most of the nursing literature relates to the use of essential oils in low doses for massage or use of the oils as environmental fragrances. Information from the wider literature may add to the evidence base for use of this therapy in nursing.

AIM:

This paper reports a literature relating to the use of aromatherapy by nurses and critically evaluates the evidence to support this practice.

METHOD:

Medline, CINAHL, MANTIS and EBSCO Host databases were searched for papers related to use of essential oils and/or aromatherapy. Papers were also obtained through cross-checking of reference lists. A total of 165 articles have been included in this review. Nursing papers were published since 1990 were included, but some references from 1971 onwards relating to scientific research conducted on essential oils were also included. These remain valuable as they are probably the only reference available for a specific oil or property, or show the development of knowledge in this area. Papers were excluded if they consisted only of brief case studies presented in abstract form. The review covers key professional issues and the principal areas of clinical practice where aromatherapy is used.

FINDINGS:

Despite calls for more research in the 1980s and 1990s, there is still little empirical evidence to support the use of aromatherapy in nursing practice beyond enhancing relaxation. Its popularity needs to be balanced against the potential risks related to allergies, safety and inappropriate use by inexperienced users.

CONCLUSIONS:

There is great potential for more collaborative research by nurses to explore the clinical applications in greater detail and to move beyond the low dose paradigm of application of essential oils.

PMID: 15347415

[PubMed - indexed for MEDLINE]

 

42. Physicians and complementary-alternative medicine: training, attitudes, and practices in Hawaii.

Chan PS, Wong MM.

http://www.ncbi.nlm.nih.gov/pubmed/15298087

 

Abstract

INTRODUCTION:

There were only few studies addressing the physicians' training, attitudes, and utilization of complementary and alternative medicine (CAM) therapies, compared to the well-documented escalating use of CAM among consumers. Patients who use CAM, however often do not disclose their utilization to their physicians. This study thus surveyed knowledge, attitudes, and practices of complementary and alternative medicine among physicians on the island of Oahu in Hawaii. The Hawaii Medical Service Association (HMSA) provided physicians' names and contact information.

METHOD:

This is a descriptive study with a questionnaire that was mailed to all physicians on the list. A total of 299 physicians responded to this survey. Response rate was 17.45%.

RESULTS:

Physicians reported having moderate acknowledge in acupuncture, massage, prayer/spiritualty chiropractic, hypnosis and meditation. They recognized the value of these treatments and refer their patients to have these treatments. On the other hand, homeopathy naturopathy, electromagnetic therapies, therapeutic/healing touch, and nutriceuticals were consistently rated as having no role in conventional medicine, strongly opposed to in practice, or would not refer patients to. Respondents felt CAM could be most effective for pain, musculoskeletal, psychological conditions and smoking cessation.

DISCUSSIONS:

Results indicated that the respondents had knowledge about prayer/spirituality, massage, chiropractic, meditation, hypnosis, and acupuncture, and also rated them as playing a role in conventional medicine, and would refer or have referred patients to. When they had little knowledge about naturopathy, electromagnetic therapies, nutriceuticals, and homeopathy, they rated these therapies as having no role in conventional medicine, and were strongly opposed to in practice or would not refer patients to. Respondents reported the least know abut the Aryurveda and Native American medicine. However, there was no significant correlation between negative attitude and practice patterns. Similarly therapeutic touch and chiropractic were perceived as therapies, but no role in conventional medicine although the respondents reported having some knowledge of these therapies. Thus, knowledge may not be necessarily associated with negative attitudes and practice patterns.

PMID: 15298087

[PubMed - indexed for MEDLINE]

 

43. A controlled trial of aromatherapy for agitation in nursing home patients with dementia.

Snow LA, Hovanec L, Brandt J.

http://www.ncbi.nlm.nih.gov/pubmed/15253846

 

Source

Houston Center for Quality of Care and Utilization Studies, Health Services Research and Development Service, Michael E.Debakey Veterans Affairs Medical Center, Houston, TX 77030, USA. asnow@bcm.tmc.edu

Abstract

OBJECTIVES:

Two controlled trials of aromatherapy to decrease agitation in persons with dementia have recently produced promising results. However, both studies combined the use of essential oils with massage. Thus, it is unclear if the effect of the aromatherapy intervention was the result of smelling or the cutaneous absorption of the oils. The purpose of this study was to determine whether smelling lavender oil decreases the frequency of agitated behaviors in patients with dementia.

DESIGN:

The study design was within-subjects ABCBA (A = lavender oil, B = thyme oil, C = unscented grapeseed oil): 4 weeks of baseline measurement, 2 weeks for each of the five treatment conditions (10-week total intervention time), and 2 weeks of postintervention measurement. Oil was placed every 3 hours on an absorbent fabric sachet pinned near the collarbone of each participant's shirt.

SETTING:

A long-term care facility specifically for persons with dementia.

PARTICIPANTS:

Seven agitated nursing home residents with advanced dementia.

MEASUREMENTS:

Agitation was assessed every 2 days using a modified Cohen-Mansfield Agitation Inventory. Olfactory functioning was assessed with structured olfactory identification and discrimination tasks, and with qualitative behavioral observation during those tasks.

RESULTS:

Split-middle analyses conducted separately for each patient revealed no treatment effects specific to lavender, no treatment effects nonspecific to pleasant smelling substances, and no treatment effects dependent on order of treatment administration. There were no differences between participants with more and less intact olfactory abilities.

CONCLUSION:

There is significant evidence in the neurologic and neuropsychologic literature that persons with dementia have impaired olfactory abilities. Concordant with this literature, this study found no support for the use of a purely olfactory form of aromatherapy to decrease agitation in severely demented patients. Cutaneous application of the essential oil may be necessary to achieve the effects reported in previous controlled studies.

Copyright Mary Ann Liebert, Inc.

PMID: 15253846

[PubMed - indexed for MEDLINE]

 

44. Does aromatherapy massage benefit patients with cancer attending a specialist palliative care day centre?

Wilcock A, Manderson C, Weller R, Walker G, Carr D, Carey AM, Broadhurst D, Mew J, Ernst E.

http://www.ncbi.nlm.nih.gov/pubmed/15198118

 

Source

Hayward House Macmillan Specialist Palliative Care Cancer Unit, Nottingham City Hospital NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK. andrew.wilcock@nottingham.ac.uk

Abstract

A randomised controlled pilot study was carried out to examine the effects of adjunctive aromatherapy massage on mood, quality of life and physical symptoms in patients with cancer attending a specialist unit. Participants were randomised to conventional day care alone or day care plus weekly aromatherapy massage using a standardised blend of oils for four weeks. At baseline and at weekly intervals, patients rated their mood, quality of life and the intensity and bother of two symptoms most important to them. Forty-six patients were recruited to the study. Due to a large number of withdrawals, only 11 of 23 (48%) patients in the aromatherapy group and 18 of 23 (78%) in the control group completed all four weeks. Mood, physical symptoms and quality of life improved in both groups. There was no statistically significant difference between groups in any of the outcome measures. Despite a lack of measurable benefit, all patients were satisfied with the aromatherapy and wished to continue. Whilst this pilot study has shown that a randomised controlled trial of complementary therapy is feasible, it has also identified several areas that would require further consideration when designing future studies, e.g., the recruitment and retention of appropriate numbers of patients and the outcome measures used.

PMID: 15198118

[PubMed - indexed for MEDLINE]

 

45. The award winning "Completing the circle" complementary therapy service initiative at Christie NHS Hospital Manchester.

Mackereth P.

http://www.ncbi.nlm.nih.gov/pubmed/15135765

 

Source

Rehabilitation Unit, Christie Hospital, Wilmslow Road, Manchester M20 4BX, UK.

Abstract

The complementary therapy team at the Christie Hospital has won a highly prestigious national Prince of Wales award. The award is for "Good Practice in Integrated Healthcare" and applauds the hospital for including complementary therapies as part of patient care at the Christie. His Royal Highness, The Prince of Wales presented The Prince of Wales Foundation for Integrated Healthcare Award to Christie staff at Lambeth Hospital in London on the 11th December 2003 (see picture). The Gateway Clinic at Lambeth Hospital jointly won the award (reference here to a future publication). The Christie Hospital started providing complementary therapies 7 years ago, and the service has greatly expanded in the last 3 years. Patients can choose a complementary therapy treatment in addition to their medical treatment. A 15-strong complementary therapy team provides back and head massages, reflexology and other treatments. The paper reports on the various aspects of the project, identifying who leads each part and how it is being developed and evaluated.

PMID: 15135765

[PubMed - indexed for MEDLINE]

 

46. Use of traditional drugs in a hospital of Chinese medicine in Germany.

Melchart D, Linde K, Weidenhammer W, Hager S, Liao J, Bauer R, Wagner H.

http://www.ncbi.nlm.nih.gov/pubmed/15073936

 

Source

Münchener Modell, Centre for Complementary Medicine Research, Department of Internal Medicine II, Technical University, Kaiserstr. 9, 80801 Munich, Germany.

Abstract

The frequency of use of traditional Chinese drugs was investigated in relation to Western and Chinese diagnostic classifications in a hospital for traditional Chinese medicine in Germany. All 1597 in-patients treated in the hospital between February 1992 and August 1993 entered a prospective observational study. About two thirds of the patients suffered from chronic pain syndromes, the most frequent single diagnosis being migraine (n=244). All patients were treated with at least one of four Chinese therapies (traditional Chinese drugs, acupuncture, Tuina-massage, Qi-gong). 95.1% of all patients received traditional Chinese drug treatment, prescribed in complex prescriptions including 3 to 12 single drugs from a total of 305. Drug patterns prescribed to patients with the same Western diagnosis tended to be similar, but could differ strongly for single drugs in subgroups with distinct Chinese diagnoses. Studies evaluating traditional Chinese treatment strategies in patients classified according to Western nosology should take into account possible diagnostic differences according to Chinese nosology. The development of a reliable coding system for Chinese diagnostic classifications is a precondition for further cross-cultural studies.

Copyright 1999 John Wiley & Sons, Ltd.

PMID: 15073936

[PubMed]

 

47. A randomized controlled trial of aromatherapy massage in a hospice setting.

Soden K, Vincent K, Craske S, Lucas C, Ashley S.

http://www.ncbi.nlm.nih.gov/pubmed/15046404

 

Source

Princess Alice Hospice, Esher, Surrey, UK. pkteash@hotmail.com

Abstract

Research suggests that patients with cancer, particularly in the palliative care setting, are increasingly using aromatherapy and massage. There is good evidence that these therapies may be helpful for anxiety reduction for short periods, but few studies have looked at the longer term effects. This study was designed to compare the effects of four-week courses of aromatherapy massage and massage alone on physical and psychological symptoms in patients with advanced cancer. Forty-two patients were randomly allocated to receive weekly massages with lavender essential oil and an inert carrier oil (aromatherapy group), an inert carrier oil only (massage group) or no intervention. Outcome measures included a Visual Analogue Scale (VAS) of pain intensity, the Verran and Snyder-Halpern (VSH) sleep scale, the Hospital Anxiety and Depression (HAD) scale and the Rotterdam Symptom Checklist (RSCL). We were unable to demonstrate any significant long-term benefits of aromatherapy or massage in terms of improving pain control, anxiety or quality of life. However, sleep scores improved significantly in both the massage and the combined massage (aromatherapy and massage) groups. There were also statistically significant reductions in depression scores in the massage group. In this study of patients with advanced cancer, the addition of lavender essential oil did not appear to increase the beneficial effects of massage. Our results do suggest, however, that patients with high levels of psychological distress respond best to these therapies.

PMID: 15046404

[PubMed - indexed for MEDLINE]

 

48. Complementary and alternative medicine: the move into mainstream health care.

O'Brien K.

http://www.ncbi.nlm.nih.gov/pubmed/15040779

 

Source

Department of Medicine, Monash Medical School, Alfred Hospital, Prahran, VIC, Australia.

Abstract

The use of complementary and alternative medicine (CAM) in Australia is extensive with over 50 per cent of the Australian population using some form of complementary medicine and almost 25 per cent of Australians visiting CAM practitioners. Expenditure on CAM by Australians is significant. The scope of CAM is extremely broad and ranges from complete medical systems such as Chinese medicine to well-known therapies, such as massage and little known therapies, such as pranic healing. There is a growing focus on CAM in Australia and worldwide by a range of stakeholders including government, the World Health Organization, western medical practitioners and private health insurance companies. CAM practices may offer the potential for substantial public health gains and challenge the way that we view human beings, health and illness. Several issues are emerging that need to be addressed. They include safety and quality control of complementary medicines, issues related to integration of CAM with western medicine and standards of practice. The evidence base of forms of CAM varies considerably: some forms of CAM have developed systematically over thousands of years while others have developed much more recently and have a less convincing evidence base. Many forms of CAM are now being investigated using scientific research methodology and there are increasing examples of good research. Certain forms of CAM, including Chinese medicine in which ophthalmology is an area of clinical specialty, view the eye in a unique way. It is important to keep an open mind about CAM and give proper scrutiny to new evidence as it emerges.

Comment in

PMID: 15040779

[PubMed - indexed for MEDLINE]

 

49. Incorporating patients' perspectives in complementary and alternative medicine clinical trial design.

Rodeheaver PF, Taylor AG, Lyon DE.

http://www.ncbi.nlm.nih.gov/pubmed/14736366

 

Source

Center for the Study of Complementary and Alternative Therapies, University of Virginia School of Nursing, Charlottesville, VA 22908, USA.

Abstract

OBJECTIVES:

To describe the importance and process of gathering the perspectives of former patients when designing clinical studies for complementary and alternative medicine (CAM) therapies and to describe how this information was used to guide the planning of a clinical study using complementary modalities to reduce symptom distress and enhance quality of life during the autologous stem cell transplantation (ASCT) process.

DESIGN:

Structured interviews with former ASCT patients to identify preferences, opinions, and other issues that may affect a clinical study in this population.

SETTING:

University of Virginia Health System Stem Cell Transplant Clinic.

SUBJECTS:

Ten (10) patients who had undergone ASCT within the previous year.

RESULTS:

In general, the 10 study participants interviewed reported that they would have been more receptive to receiving gentle Swedish massage than using guided imagery tapes during the ASCT process, although neither modality would have been particularly welcome during those treatment phases with highest physical or emotional/mental stress. Personal experiences, treatment side-effects, "personality," and life situation all had an influence on not only what was considered most stressful for the patient but also why it was perceived as stressful.

CONCLUSION:

Eliciting the views of persons who have undergone significant medical events is a necessary step in rigorous clinical trial development aimed at testing the efficacy of CAM modalities for symptom management. Consideration of patient preferences and motivations may ensure the best fit between interventions and the desired outcomes.

PMID: 14736366

[PubMed - indexed for MEDLINE]

 

50. Experience and attitudes towards CAM--a survey of internal and psychosomatic patients in a German university hospital.

Huber R, Koch D, Beiser I, Zschocke I, Luedtke R.

http://www.ncbi.nlm.nih.gov/pubmed/14727497

 

Source

Center for Complementary Medicine, University Hospital, Freiburg, Germany.

Abstract

Complementary and alternative medicine (CAM) is popular in Germany. In a consecutive survey the experiences with CAM and the need for a CAM consultation among inpatients of the departments of cardiology (CL), gastroenterology (GE), oncology (OL) and psychosomatics (PS) of the University Hospital Freiburg (FUH) were questionned. Exclusion criteria were inability to understand the questions or a Karnofsky Index < 30%. Four hundred thirty-five patients were included. Three hundred and fifty patients, 100 each in the departments of CL, GE and OL, and 50 in PS answered the questionnaires. Eighty-five patients (20%) refused. Among the 350 patients 26% had previously visited a CAM physician and 19% had visited a CAM therapist (Heilpraktiker). Information about CAM was obtained mainly by television, radio and family members. Frequently used therapies for the current disease were physical training (21%), diet (19%), massage (19%), vitamins/trace elements (19%), herbs (13%), acupuncture (10%) and homeopathy (7%). The highest frequency of CAM use had PS patients, followed by GE, OL and CL patients. High effectivity (> or = 70%) for the current disease, rated on a scale of 4 degrees, had for CL patients physical exercise and massage, for GE patients herbal treatment and for OL patients diet. Physical exercise, diet, massage and herbal treatment generally had better ratings than homeopathy, acupuncture and vitamins. 65% would welcome a CAM center and 53% asked for a consultation about CAM at FUH. OL and GE patients had the strongest (58%), PS patients a lower (52%) and patients with cardiovascular diseases the lowest (43%) interest in a CAM consultation. Twenty-five percent believed, that CAM can help to cope better with their disease. Predictors for a positive attitude towards CAM were young age, aversion to chemical medications (Spearman correlation r = 0.22), desire to participate in therapeutic decisions (r = 0.29), motivation to change, if recommended, the life style (r = 0.31) and desire for a holistic treatment (r = 0.37).

PMID: 14727497

[PubMed - indexed for MEDLINE]

 

51. Use of complementary and alternative medicine by the adult membership of a large northern California health maintenance organization, 1999.

Gordon NP, Lin TY.

http://www.ncbi.nlm.nih.gov/pubmed/14717461

 

Source

Division of Research, Kaiser Permanente Medical Care Program, Northern California Region, Oakland, Calif 94612, USA. Nancy.Gordon@dor.kaiser.org

Abstract

Data from general health surveys completed by random samples of adult members of a large Northern California health maintenance organization in 1996 and 1999 were used to investigate (a) the prevalence of use of 15 complementary and alternative medicine (CAM) modalities by adult members in 1999, (b) how prevalence varied by age group and gender, and (c) which modalities were increasing in popularity. While Northern California is not representative of the nation as a whole, it tends to be a harbinger of trends to come. The most widely used modalities in 1999 were herbal and other nonvitamin/nonmineral nutritional supplements, prayer/spiritual healing done by oneself, chiropractic, massage therapy, and mind-body medicine modalities. However, use of the different modalities varied significantly by age and gender, and rates of use of nutritional supplements and the manipulatives were approximately doubled, when restricted to subpopulations at high risk, for use because of relevant health conditions. There appeared to be a statistically significant, but modest increase in CAM use, mostly due to a large increase in use of nutritional supplements. Implications for how CAM use should be tracked for ambulatory care populations and the importance of addressing nutritional supplement use in ambulatory clinical care are discussed.

PMID: 14717461

[PubMed - indexed for MEDLINE]

 

52. Complementary and alternative therapies: what is their place in the management of chronic pain?

Snyder M, Wieland J.

http://www.ncbi.nlm.nih.gov/pubmed/14567205

 

Source

School of Nursing and Center for Spirituality and Healing, University of Minnesota School of Nursing, 6-101 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455-0342, USA. snyde002@umn.edu

Abstract

Nurses have used complementary therapies for many years to relieve anxiety, promote comfort, and reduce or alleviate pain. The therapies described in this article are examples of the many therapies available for nurses to consider when planning care for patients with chronic pain. The increasing body of scientific knowledge is providing more guidance about the efficacy of specific therapies. As with all interventions, ongoing evaluation about the effectiveness of a therapy for each patient is an important component of quality nursing care. Complementary therapies provide an avenue for nurses to be autonomous in furthering the relief of chronic pain, as many of these therapies fall within the domain of nursing. Incorporating selected therapies into the plan of care provides multiple opportunities for nurses to demonstrate caring, a premier characteristic of nursing. A number of the complementary therapies, such as journaling, hand massage, and imagery, can be taught to patients and their families, thus promoting self-care. Anecdotal evidence and findings from numerous smaller studies provide some support for the use of many complementary therapies to manage chronic pain or their use as adjuncts in the treatment regimen. Still, the nurse must weigh the risks and benefits before suggesting a therapy to a patient. Evaluating the effectiveness of the complementary therapy to promote comfort in patients with chronic pain is essential. Obtaining this information is not only critical to the care of a particular patient, but these data will assist nurses in learning more about specific therapies. Most importantly, nurses need to pursue research to further the scientific basis for many of the complementary therapies.

PMID: 14567205

[PubMed - indexed for MEDLINE]

 

53. Using massage and music therapy to improve postoperative outcomes.

McRee LD, Noble S, Pasvogel A.

http://www.ncbi.nlm.nih.gov/pubmed/14507122

 

Source

University of Arizona College of Nursing, Tucson, USA.

Abstract

An experimental pilot study was conducted to investigate the effects of preoperative massage and music therapy on patients' preoperative, intraoperative, and postoperative experiences. Participants were assigned randomly to one of four groups--a group that received massage with music therapy, a group that received massage only, a group that received music therapy only, or a control group. Hemodynamics, serum cortisol and prolactin levels, and anxiety were measured preoperatively and postoperatively. Postoperative anxiety levels were significantly lower and postoperative prolactin levels were significantly higher for all groups.

PMID: 14507122

[PubMed - indexed for MEDLINE]

 

54. Nursing and the current situation of complementary treatments.

[Article in Spanish]

Rodríguez Pérez M, Rojas Ocaña MJ, Abreu Sánchez A, Rodríguez Rodríguez JB.

http://www.ncbi.nlm.nih.gov/pubmed/14502940

 

Source

Escuela Universitaria Enfermería Huelva.

Abstract

The present situation in nursing is one of a clear advance, as the result of the search which more and more nurses consider: a real end to nursing, "the treatments" to maintain health or to recuperate it. To this end, we should make use of all the useful methods available to us. We know that with a caress of our hands we loose endorphins which help reduce pain, that music relaxes us, that color illuminates our lives, that reflexology frees us from tensions, and that, definitely, we have available to us a large number of resources which offer relief and well-being to our patients without secondary efforts, and at a low cost. These supplementary non-specialized health treatments are taught in a non-systematic manner and an optional manner in Spanish nursing schools. Nursing professionals demonstrate great interest in alternative therapies and many nurses are specialists in some of these today. However, in spite of the fact that alternative therapies are included in current study programs, scientific production by Spanish nurses en these fields is scarce. The research and development guidelines published as priorities by the Carlos III Institute and by the European Health Committee do no reflect the study of these treatment methods in a specific manner; but we have the opportunity in our own hands to demonstrate by means of our own research the extent of the benefits which these therapies may provide.

PMID: 14502940

[PubMed - indexed for MEDLINE]

 

55. The use of complementary and alternative medicines by surgical patients: a follow-up survey study.

Wang SM, Caldwell-Andrews AA, Kain ZN.

http://www.ncbi.nlm.nih.gov/pubmed/14500149

 

Source

Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut 06510, USA. shu-ming-wang@yale.edu

Abstract

In a previous study, we indicated that 42% of surgical outpatients are interested in using acupuncture as a treatment modality for preoperative anxiety. We designed this follow-up survey to assess differences in attitude toward complementary-alternative medical therapies (CAM) between patients undergoing outpatient surgeries and those undergoing inpatient surgeries. The results indicate that most surgical patients (57.4%) use some form of CAM, including self-prayer (praying for their own health; 29%), chiropractic treatment (23%), massage therapy (15%), relaxation (14%), herbs (13%), megavitamins (9%), and acupuncture (7%). Inpatient surgical respondents reported using self-prayer more than outpatient surgical respondents, but no other differences in CAM use were found between inpatient and outpatient respondents. More inpatient respondents reported disclosing their usage of CAM to perioperative physicians than did outpatient respondents. Most surgical patients were willing to accept CAM as part of their perioperative management but were not willing to pay out-of-pocket for CAM treatment. The leading CAM therapies that fewer of the respondents were willing to pay for out-of-pocket included relaxation, massage, chiropractic medicine, herbs, and acupuncture. IMPLICATIONS: Most surgical patients use some form of complementary-alternative medical therapies (CAM) and are willing to accept CAM therapy as part of their perioperative management.

PMID: 14500149

[PubMed - indexed for MEDLINE]

Free full text

 

56. Personal use of complementary and alternative therapies by critical care nurses.

Lindquist R, Tracy MF, Savik K.

http://www.ncbi.nlm.nih.gov/pubmed/12943147

 

Source

University of Minnesota School of Nursing, 6-101 WDH 308 Harvard Street SE Minneapolis, MN 55455, USA. lindq002@umn.edu

Abstract

Critical care settings are stressful to nurses, and exposure over time may contribute to stress-related symptoms and illnesses. Nurses' personal use of complementary and alternative therapies (CAT) may lessen the effects of stress and contribute to their overall well-being and health maintenance. A national survey of critical care nurses who are members of the American Association of Critical-Care Nurses revealed that a majority (96.4%) of critical care nurse respondents were using one or more CAT for personal use or had consulted a provider for CAT therapy. The most common therapies used were exercise, diet, massage, and prayer (or spiritual direction). Nurses' personal use of CAT was related to having knowledge of more types of CAT, use of more CAT in practice, a perception of benefits of greater numbers of CAT, more openness to use, more types of CAT recommended to patients, and a perception of more barriers to use in their institutional setting. Data support our model that links nurses' personal use to use in practice. Educational programs to promote nurses' knowledge and personal use of CAT could lead to an increase in appropriate use of CAT in professional practice and potential benefits to critical care patients and their families.

PMID: 12943147

[PubMed - indexed for MEDLINE]

 

57. Cultural related complementary therapies: their use in critical care units.

Snyder M, Niska K.

http://www.ncbi.nlm.nih.gov/pubmed/12943140

 

Source

University of Minnesota School of Nursing, 6-101 WDH, 308 Harvard Street SE, Minneapolis, MN 55455, USA. snyde002@umn.edu

Abstract

Complementary therapies are becoming widely used in health care in the United States. Most nurses, as are many Americans, are familiar with complementary therapies such as imagery, aromatherapy, massage, and healing touch. Many nurses, however, are not familiar with complementary therapies that are widely used in other countries and cultures. This article delineates reasons necessitating nurses to increase their knowledge about other health systems, provides examples of therapies used in selected cultures, and describes ways in which critical care nurses can incorporate these into the plan of care for patients in critical care units.

PMID: 12943140

[PubMed - indexed for MEDLINE]

 

58. Use of complementary and alternative therapies to promote sleep in critically ill patients.

Richards K, Nagel C, Markie M, Elwell J, Barone C.

http://www.ncbi.nlm.nih.gov/pubmed/12943139

 

Source

Central Arkansas Veterans Healthcare System, 2200 Fort Roots Drive, 3J/NLRVA, North Little Rock, AR 72114, USA. richardskathyc@uams.edu

Abstract

The efficacy of complementary and alternative therapies for sleep promotion in critically ill patients is largely unexamined. We found only seven studies (three on environmental interventions and one each on massage, music therapy, therapeutic touch, and, melatonin) that examined the effect of complementary and alternative therapies. A number of studies, however, have shown that massage, music therapy. and therapeutic touch promote relaxation and comfort in critically ill patients, which likely leads to improved sleep. Massage, music therapy, and therapeutic touch are safe for critically ill patients and should be routinely applied by ICU nurses who have received training on how to administer these specialized interventions. Environmental interventions, such as reducing noise, playing white noise such as ocean sounds, and decreasing interruptions to sleep for care, also are safe and logical interventions that ICU nurses should use to help patients sleep. Progressive muscle relaxation has been extensively studied and shown to be efficacious for improving sleep in persons with insomnia; however, progressive muscle relaxation requires that patients consciously attend to relaxing specific muscle groups and practice these techniques, which may be difficult for critically 11 patients. We do not currently recommend aromatherapy and alternative sedatives, such as valerian and melatonin, for sleep promotion in critically ill patients because the safety of these substances is unclear. In summary, we recommend that ICU nurses implement music therapy, environmental interventions, therapeutic touch, and relaxing massage to promote sleep in critically ill patients. These interventions are safe and may improve patient sleep, although randomized controlled trials are needed to test their efficacy. Aromatherapy and alternative sedatives require further investigation to determine their safety and efficacy.

PMID: 12943139

[PubMed - indexed for MEDLINE]

 

59. Assessment and treatment of nursing home residents with depression or behavioral symptoms associated with dementia: a review of the literature.

Snowden M, Sato K, Roy-Byrne P.

http://www.ncbi.nlm.nih.gov/pubmed/12919245

 

Source

Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA. snowden@u.washington.edu

Abstract

Depression and the behavioral symptoms associated with dementia remain two of the most significant mental health issues for nursing home residents. The extensive literature on these conditions in nursing homes was reviewed to provide an expert panel with an evidence base for making recommendations on the assessment and treatment of these problems. Numerous assessment instruments have been validated for depression and for behavioral symptoms. The Minimum Data Set, as routinely collected, appears to be of limited utility as a screening instrument for depression but is useful for assessing some behavioral symptoms. Laboratory evaluations are often recommended, but no systematic study of the outcomes of these evaluations could be found. Studies of nonpharmacological interventions out-number those of pharmacological interventions, and randomized, controlled trials document the efficacy of many interventions. Antidepressants are effective for major depression, but data for minor depressive syndromes are limited. Recreational activities are effective for major and minor depression categories. Neither pharmacological nor nonpharmacological interventions totally eliminate behavioral symptoms, but both types of interventions decrease the severity of symptoms. In the absence of comparison studies, it is unclear whether one approach is more effective than another. Despite federal regulations limiting their use, antipsychotics are effective and remain the most studied medications for treating behavioral symptoms, whereas benzodiazepines and antidepressants have less support. Structured activities are effective, but training interventions for behavioral symptoms had limited results. There are sufficient data to formulate an evidenced-based approach to treatment of depression and behavioral symptoms, but more research is needed to prioritize treatments.

PMID:

12919245

[PubMed - indexed for MEDLINE]

 

60. Hospitalized patients' preference in the treatment of insomnia: pharmacological versus non-pharmacological.

Azad N, Byszewski A, Sarazin FF, McLean W, Koziarz P.

http://www.ncbi.nlm.nih.gov/pubmed/12879147

 

Source

Geriatric Assessment Unit, The Ottawa Hospital, General Campus, Ottawa, Canada. nazad@ottawahospital.on.ca

Abstract

BACKGROUND:

Insomnia is common in hospitalized patients, who become significantly vulnerable to the adverse effects of the benzodiazepines (BZDs) used to treat this condition. Consequently, there has been a logical search for non-drug alternatives (NDAs) for the treatment of insomnia.

METHOD:

Inpatient insomnia cases were surveyed over the Summer of 1999. Our hypotheses were that an attitudinal difference exists between acute and chronic users of BZDs towards NDAs; and that inpatients who were prescribed BZDs have also received proper information about alternative therapies.

RESULTS:

One hundred insomnia cases met the inclusion criteria. Fifty-one per cent were younger than age 65. Short acting BZDs were used in 88% of the cases. Fourty per cent of patients had started experiencing insomnia while in the hospital. Only 11% of patients received information about NDA therapy for insomnia. Eighty-two patients felt that NDAs were healthier, and the majority (n=67) responded that if an NDA were offered in the hospital, they would be willing to accept it. Female participants were more willing to consider NDAs (P<0.01). First time users of BZDs were by far more receptive to NDA remedies than were chronic users of BZDs (P<0.002). A significant number of participants who were receiving short-acting BZDs were willing to try an NDA (P<0.001). Participants interested in NDA therapies expressed preferences for for massage therapy, sleep hygiene, music and relaxation techniques (P<0.001).

CONCLUSION:

Significant attitudinal differences are seen in several domains of patient characteristics. First time female users of BZDs and those taking short acting BZD were more willing to try an NDA. Educational programs are needed for appropriate evidence-based management protocols for insomnia.

PMID: 12879147

[PubMed - indexed for MEDLINE]