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82 Cards in this Set
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Biomedical vs. Integrative Health Care Models
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Biomedical Model
- Focus on physical body - Focus on treatment of symptoms using drugs and surgery - Health care provider directs care - Focus on disease states - Technologic, invasive - Increasing cost - Little focus on prevention Integrative Model - Focus on health and wellness - Noninvasive - Lower cost - Focus on prevention - Focus on mind-body-spirit - Focus on self-healing of body using herbs, nutrition, stress management - Individual directs care; encourages personal responsibility for health |
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Biologic-Based Therapies
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Herbal therapy
Nutriceuticals Nutritional therapy Aromatherapy |
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Nutriceuticals
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A food or naturally occurring food supplement thought to have a beneficial effect on human health.
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Nutritional therapy
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Diet
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Manipulative & Body-Based Methods
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Chiropractic therapy
Acupressure Massage therapy Yoga |
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Energy Therapies
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Therapeutic touch (TT)
Healing touch Reiki Magnet therapy |
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Concepts Basic to Alternative Practice
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Holism
Humanism Balance Spirituality Energy Healing Environment |
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Holism
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Paradigm of whole systems
Belief that people are more than physical bodies Combined mental, emotional, spiritual, relationship, & environmental components Interventions individualized within the entire context of the person’s life |
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Humanism
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Mind & body are indivisible
People have the power to solve own problems People are responsible for the patterns of their lives Well-being is a combination of personal satisfaction & contributions to the larger community |
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Balance
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Consists of mental, physical, emotional, spiritual, & environmental components
Each component needs to be balanced Equilibrium needed among the components |
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Spirituality
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Includes the drive to become all that one can
Bound to intuition, creativity, & motivation Relationship with oneself, with others, and with a higher power Gives people meaning & purpose in lives Involves significant meaning in the entirety of life |
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Energy
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Forces that integrates the body, mind, & spirit
Grounding to the ground to one’s whole contact reality Centering Focusing one’s mind on the center of energy allowing one to operate intuitively & with awareness, channeling energy throughout the body |
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Alternative Medical Systems
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Traditional Chinese medicine (TCM)
Ayurveda Native American Health Care Hispanic Health Care Homeopathy Naturopathy |
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Traditional Chinese Medicine (TCM)
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The standard of care in the Orient for over 3000 years
Incorporates the use of acupuncture, diet, and herbal remedies with physical movement (qi gong and t’ai chi) & massage (known in Japan as shiatsu, “finger-pressure” ). Oriental doctors see the body as an intricate web of organs interconnected by channels (meridians) through which universal energy (chi or qi) flows. Healthy bodies have a dynamic balance of yin and yang energy, opposites that occur in nature (female/male, moon/sun, etc.). According to the tenets of Oriental medicine, disease (dis-ease) arises when the flow of qi is blocked and balance is disturbed, either within the body or between the body & its environment. Disease is prevented & health maintained by restoring the balance and flow. |
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Yin & Yang
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Two primal opposing but complementary principles said to be found in all non-static objects & processes in the universe.
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Ayurveda
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Originating over 5000 years ago in India, predates all other known medical systems.
Ancient form of healing stresses the mind-body-spirit connection. Ayurvedic doctors believe that prana — or life force — responds to equivalent treatments in a different way in each person. Healing & preventative regimens are customized specifically around a person’s body & spiritual type, or dosha. Ayurvedic medicine encompasses meditation, yoga, bodywork, aromatic oils, diet & medicinal herbs to foster balance in the body & cleanse impurities. |
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Native American Health Care
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Most Indian traditions teach that the “interconnectedness” of all things leads to a relationship between man, Creator/God, fellow man, & nature.
In many Indian traditions, healing, spiritual belief or power, & community were not separated, & often the entire community was involved in a healing ceremony & in maintaining the power of Indian “medicine.” The term “medicine” is often used to denote actions, traditions, ceremony, remedies, or other forms of prayer or honoring the sacred. The concept of healing power that is maintained by the collective consciousness & belief of people of an Indian community is referred to here. In some tribes/nations causes of illness were considered to be an "imbalance" between the spiritual, mental, physical, & social interactions of the individual & his family or clan. Healing is considered sacred work & in many Indian traditions cannot be effective without considering the spiritual aspect of the individual. Many Western pharmaceuticals were actually based on Indian herbal medicines (for example, aspirin is derived from willow bark). Many contemporary Indians use "white man's medicine" to treat "white man's diseases.“ For example, diabetes, cancer, & gallbladder disease, & use Indian medicine to treat Indian problems (pain, disturbed family relationships resulting in physical symptoms, or sicknesses of the spirit, which may include mental illness and alcoholism). |
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Hispanic Health Care
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Physical or mental illness may be attributed to an imbalance between the person & environment.
Influences include emotional, spiritual, & social state, as well as physical factors such as humoral imbalance expressed as too much "hot" or "cold“. In general, cold diseases/conditions are characterized by vasoconstriction & low metabolic rate. "Cold" diseases/conditions include menstrual cramps (frio de la matriz), coryza (rhinitis), pneumonia (empacho), & colic. "Hot" diseases/conditions are characterized by vasodilation & high metabolic rate. Pregnancy, hypertension, diabetes, acid indigestion, susto, ojo, & bilis are examples of hot conditions "Cold" conditions are treated with "hot" medications and "hot" with "cold" medications, thus bringing the individual back into balance. Problems that are primarily spiritual in nature are treated with prayer & ritual. However, some Hispanics who use folk means of treating illness are troubled by simultaneously using cosmopolitan treatments such as antibiotics, antihypertensives, & etc. Hierarchy of “Healers” Home remedies or seeking assistance from relatives or neighbors (especially female) Yerbero (herbalist), Sobador (massage therapist), or Partera (midwife who may also treat young children). Cuaranderos/Cuarandero Total (lay healer who intervenes in multiple dimensions, e.g., physical and spiritual) Note also that medications, including prescription, are shared within social networks. There are instances in which a sick person may simultaneously be using prayer, folk &/or herbal medicine, prescription medications obtained from a friend, & prescription medications prescribed by a nurse practitioner or physician. Regardless of the source of care, the patient (and family) are likely to include faith in God as a vital component of understanding of the problem and the cure . |
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Homeopathy
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Founded in early 19th century Europe, based on the ancient law of similars: the same substances that cause an illness will cure it when administered in infinitesimally small doses. (Vaccines operate on a similar principle).
Using serially diluted remedies from natural sources, homeopaths (most of whom are naturopaths) treat & prevent illness using one medicine at a time at the lowest dosage possible to create the required response. Licensing requirements vary from state to state, & you will often find acupuncturists, naturopaths, herbalists, DO’s & MD’s who are also licensed homeopaths. |
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Naturopathic Medicine
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Naturopathy has its roots in ancient medicinal practices, but took form as a separate discipline in Germany in the 19th century.
Founded on the precepts of a medical regimen of hydrotherapy, exercise, fresh air, sunlight, & herbal remedies, this system has evolved today to include a wide spectrum of holistic practitioners. Belief system that holds the body as innately capable of recovering from injury & disease, & that health is the natural state. Most naturopaths implement elements from various alternative methods to create health, including homeopathy, herbal medicines, acupuncture, nutrition therapy, & bodywork. Founded on the precepts of a medical regimen of hydrotherapy, exercise, fresh air, sunlight, & herbal remedies, this system has evolved today to include a wide spectrum of holistic practitioners. A system of medicine A way of life Emphasis on responsibility, health maintenance, & disease prevention MODEL HEALTH SYSTEM OF THE FUTURE |
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Naturopathic Physicians
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Do not provide emergency care or do major surgery
Rarely prescribe drugs Treat clients in private practice & outpatient clinics |
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Goal of Naturopathic Treatment
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Restoration of health & normal body functions
Customized to the client Primary consideration is least invasive method |
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Manual Healing Methods
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Chiropractic
Massage Acupuncture/Acupressure/Reflexology Hand-mediated bio-field therapies |
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Chiropractic
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Reduce or eliminate pain
Correct spinal dysfunction Muscles & ligaments strengthened by spinal rehabilitative exercises Preventive maintenance to ensure the problem does not recur 1895 Iowa, as we know chiropractic, but it is an ancient art Restore & maintain health by aligning spine Acute, corrective or preventative Best known for back pain, other uses: HA, dizziness, dysmenorrhea, musculoskeletal problems Not used in some diseases: malignancy, infection, fx., RA… |
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Massage
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Aids the ability of the body to heal itself
Aimed at achieving or increasing health & well-being (i.e., therapeutic touch) |
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Acupuncture/Acupressure/Reflexology
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Treatments rooted in the traditional philosophy of Qi, or life energy
Blocked or congested energy causes pain, frustration, & irritability Goal of care is to recognize & manage disruption before illness or disease occurs by applying pressure or stimulation to specific points on the body |
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Conditions That May Benefit from Acupuncture
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Pain management
Surgical analgesia Chemotherapy-induced nausea Asthma Neurological disorders Acute stroke, stroke rehab Gynecologic and obstetric conditions Inducing labor, infertility, others Gastrointestinal conditions Irritable bowel syndrome (IBS), chronic constipation Substance abuse Smoking cessation, opioid dependence |
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Hand-Mediated Bio-Field Therapies
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Includes therapeutic touch (TT), healing touch (HT), & Reiki
Use of hands on or near with intention to heal Goal of care is to accelerate person’s own healing process Facilitate healing of body, mind, emotions, & spirit |
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Mind-Body Therapies
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Yoga
Meditation Hypnotherapy Guided imagery Qigong T’ai chi |
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Mind–Body Interventions
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Prayer
-Meditative -Ritualistic -Colloquial -Intercessory Relaxation breathing Meditation Biofeedback Imagery Hypnosis Music therapy Art therapy Journaling Animal-assisted therapy (AAT) |
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Mind-Body Therapies - Common Goals
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Creating balance
Reducing stress Increasing relaxation of the mind & body |
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Bioelectromagnetics
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Every animal, plant, & mineral has an electromagnetic field
Enables organic & inorganic objects to communicate & interact Penetrate the body affecting the functioning of cells, tissues, organs, & systems Magnets are used to relieve joint pain, headaches, speed up healing of wounds by increasing blood flow, & improve bone repair. Contraindications: - Pregnancy, pacemakers, implanted defibrillators, aneurysm clips, cochlear implants, other implanted electrical devices, anticoagulants, active bleeding, open wounds, or freshly torn muscles. |
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Infrared Photoenergy Therapy
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Increase energy inside cells
Improve circulation |
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Detoxification
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Belief that physical impurities & toxins must be cleared from the body
Types: - Hydrotherapy - Colonics - Chelation therapy |
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Hydrotherapy
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Use of water as a healing treatment
Makes use of the body’s response to heat & cold (solid, liquid, or gas) Used to: - Decrease pain & fever - Reduce swelling & cramps - Induce sleep - Improve physical & mental tone |
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Colonics or Colon Therapy
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Colonics is the procedure for washing the inner walls of the colon by filling it with water or herbal solutions & then draining it.
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Chelation Therapy
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Introduction of chemicals into the bloodstream that bind with heavy metals in the body.
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Animal-Assisted Therapy (AAT)
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Physical or psychological conditions (i.e. throwing a ball for a dog increases UE ROM, walking a dog increases mobility, tending to an animal increase attention & concentration while decreasing loneliness/depression)
Resident Animals Companion Animals |
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Prayer
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Form of communication & fellowship with the Deity or Creator
Self-Care strategy Provides comfort, increases hope, & promotes healing & psychological well-being |
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Humor
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Establishes relationships
Relieves tension & anxiety Release anger & aggression Facilitate learning Cope with painful feelings |
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Sight
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Colors effect how we feel.
Sunlight through a window is welcoming |
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Smell
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Aromas can evoke memories
and feelings |
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Describe effects of colors
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Brown Grounding/ nurturing
Red Physical energy, stimulant Orange Courage Gold Uplifting Pink Love Green New life Blue General healer Turquoise Protective Indigo Mental Clarity Yellow emotional balance White Purity Purple Meditation |
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Touch
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A soft touch has a relaxing effect.
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Hearing
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Music can be helpful
In creating any mood. Quiet, Peaceful, uplifting, sombre, and Deep. |
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Healing Environments
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Created when nurses provide holistic nursing care
Created by providing knowledge, skills, & support Synthesis of medical-curing & nursing-healing approach Created when time is taken to be with clients in a deeply caring way Nurses need to create healing environments for THEMSELVES! Nurses need to learn how to restore energy & replenish themselves! What is your “Self-Care Plan?” |
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Self-Care Plan
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Clarify values & beliefs
Set realistic goals Challenge the belief that others always come first Learn to manage stress |
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Managing Stress
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Acknowledge the mind-body connection
Monitor the stress warning signals - Increase in B/P, pulse, respirations - Headache, fatigue, irritability, & loss of focus or concentration - Changes in appetite, sleep disturbances, & impulses to “self-medicate” |
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Herbal Therapies
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An herb is a plant or plant part (bark, roots, leaves, seeds, flowers, fruit) that produces and contains chemical substances that act on the body.
Use of individual herbs or mixtures of herbs for therapeutic benefit - Estimated 25,000 plant species are used medicinally - Roughly 30% of prescription drugs are derived from plants |
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History
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Herbs are the oldest form of medicine
- Used by Neanderthals 60,000 years ago Gained widespread popularity as early as 3000 BC, but began to decline with technological developments |
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Herbal Therapy Use
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Approximately 80% of the world’s population relies extensively on plant-derived remedies.
In the United States herbal products are classified as dietary supplements for their medicinal value. |
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Clinical Applications
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Medicinal plants work much like drugs
- Both are absorbed & trigger biologic effects that can be therapeutic. - Many have more than one physiologic effect & condition for which they are used. 95% of herbal use is self-care based - Most patients do not include scientific data in decision making about the use of herbs. - If there is symptomatic relief, patient continues use. |
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Advantages of Supplements
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Fewer side effects
Amenable to self-care Lower cost |
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Disadvantages of Supplements
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Longer time to onset of action
Possible drug–herb interactions Inconsistent manufacturing practices Lack of available & reliable information for consumers |
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Herbs & Prescription Drugs
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Many prescription drugs are derived from plants
Most herbal medicines present no danger if taken appropriately Some can cause serious side effects if taken in excess, or over a prolonged period of time Caution when combining with prescription & OTC medications Caution about becoming dependent on herbal remedies Caution pregnant & breast-feeding women not to take herbs without consulting their physician first |
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Commonly Used Herbs
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Aloe
Bilberry Echinacea Evening primrose Feverfew Garlic Ginger Ginkgo bilobaGinseng Goldenseal Glucosamine Kava Milk thistle St. John’s wort Saw palmetto Valerian |
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Aloe
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Common Uses:
- Constipation - Genital herpes - Psoriasis vulgaris Caution: - Use no longer than 7 days - May cause electrolyte imbalance - May lower blood glucose |
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Bilberry
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Common uses:
- Cataracts - Retinopathy - Peripheral vascular disease - Varicose veins - Diabetes mellitus Caution: - May increase risk of bleeding - May lower blood glucose |
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Chamomile
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Common Uses
- Common cold - Gastrointestinal disorders - Sleep aid/sedation Cautions - Generally safe for 6 months - Not for use with ragweed sensitivity or pregnancy - May cause drowsiness - May increase risk of bleeding |
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Echinacea
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Common Uses
- Treatment and prevention of upper respiratory infections - Immune system stimulation Cautions - Short-term use recommended (10 to 14 days) - May lead to liver inflammation - Use caution with immune system conditions |
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Evening Primrose
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Common Uses:
- Eczema - Skin irritations Contraindicated in people with seizure disorder |
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Feverfew
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Common uses:
- Migraine headache prevention - Arthritis Caution: - May increase risk of bleeding - Long-term users may experience withdrawal symptoms |
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Garlic
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Common uses:
- Hyperlipidemia - Hypertension Caution: - Use caution with bleeding disorders - Do not use in large amounts |
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Ginger
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Common uses:
- Nausea/vomiting (associated with pregnancy or chemotherapy treatment) - Motion sickness Caution: - Use caution with bleeding disorders - Use in pregnancy should not exceed 1 g/day & should be monitored by a health care provider |
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Ginkgo Biloba
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Common uses:
- Dementia treatment - Claudication - Cerebral insufficiency Caution: - Generally well tolerated up to 6 months - May increase risk of bleeding - May affect blood glucose |
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Ginseng
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Common uses:
- Improve mental performance - Lower blood glucose (type 2 diabetes) Caution: - Use caution with diabetic patients and those taking medications, herbs, or supplements that affect BP or heart rhythm - Generally safe for 3 months |
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Glucosamine
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Common uses:
- Osteoarthritis Caution: - Use caution with shellfish allergies |
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Goldenseal
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Common uses:
- Heart failure - Immunostimulant - Infectious diarrhea - Upper respiratory tract infection Caution: - Should not use longer than 2 to 3 weeks - Use caution with cardiovascular disease - May increase risk of bleeding |
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Kava
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Common uses:
- Anxiety Caution: - Should only be used under health care practitioner supervision - May cause hepatotoxicity - May increase risk of bleeding |
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Milk Thistle
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Common uses:
- Hepatitis (chronic) - Cirrhosis Caution: - Generally safe up to 4 to 6 years - Use caution in diabetes |
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St. John’s Wort
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Common uses:
- Depressive disorder - Anxiety Caution: - Generally well tolerated up to 1 to 3 months - Interacts with many herbs, supplements, & medications - Advise patients to consult a health care provider |
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Saw Palmetto
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Common uses:
- Benign prostatic hyperplasia Caution: - Generally well tolerated for extended periods of use - May increase risk of bleeding - May increase BP |
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Valerian
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Common uses:
- Insomnia - Anxiety disorders Caution: - Generally safe up to 4 to 6 weeks - Chronic use may result in insomnia |
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Gerontologic Considerations
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Herbs commonly used by older adults:
- Ginkgo biloba - Ginseng - St. John’s Wort - Saw palmetto - Echinacea Safety concerns - Age-related changes - Polypharmacy |
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Safety
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Most herbs are safe without professional assistance
Side effects & interactions with prescription drugs have been reported Consumers tend not to report use of supplements to their physician |
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Clinical Application
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Patients should be advised
- Adhere to the suggested dosage - Be cautious changing brands - Disclose to health care provider all herbs & supplements being taken |
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Caution Use of Herbs In
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- Infants
- Young children - Pregnant women - Nursing mothers - Older adults with liver or cardiovascular disease |
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Patient Teaching
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Ask about use
- Include dosage, brand name, frequency, & why herb is taken Instruct patient to report use to health care providers Educate about risks & benefits Advise about possible side effects Encourage thorough examination of product labels Discontinue use 2 to 3 weeks before surgery |
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Nurse’s Role
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Assessment
Promoting safety & serving as a resource Providing holistic self-care & holistic nursing practice Serving as a provider Participating in research |
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Assessment Questions
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What is your view of the ideal relationship between yourself & your health care provider?
Are you using any vitamin, mineral, dietary, or herbal supplements? Do you have any conditions that have not responded to conventional medicine? If so, have you tried any other approaches? Are you interested in obtaining information about alternative or complementary approaches? |
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Core Concepts of Holistic Nursing
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1. Accepts patients
2. Care is based on holism 3. Serves as a facilitator 4. Incorporates self-care and self-responsibility 5. Practice is guided by holistic education and research |
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Which information obtained by the nurse when admitting a patient with osteoarthritis indicates a need for patient teaching?
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a. The patient gets information about herbal therapies from a health food store employee.
b. The patient takes glucosamine daily to prevent knee & hip pain. c. The patient attends a weekly yoga class to improve flexibility & balance. d. The patient states that prayer helps to improve the knee pain & function. |
Correct Answer: A
Rationale: Patients should be informed that employees at health food stores are not educated medical professionals. The other information given by the patient indicates appropriate use of complementary & alternative therapies, & no further teaching is necessary. |
