ALTERNATIVE SYSTEM OF HEALTH &COMPLEMENTARY THERAPIES

INTRODUCTION
In 2 million year history people recovered from many

illnesses without the intervention of high technology scientific medicine. A variety of healing practices clearly existed long before the advent of modern medicine. Other choices for medical help include a wide range of alternative complementary& traditional therapies. These OPTIONS are often influenced by economic, social cultural factors.

DEFINITION
ALTERNATIVE THERAPIES These are the therapies used in place of traditional allopathic therapies
COMPLEMENTARY THERAPIES These are the therapies used in conjunction with traditional allopathic therapies

CAT
CATs are interventions for improving ,maintaining and

promoting health & wellbeing ,preventing disease or treating illness that are not a part of the standard North American System of Health Care or Disease prevention. Allopathic medicine: A system of medicine that embraces all methods of proven value in the treatment of disease.(AMA) These are derived from scientific model of inquiry & involve the extensive use of technology.

CLASSIFICATION OF CAT
Alternative medical system
Mind body therapies Biologically based therapies Manipulative therapies Energy therapies

ACUPUNCTURE

ALTERNATIVE MEDICAL SYSTEM

CHINESE MEDICINE: ACUPUNTURE

It was developed in china has been use in >2000 years. It stimulating specific anatomic points in the body for therapeutic purposes. Body has >2000 acupuncture points which connect 12 main &8 secondary meridians . These points are stimulated by using a thin hair sized needle. They may also use heat, pressure, friction, suction,laser light or impulses electromagnetic energy.

 Physiology
Adverse effects are infection, organ puncture. Contraindications:

Phobias to needles Clotting disorders(Hemophilia) pregnancy Age <7years Influence of alcohol or narcotic Medications, Dementia.

USED IN
Addiction
Headache Menstrual cramps

Tennis elbow
Fibromyalgia Myofascial pain Osteoarthritis Lower back pain& Stroke rehabilitation Carpal tunnel syndrome &Asthma

ACUPRESSURE

ACUPRESSURE
It is a combination of acupuncture and massage in

which the thumbs & fingertips apply pressure to stimulate pressure points along the acupuncture meridians. Acupressure may be incorporated into a massage therapy session.

Used for relieving chemotherapy associated nausea &

vomiting

AURICULAR THERAPY

AURICULAR THERAPY
Auricular therapy is the diagnosis & treatment of pain

& disease using the auricle or pinna of the ear.

Points on the ear which represent different parts of the

body ,& its structure are stimulated with needles, magnets, lasers, massage or electricity.
It is useful in smoking cessation & addiction control

therapy.

MOXIBUSTION

MOXIBUSTION
Moxibustion uses the powdered leaves of moxa herb

(Artemisia vulgaris). The herb is burned above the skin or on an already inserted needle at the acupuncture points to apply heat and alleviate a variety of symptoms. Qi Gong ,Chi Kung, &T ai Chi. T ai chi means meditation in motion . It involve vigorous exercise or slow movement & postures that focus on Qi, performed in a continuous chain of movement. It can increase circulation.

HOMEOPATHY
Over all health maintenance program. HOMEOPATHY: American institute of Homeopathy(United states

1845) first national medical society. 1847-AMA was founded.(Slowed Homeopathy) 1970-Holistic health movement(Growth-Homeopathy Principle-The law of similar- like cures like. Similar-suggest that any state of disturbance that is not corrected spontaneously (disease) can be corrected by minute doses of a compound which at

CONT.
a higher dose can produce effects closely resembling the symptoms of the disease being treated 0r by minute amounts of the compound actually causing the disease (vaccine).

HYPNOSIS

MIND BODY& SPRITUAL THERAPY

It involves psychologic social & spiritual approaches. HYPNOSIS: It is a state of attentive, focused concentration with suspension of some peripheral awareness. It has 4 components.

1. Absorption or deep contemplation of a theme or focus. 2.Controlled alteration of attention. 3.Dissociation compartmentalization of ones experience. 4.Suggestibility or capacity for heightened responsiveness to instructions.

USED IN; To treat pain , duodenal ulcer , irritable bowel syndrome, nausea & smoking cessation.

IMAGERY

IMAGERY
It involves mental processes that encourage attitude

behavior or physiologic reactions. It attempts to cause an internal representation of events that involve senses. It is believed to be the natural language of the unconscious mind & involves thinking with ones senses. It communicates information between mind, senses & emotions so that psychologic insight or bodily responses can become agents of therapeutic change.

USES
More in control of ones health or recovery process.
To treat anxiety Enhance immune response

Help children to cope with the stress of illness

Help cancer patients cope with pain Support the dying process Provides support during stressful procedures used in

conjunction with music to enhance healing Support coping

 Promote relaxation
Enhance post op recovery

IN PSYCHOTHERAPEUTIC SETTING It deepens patients ability to reach therapeutic levels of insight growth. TYPES OF IMAGERY Diagnostic imagery Mental rehearsal imagery End stage imagery

GUIDED IMAGERY

GUIDED IMAGERY
It uses cognitive techniques: Simple visualization or direct suggestions Story telling Dream interpretation Drawing Active imagination Clinician uses to bring a specific outcome Imagery in biofeedback ,subjects learn how to alter their physiologic responses

Cont
It can contribute to insight & understanding into

current concerns , support system management(pain, depression ,difficulty breathing) Improve the patients functional status(self soothing to decrease vomiting in bulimia nervosa) SPIRITUALITY Spirituality is ones inward sense of something greater than the individual self ,a personal awareness of dimensions of existence that extend beyond the physical domain.

SPIRITUALITY

Cont
Spiritual understanding depends on a basic faith, & it

has no tangible or physical benefit or value. The healing components of spirituality involves the intentional influence of one or more persons on a living system without using known physical means of interaction. It has 2types 1. Healer views the patients 2.Healer touches the patients(energy flows healer to patients).

Cont
Reports says that healers being able to influence a

variety of cellular & other biologic systems through mental means.

Patients may occasionally heal themselves.
Miracle do happen (cancer can disappear) The belief may help restore hope & a fighting spirit

which are important to recovery from illness.

PRAYER
It is a conscious relationship with the force of the universe

or God.
Forms-prayer, confession , gratitude or silent communion. It involves no direct physical contact , no attempt to do

anything or give anything.

The only goal is to become one with the person & his God.

MEDITATION

MEDITATION
Meditation

creates a state of deep, quiet contemplation that filters out distractions & seeks to refine consciousness so that thought & being are in tune with the universal plan.

It Redirect energy for healing. Decreases stress,

decreases oxygen consumptions, cardiac & respiratory rates. Contra-indication;-schizophrenia or psychosis.(20minutes)

YOGA

YOGA
Yoga is a philosophy that integrates the spiritual,

mental , emotional & physical aspects of life. The word yoga means the union of different aspects of the individual. It has different forms but all involve self improvement through focused breathing , stretching & meditation. Yoga emphasizes breath-it connects mind, body, spirit & emotions. It can be used in hypertension , depression, osteoporosis & menopause problem.

GROUP THERAPY

GROUP THERAPY
It usually centers around a common

provides mutual socialization.

supports

theme. It encouragement,&

Used in psychological therapy, to work through grief

and loss , to lose weight ,or to work on self improvement.(breast cancer survivors support group).

ART & COLOUR THERAPY

Art , light, color & environment affect mood attitude.
Art & color allow a person to express inner needs and

desires record dreams & meditation. Art & color therapy may be used along with other mind & body therapies . MUSIC THERAPY Different parts of the body resonate to different sounds & pitches. Music therapy is used effectively CCU, NEONATAL ICU

MUSIC THERAPY

BIOFEEDBACK

CANCER UNIT. It also decreases stress , anxiety & H.R & promotes relaxation. Music chosen for relaxation must meet the individuals needs & preferences, since individual responses can vary. BIOFEEDBACK It involves the self regulation or voluntary control of an internal state. Patients learn to regulate their physiologic functions in subtle ways through the use of non invasive electronic monitoring equipment involving blood pressure , heart rate ,skin temperature, electroencephalogram or electromyogram recordings.

 It allows patients to participate in their own healing .

It is helpful in treating hypertension , Raynauds

disease, migraines and lower back pain.

HUMOR THERAPY
1964-NORMAN COUSINS editor of Saturday Review who

was suffering from ankylosing spondylitis .

After watching Marks Brothers & BELLY-LAUGHING . His ESR RATE decreased 5 points permanently. Increases immune response-(Bennet et al 2003). Wooten -2005 suggestion for HUMOR PROGRAM-where

patients families can play games.

RELAXATION THERAPY
Relaxation

therapy used as a part of stress management. Stress erodes health & wellbeing . It affects -Nervous immune system -Emotion -Relationship with others Stress management techniques may reverse disease & lower blood pressure & heart rate.

 It can be somatic or cognitive.

Somatic-it uses observation to purposefully relax muscles. Cognitive-uses a mental device such as a word ,sound or breathing to relax the body & mind. Relaxation techniques are effective in Reducing chronic pain Headache Back pain

 Menstrual pain
Orthopedic post operative pain Rheumatic pain

PSYCHONEUROIMMUNOLOGY It is the study of mechanisms that turns thoughts and feelings into chemical & neurologic sequelae. It explores the interaction between behavior , neural & and endocrine activity & the immune process. Physiologic distress can suppress the immune system . At the same time a person can work with mind & emotions

Cont
to increase resistance to disease or to influence recovery. USED IN: Headache Blood pressure Heart rate& rhythm Ulcer Irritable bowel syndrome Pain ,anger , anxiety ,panic & reduce muscle spasm.

BIOLOGICALLY BASED THERAPIES

It includes the use of natural products both botanical

& herbal & nutritional supplements. HERBAL MEDICINE: PHYTOMEDICINE-The use of plant material for medical purposes. People often assume herbal products are safe because they are natural. But natural does not always guarantee safety . A new drug goes through a lengthy trial to ensure its safety .But herbal are not subject to clinical trials. Available adverse effects based on case reports

GENERAL PRINCIPLES CONCERNING HERBAL PRODUCTS

rather than clinical trails. Herbal products are relatively safe because of the lower concentration of active ingredients. Therapeutic effect takes time to develop. Pharmacologic actions are not well understood. These are not usually appropriate in emergency or acute care situation. Most often used for patients with chronic illness It also has potential drug interactions with prescribed

drugs. There are contraindications to use. Herbal products have the potential for multiple effects (aspirin , digoxin ,atropine ,& morphine).
COMMONLY USED HERBAL PRODUCTS PATIENTS TEACHING GUIDELINES FOR SAFE PRACTICE

NUTRITION
Nutrition is the science that studies the use of food.
It is one of the most commonly used CATs.

Nutrition plays major role in the prevention & treatment of

chronic illness.
Certain foods are associated with improvement of certain

symptoms. Lab findings can guide nutritional supplementation.( MENOPAUSE SYMPTOMS-SOY PRODUCTS,GREEN TEA CVS &CANCER).

AROMATHERAPY
Aromatherapy involves the use of essential oils

hydrosols to promote health & balance & heal the mind ,body ,& spirit. HISTORY Used since 5000 years Distillation devices to extracts oil were found in Mesopotamia. Egyptians embalmed the dead with oil. World war 1&2 soldiers carried lavender oil to disinfect wounds.

 Dr.Rene Maurice Gattefosse coined

aromatherapy & he is called father aromatherapy. Essential oils are applied or inhaled to achieve physical, emotional& spiritual balance & harmony. Odors also act on hypothalamus which controls the secretion of hormones in the endocrine system. Smells can affect intuition , emotion & creativity. Persons reaction to odor occurs on an emotional & subconscious level.

the term of modern

Cont
Odors via the olfactory nerve

Stimulate the limbic system of brain

Controls primitive needs hunger,thirst&emotion

 Smell is connected with memory-may be pleasant or

painful. Oils contains hormones ,vitamins ,natural antibiotics & antiseptics. These are obtained by the process of distillation. Roots ,leaves ,flower ,seeds ,resins ,gums from plants , flowers , shrubs , or trees are heated with water to release oils in a vaporized form .The steam &vapor are condensed to a liquid state . Essential oil floats . Remaining are termed as hydrosol.

USES
It may be used with or without touch therapies.
Aromatherapy hydrosols are mixed with a base oil of

lotion & applied to the skin. It can be used in massage lotions,baths,compresses, steam inhalation,& hair & skin care products. Small quantities are therapeutic but larger quantities could be toxic. Internal use is rarely recommended.

BACH FLOWER REMEDIES

British physician Edward Bach-discovered by him. His The Bach Flower Remedies book is a reference

guide. The combinations are selected from among 38 common nontoxic flowers. For example: rescue remedy is a combination of five flowers. STAR OF BETHLEHEM ROCK ROSE IMPATIENTS

CHERRY PLUM CLEMATIS Used to deal with every day emergency. It is benign & produces no unpleasant reaction & it is preserved using brandy. 2or 3 drops under the tongue or glass of water that they sip throughout the day. Hydrotherapy baths , douches,& packs can also be made with Bach flower remedies.

MANIPULATIVE & BODY BASED THERAPIES

Manipulative & body

based therapies integrate the structural & functional integrity of the body using manual methods. It includes MASSAGE CHIROPRATIC CRANIOSACRAL TRAGER ALEXANDER TECHNIQUE REFLEXOLOGY

MASSAGE

MASSAGE
It

manipulates the soft muscles,tendons,ligaments,fascia within the soft tissues.

tissuesskin and structures

It may use their hands , forearms , or elbows to apply pressure & move the body tissues.

Techniques

includes touch,stroking(effleurage), friction,vibration, percussion(tapotement), kneading(petrissage), stretching & compression.

 Massage modalities include European, Swedish,Sports,

Esalen, deep tissue therapy manual lymph draining. Origin found in folk medicine In 1900 Albert Hoffa published Technik Der Massage which is the basis for all modern massage.
In 1918 polio epidemic renewed interest in massage

therapy. Now 2-nd most common therapy in US

USED IN
It integrates mechanical, physiologic , reflexive, mind-

body and energetic mechanisms. It affects Musculoskeletal Circulatory Lymphatic Nervous Other body system

It reduces muscle tension It improves circulation It decreases blood pressure It reduces acute & chronic pain It increases joint mobility range of motion It increases oxygen delivery to the tissues &improves the removal of lactic acid &other waste products from the cells Beta-endorphins increases & decreases pain perception

 Creates a state of relaxation that relieves anxiety &

enhances individuals wellbeing.

It recharges energy activates the parasympathetic

nervous system for restoration & rejuvenation

Settings-such as cancer clinics, OG, post surgical units,

& rehabilitation unit.

CHIROPRACTIC

CHIROPRACTIC
It means hand works & refers to manual therapy that focus on the spine & its effects on the nervous system The practitioner analyses structural relationships & manipulates them to restore proper alignment & funtion.
They use patient history,

physical examination neuromuscular examination radiographic examination &lab test &special tests to determine the appropriateness of chiropractic care for the individual patient.

USED IN

To treat shoulder pain Lower back pain Temporomandibular joints disorder Spinal disorder Altered musculoskeleton function Altered flexibility Disturbed physical performance. Studies have shown that chiropractic care for lower backpain is more effective than conventional medical care.

Cont
Used in the treatment of headaches
Neck pain

ADVERSE EFFECTS Brain stem or cerebellar infarction Spinal cord injury Vertebral fracture Tracheal rupture Diaphragm paralysis & even death

CRANIOSACRAL THERAPY
Therapy is based

on the theory that cranio sacral rhythm or pulse motion reflects the rise & fall of the cerebrospinal fluid within the duramater compartment& occurs 6 to 12 times in a healthy person. It is believed that the skull sutures are not entirely fused , as is commonly believed , but can be used to access the flow of cerebrospinal fluid through the dural membranes. The therapist work with the patient to identify where

The pulsing rhythm is obstructed. They monitor the rhythm using light ,gentle touch, no heavier than 5gm. After identifying an obstruction , the practitioners assists the natural flow of fluid to help the body self correct. Work in this area can increase energy flow& break up restrictions. It is used in chronic fatigue syndrome, chronic headaches, joint problems, & head injuries & as a part of stroke rehabilitation.

TRAGER
MILTON TRAGER-1920 It uses gentle rhythmic movements or rocking to give

the mind sensory information about where body parts are & how they feel &move. It connects a person to his body ,stimulates deep relaxation& focuses on a model of optimal functioning. This approach provides a background for physical therapy , occupational therapy , chiropractic care , physical rehabilitation ,& psychotherapy. It can also involve a program of do it yourself exercise .

PRINCIPLES OF TRAGER
Length creates freedom of movement ,which takes less

effort. Finding width: taking up our full space gives way to feeling . Presence in relationships does matter. Giving up weight makes one feel lighter. Movement increase sensation. Repetition is the way we learn, and we learn our entire lives. Assessment is treatment.

designed to release blocked areas in both the mind &body. ALEXANDER TECHNIQUE AUSTRLIAN,FREDERICK MATHIUS ALEXANDER Shakespearean reciter developed the technique(vocal problem).
This technique is the system of posture & movement that capitalizes on the bodys natural grace and poise. The technique focuses on postural reflexes or antigravity reflexes.the use of ourselves

Used in performing arts physical therapy.

Clinical benefits are

Chronic pain Traumatic injury Back hip & neck dysfunction Repetitive stress injuries Neurologic dysfunction Respiratory dysfunction Posture or balance disorder

REFLEXOLOGY

REFLEXOLOGY

Reflexology involves applying pressure with the thumb & fingers to stimulate the reflex areas in the feet & hands that correspond to all the gland , organs & parts of the body. It can improve the whole function of the body or a specific targeted area that may be distant from the area being stimulated. It encourages energy flow and removes impurities to promote healing. It is based on the theory blockages of the bodys energy

 Blockages of the bodys energy pathways can lead to

energy loss discomfort & illness.

They work each reflex ,triggering release of stress&

tension in the corresponding area or body zone & promoting overall relaxation response.
Patients express relief from tension & pain , greater

wellbeing &increased energy.

EXERCISE

EXERCISE
It is an movement

that promotes health &fitness including cardiovascular endurance, muscle strength &body flexibility. Stretching relaxes& loosens muscles ,releases toxins It decreases stress hormone Improves relaxation Deals with stress more effectively Improves cardio vascular& pulmonary function Decreases hypertension , diabetes ,osteoporosis& depression.

ENERGY THERAPIES
All living system are based on energy & vibration,& all

forms of body works interact with this energy in some way. Energy therapies includes Therapeutic touch Reiki Physioacoustics Bioelectromagnetics

THERAPEUTIC TOUCH
It developed in 1972 by Delores kreiger , a nurse &

professor.(New york University ,&Dora kunz,a natural healer. The use of the hands on or near the body with the intent to help or heal.
Contrary to the name implies, the therapeutic touch

practitioners modulates the patients energy field without physically touching the patient.The technique is based on Rogers theory of unitary human being,The body is an open energy field that interact with environment.The practitioner consciously directs sensitively modulates human energies.

 Therapists centers then accesses

the energy fields, unruffles or clears immobilizes the energy field, directs energy, & balances the energy field. Used in To decrease pain perception & anxiety To improve wound healing To promote relaxation.

HEALING TOUCH
The practitioner uses the hands to clear energize,

balance the human energy field ,thus mobilizing the persons own ability to heal. It was offered in the 1980s as a continuing education program for nurses by American Holistic Nurses Association . It is widely used in conjunction with allopathic treatment.

REIKI

REIKI
Reiki involves the use of intentional touch with a

receptive patient to promote healing. The term reiki means universal life force energy. Reiki practitioners draw energy into their bodies through the crown of their heads . This energy then passes through the body & out of their hands to the patients. They use specific hand placements to cover the major human organs , focusing on the bodys 7 major energy centers or chakras.

PRINCIPLES OF REIKI
Healing occurs as energy passes to the patients
JUST FOR TODAY I WILL LIVE THE ATTITUDE OF

GRATITUDE. JUST FOR TODAY I WILL NOT WORRY. JUST FOR TODAY I WILL NOT ANGER JUST FOR TODAY I WILL DO MY WORK HONESTLY JUST FOR TODAY I WILL SHOW LOVE

VIBRATIONAL MEDICINE
All matter is believed to vibrate to precise frequency.
Vibrational medicine uses fluctuating energy fields

from electronic devices , the human voice ,or musical instruments to promote health.
The use of resonant vibration through music & sound

can produce changes in heart rate , blood pressure, brain waves, muscle contractions & restore this balance in the body.

PHYSIOACOUSTICS
It specifically applies low frequency stimulation to the

human body to obtain desired effects. It uses sine waves in the range of 20 to 120Hz. The subject may sit in a special chair or lie on a special mattress Pre selected frequencies or sounds are played through simple speakers & are more felt than heard. Contra indication-acutely herniated disk. Uses-reduction of stress, anxiety, pain.

BIOELECTROMAGNETICS
It explores the interactions of electromagnetic fields &

radiation with living tissues. All physical bodies have magnetic fields. The earth has a geomagnetic field of 0.5gauss. Exogenous static & electro magnetic fields influence & moderate the properties of biologic systems , yet there is no consensus about how they operate. Used in diagnosis-ECG ,EEG& MRI, EYE MAGNET (to remove sharp) to treat retinal tears , external cardiac defibrillators & pacemakers.

 Research is going on to use in wound healing & the

treatment of muscle , bone & joint pain.

Women with bladder incontinence& men who have

had prostatectomies are using chairs with pulsed magnetic fields to improve continence.
Still studies need to be done to find out adverse effects

STRATEGIES FOR INTRODUCING CAT

Identify the goal of treatment.
Assess patients KAB on CAT. Educate CAT options.

Offer options that may be beneficial to the patient

Share current research outcomes. Discuss expected outcomes of therapy. Obtain clinical informed consent. Ask the patient to evaluate the therapy.

NURSING MANAGEMENT
Nurse must be aware of & sensitive to patients

interpretation about health , illness, promotion & prevention aspects. Unique health practices &beliefs must be identified & respected. Nurses needs to knowledgeable about cultural beliefs & alternative practices. Deliver effective individualized holistic care. Nurses need to be knowledgeably about CATs & their complication ,contraindications ,potential benefit &

adverse effects. Use of special prayers, special foods are integrated into the plan of care whenever possible. Success may be small(cultural food ,relaxation exercise) but their cumulative effect can be powerful. Suggest to the patients to keep a daily log of therapy used and document symptom improvement & side effects. Help patients explore CAT therapies that are suitable for them.

CONT
It is important for patients to know how to access &

evaluate safe & competent practitioners. CONCLUSION There is a great opportunity for nurses to expand their practice to meet existing patients needs as well as to promote health.As new therapies demonstrate their effectiveness they can be added to the assessment.It is expected that CAT will become a larger part of nursing.