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Course: Fundamentals of Nursing

Topic: Holistic Healing

The Nurses International Community

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Module Goals

Learners will be able to:

Define what is meant by holistic healing.
Describe various types of alternative therapies categories of CAM.
Explain how traditional medicine and CAM can be used in client care.
Detail the nurses role in client education and CAM.

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Holistic Healing and Holistic Practices

Holistic Healing: Refers to the method where an individual is treated as a whole (body, mind, soul, spirit) not just the disease conditions.

Holistic Practices:

A combination of alternative therapies and traditional medicine to do holistic healing.
Fall outside purely pharmaceutical or surgical treatments.

Other Names:

Alternative medicine, complementary therapies, holistic practices, natural healthcare, integrative medicine.

University of Minnesota, n.d.

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Some Examples of Holistic Healing

Massage
Ayurveda
Acupuncture
Yoga
Meditation
Naturopathy

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Types of Complementary and Alternative Medicine (CAM)

Traditional Alternative Medicine:

Therapies have been practiced worldwide for ages.
Sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures
Used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness
Traditional alternative medicine may include:

Acupuncture
Ayurveda
Homeopathy
Naturopathy
Chinese or Oriental medicine

World Health Organization, n.d.), John Hopkins Medicine, n.d.

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Types of Complementary and Alternative Medicine (CAM)

Body:

Method of touching has been used form very long time.
It focus on idea that illness or injury in one area can affect the whole body.
Manual manipulation can revive the injured part.
Examples:

Massage, chiropractic and osteopathic medicine.
Body movement therapies.
Tai chi, Yoga.

John Hopkins Medicine, n.d

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Types of Complementary and Alternative Medicine (CAM)

External energy: Some people believe external energies from objects or other sources directly affect a person's health.

An example of external energy therapy is:

Electromagnetic therapy
Reiki
Qigong

John Hopkins Medicine, n.d

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Types of Complementary and Alternative Medicine (CAM)

Senses. Some people believe the senses, touch, sight, hearing, smell, and taste, can affect overall health.

Examples of therapies incorporating the senses include:

Art, dance, and music
Visualization and guided imagery

John Hopkins Medicine, n.d

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Types of Complementary and Alternative Medicine (CAM)

Diet and herbs:

Nutritional excess and deficiency creates problems in our body
Can lead to minor to chronic diseases
Dietary and herbal approaches to balance the body's nutritional well-being.
It may include:

Dietary supplements
Herbal medicine
Nutrition/diet

John Hopkins Medicine, n.d

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Types of Complementary and Alternative Medicine (CAM)

Mind:

It emerges from a concept of mind and body are connected
Studies have found that people heal better if they have good emotional and mental health.
Therapies using the mind may include:

Meditation
Biofeedback
Hypnosis

John Hopkins Medicine, n.d

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Aroma Therapy

Use of essential oils from plants for healing
Can also be massaged into the skin, or rarely, taken by mouth.

Used to treat:

Hair loss
Agitation
Anxiety
Pain
Insomnia
Itching
Herpes infections
Psoriasis

Mount Sinai, 2015

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Traditional Medicine and CAM in Client Care

Complementary therapies has been used for many years to relieve anxiety, promote comfort, and reduce or alleviate pain.
Complementary therapies, such as journaling, hand massage, and imagery, can be taught to patients and their families, thus promoting self-care.
The acupuncture is being practiced for relief or the prevention of pain and for various other health conditions.

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Traditional Medicine and CAM in Client Care

Most of the techniques and medicines are from nature.
Most of them are non invasive and cause no or less side effects
It bridges the gap of treatment (modern medicine and traditional methods).
It encompassess proper nutrition, exercise, adequate rest, thus creates emotional and spiritual balance.
More accessible, more affordable, and more acceptable to local populations.
Prestigious medical centers: e.g Mayo Clinic, University of California San Francisco, and Duke University Medical Center currently offer Oriental medicine and other complementary and alternative medicine (CAM) treatments to their patients.

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Traditional Medicine and CAM in Client Care

Biofeedback teach you to control certain involuntary body responses, such as: brain activity, blood pressure, muscle tension and heart rate.
Biofeedback has been shown to be helpful in treating several medical conditions, including asthma, Raynaud’s disease, irritable bowel syndrome, incontinence, headaches, cardiac arrhythmias, high blood pressure, epilepsy.
Hypnotherapy has the potential to help relieve the symptoms of a wide variety of diseases and conditions.

Cleveland Clinic, 2020

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Traditional Medicine and CAM in Client Care

Ayurveda, which literally means “the science of life”,
A natural healing system developed in India
A comprehensive system of medicine that focuses on the body, mind and spirit, and strives to restore the innate harmony of the individual

Some of the primary Ayurvedic treatments include diet, exercise, meditation, herbs, massage, exposure to sunlight, and controlled breathing

Ayurvedic medications have the potential to be toxic
Most Ayurvedic medications consist of combinations of herbs and other medicines, so it can be challenging to know which ones are having an effect and why

Tabish , 2008

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Personal Anecdote:

“During my clinicals, I saw clients (at least 2 in a month) admitted in the ward with chronic liver disease and kidney failure. On assessment it was found that those clients were in herbal remedies for a very long period of time. And most of them would not survive!

In countries like Nepal, India, Bangladesh, there is practice of going to traditional healers for minor problems where the practitioners prescribe traditional medication/herbal medications. The medications are not measured doses nor are they supported by research and there is often no antidote available. There is a prevalent belief that they are natural the don’t any side effects. Ultimately, such medications builds up in body to toxic levels. “

Seeta Ghimire, Content writer, NI

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What would the nurse do?

Mr. A is admitted in a medical ward with a acute abdominal pain. On assessment, he says that he takes herbal medications for his prostate enlargement.

What would be the nurse’s response to the client to identify the need of additional education?

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Role of RNS

The recognition of the potential benefits of these therapies;

Limitations and side effects of orthodox treatment approaches;

An increasing expectation for a more holistic approach to providing care;

Quality of life issues;

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Nursing Roles:

Nurses need to pursue research to further the scientific basis for many of the complementary therapies.
RNs can, and often use, holistic nursing therapies that can be described as complementary or alternative in nature.
RNs should obtain and maintain appropriate education and clinical experience in order to maintain competency in CAT.
RNS should be familiar with the Nurse Practice Act and perform only those therapies inherent in the RN’s scope of practice.

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Nursing Roles:

RNs have an ethical and professional responsibility to support an individual’s choice regarding health care and
Educate the client about various therapeutic options and the risk and benefits associated with each
Health care professionals should be aware of their existence, uses, benefits, and dangers so that they may counsel their patients accordingly
Information of the therapies treating various illnesses, especially in children

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Red Flags

The combination of self-medication, non-expert consultation and lack of risk awareness of herbal medicine is potentially harmful.

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What would the nurse do?

A client tells the nurse that she is attending a t'ai chi class to help her improve her balance and increase her physical stamina.

Which nursing intervention(s) is/are safe and probably effective for the client's purposes?

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Encourage the client to attend t'ai chi and follow up later to monitor the effects and any side effects.

Rationale:

Nurses should promote and use practices that are safe and helpful, not discourage practices that are neutral (safe) and that may help, and discourage and protect the clientagainst practices that may be harmful. T'ai chi is relatively safe for people of all ages, and it is thought to be beneficial for improving balance and increasing physical stamina. The nurse should not discourage the client's practice. The nurse should document the client's CAM therapies, and monitor improvements and side effects that occur. The nurse does not need to know agency policy because the nurse is not providing the therapy, nor advising the client to use the therapy. For a practitioner-based therapy, such as Reiki, the nurse would need to know agency policy before administering the therapy.

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Cultural Considerations

Many populations see alternative therapies such as acupuncture as “work of the devil” as they are not Christian focused
Many people in Africa, Asia and Latin America choose traditional and complementary medicines for their primary health care needs (Razak et al. , 2016)
Burma: Karen people are largely dependent on traditional medicines (eg. herbs) available in the mountains, and this may affect their familiarity with biomedical procedures.
India, Nepal, Bangladesh, Vietnam: Food, illness and medications are usually classified as ‘hot’ or ‘cold’ according to the perceived effects on the body.

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Cultural Considerations

Vietnam: Use traditional methods of healing in parallel with biomedical health care.
Fiji: People are often less likely to participate in traditional healings due to Christian beliefs.
Karen: Like many others from South East Asia, Karen people may attribute illness to imbalance in natural forces, including wind, fire and water.

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References:

Cleveland Clinic (2020, December, 21). Treatment and procedure: Biofeedback. https://my.clevelandclinic.org/health/treatments/13354-biofeedback

Institute of Medicine (US) Committee on the Use of Complementary and Alternative Medicine by the American Public. Complementary and Alternative Medicine in the United States. Washington (DC): National Academies Press (US); 2005. 7, Integration of CAM and Conventional Medicine. Available from: https://www.ncbi.nlm.nih.gov/books/NBK83807/

Razak Mohammed Gyasi, Felix Asante, Kabila Abass, Joseph Yaw Yeboah, Samuel Adu-Gyamfi & Padmore Adusei Amoah | Jamie Halsall (Reviewing Editor) (2016) Do health beliefs explain traditional medical therapies utilisation? Evidence from Ghana, Cogent Social Sciences, 2:1, DOI: 10.1080/23311886.2016.1209995

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References:

Multicultural Clinical Support Resource. Retrived on 3rd of Septmember 2020 from https://www.health.qld.gov.au/__data/assets/pdf_file/0035/158669/14mcsr-pregnancy.pdf
Mount Sinai. (2015, September 11). Health: Aromatherapy. https://www.mountsinai.org/health-library/treatment/aromatherapy

Tabish S. A. (2008). Complementary and Alternative Healthcare: Is it Evidence-based?. International journal of health sciences, 2(1), V–IX.

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References:

World Health Organization (n.d). Health topics: Traditional, complementary and integrative medicine. Retrieved on 26 og August from https://www.who.int/health-topics/traditional-complementary-and-integrative-medicine#tab=tab_1
Zhang Q. Traditional and Complementary Medicine in Primary Health Care. In: Medcalf A, Bhattacharya S, Momen H, et al., editors. Health For All: The Journey of Universal Health Coverage. Hyderabad (IN): Orient Blackswan; 2015. Chapter 12. Available from: https://www.ncbi.nlm.nih.gov/books/NBK316267/

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