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[Multiple therapy (complementary therapy)].

The term "Multiple therapy" is used to describe the combined use of more than one therapist for one patient following a preconceived plan (German: "Komplementärtherapie"). Combined with dynamic ward groups this approach intensifies the impact of short term in-hospital treatment. The purpose of this strategy is to fragment the patient's defenses, to shorten the therapeutic process and to prime and prepare the patient for ambulatory treatment after discharge. The employment of Multiple therapy in a hospital minimally necessitates workable interpersonal relationships between the members of the team, intensive supervision to prevent countertransference problems and a compatible point of view regarding the goal of treatment amongst the staff. All therapeutic methods, new or old, are in the final analysis nothing else than what the word connotes: a method, a means to an end. They never represent the way itself. The quality of psychiatric therapy and treatment does not depend upon the method, be it multiple therapy, individual analytic therapy, one of the non-verbal methods used or any other. What really counts is 1) whether the method is used by a team which truly wants to cooperate for the benefit of the patient, transcending their own ego demands, 2) whether it really improves interpersonal communication. Every psychiatric patient is somehow alienated and removed from his fellow men. Therapeutic methods employed at the hospital are valid if they facilitate to bridge this gap. If that is achieved, therapy can be considered successful. If not, such approaches merely represent meaningless occurrences which at best foster an illusion that "something really happened". That is not the same as when we see the beginning of a healing process. The therapeutic atmosphere in the hospital is meant to create a climate wherein a natural innate healingpower of man will be liberated. The Romans knew it already: Medicus curat, natura sanat.

Adolescent↗

Pharmacist's role in meeting the psychosocial needs of cancer patients using complementary therapy.

Complementary therapy is commonly used amongst cancer patients. The motivation for cancer patients to use complementary therapy is complex. Pharmacists at the British Columbia Cancer Agency are often called on to advise patients on the use of herbs and dietary supplements. However, they do not routinely address the psychosocial needs that motivate the patients to use these products. The most common factors involved are increased anxiety, need for information, maintenance of hope, a sense of control, negative experience with conventional medicine, and perceived holistic nature of complementary therapy. Pharmacists are in a position to identify and address some of the psychosocial issues, either directly or through referral to appropriate psychosocial counsellors. This includes screening for patients with significant anxiety, helping search for accurate information on conventional and complementary treatments, and maintaining a sense of hope and self control. The opportunity to provide basic psychosocial training to pharmacists should be explored, so that they may systematically assess and address the more common, simple psychosocial issues in cancer patients who seek to use complementary therapy. Given the propensity of distress in cancer patients, in general, this may provide potential benefits for patients seeking conventional and complementary therapies.

Attitude to Health↗

Culture and complementary therapies.

Complementary therapies are becoming increasingly popular in cultures dominated by biomedicine. Modalities are often extracted from various healing systems and cultural contexts and integrated into health care, expanding the focus from treatment of disease to the promotion of health. The cultural aspects of biomedicine are presented and compared and contrasted with other healing systems. Three healing systems; traditional Chinese medicine, Yoga, with roots in Ayurvedic medicine and Shamanic healing illustrate these fundamental differences in approaches to healing. A reverse example of isolating one healing intervention from biomedicine and interpreting it through other cultural lenses is presented. Implications are drawn for practice and research.

Complementary Therapies↗

Research issues in complementary therapies.

Complementary medicine views health as a balance of forces to achieve optimum wellbeing of body, mind and spirit, whilst conventional healthcare focuses on the prevention, diagnosis and treatment of disease. The World Health Organisation estimates that globally 80% of primary consultations occur within holistic therapies (Lewith 1995). Numerous reasons explain this, e.g. dissatisfaction with technological medicine, increasing individual responsibility for health, and more client involvement in treatment. The increased use of complementary therapies in the UK has stimulated debate about health, illness and care which poses issues for the overall delivery of contemporary healthcare. Rising standards of accountability create expectations that research is available which informs safe and effective practice. This article reflects on the particular issue of research methodology into the effectiveness of healthcare.

Complementary Therapies↗

Regulation, religious experience, and epilepsy: a lens on complementary therapies.

Complementary and alternative medical (CAM) therapies include chiropractic, acupuncture and traditional Oriental medicine, massage therapy, and herbal remedies; mind-body therapies (such as meditative practices and visualization); and folk practices and religious healing. Of these, modalities based on spiritual healing create a number of conundrums for the clinician, including legal, regulatory, and ethical issues. Further, the historic relationship between the study of epilepsy and religious experience suggests particular, potential associations between CAM therapies (and especially spiritual healing) and care for epileptic patients. There are at least two dimensions to this exploration: first, the widespread use of spiritual healing for treatment of epilepsy; and second, the hypothesized connection between epileptic seizures and mystical states. A number of legal rules help address potential abuse of authority by health care professionals, and include: (1) medical licensure; (2) scope of practice; (3) professional discipline; (4) malpractice; and (5) fraud. This article offers a preliminary resource for clinicians interested in these topics.

Complementary Therapies↗

Culture and therapy: complementary strategies for the treatment of type-2 diabetes in an urban setting in Kerala, India.

There is an epidemic rise in diabetes in the developing world, with ensuing concern about the management and control of the disease. This study investigates the use of complementary therapies to manage Type 2 diabetes in an urban population in Kerala, a state in Southern India. Using ethnographic methods, it shows that the subjects' experiences of the disease and their health management decisions are closely linked to their cultural background and the environmental resources of the region. Participants in the study relied on biomedicine for treating diabetes, but frequently used Ayurvedic medicine and folk herbal remedies as supplements. They named 24 local plants and plant products that were employed to lower blood glucose levels. Knowledge of tried and tested local or regional remedies and their incorporation into individual and community health care practices are evidence of medical knowledge as cultural capital. Greater attention needs to be paid to the broader systems of the environment and culture and their interconnections to understand the use of complementary therapies by persons with chronic illnesses such as diabetes.

Adult↗

Factors associated with complementary therapy use in people living with HIV/AIDS receiving antiretroviral therapy.

OBJECTIVES: This study examined the extent to which people living with HIV/AIDS (PLWHIV) taking combination antiretroviral therapy used complementary therapy, and the relationship of their reported symptoms to the use of complementary therapy and health-related outcomes. DESIGN: A descriptive design was used in which data were obtained from individual interviews and medical records. SETTINGS: PLWHIV were identified through flyers distributed in five HIV clinics in urban and suburban locations in a Western state of the United States. SUBJECTS: The sample consisted of 182 people living with HIV/AIDS, self-identified as white (24.12%), black (44%), and Hispanic (31.88%) with a mean age of 38 (range, 22-66) years. The majority (n = 160; 87.91%) was using as least one category of complementary therapy. Approximately 56% were experiencing symptoms from HIV or their treatment, and 51% discussed their complementary therapy therapies with their health care providers. OUTCOME MEASURE: Three categories of complementary therapy--physical/body-mind therapies, religion, herbs and supplements--and two health-related outcomes--CD4 count and viral load--were explored. RESULTS: Complementary therapy use was associated with higher education, being Christian, white or black, and working part or full time. Significantly more PLWHIV with symptoms used physical/body-mind therapies than those without symptoms. No differences were found between users and nonusers of complementary therapy with respect to CD4 count and viral load. The use of herbs/supplements was significantly associated with the use of protease inhibitors. Among the categories of complementary therapy, religion, especially prayers, were most frequently used. CONCLUSIONS: A substantial proportion of PLWHIV reported using complementary therapy, most predominantly religion (specifically prayers). Further study is recommended to explore the PLWHIV's perceived benefits of using complementary therapy, and to examine the effect of complementary therapy on the patients' symptoms and disease progression. Health care providers need to be alert to potentials of interactions between combination antiretroviral therapies and specific complementary therapy in PLWHIV.

Adult↗

Complementary therapies.

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Complementary Therapies↗

[The risks of complementary therapy methods].

Complementary treatments are currently more popular than ever-not least because they are perceived to be innocuous. This perception is, however, almost certainly wrong. Serious complications are being reported with worrying regularity, as is shown by the present article using acupuncture and herbal remedies as examples. The true incidence of such complications is, for the most part, unknown. Only when reliable figures have been provided by systematic investigation will it be possible to undertake a risk-benefit analysis. It follows that a study of this problem is now a matter of urgency.

Acupuncture Therapy↗

General practitioners' attitudes toward complementary therapies.

Attitudes toward complementary therapies were elicited from a postal survey of all identified general practitioners in the state of Tasmania, Australia. Regression analysis of the data indicated that demographic features associated with favourable attitudes were younger age and location in small or single practices. Personal experiences of such therapies or patient endorsement of them were also associated with favourable attitudes. Those who saw the holistic orientation of complementary medicine as an advantage were likely to hold favourable attitudes. Those who saw the cure rate of complementary therapies as problematic and/or had personal knowledge of the harmful effects of such therapies were less likely to have favourable attitudes.

Adult↗

Therapies in practice: a survey assessing nurses' use of complementary therapies.

This paper reports the findings of an informal survey to assess nurses' use of complementary therapies within the health care setting. Increasing interest amongst the general public and health care professionals appears to have resulted in an assumption that there is currently widespread use of therapies such as massage, homoeopathy, aromatherapy, reflexology and acupuncture within the health care setting. However, to date there have been no national research studies undertaken to substantiate this assumption. This study attempted to identify the range of practices and magnitude of use by nurses who are members of the Royal College of Nursing Complementary Therapy Forum (RCNCTF) UK. A convenience sample was used and a semi-structured questionnaire was inserted into the group's bi-annual newsletter and sent to all members of the RCNCTF (n = 1662). A total of 178 subjects completed and returned the questionnaire, representing a 9.3% response rate. Given the informal nature of this survey, and the fact that it was an insert in a newsletter, a relatively low response was anticipated. Contrary to expectation, findings indicated that the majority of respondents were aged between 41 and 50 years. The six principal therapies practised were (in order of use) massage, aromatherapy, reflexology, relaxation, visualization and acupuncture. The three most common areas of practice, both in the NHS and private sector, were in the community, palliative care and oncology. Findings also indicated that complementary therapies were more commonly practised in the private sector as part of formal working practice. This was in contrast to nurses working in the NHS, where complementary therapies appeared to form less than 20% of their formal nursing care and respondents indicated that, when used, it was often in addition to daily nursing care. Results indicate that nurses are practising complementary therapies less than has been assumed. Those therapies commonly practised form a broader mantle than therapies commonly presented as the primary therapies in complementary medicine, namely homoeopathy, acupuncture, herbalism, chiropractic and osteopathy. This survey represents a single snapshot of nurses' use of complementary therapies. The convenience sample focused upon a self-selected group of people who were members of the RCNCTF and this has to be borne in mind when considering the results. The intention is to report the findings and no attempt is made to generalize upon the results. However, there is clearly a need to identify national utilization of complementary therapies within the health care sector.

Adult↗

Assessing complementary therapy services in a hospice program.

Increasing numbers of people have been supplementing their health care needs with complementary therapies. Complementary therapies have been used to promote health and treat patients with a variety of ailments. Types of complementary therapies used with terminally ill patients have included massage, therapeutic touch, Reiki, art and music therapy, aromatherapy, and hypnotherapy. The purpose of this study was to survey primary caregivers (PCGs) regarding their perceptions and satisfaction with a hospice complementary therapy program. Perhaps this study's most interesting finding is that patients who received complementary therapies were generally more satisfied with overall hospice services.

Adult↗

Researching complementary therapies: a Delphi study to identify the views of complementary and orthodox practitioners.

Twenty five participants were invited to a workshop looking at the role of research and development in complementary therapies. These participants took part in a modified Delphi study to ascertain a consensus from their broad spectrum of views and see how those views changed over time. Opinions were sought about respondents' perceptions of complementary therapies, the type and scope of research needed, and how such research should be coordinated. The workshop, arranged by the Regional Health Authority, included orthodox and complementary practitioners, purchasers, providers and academics. Questionnaires were administered at the beginning and end of the workshop and 6 months later. The group was small and potentially positively biased, having both pre-existing knowledge and interest in complementary therapies. In consensus, the more mainstream complementary therapies of osteopathy, acupuncture, and homeopathy were perceived to be the most beneficial to patients, and therefore, most likely to be recommended as treatments. These were also felt to be the priority areas for research. For some unknown reason homeopathy had lost its popularity in ranking 6 months later. The respondents agreed that research into complementary therapies was needed and ideally should be collaborative between practitioners, professional bodies, and academics. The workshop appeared to produce some changes in knowledge that were not always maintained over time. It was, however, formative in the decision of the Regional Health Authority to allocate research funding into complementary therapies.

Adult↗

Brain injury: the uncertainties of using complementary therapies.

The use of complementary therapies is fast growing in the UK, but their place within health care is still unclear. This study explored the views of families using a specific complementary therapy in the care of their brain-injured children, and of professionals involved in the care of the children. The findings revealed an interesting comparison of views about the use of complementary therapies and attitudes towards their use.

Adolescent↗