Complementary therapies in nursing & midwifery最新文献

The majority of North American pregnant women experience some degree of nausea and vomiting, usually in the first few months of pregnancy. Women utilize many coping strategies, including self-treatment with herbal medicine and other alternative therapies. In a qualitative study of self-care in pregnancy, birth and lactation within a non-random sample of 27 women in British Columbia, Canada, 20 women (74%) experienced pregnancy-induced nausea. Ten of these women used anti-emetic herbal remedies, which included ginger, peppermint, and Cannabis. The safety and efficacy of each of these herbal remedies is discussed here. Only ginger has been subjected to clinical trials among pregnant women, though all three herbs were clinically effective against nausea and vomiting in other contexts, such as chemotherapy-induced nausea and post-operative nausea. While safety concerns exist in the literature for all three herbs with regards to their use by pregnant women, clinical evidence of harm is lacking.

Orthodox medicine generally demands evidence in the form of randomised controlled trials (RCTs) before accepting the value of a particular therapy/intervention from the CAM field. Yet many RCTs are badly executed as they are carried out by doctors or scientists rather than holistic practitioners, and peer reviewers for conventional medical journals may not have sufficient knowledge to be able to assess a CAM paper properly. This article discusses inadequacies found in RCTs and other papers related to CAM, and pinpoints how research should be critically evaluated and reviewed. Examples are taken from the fields of aromatherapy, herbalism, acupuncture/TCM and homeopathy. The aim of this paper is to highlight common misunderstandings and misguided assumptions that may arise when undertaking research in the field of complementary medicine that may result in erroneous conclusions being drawn from data and which may have far reaching implications for clinical practice. The STRICTA recommendations for acupuncture are discussed.

The first of three papers that considers claims made for the perception or detection of vital energy. Many systems of Complementary and Alternative Medicine (CAM) assume the existence of a vital force that mediates therapeutic efficacy, for example chi or qi in Traditional Chinese medicine. Vital energy directly perceived or imaged that surrounds living organisms is frequently termed the aura. This paper aims to show how phenomena that arise as a consequence of the normal functioning of the human visual system can be inappropriately offered as support of claims for the direct perception of vital energy or the aura. Specifically, contrast and complementary colour phenomena, entoptic phenomena and the deformation phosphene, the ‘flying corpuscle effect’, the blind spot and the ‘reverse telescope effect’ are explained and discussed.

Dolphins have been shown to have a powerful impact on the wellbeing of humans, how do they do it? This article reflects the thoughts of one person after spending time with these wonderful creatures.

Pregnant women with an ostomy face many challenges during the prenatal period. Although these challenges may be present, pregnancy in the ostomate is presented as a continuum of health and wellness in this article. Collaborative care professionals, especially nurses and midwives, are often the most accessible professional sources for health care information, but current research and information on this topic is sparse. Ostomy-related problems that may occur during pregnancy, include: intestinal obstruction, peristomal hernia, pouching problems, including the effect of nausea and vomiting on pouch hydration, stomal retraction, stenosis, or laceration, and stomal prolapse. Three types of ostomies are discussed: continent ileostomies, urostomies and colostomies. A description of the normal characteristic appearance of each is also included.

Collaborative care from pre-conception through the post partum period is described with emphasis on teaching self-help techniques such as: special nutritional considerations, how to recognize potential problems, and how to fit and adapt appliances to the changing body form of the patient as the pregnancy progresses.

Phenomenologic information about the pregnant ostomate's perceptions about her pregnancy experience is also presented. Psycho-prophylaxis methods of complementary therapy alternatives alleviating nausea and vomiting within pregnancy, as well as the pain of childbirth are also presented. Although nursing/midwifery management of a pregnant ostomy patient is a challenge, those challenges are surmountable and outcomes resemble those found in the general population.

In the past 20 years, the popularity of natural medicine has increased, with nurses and medical practitioners being amongst several groups of clinicians expressing a widespread interest in natural therapies. It is argued that the degree of natural therapy use and the attitudes of these practitioners toward natural medicine may not only influence patient exposure to these therapies, but also have some bearing on the future use of natural medicine. Hence, in a critical review of recent studies, the utilisation of natural therapies and the attitudes of nurses, medical practitioners and the public toward natural medicine are explored.

This paper reviews some of the evidence in relation to herbal remedies, and considers both their efficacy and safety for pregnant and childbearing women. It concludes with some suggested guidelines for midwifery and obstetric practice.