Nurses are increasingly using Traditional Chinese Medicine (TCM) for relief of personal health issues. The purpose of this qualitative case study is to explore how nurses’ TCM experiences affect nurses’ professional identities and practices. Symbolic interaction is the research framework used. Mixed methods of coding facilitate data analysis. Sociological theories explain the findings. The study included 20 semistructured interviews of 10 practicing nurses and 10 faculty members in the Twin Cities area of Minnesota. The data provide the basis for several new conclusions. Nursing subspecialty practice norms determine how TCM experience affects nurses’ professional identities and nursing practices. Mutable nursing careers enable nurses to incorporate TCM into their nursing ‘‘toolbox.’’ Among the significant findings from this study is that nurses try TCM and share that information with others, creating inroads for integration of TCM into Western medicine.
There is a place for the acupuncture profession within primary care. Nationwide, community clinics that serve the population of under- and uninsured persons are facing a tremendous shortage of primary care practitioners. Marginalized health care professions, that is, acupuncture, chiropractic, and naturopathy, are being drawn into a primary care role. An unanticipated workforce opportunity exists to fill the caregiver gap in community clinics. This transition can be quickly realized in states such as California where statutory code states that acupuncture is to be regulated and controlled as a primary care profession, but the requisite training has yet to be provided. Specific clinical experience in primary care settings would help overcome long-standing barriers that have resulted in the marginalization of the profession, high under- and unemployment among acupuncturists, and result in greater access to acupuncture treatment. A 1-year primary care training program for licensed acupuncturists (LAcs), which features clinical and didactic training, akin to what a physician assistant receives, would prepare acupuncturists to work in mainstream medicine. With appropriate training and biomedical collaboration skills, the participation of acupuncturists in mainstream medical settings can be accomplished with support from the acupuncture profession and mainstream medicine.
Acupuncture was first legalized in Maryland in 1973. By the end of 2009, regulatory legislation had passed in all but six states. The growth of acupuncture is most commonly measured by its well-documented demand as a treatment modality and the rapid increase in the number of licensees. Much less documented is a puzzling stagnation in work opportunities and income. As many as half of all licensees, on graduation and licensure, may be unable to support themselves by working in their chosen profession. However, unlike other well-established complementary and alternative health professions, such as chiropractic and massage, acupuncture is conspicuously absent from the Bureau of Labor and Statistics occupations manual, with only a handful of secondary and incomplete studies available, which together provide an inexact picture of the workforce. In this article, the authors review seven reports that provide limited information including hours worked, income, and practice type. Although data from these published articles are not standard, it can be reasonably concluded from the available information that, over the past decade, 50% of the licensed acupuncture (LAc) workforce is working less than 30 hr weekly; 50% are earning less than $50,000 on average; and the number of LAcs working independently in practice, either in their own office or sharing one, has increased from approximately 75% to 90%. Suggestions are presented for conducting a much needed comprehensive analysis of the acupuncture workforce.
The presence of traditional medicine (TM) and medical practitioners in remote areas of the world is well documented by anthropological studies. However, social, cultural, and environmental factors influencing health and traditional health systems are usually analyzed separately, ignoring the interlinkages existing among them and the resulting synergies, as well as the impact these will have on multiple aspects of local communities. This article presents an innovative and integrated approach to the promotion of a traditional health knowledge system through a community-based entrepreneurship initiative, the Gram Mooligai Company Limited (GMCL), operating in Tamil Nadu (India). The field study took place in Tamil Nadu over a period of 4 months. The data were collected through individual and group interviews and were complemented by participant observations. The research highlights the existence of a strong relationship between commercial initiatives centered on ethnomedicine, enhancement of local livelihoods, gender empowerment, and conservation and enhancement of traditional knowledge through community capacity building. The article points out the importance of promoting and sustaining community initiatives such as GMCL with appropriate policies and affirms the necessity of reinforcing the links among culture, conservation, and socioeconomic development of local communities, particularly among the most vulnerable sectors of society.
The vast majority of the medicinal plants in Chile have been studied from a pharmacological point of view. These studies, although giving important insights into the understanding of the Mapuche’s traditional medicine in terms of the therapeutical value of the plants, fail, however, to portray the numerous sociocultural and symbolic aspects of this form of medicine. This article aims to overcome this shortcoming by analyzing the sociocultural and religious values of medicinal plants among the Mapuche’s rural communities in Araucanía, Chile, as well as their role in traditional medicine. The methods utilized combined participant observation with individual interviews with local shamans (machi) and villagers. Data from free-list interviews and conversations with research participants were used to develop a series of semi-structured interview questions on knowledge of herbal medicines and plants. Data show that the therapeutic efficacy of Mapuche medicine is not only based on ‘‘active agents’’ but is also related to the symbolic and religious meaning attributed to the treatments by healers and patients. The article concludes that in order to fully understand the therapeutic efficacy of the plants, it is thus necessary to comprehend the sociocultural context in which they are used.
Clinical depression is a common illness, with prevalence of current depressive symptoms in the general population of nearly 10% and lifetime diagnosis almost 16%. Yoga offers an attractive option for complementary therapy of depression. The purpose of this study was to examine research regarding the benefits of yoga for depression, to learn to what extent yoga is beneficial as a complementary therapy for this condition. The method used in this study was a systematic qualitative review of interventions obtained from MEDLINE, CINAHL, and ERIC databases. A total of 18 studies met the criteria. Some of the designs utilized by the interventions were pretest posttest, quasi-experimental and randomized controlled trials. It was found that majority of the interventions (17) were able to significantly reduce depressive symptoms in the patients under study. However, several methodological limitations were identified in the conduct of the intervention trials, which future interventions must consider.
Objectives: Mindfulness training may help seniors successfully manage the physical and psychological challenges of aging in a manner that reduces distress and promotes vitality. The purpose of this retrospective analysis is to evaluate the impact of mindfulness-based stress reduction (MBSR) training on mood states in older adults. Methods: The authors identified 141 older adults (>60 years) who completed MBSR training. All participants completed the Profile of Mood States - Short Form (POMS-SF) at baseline and following 8 weeks of MBSR. Using paired t tests, the authors evaluated changes in mood following training in MBSR. In a subset analysis, the authors further examined the impact of MBSR training in individuals with the highest scores on depression and anxiety. Primary reasons cited for MBSR enrollment are also reported. Results: Overall emotional distress and all sub-scale mood measurements improved significantly following MBSR training. MBSR training resulted in >50% reduction in the number of older people reporting clinically significant depression and anxiety. Most enrolled in MBSR training to improve stress management skills. Discussion: MBSR training is a promising, group-based intervention for decreasing psychological distress in older adults. Larger randomized controlled trials are needed to confirm study findings.
Aims: African American (AA) subjects with type 2 diabetes mellitus were studied to determine effects of Massage Therapy/Acupressure (MTA) on vital signs (VS): blood pressure (BP), heart rate (HR), blood flow (BF), skin temperature (TEMP), O-2 saturation (O-2); well-being (WB); glycosylated hemoglobin (A1c), cortisol, and insulin. Method: Eleven AA ages 45 to 72, (8 female/3 males) were subjects. VS were obtained before and after each of 20, 60-minute MTA sessions. BF was measured with a Pulsed Doppler and decibel meter. Blood collections (n = 9) and Well-Being-22 Questionnaires [(WBQ-22) n = 11] were completed at baseline and following the 20th massage. MTA involved acupressure on spine-T-8/T-9, Urinary Bladder-UB17/UB23/U2, Stomach-ST2, Kidney-K5, Renal-R3; and Effleurage-gliding/stroking, Petrissage-kneading, Tapotement-cupping/hacking/pinching of extremities, and back/torso and Vibration Friction-neck. Hand pressure provided massage to the pancreas. VS were analyzed with General Estimation Equations, and Wilcoxon Sign Tests evaluated WBQ-22/blood work. Results: Pre/Post MTA BF increased with sessions (p = .001). Immediately following a MTA session, BP (systolic) increased while HR and TEMP decreased. Over-time MTA therapy led to significant increases in HR and BF, while TEMP decreased. No significant changes in cortisol, A1c, or insulin were noted. WBQ-22 parameters improved insignificantly; +Energy, +Positive WB, and +Total WB. Anxiety/Depression decrease. 19.5%/13.8%, respectively. Conclusions: Immediate effects of MTA were increased BP (systolic) and lower HR and TEMP. Long-term effects were higher resting HR and increased BF, while TEMP significantly decreased. MTA was feasible, well received and could have potential health benefits. Randomized controlled studies are needed to thoroughly explore this therapy as a useful adjunct to conventional allopathic care.
Over half of the patients diagnosed with cancer suffer from pain. Often, analgesic medications do not completely relieve the pain and alternative measures are sought out for relief. Mind-body techniques such as guided imagery (GI) have been thought to be helpful and used as an adjuvant to pain relief. This article evaluates and summarizes studies performed from 2001 to 2008, which investigated the use of GI for relief of cancer pain. Electronic databases were searched with the keywords cancer pain, visualization, and guided imagery, for any studies utilizing GI with an outcome measure of pain. Five studies included pain as either a primary or a secondary outcome measure. In three of those, pain intensity and pain-related distress decreased in the GI intervention versus control. There is inconsistency in the methodological qualities of these trials and further research is necessary to provide better evidence for the use of GI in cancer pain.
This article presents an in-depth, qualitative study, analyzing responses to focus-group interviews regarding individuals' self-reported experiences and attitudes during Qi Gong practice. Semistructured interviews were conducted with three Qi Gong groups in order to collect research data. These data were transcribed verbatim and subjected to content and thematic analysis across and within groups. The analysis indicates extraordinary experiences of Qi Gong practitioners on various levels of bio-psycho-spiritual/energetic functioning. The results indicate how Qi Gong influences the complexity and multidimensionality of individuals' health. In the discussion, the author compares and contrasts his results with other recently performed research.
Mindfulness is quickly becoming recognized as an important theoretical construct in health promotion and disease prevention research. Greeson (2009) recently evaluated the basic and clinical research on mindfulness, and the accumulated evidence from this review of the literature suggested that the cultivation of mindfulness has beneficial effects on mental, emotional, and behavioral health and well-being. The notion that mindfulness has a positive influence on health has also been supported by evidence suggesting that mindfulness-based interventions have protective influences on some physiological, psychosocial, and behavioral domains of health among both clinical and nonclinical samples comprising youth (Black, Milam, & Sussman, 2009) and adults (Brown, Ryan, & Creswell, 2007; Grossman, Niemann, Schmidt, & Walach, 2004). These empirical findings lend evidence regarding the effectiveness of mindfulness-based interventions on certain health outcomes; however, relatively little is known regarding the mechanisms whereby mindfulness produces change in health behavior outcomes. In this respect, little attention has been directed toward testable theoretical models underlying mindfulness and its influence on health behavior, even though some recent attention has been directed toward the integration of mindfulness and theories of mental health (Grossman et al., 2004). Thus, integrating mindfulness within existing theories of health behavior is one important next step in mindfulness research, considering the widespread application of mindfulness-based interventions in community, school, and clinic settings. To date, one known study examined mindfulness within the context of a formalized theory of health behavior (Chatzisarantis & Hagger, 2007). This prospective study found that mindfulness moderated the intention–behavior relationship within the Theory of Planned Behavior among a college student sample. According to this study, those respondents higher in trait mindfulness, as measured with the Mindful Attention Awareness scale (MAAS), were more likely to enact their behavioral intentions than less mindful respondents. The implications of this study are important, considering that strengthening the intention–behavior link is a key strategy in health promotion programming. Thus, future studies are needed to develop and rigorously test hypotheses that represent theoretical models which elucidate how mindfulness
Although preliminary evidence supports the psychophysical benefits of dance for adults with Parkinson disease, guidelines for community-based dance programs await further scrutiny for safety and efficacy. This pilot study was designed to assess the feasibility of an intensive trial of group-delivered modern dance for 11 adults with early-to-middle stage Parkinson’s. The Timed ‘‘Up and Go’’ test and the Fullerton Advanced Balance scale were administered to assess balance safety and re-administered at closure along with a self-reported feedback questionnaire. Video recordings were analyzed for qualitative behavioral change. Pre/posttest comparisons from the Timed ‘‘Up and Go’’ test were not significant, while those from the Fullerton Advanced Balance Scale were significant at the .05 level for the group as a whole (p = .01) with an average score change of +3.1 points. Although qualitative results generally concurred with the social benefits associated with an enjoyable form of expressive exercise, important indicators surfaced bearing on future research and community program designs. These include need for more rigorous stratification of participants and adapting dance class structure to address specific group needs to promote motor learning for sustained functional gains.
In the current article, the authors examine the potential role of mind-body interventions for preventing or reducing health disparities in a specific group—African American women. The authors first discuss how health disparities affect this group, including empirical evidence regarding the influence of biopsychosocial processes (e.g., psychological stress and social context) on disparate health outcomes. They also detail how African American women’s unique stress experiences as a result of distinct sociohistorical and cultural experiences related to race and gender potentially widen exposure to stressors and influence stress responses and coping behaviors. Using two independent, but related, frameworks (Superwoman Schema [SWS] and the Strong Black Woman Script [SBW-S]), they discuss how, for African American women, stress is affected by ‘‘strength’’ (vis-à-vis resilience, fortitude, and self-sufficiency) and the emergent health-compromising behaviors related to strength (e.g., emotional suppression, extraordinary caregiving, and self-care postponement). The authors then describe the potential utility of three mind-body interventions—mindfulness-based stress reduction (MBSR), loving-kindness meditation (LKM), and NTU psychotherapy—for specifically targeting the stress-, strength-, and contextually related factors that are thought to influence disparate outcomes for African American women. Self-awareness, self-care, inter- and intrapersonal restorative healing and a redefinition of inner strength may manifest through developing a mindfulness practice to decrease stress-related responses; using LKM to cultivate compassion and forgiveness for self and others; and the balance of independence and interdependence as a grounding NTU principle for redefining strength. The authors conclude with a discussion of potential benefits for integrating key aspects of the interventions with recommendations for future research.
Mindfulness is an ancient spiritual practice as well as a unique behavioral technique involving the cultivation of non-judgmental, non-reactive, metacognitive awareness of present-moment experience. Given the growing interest in mindfulness across numerous academic and clinical disciplines, an agenda is needed to guide the next wave of research. Here, we suggest four areas that, in our view, are important for a future contemplative science of mindfulness: performance-based measures of mindfulness, scientific evaluation of Buddhist claims, neurophenomenology of mindfulness, and measuring changes in mindfulness-induced gene expression. By exploring these domains, the wisdom of the meditative traditions may be complemented by leading-edge empirical research methodologies.
Many parents use complementary and alternative medicine (CAM) for their children. A number of medical schools are introducing CAM teaching, and this study was undertaken to explore the medical education priorities of parents who use CAM for their children. A total of 27 parents (25 females, 2 males) participated in 1 of 6 focus group discussions. Transcripts were analyzed using an iterative process of concept identification, hypothesis testing, and detailed comparisons. Participant preferences for health care for their children were complex and informed by previous health care experiences and current family health care needs. Using CAM allowed parents choice and control in managing their family's health care. Many participant priorities for medical education in CAM echoed key principles of patient-centered care in addition to specific suggestions for curriculum development. Participating parents believed that it was important to increase medical students' knowledge and understanding of both CAM modalities and the perspectives of parents.
The current study examined the relation of a commonly used measure of mindfulness (Mindful Attention Awareness Scale [MAAS]) and psychological flexibility (Acceptance and Action Questionnaire [AAQ]) to mental health-related variables within an African American college sample. The study also examined these constructs as potential mediators of the link between self-concealment and mental health variables. The AAQ did not show adequate internal consistency, and thus was not used in subsequent analyses. Mindfulness was found to be a significant predictor of mental health-related variables and mediated the relation between self-concealment and emotional distress in stressful interpersonal situations (full mediation) and general psychological ill health (partial mediation). These results are suggestive that mindfulness may be useful to understand mental health within African Americans college students, although additional research is clearly needed.
Tong Ren (TR) is an untested energy healing modality with anecdotally- reported effectiveness for a variety of disorders. Study objective: To describe participant reports of effectiveness and safety. Design: Cross-sectional, anonymous survey. Setting: Weekly group sessions in the Northeast US. Participants: Adults attending group sessions. Measures: Changes in conditions attributed to TR. Results: Response rate 89% (n = 265). Cancer (30.6%), endocrine/autoimmune (17.5%) and musculoskeletal disorders (17.2%) were the most commonly reported conditions. Among respondents who had attended more than one session (n = 216), 30% used superlatives (e.g., "amazing'') to describe TR's impact, and one-third noted improved quality of life. No adverse effects were described. Anxiety, depression, cancer, and autoimmune disorders appeared to have the greatest treatment responses, with 63.8%, 61.0%, 60.3%, and 58.1% of participants with these conditions reporting substantial improvements. Conclusion: This first study documenting self-reported effects of TR shows subjective benefits and no adverse effects. Further research on this approach is warranted.
Despite the recommendations in 2006 that naturopaths and Western herbal medicine practitioners be more closely regulated, there have been no moves toward state-mandated (statutory) registration or licensure of naturopaths in any Australian state or territory. Debate within the naturopathic profession on the appropriateness of statutory practitioner regulation has historically contributed to dissent and the creation of organizational factions. In turn, the opposing factions and resulting disunity are disincentives for government endorsement of statutory registration. This article provides an overview of the naturopathic profession in Australia and the regulatory quest, highlighting how professional marginalization and the pursuit of state protection have fueled the push for statutory registration. Considering the extent of public support for complementary and alternative medicine (CAM) practices, the unification of the dissenting factions within the naturopathic profession could create a powerful group, one in which current self-regulatory mechanisms might be more effective, so negating some of the perceived needs for statutory regulation. However, with the increasing use of CAM and most health professions regulated via registration Acts, there are significant arguments to support statutory registration for naturopaths in a manner similar to other health care professionals.
This article explores whether complementary and alternative medicine (CAM) users view CAM as a unified concept or individualize the modalities. A survey about the beliefs and concerns surrounding the use of 22 CAM modalities was posted to a random sample of 1,308 people in five rural and two metropolitan localities in Victoria, Australia. The response rate was 40% (n = 459). Overall, 91% of respondents were found to either have used one CAM modality (85%, n = 386) or be open to future use (6%, n = 33). Respondents did not view CAM as a unified concept. Each modality was used by people with different characteristics and beliefs about health care. However, it was practical to divide the 22 CAM modalities into four categories that we have named natural remedy, wellness, accepted, and established modalities. The four categories lie along a set of continua extending from natural remedy modalities and ‘‘holistic health care’’ beliefs at one end to established modalities and a belief in the tenets of conventional medicine at the other. We were able to develop a model to show this diagrammatically.
A 45-year-old previously healthy male suffered a major visual setback following a blunt injury to his left eye. The vision in the affected eye was lost immediately and did not return after the resolution of initial inflammation. His retinal examination revealed a subretinal hemorrhage with an area of chorioretinal atrophy in the left macula. A 3-month trial of conventional therapy, consisting of hemostatics, antioxidants, steroids, and vitamin A, was of no avail except for the return of vision to finger-counting ability. An optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) conducted at 3 months revealed hyper-reflectivity and irregularity at retinal pigment epithelium (RPE) Bruch’s membrane complex and decreased retinal thickness. Ayurvedic therapy was started at this time. At a 3-month treatment follow-up (6 months following the injury), there was a remarkable improvement in vision in the left eye, which was observed as 6/18 on the Snellen chart. After a total of 6 months of Ayurvedic therapy followed by 6 months of withdrawal, a subsequent follow-up found the vision in the patient’s left eye to be 6/12. OCT and an FFA done at this time was marked by substantial improvements in the RPE Bruch’s membrane complex. Ayurvedic therapy seems to have contributed substantially to the improved vision, which had been lost completely following a blunt injury to the left eye.
