1
|
Papathanassoglou E, Park T, Punjani N, Pokharel B, Taha M, Hegadoren K. Implementing integrative therapies in adult critical care: Barriers and strategies. Aust Crit Care 2024:S1036-7314(23)00192-3. [PMID: 38218673 DOI: 10.1016/j.aucc.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/10/2023] [Accepted: 11/24/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Critically ill patients experience intense physical and psychological stressors in the intensive care unit (ICU). More than half of ICU survivors report overwhelming mental health symptoms after ICU discharge, such as post-traumatic stress symptoms, anxiety, and depression. Relaxation-inducing integrative therapies such as guided imagery, massage, therapeutic touch, music therapy, and spirituality-based healing practices have the potential to promote comfort and relaxation and improve patient outcomes. OBJECTIVES The aim of this study was to explore the attitudes of healthcare professionals towards the implementation of relaxation-inducing integrative therapies in critical care, barriers to implementation, and potential strategies to overcome them. METHODS We conducted seven focus group interviews with 23 critical care clinicians (70% nurses, 17% allied health professionals, 13% physicians). Interviews were audiotaped and transcribed verbatim. Data were thematically analysed using an inductive content analysis approach. FINDINGS Results reveal a constant interplay between mostly positive personal attitudes towards implementation of integrative therapies and the perceived culture and priorities of the unit. The main benefits for critically ill patients as perceived by participants were promotion of comfort, sleep, and coping, increase of trust, and decrease of pain and stress. As for barriers, dominant themes were a perceived lack of evidence, cost, and time constraints and the fear of loss of professional credibility. Participants related nurses' education and training, family involvement, and leadership were seen as main strategies for implementation. CONCLUSIONS The dominant ICU culture needs to be considered when implementing integrative therapies. Education, access to evidence, and role modelling are proposed as means to shift the ICU culture towards utilisation of integrative therapies in critical care.
Collapse
|
2
|
Kambouris ME, Patrinos GP, Velegraki A, Manoussopoulos Y. Historical microbiology: researching past bioevents by integrating scholarship (re)sources with paleomicrobiology assets. Future Microbiol 2023; 18:681-693. [PMID: 37584528 DOI: 10.2217/fmb-2023-0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023] Open
Abstract
The analysis of past epidemics and pandemics, either spontaneous or of human origin, may revise the physical history of microbiota and create a temporal context in our understanding regarding pathogen attributes like virulence, evolution, transmission and disease dynamics. The data of high-tech scientific methods seem reliable, but their interpretation may still be biased when tackling events of the distant past. Such endeavors should be adjusted to other cognitive resources including historical accounts reporting the events of interest and references in alien medical cultures and terminologies; the latter may contextualize them differently from current practices. Thus 'historical microbiology' emerges. Validating such resources requires utmost care, as these may be susceptible to different biases regarding the interpretation of facts and phenomena; biases partly due to methodological limitations.
Collapse
Affiliation(s)
| | - George P Patrinos
- Department of Pharmacy, University of Patras, Rio Patras, 26504, Greece
- Department of Genetics & Genomics, College of Medicine & Health Sciences & Zayed Center of Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | | | - Yiannis Manoussopoulos
- Plant Protection Division of Patras, Institute of Industrial & Forage Plants, NEO & Amerikis, Patras, 26004, Greece
| |
Collapse
|
3
|
Girgis MMF, Fekete K, Homoródi N, Márton S, Fekete I, Horváth L. Use of Complementary and Alternative Medicine Among Patients With Epilepsy and Diabetes Mellitus, Focusing on the Outcome of Treatment. Front Neurosci 2022; 15:787512. [PMID: 35087374 PMCID: PMC8787116 DOI: 10.3389/fnins.2021.787512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/06/2021] [Indexed: 12/08/2022] Open
Abstract
Introduction: Millions all over the world live with epilepsy, and they may require long-term drug treatment. The use and interest in complementary and alternative medicine (CAM) have grown over the previous years. Coadministration of herbal products with medicines may result in adverse drug reactions (ADRs) and/or unfavorable interactions. The aims of this study were to determine the prevalence of CAM use among patients with epilepsy, to compare the results to those of the patients with diabetes mellitus (DM), to reveal factors that may drive the use of CAM, and to measure outcomes and adherence. It was also our intent to have state-of-the-art information on CAM use in our region among patients with the two diseases above. Materials and Methods: We conducted a non-interventional study using a self-developed questionnaire. It was distributed among adult patients with either epilepsy or DM who also suffered from cardiovascular consequences. A database was compiled from the anonymous questionnaires filled in voluntarily by the patients. Basic statistics were used to analyze this database. Results: A total of 227 questionnaires were filled in by 127 patients (55.9%) with epilepsy and 100 patients (44.1%) with DM. Mean age was 54.54 ± 17.33 years. Of the patients, 50.2% were male. Average body weight was 80.3 ± 17.3 kg. Of the patients, 22 (9.7%) used CAM because they believed in CAM. Two of them reported ADRs. Among the patients with epilepsy, the ratio was only 7.9% compared to 12% among those with DM. While the number of CAM users was higher among younger patients with epilepsy, it was the elderly patients with DM who tended to use CAM. Conclusion: Attention should be paid to reliance on CAM during the follow-up. Our finding that health-conscious patients tend to use CAM more often (than the general population) may indicate it is necessary to discuss CAM usage sincerely. CAMs modulating cytochrome P450 (CYP) enzymes were the most common, leading to interactions with medication used and resulting in ADRs. This shows the importance of educating patients and treating team including clinical pharmacists in this field.
Collapse
Affiliation(s)
- Michael Magdy Fahmy Girgis
- Department of Pharmaceutical Surveillance and Economics, Faculty of Pharmacy, University of Debrecen, Debrecen, Hungary
| | - Klára Fekete
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Nóra Homoródi
- Institute of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Sándor Márton
- Institute of Political Science and Sociology, Faculty of Arts, University of Debrecen, Debrecen, Hungary
| | - István Fekete
- Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - László Horváth
- Department of Pharmaceutical Surveillance and Economics, Faculty of Pharmacy, University of Debrecen, Debrecen, Hungary
- *Correspondence: László Horváth,
| |
Collapse
|
4
|
Mamba WM, Filmalter CJ, Heyns T. Integrative therapies in intensive care units: A scoping review. J Clin Nurs 2021; 30:2745-2757. [PMID: 33829596 DOI: 10.1111/jocn.15775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/25/2021] [Accepted: 03/16/2021] [Indexed: 11/30/2022]
Abstract
AIM We reviewed literature describing the incorporation of integrative therapies in intensive care units. We aimed to elicit an overall picture of research and find existing knowledge gaps on this topic. DESIGN We conducted a scoping review guided by Arksey and O'Malley's methodological framework and were guided by the PRISMA-ScR Checklist. METHODS Various databases were searched for relevant literature. English language articles published between 1999 and 2019 were retrieved. Data were extracted based on sample, sample size, methodology, findings and implications for practice. RESULTS From 275 studies retrieved, 30 were included, based on the inclusion criteria. Three key themes related to integrative therapies in intensive care units emerged from the literature: 1) general information on integrative therapies; 2) interventions using integrative therapies; and 3) perceptions and attitudes of nurses on integrative therapies. Positive outcomes were observed in ICUs, and nurses showed positive attitudes towards using integrative therapies.
Collapse
Affiliation(s)
- Welile M Mamba
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
| | - Celia J Filmalter
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
| | - Tanya Heyns
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
5
|
Alqudimat MR, Toupin April K, Hundert A, Jibb L, Victor C, Nathan PC, Stinson J. Questionnaires assessing the use of complementary health approaches in pediatrics and their measurement properties: A systematic review. Complement Ther Med 2020; 53:102520. [PMID: 33066855 DOI: 10.1016/j.ctim.2020.102520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/16/2020] [Accepted: 07/17/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To identify questionnaires assessing the use of complementary health approaches (CHA) in pediatrics, describe their content, and appraise the methodological quality of the studies and the measurement properties of the questionnaires. METHOD Major electronic databases were searched from 2011 to 2020. Studies which aimed to assess the use of CHA and studies which reported developing and validating CHA questionnaires in pediatrics were included. Two reviewers independently screened the studies, extracted the data, and rated the methodological quality of the studies and measurement properties of the questionnaires using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. When consensus was not reached, a third reviewer was consulted. RESULTS Thirty-eight studies were included. From these studies, 35 CHA questionnaires with a variety of different items were identified. Only two studies aimed to evaluate the measurement properties of two questionnaires. One questionnaire, available as a self- and proxy-report, was initially validated in children with juvenile idiopathic arthritis, and the other, available as an interviewer-administered questionnaire, was validated in children with cancer. According to the COSMIN, the methodological quality of both studies was inadequate or doubtful, and both questionnaires was not thoroughly validated. CONCLUSION This systematic review showed a lack of a thoroughly validated CHA questionnaire in pediatrics. However, two questionnaires were found to hold promise. To address this gap, one of the existing questionnaires should be adapted and further validated.
Collapse
Affiliation(s)
- Mohammad R Alqudimat
- University of Toronto, Lawrence S. Bloomberg Faculty of Nursing, 155 College Street, Suite 130, Toronto, ON M5T 1P8, Canada; The Hospital for Sick Children, Child Health Evaluation Sciences, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
| | - Karine Toupin April
- Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road Ottawa, ON K1H 8L1, Canada; University of Ottawa, Department of Pediatrics and School of Rehabilitation Sciences, 451 Smyth Road, Ottawa, ON K1H 8M5, Canada
| | - Amos Hundert
- The Hospital for Sick Children, Child Health Evaluation Sciences, 555 University Avenue, Toronto, ON M5G 1X8, Canada
| | - Lindsay Jibb
- University of Toronto, Lawrence S. Bloomberg Faculty of Nursing, 155 College Street, Suite 130, Toronto, ON M5T 1P8, Canada; The Hospital for Sick Children, Child Health Evaluation Sciences, 555 University Avenue, Toronto, ON M5G 1X8, Canada
| | - Charles Victor
- University of Toronto, Institute of Health Policy, Management and Evaluation, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada
| | - Paul C Nathan
- The Hospital for Sick Children, Division of Haematology/Oncology, 555 University Avenue, Toronto, ON M5G 1X8, Canada
| | - Jennifer Stinson
- University of Toronto, Lawrence S. Bloomberg Faculty of Nursing, 155 College Street, Suite 130, Toronto, ON M5T 1P8, Canada; The Hospital for Sick Children, Child Health Evaluation Sciences, 555 University Avenue, Toronto, ON M5G 1X8, Canada
| |
Collapse
|
6
|
Jong MC, Boers I, van Wietmarschen H, Busch M, Naafs MC, Kaspers GJL, Tissing WJE. Development of an evidence-based decision aid on complementary and alternative medicine (CAM) and pain for parents of children with cancer. Support Care Cancer 2019; 28:2415-2429. [PMID: 31493135 PMCID: PMC7083801 DOI: 10.1007/s00520-019-05058-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 08/28/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE To develop an evidence-based decision aid for parents of children with cancer and to help guide them in the use of complementary and alternative medicine (CAM) for cancer care. METHODS This study had a mixed research design. The needs of parents were investigated by survey and focus group. A systematic review and meta-analysis were performed on the effectiveness of CAM using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Clinical experts were interviewed and a decision aid on CAM treatment for pain was developed. RESULTS Parents emphasized the importance of reliable information on CAM, focusing primarily on communication and a broad spectrum of complaints related to cancer treatment. The decision aid on CAM for pain included five modalities based on 11 randomized control trials (RCTs): hypnotherapy, mind-body techniques, massage, healing touch, and music therapy. Meta-analysis could be performed on hypnotherapy, which significantly reduced cancer-related procedural pain compared with standard care (MD, - 1.37; 95% CI, - 1.60, - 1.15; P < 0.00001) and attention control (MD, - 1.13; 95% CI, - 1.34, - 0.94; P < 0.00001), and massage, demonstrating no effect on pain compared with standard care (MD, - 0.77; 95% CI, - 1.82, 0.28; P = 0.15). Research evidence and supplementary information from clinical practice and patient were incorporated in a website-based decision aid. CONCLUSIONS An evidence-based decision aid was developed to support parents of children with cancer in making decisions about CAM for pain management. Next steps will be to expand the website to include additional childhood cancer-related complaints and to evaluate its use in practice.
Collapse
Affiliation(s)
- Miek C Jong
- Department of Health Sciences, Mid Sweden University, Holmgatan 10, 851 70, Sundsvall, Sweden.
| | - Inge Boers
- Department Nutrition & Health, Louis Bolk Institute, Kosterijland 3-5, 3981 AJ, Bunnik, The Netherlands
| | - Herman van Wietmarschen
- Department Nutrition & Health, Louis Bolk Institute, Kosterijland 3-5, 3981 AJ, Bunnik, The Netherlands
| | - Martine Busch
- Van Praag Institute, Springweg 7, 3511 VH, Utrecht, The Netherlands
| | - Marianne C Naafs
- Netherlands Childhood Cancer Parent Organization VOKK, Schouwstede 2b, 3431 JB, Nieuwegein, The Netherlands
| | - Gertjan J L Kaspers
- Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Paediatric Oncology, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
| | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS, Utrecht, The Netherlands
- Department Paediatric Oncology, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| |
Collapse
|
7
|
Music is an effective intervention for the management of pain: An umbrella review. Complement Ther Clin Pract 2018; 32:103-114. [DOI: 10.1016/j.ctcp.2018.06.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 01/08/2023]
|
8
|
Abstract
INTRODUCTION Fresno, California, is home to more than 30,000 Hmong. The purpose of this research was to explore the utilization of Hmong shamans 40 years after the first Hmong immigrants arrived in the United States. Hmong shamanism is examined to identify and analyze changes to shamans' practices or patients. METHODS Using grounded theory, semistructured interviews were conducted with a convenience sample of 20 shamans in their homes. Transcribed data were qualitatively analyzed. RESULTS Shamans continue to train and practice in this community; utilization by older patients persists while young adult patients have become the fastest-growing group of users. Healing rituals have changed in response to the legalities of animal sacrifice in urban areas and the time demands of work schedules. DISCUSSION Nurses' awareness that the availability of biomedicine does not preclude the continuing or recurring utilization of traditional healers can facilitate understanding of culturally defined health care needs.
Collapse
|
9
|
Kramlich D. Complementary Health Practitioners in the Acute and Critical Care Setting: Nursing Considerations. Crit Care Nurse 2018; 37:60-65. [PMID: 28572102 DOI: 10.4037/ccn2017181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
In response to the rising demand by patients and their families for complementary health approaches, hospitals are increasingly integrating complementary health approaches with their conventional medical practices to create healing environments. Results of the 2010 Complementary and Alternative Medicine Survey of Hospitals indicated that the top 6 inpatient modalities included pet therapy, massage therapy, music or art therapy, guided imagery, relaxation therapy, and Reiki and therapeutic touch. Whether complementary health approaches are provided by complementary health practitioners through hospital-based integrative medicine programs, volunteer practitioners, or bedside nurses, the regulatory, legal, ethical, and safety concerns remain constant. Previous articles in this column of Critical Care Nurse provided an overview of complementary health approaches that nurses may encounter in their practices, with specific attention to implications for acute and critical care nurses, as well as important legal, ethical, safety, quality, and financial implications that acute and critical care nurses should consider when integrating complementary health approaches with conventional care. This column provides the acute and critical care nurse with key information about validation of credentials, experience, and competence of nurses and volunteers providing complementary health approaches, as well as about institutional policies and scope of practice.
Collapse
Affiliation(s)
- Debra Kramlich
- Debra Kramlich is an assistant professor of nursing, University of New England, Portland, Maine. She is also a traditional Usui Reiki master/teacher with more than 10 years of experience.
| |
Collapse
|
10
|
Kramlich D. Strategies for Acute and Critical Care Nurses Implementing Complementary Therapies Requested by Patients and Their Families. Crit Care Nurse 2018; 36:52-58. [PMID: 27908946 DOI: 10.4037/ccn2016974] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
As consumer use of complementary and alternative medicine or modalities continues to increase in the United States, requests for these therapies in the acute and critical care setting will probably continue to expand in scope and frequency. Incorporation of complementary therapies in the plan of care is consistent with principles of patient- and family-centered care and collaborative decision-making and may provide a measure of relief for the distress of admission to an acute or critical care setting. An earlier article provided an overview of complementary and alternative therapies that nurses may encounter in their practices, with specific attention to implications for acute and critical care nurses. This article provides key information on the legal, ethical, safety, quality, and financial challenges that acute and critical care nurses should consider when implementing patient and family requests for complementary therapies.
Collapse
Affiliation(s)
- Debra Kramlich
- Debra Kramlich is an assistant professor of nursing, University of New England, Portland, Maine. She is also a traditional Usui Reiki master/teacher with more than 10 years of experience.
| |
Collapse
|
11
|
Shorofi SA, Arbon P. Complementary and alternative medicine (CAM) among Australian hospital-based nurses: knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users. Complement Ther Clin Pract 2017; 27:37-45. [PMID: 28438278 DOI: 10.1016/j.ctcp.2017.03.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 03/19/2017] [Accepted: 03/23/2017] [Indexed: 01/25/2023]
Abstract
OBJECTIVE This study was intended to examine CAM among Australian hospital-based nurses, identifying their knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users. METHODS AND MATERIALS Nurses holding a qualification in nursing and working in surgical wards were included using a convenience sampling technique. A self-complete questionnaire was developed to achieve the aims of the study. Descriptive and non-parametric statistics were calculated to describe and analyse data. RESULTS Overall, 95.7% and 49.7% of nurses reported personal and professional use of CAM, respectively. The most popular CAM/CAM domain personally and professionally used by nurses was massage therapy and mind-body therapies. The primary reason for personal use of CAM was "[it] fits into my way of life/philosophy". Furthermore, massage therapists were the most commonly recommended CAM practitioners to patients. Only 15.8% of nurses would always ask patients about use of herbal medicines as part of nursing history taking. Over one-fifth (22.4%) of nurses rated their attitude as having a very positive, and 60.3% rated themselves as having very little or no knowledge of CAM. A positive correlation was also found between knowledge and attitude about CAM. Positive attitude and higher knowledge about CAM were positively correlated to CAM referrals. Several socio-demographic factors predicted personal and professional use of CAM. CONCLUSION This study revealed that nurses generally believe not to have sufficient knowledge of CAM but are open to use CAM with patients. Nurses' positive attitude toward and personal use of CAM could be an indication that they are poised for further integration of evidence-based CAM into nursing practice to treat whole person.
Collapse
Affiliation(s)
- Seyed Afshin Shorofi
- Traditional and Complementary Medicine Research Centre, Mazandaran University of Medical Sciences, Sari, Iran; Adjunct Research Fellow, Flinders University, Adelaide, Australia.
| | - Paul Arbon
- Flinders University, Adelaide, Australia
| |
Collapse
|
12
|
Ghaedi F, Dehghan M, Salari M, Sheikhrabori A. Complementary and Alternative Medicines: Usage and Its Determinant Factors Among Outpatients in Southeast of Iran. J Evid Based Complementary Altern Med 2016; 22:210-215. [PMID: 26666436 DOI: 10.1177/2156587215621462] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Prevalence of complementary and alternative medicines is increasing specially in patients with chronic diseases. Therefore, based on the high prevalence of chronic disorders, the present study aimed to determine complementary and alternative medicine usage frequency and its determinant factors. This was a cross-sectional study. Five hundred clients participated in the study by using convenience sampling. A 2-part questionnaire (including demographic form and researcher-created questionnaire) was used for studying the prevalence of using complementary and alternative medicine methods, and users' satisfaction. Findings showed that 75.4% of people used at least one complementary and alternative medicine method. Most of users consumed medicinal plants (69.4%). The most common reason of using a complementary and alternative medicine method was common cold (32.9%). The highest satisfaction belonged to massage (2.94 ± 0.74). The usage of complementary and alternative medicine was 3.22 times higher in people with academic educations when compared with illiterate people. Concerning the high usage of complementary and alternative medicine, it is necessary to train specialists in this field in order to offer such treatments in a safe manner. Also, outcomes of application of complementary and alternative medicine methods should be studied.
Collapse
Affiliation(s)
- Fateme Ghaedi
- 1 Isfehan University of Medical Sciences, Isfehan, Iran
| | | | | | | |
Collapse
|
13
|
Esakkimuthu S, Mutheeswaran S, Arvinth S, Paulraj MG, Pandikumar P, Ignacimuthu S. Quantitative ethnomedicinal survey of medicinal plants given for cardiometabolic diseases by the non-institutionally trained siddha practitioners of Tiruvallur district, Tamil Nadu, India. JOURNAL OF ETHNOPHARMACOLOGY 2016; 186:329-342. [PMID: 27090346 DOI: 10.1016/j.jep.2016.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/09/2016] [Accepted: 04/12/2016] [Indexed: 05/13/2023]
Abstract
ETHNOBOTANICAL RELEVANCE The burden of cardiometabolic diseases such as dyslipidemia, hyperglycemia, hypertension, visceral obesity and atherosclerotic cardiovascular diseases and the use of traditional medicine for the management of such diseases are high in India; hence there is a need to document and analyze such therapies. AIM OF THE STUDY This study documented and analyzed the medicinal plants prescribed for cardiometabolic diseases by the non-institutionally trained siddha practitioners of Tiruvallur district of Tamil Nadu, India. METHODOLOGY The field survey was conducted between December 2014 to November 2015. Successive free listing assisted with field-walks was used to interview the informants. After assessing the sampling sufficiency using rarefaction curve analysis, indices such as Informant Consensus Factor (Fic) and Index of Agreement on Remedies (IAR) were calculated for the data. The indicators of informant's medicinal plant knowledge such as Shannon's index, equitability index, etc., were regressed with the demographic profile of the informants. RESULTS For this study 70 non-institutionally trained Siddha medical practitioners were approached; the data from 36 practitioners who were treating cardiometabolic diseases were documented. This study recorded the use of 188 species which were used to prepare 368 formulations to treat illnesses categorized under cardiometabolic diseases. In this, 53.04% claims were singletons. Regression analysis showed that single species dominance was reduced and the diversity of medicinal plants was increased with the increase in the age and experience. Increase in the years of formal education increased the equitability in the uses. The plants such as Nelumbo nucifera Gaertn. (cardiovascular diseases), Allium sativum L. (dyslipidemia), Cuminum cyminum L. (hypertension), Macrotyloma uniflorum Verdc. (obesity) and Azadirachta indica A. Juss. (type 2 diabetes) were the highly cited medicinal plants. CONCLUSION This survey has identified the plants most commonly used by Siddha practitioners of Tiruvallur district, Tamil Nadu, India for cardiometabolic diseases. The prevalence of chronic, non-communicable metabolic illnesses such as type 2 diabetes, hypertension and obesity are increasing worldwide due to the rapid changes in the lifestyle. These ailments require a life-long care and in such instances, people tend to use complementary therapies in most cases, alongside with conventional therapies. In view of the high use of traditional therapies for treating cardiometabolic illnesses, this study supports the need for more research to evaluate the potential benefits of the treatments and to identify any safety concern.
Collapse
Affiliation(s)
- S Esakkimuthu
- Division of Ethnopharmacology, Entomology Research Institute, Loyola College, Chennai, Tamil Nadu 600034, India
| | - S Mutheeswaran
- Division of Ethnopharmacology, Entomology Research Institute, Loyola College, Chennai, Tamil Nadu 600034, India
| | - S Arvinth
- Department of Botany, PSG College of Arts & Science, Coimbatore, Tamil Nadu 641 014, India
| | - M Gabriel Paulraj
- Division of Ethnopharmacology, Entomology Research Institute, Loyola College, Chennai, Tamil Nadu 600034, India
| | - P Pandikumar
- Division of Ethnopharmacology, Entomology Research Institute, Loyola College, Chennai, Tamil Nadu 600034, India.
| | - S Ignacimuthu
- Division of Ethnopharmacology, Entomology Research Institute, Loyola College, Chennai, Tamil Nadu 600034, India; Visiting Professor Programme, Deanship of Scientific Research, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.
| |
Collapse
|
14
|
The Effects of Guided Imagery on Patients Being Weaned from Mechanical Ventilation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:802865. [PMID: 26640501 PMCID: PMC4657064 DOI: 10.1155/2015/802865] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 10/19/2015] [Accepted: 10/21/2015] [Indexed: 11/17/2022]
Abstract
The study purpose was to assess the effects of guided imagery on sedation levels, sedative and analgesic volume consumption, and physiological responses of patients being weaned from mechanical ventilation. Forty-two patients were selected from two community acute care hospitals. One hospital served as the comparison group and provided routine care (no intervention) while the other hospital provided the guided imagery intervention. The intervention included two sessions, each lasting 60 minutes, offered during morning weaning trials from mechanical ventilation. Measurements were recorded in groups at baseline and 30- and 60-minute intervals and included vital signs and Richmond Agitation-Sedation Scale (RASS) score. Sedative and analgesic medication volume consumption were recorded 24 hours prior to and after the intervention. The guided imagery group had significantly improved RASS scores and reduced sedative and analgesic volume consumption. During the second session, oxygen saturation levels significantly improved compared to the comparison group. Guided imagery group had 4.88 less days requiring mechanical ventilation and 1.4 reduction in hospital length of stay compared to the comparison group. Guided imagery may be complementary and alternative medicine (CAM) intervention to provide during mechanical ventilation weaning trials.
Collapse
|