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Integrative and Holistic Health

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Title: Integrative and Holistic Health


1
Integrative and Holistic Health
  • Kamron Keep RN, BSN

November 1st, 2010
2
What is Integrative Medicine?
  • Conventional Medicine practiced by physicians
    and allied health professionals.
  • Complementary Using complementary and
    alternative medicine (CAM) together with
    conventional care.
  • Alternative The use of CAM in place of
    conventional care.
  • Integrative Combines conventional and CAM
    treatments that show evidence of safety and
    effectiveness. The best of both worlds.

3
What is a Modality?
  • A modality is a specific approach to or method
    for healing.
  • The National Center for Complementary and
    Alternative Medicine (NCCAM) divides the various
    CAM modalities into four categories
  • mind-body medicine
  • biologically based practices
  • manipulative and body-based practices
  • energy medicine
  • Source www.ahna.org

4
Mind-Body Medicine
  • Focuses on the belief that interactions between
    the brain, mind, body, and behavior can affect
    physical functioning and promote health (Source
    www.nccam.nih.gov).
  • Several mind-body approaches ranked among the top
    10 CAM practices reported by adults in the 2007
    NHIS.
  • 12.7 percent of adults had used deep-breathing
    exercises
  • 9.4 percent had practiced meditation
  • 6.1 percent had practiced yoga
  • Progressive relaxation and guided imagery were
    also among the top 10 CAM therapies for adults
  • Deep breathing and yoga ranked high among
    children
  • Acupuncture had been used by 1.4 percent of
    adults and 0.2 percent of children.

5
Biologically Based Practices
  • Includes use of a variety of herbal medicines
    (also known as botanicals), vitamins, minerals,
    and other "natural products." Many are sold over
    the counter as dietary supplements (Source
    www.nccam.nih.gov).
  • Interest in and use of CAM natural products have
    grown considerably in the past few decades. The
    2007 NHIS found that 17.7 percent of American
    adults had used a nonvitamin/nonmineral natural
    product. These products were the most popular
    form of CAM among both adults and children.

6
Manipulative and Body-Based Practices
  • Focuses primarily on the structures and systems
    of the body, including the bones and joints, soft
    tissues, and circulatory and lymphatic systems.
    Spinal manipulation and massage are two commonly
    used therapies that fall within this category
    (Source www.nccam.nih.gov).
  • According to the 2007 NHIS, chiropractic/osteopath
    ic manipulation and massage ranked in the top 10
    CAM therapies among both adults and children.
  • 8.6 percent of adults and 2.8 percent of children
    had used chiropractic or osteopathic manipulation
  • 8.3 percent of adults and 1 percent of children
    had used massage

7
Energy Medicine
  • Involves manipulation of various energy fields to
    affect health (Source www.nccam.nih.gov).
  • Practices can include qigong, Reiki and Healing
    Touch.
  • The 2007 NHIS found relatively low use of energy
    therapies.
  • 0.5 percent of adults and 0.2 percent of children
    had used energy healing/Reiki.

8
Who Uses CAM and Why?
  • People of all backgrounds use CAM.
  • In adults, greater use among women and those with
    higher levels of education and higher incomes.
  • Motivation for most people is
  • A perceived benefit from CAM
  • A desire to feel more in control of their health
  • A strong belief in CAM

9
Benefits of CAM
  • Research has shown that CAM may help
  • Improve quality of life and overall wellbeing
  • Decreased pain
  • Decrease stress and anxiety
  • Improve mood
  • Help with insomnia
  • Decrease headaches
  • Decrease side effects and symptoms, such as
    nausea and hot flashes.
  • National Center for Complementary and Alternative
    Medicine at www.nccam.nih.gov.

10
Considerations of Using CAM
  • While research is becoming more available,
    rigorous, well-designed clinical trials for many
    CAM therapies are often lacking.
  • The safety and effectiveness of many CAM
    therapies are uncertain.
  • As with any medical treatment, there can be risks
    with CAM therapies. These general precautions can
    help to minimize risks
  • Select CAM practitioners with care. Find out
    about the practitioner's training and experience.
  • Be aware that some dietary supplements may
    interact with medications or other supplements,
    may have side effects of their own, or may
    contain potentially harmful ingredients not
    listed on the label. Also keep in mind that most
    supplements have not been tested in pregnant
    women, nursing mothers, or children.
  • Patients dont often tell their health care
    providers about the CAM practices they may be
    using. And, health care providers arent asking
    about what the patient may be using.
  • Source www.nccam.nih.gov

11
What is the Nurses Role with CAM?
  • According to a recent survey, while almost 2/3 of
    people aged 50 and older are using some form of
    CAM, less than 1/3 of those people talk with
    their providers about CAM use. (Survey by AARP
    and NCCAM)
  • What is your personal belief of CAM?
  • Ask patients about their use of CAM and document!
    Be direct and non-judgmental.
  • Learn more about CAM and/or familiarize yourself
    with reputable resources and information on CAM
  • St. Lukes Comfort Corner Link
  • National Center for Complementary Alternative
    Medicine
  • American Holistic Nurses Association

12
CAM at St. Lukes
  • MSTI Integrative Medicine Program
  • Kamron Keep RN, BSN at 706-5410 or
    keepk_at_slhs.org.
  • Wood River Integrative Therapies Program
  • Mary Kay Foley at 727-8417 or foleym_at_slhs.org.
  • Comfort Corner Website
  • Inside St. Lukes Clinical Resources
  • C.A.R.E. Channel (74 and 76)
  • Antepartum
  • Birth and Parenting

13
What is Holistic Health and Holistic Nursing?
  • Holistic Concerned with the interrelationship of
    body, mind and spirit in an ever changing
    environment.
  • Holistic nursing is all nursing that has healing
    the whole person as its goal (AHNA Definition of
    Holistic Nursing, 1998).
  • Holistic nursing is more than modalities
  • It is a way of being
  • Relationship Based Care
  • Relationship with patient/family
  • Relationship with self
  • Relationship with colleagues

14
Healing versus Curing
  • What does healing mean to you?
  • Heal- to be or become whole
  • From Greek Halos
  • From Anglo-Saxon Haelan
  • Healing- restoring balance and harmony, moving
    toward wholeness, completion and the integration
    of the totality of the person.
  • Healing is when care is attentive to mind, body
    and the spirit when patients feel they have a
    relationship with their healer and when they are
    actively involved in decisions regarding their
    own care (RBC Information).
  • Instead of asking what cures, ask what heals.
    How is this different?
  • Healing as a journey, rather than a destination.

15
Benefits of Holistic Nursing Practice
  • Embodies Relationship Based Care Model
  • Public seeking more holistic, caring,
    compassionate approach 38-64 utilizing CAM
  • Holistic nurses in prime position to meet the
    need/provide leadership
  • Enhances personal professional life
  • Opportunity to truly know, partner, be present
    with our clients/patients
  • Holistic focus allows healing on many levels
    emotional, spiritual, relational, physical and
    mental
  • Honors and integrates wisdom and knowledge from
    many sources and cultures
  • Holistic model promotes wellness and empowerment
    for giver and receiver
  • Source www.ahna.org

16
Self-care and Self-Reflection
  • Kamron Keep RN, BSN

17
We Cannot Nurture Others from a Dry Well
Jennifer Louden
18
(No Transcript)
19
What is One of the Best Things You Can Do For
Your Patient?
20
Nurse as an Environment of Healing
  • It is important to realize that the nurse is not
    only in the environment, able to make significant
    changes in ways of Being/Doing/Knowing in the
    physical environment, but the nurse is the
    environment
  • Quinn 1992 Watson 2005

21
Nurse as an Environment of Healing
  • If I am the environment, how can I be a more
    caring-healing environment?
  • How can I become a safe, healing space for this
    person? To draw out healing and wholeness?
  • How can I use my consciousness, my
    intentionality, my being, my presence, my voice,
    touch, face, heart, hands and so on, for healing?
  • Source Quinn, 1992 Watson 200594-95).
  • How can I do all of this and be all of this for
    my patient and not burn myself out?

22
Why Self-Care?
  • Burnout occurs from walling ourselves off,
    closing our hearts to human connection. When we
    connect with another person, even briefly, we
    have more purpose in our life and work. If this
    connection is not there, we feel a void and
    dispirited. The same thing happens to our
    patients. Jean Watson
  • In order to be a present, healing environment for
    our patients and help prevent burnout, we must
    practice self-care. We must fill our own well.
  • What is something that nourishes and refreshes
    you? That feels good to your body, mind and
    spirit?

23
Why Self-Reflection/Self-Knowing?
  • Everything is connected
  • What affects one aspect of ourselves,
    influences all others.
  • Mind-Body-Spirit-Environment-Relationships
  • Leads to an appreciation to the
    interconnectedness of all things, healthier
    relationships and more self-awareness, insight
    and clarity.
  • To be of service to others
  • You need to understand your own personal journey
  • You need to do periodic self-assessments
  • Pursue personal development
  • Self-care and self-healing

24
Holistic Self-Assessment-Circle of Human
Potentials
  • Living a life in balance
  • Circle of Human Potentials. Source Reprinted
    with permission from B.
  • Dossey and L Keegan, Holistic Nursing A Handbook
    for Practice, 2009,
  • Jones and Bartlett Publishers, Sudbury, MA .

25
Holistic Self-Care Ideas
  • Hand washing ritual
  • Meditation through simple, daily activities that
    bring you joy and meaning
  • Connecting through the heart center
  • Journaling/self-reflection
  • Being in nature
  • Dancing and singing
  • Yoga and movement
  • Good nutrition
  • Gardening
  • Knitting/sewing

26
You always have your breath
  • Simply focus on your breath moving in and out.
    Saying to yourself, I am breathing in, I am
    breathing out.
  • Or, choose a word that helps you feel relaxed
    (for example, peace, ocean, love). Close your
    eyes, breathe in and out through your nose.
    Become aware of your breathing. As you breathe
    out, say your word silently to yourself. When
    you notice your mind has wandered (and it will)
    gently and kindly bring your focus back to your
    word and your breath. (The Relaxation Response,
    Benson. H. William Morrow and Co., NY 1975)

27
Self-Care Plan
  • From your holistic self-assessment, take a few
    moments to consider a self-care plan in one of
    the areas you see is out of balance. What is one
    step you can take to nourish yourself? Write it
    down!

28
Self-Care Plan
  • Small steps can help lead you to your goal.
  • Since every aspect of who you are is
    interrelated, when you create health in one area
    of your life the positive effects spill into all
    other areas of your life! (Thornton, 2006)

29
Lets Take a Moment to Relax
30
Resources and References
  • The National Center for Complementary and
    Alternative Medicine www.nccam.nih.gov.
    Research, information on modalities, how to
    choose a practitioner, etc.
  • The American Holistic Nurses Association
    www.ahna.org. Information on membership,
    holistic educational opportunities, self-care and
    links to Holistic Nurse Certification.
  • Inside St. Lukes, Clinical Resources, Comfort
    Corner, Complementary and Integrative Therapies.
  • Inside St. Lukes, Nursing at St. Lukes,
    Relationship Based Care
  • Benson, H.W. (1975). The Relaxation Response.
    Morrow and Co NY.
  • Watson, J. (2008). Nursing The Philosophy and
    Science of Caring. University Press of Colorado
    Colorado.

31
Thank you! Questions?
  • Kamron Keep RN, BSN, MSTI Integrative Medicine
    Coordinator at 208-706-5410 or keepk_at_slhs.org.
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