Complementary and alternative medicine in midwifery practice: Managing the conflicts

Counseling lifestyle medicine in oncology: A qualitative analysis of interprofessional patient-nurse-physician interactions

OBJECTIVES

Counseling plays a key role in promoting health behaviors, providing evidence-based information, and supporting patients with cancer during and after treatment. This study aimed to evaluate an interprofessional counseling service on Complementary and Integrative Health (CIH) for patients being treated at Comprehensive Cancer Centers (CCCs) in Southern Germany.

METHODS

Patients participating in the CCC-Integrativ study received three CIH counseling sessions within three months in addition to their conventional cancer treatment. Medical and nursing staff participated in a study-specific blended learning training program before conducting the counseling. As part of the process evaluation, 30 audio-recorded counseling sessions were transcribed verbatim and analyzed by conducting a content analysis using MAXQDA 2020.

RESULTS

Throughout the counseling, patients were conceded to address various health issues, which mainly revolved around symptom management interlaced with the areas of nutrition, exercise, and relaxation. The interprofessional teams conducted the counseling in a structured and patient-oriented manner. They worked together to motivate the patients to apply procedures from the CIH field independently, even if patients sometimes experienced difficulties in implementation.

CONCLUSIONS

Interprofessional collaboration improved healthcare quality, as patients received comprehensive and evidence-based advice on their supportive needs and lifestyle issues. Both professions could equally contribute their areas of knowledge and expertise and apply them to the benefit of the patients.

PRACTICE IMPLICATIONS

Providing an integrative counseling service and adequate training on interpersonal communication and CIH for healthcare professionals will improve patient-centered care.

Mapping Uncharted Terrain: A Systematic Review of Complementary and Integrative Health Communication Using Observational Data in Biomedical Settings

Complementary and integrative health (CIH) use is diverse and highly prevalent worldwide. Prior research of CIH communication in biomedical encounters address safety, efficacy, symptom management, and overall wellness. Observational methods are rarely used to study CIH communication and avoid recall bias, preserve ecological validity, and contextualize situated clinical communication. Following PRISMA guidelines, we systematically reviewed studies at the intersection of social scientific observational research and findings about CIH communication between clinicians, patients, and caregivers in biomedical settings. We identified international, peer-reviewed publications from seven databases between January 2010 and December 2020. Titles and abstracts were first screened for inclusion, then full studies were coded using explicit criteria. We used a standard checklist was modified to assess article quality. Ten of 11,793 studies examined CIH communication using observational methods for CIH communication in biomedical settings. Studies used a range of observational techniques, including participant and non-participant observation, which includes digital audio or video recordings. Results generated two broad sets of findings, one focused on methodological insights and another on CIH communication. Despite methodological and topic similarities, included studies addressed CIH communication as a process and as proximal and intermediate health outcomes. We recommend how observational studies of CIH communication can better highlight relationships between communication processes and health outcomes. Current research using observational methods offers an incomplete picture of CIH communication in biomedical settings. Future studies should standardize how observational techniques are reported to enhance consistency and comparability within and across biomedical settings to improve comparability.

The influence of complementary and alternative medicine use in pregnancy on labor pain management choices: results from a nationally representative sample of 1,835 women

OBJECTIVES

This study examines involvement with a range of complementary and alternative medicine (CAM) during pregnancy on the use of pharmacologic (PPMT) and nonpharmacologic (NPMT) pain management techniques for labor and birth.

DESIGN

Longitudinal analysis of survey data.

PARTICIPANTS

A substudy (n=2445) of the "young" cohort of the nationally representative Australian Longitudinal Study on Women's Health was conducted.

OUTCOME MEASURES

Use of PPMT and NPMT during labor and birth.

RESULTS

The survey was completed by 1835 women (response rate, 79.2%). Most respondents used either intrapartum PPMT (81.9%) or NPMT (74.4%). Many (60.7%) used some form of CAM during pregnancy and also used PPMT during birth. More than two thirds of women (66.7%) who used NPMT used CAM during pregnancy. There was a general trend of increased likelihood of NPMT use by women who applied CAM during pregnancy. There was an inverse effect on use of epidural analgesia for women who consumed herbal teas during pregnancy (odds ratio, 0.60).

CONCLUSIONS

Because of the study design, this paper does not confirm a causative relationship between the use of CAM during pregnancy and intrapartum pain management choices. It does, however, indicate that the use of CAM during pregnancy may not significantly affect the uptake of intrapartum PPMT, despite possible attempts to reduce PPMT by using NPMT. It also highlights the possibility of potential interactions between CAM and PPMT, given the high prevalence of concomitant use.