CAM education: promoting a salutogenic focus in health care

Re-orienting healthcare for healthy living communities: A qualitative exploration of nursing students utilising the salutogenic theory for community health practice

BACKGROUND

Salutogenesis is a resource-oriented approach that focuses on health creation. With the shift in focus from healthcare to health, there is a need to develop salutogenic inquiry and capacity of future nurses to promote good health and well-being in the community.

OBJECTIVE

This study explored nursing students' perspectives on utilising the salutogenic theory in the community for health promotion, including the scope, perceived benefits, and challenges of theory application.

DESIGN

A qualitative study using framework analysis.

SETTING

A tertiary institution in Singapore.

PARTICIPANTS

Nursing students who were taught the salutogenic theory for 'Healthy Community Living' module.

METHODS

Data were gathered from four focus group discussions (n = 18) and 32 students' written assignments. They were analysed based on five components of knowledge framework.

RESULTS

Four themes were identified: re-orienting healthcare for healthy living communities; ambivalent learning experiences; attracting early adopters of salutogenic paradigm; and practices for positive health development in complex systems: future directions. Findings reflected the value, versatility, and usefulness of introducing the salutogenic paradigm into the curriculum of healthcare education. Practical know-hows of applying the theory in community practice and development of health intervention were elicited.

CONCLUSION

Much work is needed to future-proof the next generation of nurses in embracing and unifying the concept of salutogenic science into the existing pathogenic-driven care model. The real challenge would be the continual support of nursing education and health system to provide salutogenic care in the community.

Experiences and Perceived Effects of Rosary Praying: A Qualitative Study

The aim of this study is to explore experiences and perceived effects of the Rosary on issues around health and well-being, as well as on spirituality and religiosity. A qualitative study was conducted interviewing ten Roman Catholic German adults who regularly practiced the Rosary prayer. As a result of using a tangible prayer cord and from the rhythmic repetition of prayers, the participants described experiencing stability, peace and a contemplative connection with the Divine, with Mary as a guide and mediator before God. Praying the Rosary was described as helpful in coping with critical life events and in fostering an attitude of acceptance, humbleness and devotion.

College students' communication about complementary and alternative medicine practices

While the use of Complementary/Alternative Medicine (CAM) has increased over the last two decades, how patients communicate about their decisions to use CAM has yet to be fully explored. The purpose of this study is to examine college students’ decision-making and communication about CAM. Fourteen college students participated in semi-structured focus group interviews about their CAM use and communication about CAM with family, friends, and health care providers. Participants use CAM to improve their physical and mental health. However, they have difficulties justifying their decision to practice CAM to others. They relied on CAM not only for physical and mental stability, but also as a sounding board for larger spiritual issues. Participants use passive communication strategies to communicate about their CAM use and often do not disclose CAM use to their providers because of the stigmas related to CAM. There is potential danger for CAM users who do not disclose CAM use to providers, family, and friends. More efforts are needed to encourage open and honest communication about CAM use.

Complementary and alternative medicine (CAM) following traumatic brain injury (TBI): Opportunities and challenges

Traumatic brain injury (TBI) is highly prevalent and occurs in a variety of populations. Because of the complexity of its sequelae, treatment strategies pose a challenge. Given this complexity, TBI provides a unique target of opportunity for complementary and alternative medicine (CAM) treatments. The present review describes and discusses current opportunitites and challenges associated with CAM research and clinical applications in civilian, veteran and military service populations. In addition to a brief overview of CAM, the translational capacity from basic to clinical research to clinical practice will be described. Finally, a systematic approach to developing an adoptable evidence base, with proof of effectiveness based on the literature will be discussed. Inherent in this discussion will be the methodological and ethical challenges associated with CAM research in those with TBI and associated comorbidities, specifically in terms of how these challenges relate to practice and policy issues, implementation and dissemination. This article is part of a Special Issue entitled SI:Brain injury and recovery.

Barriers to Testing and Treatment for Chagas Disease among Latino Immigrants in Georgia

Background. The lack of testing and treatment of Chagas disease (CD), caused by Trypanosoma cruzi, amongst infected immigrants in the USA increases the risk of serious health complications and transmission (congenital or via blood transfusions). Goal. Our goal was to identify the barriers to testing and treatment of CD and understand the process of seeking healthcare amongst Latino immigrants in Georgia. Methods. In this qualitative study, eleven focus group discussions were conducted with 82 Latino immigrants, including migrant farm workers. Grounded theory was used to collect and analyze the data to develop an inductive conceptual framework to explain the context and process of seeking healthcare for CD amongst this at-risk population. Results. Participants were not aware of CD. Three healthcare seeking behaviors were identified: delaying treatment, using traditional remedies, and using either mainstream or alternative health providers. Behaviors and motivations differed by gender, and the use of licensed medical providers was considered a last resort due to the cost of healthcare, loss of earnings while seeking care, and fear of diagnosis with fatal illness. Discussion. Providing free or low cost services, mobile clinics, and education regarding CD is critical to increase testing and treatment of CD in the US.

Towards salutogenesis in the development of personalised and preventive healthcare

The purpose of this review is to discuss how a salutogenetic approach that takes into consideration the human being as physical, psychological and spiritual entity may provide some answers to the difficulties faced by healthcare systems. The choice of medical intervention needs to take into account the technological advances of biomedicine but tailor them to the physical, psychological and spiritual needs of the patient in the context of their biography. Such person-centred medicine aims to strengthen Antonovsky’s concepts of resilience and sense of coherence with each therapeutic intervention so that overcoming illness becomes the foundation for better future health. Appropriate evaluation parameters need to be developed and included in order to evaluate the success of interventions in a person-centred, salutogenetic system.

Resident-initiated integrative medicine curriculum in an allopathic family medicine residency

OBJECTIVES

Although integrative medicine modalities are widespread and increasingly popular among patients and physicians, exposure to integrative medicine teaching remains limited during allopathic residency training. There is a need for innovative ways to incorporate integrative medicine teaching into family medicine residency training.

INTERVENTIONS AND RESULTS

In an allopathic family medicine program, residents developed an integrative medicine curriculum consisting of 37 weekly seminars tailored to the interests of the group. At the end of the academic year, the participants evaluated the program using a modified nominal group technique. Major strengths were the unique content, the joy and support shared with the group, and the inspiring experience. Participants suggested incorporating more practical applications and hands-on experiences in future seminars and protecting time for attendance.

CONCLUSIONS

For residents with interest in integrative medicine, weekly resident-run teaching sessions support their personal and professional growth and may improve their overall spirit during residency. In residency programs with limited teaching in integrative medicine, residents can successfully take initiative and create their own curriculum with support from community providers and interested faculty.

The potential of complementary and alternative medicine in promoting well-being and critical health literacy: a prospective, observational study of shiatsu

Background

The potential contribution of complementary and alternative medicine (CAM) modalities to promote and support critical health literacy has not received substantial attention within either the health promotion or the CAM literature. This paper explores the potential of one CAM modality, shiatsu, in promoting well-being and critical health literacy.

Methods

Data are drawn from a longitudinal, 6 months observational, pragmatic study of the effects and experience of shiatsu within three European countries (Austria, Spain and the UK). Client postal questionnaires included: advice received, changes made 6 months later, clients 'hopes' from having shiatsu and features of the client-practitioner relationship.

Result

At baseline, three-quarters of clients (n = 633) received advice, on exercise, diet, posture, points to work on at home or other ways of self-care. At 6 months follow-up, about four-fifths reported making changes to their lifestyle 'as a result of having shiatsu treatment', including taking more rest and relaxation or exercise, changing their diet, reducing time at work and other changes such as increased body/mind awareness and levels of confidence and resolve. Building on the findings, an explanatory model of possible ways that a CAM therapy could contribute to health promotion is presented to guide future research, both within and beyond CAM.

Conclusion

Supporting individuals to take control of their self-care requires advice-giving within a supportive treatment context and practitioner relationship, with clients who are open to change and committed to maintaining their health. CAM modalities may have an important role to play in this endeavour.

Complementary and alternative medicine for the allergist-immunologist: where do I start?

Complementary and alternative medicine (CAM) therapies present a growing information management challenge for physicians because nearly 40% of their patients may be using and another 50% may be considering use of CAM as part of their healthcare regimen. The National Health Statistics Reports for 2007 described the most commonly used nonvitamin, nonmineral therapy as natural products (eg, herbals at 17.7%). More than 5% of children under the age of 18 years used CAM for allergic conditions including asthma. The amount and quality of information available and concerns about liability risk represent a challenge for most physicians. This review focuses on considerations for approaching a CAM-related consultation, incorporating legal and logistic factors affecting how such an encounter should be approached. A 10-step process is presented that addresses different components of CAM consultations and what should be documented. Access to timely, high-quality information regarding product specific efficacy and safety data, as found in the Natural Medicines Comprehensive Database, is needed to support CAM consultation efficiently. Understanding of serious adverse events associated with CAM is limited; an international need exists for improved safety surveillance and information sharing. Allergy-immunology, as a specialty with expertise in adverse drug reaction evaluation and management, has a unique opportunity to support enhanced CAM-related adverse events evaluations, reporting, and research.