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Romeyke T, Stummer H. Multimodal Approaches in the Treatment of Chronic Peripheral Neuropathy-Evidence from Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:66. [PMID: 38248531 PMCID: PMC10815843 DOI: 10.3390/ijerph21010066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/27/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
Patients with chronic peripheral neuropathy suffer greatly and their quality of life is often restricted. Drug therapy can be accompanied by undesirable side effects and intolerances, or the hoped-for effect does not materialize. Therefore, in addition to drug therapy, attempts are also made to treat the physical symptoms with complementary procedures. In the case of severe forms, the search for a suitable form of therapy is difficult. Complex treatments can be an innovative way to treat peripheral neuropathy. At the same time, several different therapy methods are carried out at high frequency by a specialized treatment team. This study aimed to provide an overview of possible complementary forms of therapy. The focus was on a comparison of two interdisciplinary complex therapies that are used in severe cases in an acute inpatient care setting in Germany. The six dimensions (energy, sleep, pain, physicality, emotional response and social isolation) of the Nottingham Health Profile (NHP) were used to assess quality of life. Both complex treatments (naturopathic complex therapy/multimodal pain therapy) showed a significant reduction in impairment in all dimensions of the NHP. In addition, a multivariate analysis was carried out to take into account several influencing variables at the same time. At the time of admission to the hospital, the degree of chronicity was recorded for each patient. This allowed statements to be made about the effect of the respective therapy depending on the chronification stage of the patient. It has been shown that patients with acutely exacerbated pain with the highest degree of chronicity also benefit from both complex treatments. The naturopathic complex treatment gives the treatment team more options. Aspects such as nutrition, methods from phytotherapy and traditional Chinese medicine can be integrated into inpatient care. Thus, a patient-centered, holistic therapy can take place. However, an interdisciplinary holistic therapy requires more time for both the practitioner and the patient. This should be taken into account in the health systems in the context of the diagnosis related groups.
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Affiliation(s)
- Tobias Romeyke
- Institute for Management and Economics in Health Care, UMIT—University of Health Sciences, Medical Informatics and Technology, 6060 Hall in Tirol, Austria;
- Waldhausklinik, Acute Hospital for Internal Medicine, Pain Therapy, Complementary and Individualized Patient Centred Medicine, 86391 Deuringen, Germany
| | - Harald Stummer
- Institute for Management and Economics in Health Care, UMIT—University of Health Sciences, Medical Informatics and Technology, 6060 Hall in Tirol, Austria;
- University Seeburg Castle, 5201 Seekirchen am Wallersee, Austria
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Luis NL, Rodríguez-Álvarez C, Cuéllar-Pompa L, Arias Á. Evaluation of Delayed Effective Discharge for Non-Medical Reasons in Patients Admitted to Acute Care Hospitals in Spain: A Scoping Review. NURSING REPORTS 2023; 14:12-24. [PMID: 38251180 PMCID: PMC10801493 DOI: 10.3390/nursrep14010002] [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: 12/05/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Delayed discharge for non-clinical reasons is defined as a period of stay that continues after a patient has been deemed medically fit to leave the hospital but is unable to do so for non-medical reasons. This circumstance overburdens the healthcare system and constitutes a major problem for healthcare systems and the patients themselves in this situation. The aim of this study was to evaluate the delay in effective discharge for non-medical reasons for patients admitted to acute care hospitals in Spain. A scoping review followed the Joanna Briggs Institute methodology guidelines to search for and synthesize studies published between 2019 and 2022. To identify potentially relevant documents, the following bibliographic databases were searched: EMBASE, CINAHL and MEDLINE. For the search, we used free terms («delayed discharges», «discharge delays», «bed-blocking», «timely discharge», «unnecessary days» and «inappropriate stays»). Quantitative or qualitative studies published in scientific journals on delayed effective discharge for non-medical reasons for patients admitted to a hospital for any health issue of medical or surgical origin were selected. Information collection of the documents was performed using a structured datasheet specifically developed by the authors. The initial search strategy identified a total of 124 references, which were successively screened to a final selection of 13 studies. To conclude, delayed discharge from a hospital for non-clinical reasons is a multifactorial problem. This may be due to factors internal or external to the hospital, as well as personal factors. The main causes of the delay were similar among the studies found, as were the clinical characteristics of the patients, most of whom were elderly, frail and more dependent due to declining functional capacities. Further studies addressing the socio-familial characteristics of the patients and the perspective of the patient and families would be necessary.
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Affiliation(s)
- Noelia López Luis
- Primary Care Management of Tenerife, Canary Islands Health Service, 38004 Santa Cruz de Tenerife, Spain;
| | | | - Leticia Cuéllar-Pompa
- Institute of Care Research of the Nurses Association of Santa Cruz de Tenerife, 38001 Santa Cruz de Tenerife, Spain;
| | - Ángeles Arias
- Department of Preventive Medicine and Public Health, University of La Laguna, 38320 Santa Cruz de Tenerife, Spain;
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Art Therapy in Advanced Cancer. A Mapping Review of the Evidence. Curr Oncol Rep 2022; 24:1715-1730. [PMID: 35997935 DOI: 10.1007/s11912-022-01321-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW The benefits of arts in improving well-being in end-of-life patients have been stated by the WHO. To inspire clinical practice and future research, we performed a mapping review of the current evidence on the effectiveness of art therapy interventions in stage III and IV cancer patients and their relatives. RECENT FINDINGS We identified 14 studies. Benefits reported by the authors were grouped as improved emotional and spiritual condition, symptom relief, perception of well-being, satisfaction, and helpfulness. As a body of evidence, notable limitations were observed: Only 1 study was a randomized controlled trial (RCT), and there was heterogeneity in the interventions and outcome measures. This mapping review highlights the evidence available on the effectiveness of art therapy in advanced cancer, which remains limited and presents specific challenges. It also provides a visual representation of the reported benefits, encouraging further and more rigorous investigation.
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Romeyke T. A Multimodal Approach in the Treatment of Persistent Post-COVID. Diseases 2022; 10:diseases10040097. [PMID: 36412591 PMCID: PMC9680432 DOI: 10.3390/diseases10040097] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/10/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Many patients suffer from the consequences of a COVID infection. The so-called long or post-COVID syndrome affects the quality of life of patients and can lead to severe physical impairments. There are currently no suitable therapies for the treatment of long/post-COVID. CASE PRESENTATION A 49-year-old patient with post-COVID was admitted to a specialized clinic to carry out a multimodal therapy approach in the event of a therapy-resistant course. In addition to pronounced fatigue, sleep disorders, inner restlessness, and depression were seen in the patients' high levels of suffering. A naturopathic complex therapy including systemic whole-body hyperthermia was carried out. Well-being and physical well-being were recorded using the visual analog scale, and depression was recorded using the Patient Health Questionnaire Depression (PHQ-D). There was close monitoring of the vital parameters, and an evaluation of the therapy result was performed. DISCUSSION AND CONCLUSION The implementation of a naturopathic complex therapy including systemic whole-body hyperthermia was able to significantly improve the mental state, physical well-being, and mood of the patient. Since there are still no evidence-based therapy recommendations for the treatment of long/post-COVID, clinical research is called upon to intensively deal with this topic and to examine treatment concepts.
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Affiliation(s)
- Tobias Romeyke
- Medical Informatics and Technology, Institute for Management and Economics in Health Care, UMIT—University of Health Sciences, 6060 Hall in Tirol, Austria;
- Waldhausklinik Deuringen, Acute Hospital for Internal Medicine, Pain Therapy, Complementary and Individualized Patient Centered Medicine, 86391 Deuringen, Germany
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Chu SWF, Ng WJ, Yeam CT, Khan RQ, Low LL, Quah JHM, Foo WYM, Seng JJB. Manipulative and body-based methods in chronic kidney disease patients: A systematic review of randomized controlled trials. Complement Ther Clin Pract 2022; 48:101593. [DOI: 10.1016/j.ctcp.2022.101593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 04/10/2022] [Accepted: 04/10/2022] [Indexed: 12/21/2022]
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Pain Changes Induced by Acupuncture in Single Body Areas in Fibromyalgia Syndrome: Results from an Open-Label Pragmatic Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9991144. [PMID: 34621328 PMCID: PMC8492291 DOI: 10.1155/2021/9991144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 09/13/2021] [Indexed: 12/22/2022]
Abstract
To date, there is considerable evidence of the effectiveness of acupuncture in fibromyalgia syndrome (FM). However, it is not known in which body areas acupuncture is more effective. The objective of this study was to assess the improvements of pain induced by acupuncture in single body areas in patients with FM. In this open-label pragmatic study, FM patients in a state of high disease severity were consecutively enrolled and treated with a course of 8 weekly sessions of manual acupuncture. Patients were assessed with the Self-Administered Pain Scale (SAPS) of the Fibromyalgia Assessment Status at baseline and at the end of eight acupuncture sessions. Acupuncture sessions were all conducted with the same acupuncture formula (LV3, SP6, ST36, LI4, CV6, CV12, Ex-HN-3, and GV20) in each session and in each patient. Ninety-six FM patients completed the course of treatment. All the 16 body areas assessed by SAPS showed improvement in pain. A statistically significant improvement was achieved in 12 of the 16 body areas investigated, with the best results in abdomen and forearms (p = 0.001), while the worst results were registered for neck (p = 0.058), chest (p = 0.059), left buttock (p = 0.065), and right thigh (p = 0.052). The treatment has also shown significant effectiveness in improving fatigue and sleep quality (p < 0.0001). Acupuncture has a beneficial effect on pain in all body areas in FM patients with high disease severity, with the greatest effects in the abdominal region and in the forearms, allowing a personalization of the treatment.
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Maggot Therapy as a Part of a Holistic Approach in the Treatment of Multimorbid Patients with Chronic Ulcer. Clin Pract 2021; 11:347-357. [PMID: 34199361 PMCID: PMC8293264 DOI: 10.3390/clinpract11020049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/16/2022] Open
Abstract
Patients with chronic wounds (leg ulcers, decubitus, and diabetic foot ulcers) suffer from marked restrictions in their quality of life and can often no longer adequately carry out their everyday tasks. The need for nursing and medical care increases when other illnesses and complaints are present at the same time. Qualified wound care and the treatment of comorbidities are therefore of particular importance. The treatment of this disease, which is increasing in number, requires a holistic, multimodal treatment approach which, in addition to professional wound care, also includes comorbidities in the treatment. This case study describes an old treatment method for refractory wounds, the so-called "maggot therapy", and shows how this is integrated into a holistic, multimodal therapeutic approach.
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Cuen-Ojeda C, Hinojosa CA, Contreras-Yáñez I, Elenes-Sánchez E, Rosas-Ríos C, Méndez-Sosa MA, Ballinas-Sánchez A, Pascual-Ramos V. A comprehensive approach to complementary and alternative medicine usage among patients from a vascular department. Vascular 2021; 30:310-319. [PMID: 33853457 DOI: 10.1177/17085381211006595] [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: 11/15/2022]
Abstract
INTRODUCTION Use of complementary and alternative medicine (CAM) therapies had been described in patients with disabling, chronic and painful conditions; these characteristics define the majority of vascular surgery (VS) entities. A lack of disclosure about CAM use from patients has been universally cited and may impact effective patient-doctor communication. Our primary objective was to describe CAM use, modalities, perceived benefits, safety, and associated factors among adult patients attending a VS outpatient clinic; we additionally explored patient's attitudes about CAM disclosure with their primary vascular surgeon. METHODS This cross-sectional study invited 223 consecutive outpatients to an interview where the ICAM-Q (International Complementary and Alternative Medicine Questionnaire) and the PDRQ-9 (Patient-Doctor Relationship Questionnaire-9 items) were applied. In addition, sociodemographics, vascular disease and treatment-related information, comorbidity, and disease severity characteristics were obtained. Appropriated statistics was used; multiple logistic regression analysis identified factors associated to CAM use. All statistical tests were two-sided, and a p value ≤ 0.05 was considered significant. IRB approval was obtained. RESULTS Patients recruited were primary females (69%) and had a median age of 65 years (54-75). Most frequent vascular diagnoses were chronic venous insufficiency (36.2%) and peripheral artery disease (26%). There were 104 (46.6%) patients who referred CAM use, primarily self-helped practices (96%), and use of herbal, vitamins, or homeopathic medicines (23.7%). Overall, the majority of the patients perceived CAM modalities helpful and 94.6% denied any adverse event. Female sex (OR: 1.768, 95% CI: 0.997-3.135, p = 0.051) and hospitalization during the previous year (OR: 3.173, 95% CI: 1.492-6.748, p = 0.003) were associated to CAM use. The majority of the patients (77%) agreed about CAM disclosure with their primary vascular surgeon; meanwhile, among CAM users, up to 54.9% did not disclose it, and their main reasons were "Doctor didn't ask" (32%) and "I consider it unnecessary" (16%). The patient-doctor relationship was rated by the patients with high scores. CONCLUSIONS CAM use is frequent and perceived as safe and beneficial among VS outpatients; nonetheless, patients do not disclose CAM use with their primary vascular surgeons, and a wide range of reasons are given by the patients that prevent effective and open communication.
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Affiliation(s)
- Cesar Cuen-Ojeda
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias, Médicas y Nutrición, Salvador Zubirán, Mexico
| | - Carlos A Hinojosa
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias, Médicas y Nutrición, Salvador Zubirán, Mexico
| | - Irazú Contreras-Yáñez
- Immunology and Rheumatology Department, Instituto Nacional de Ciencias, Médicas y Nutrición Salvador Zubirán, Mexico
| | - Erika Elenes-Sánchez
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias, Médicas y Nutrición, Salvador Zubirán, Mexico
| | - Casandra Rosas-Ríos
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias, Médicas y Nutrición, Salvador Zubirán, Mexico
| | - Miguel A Méndez-Sosa
- Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, Instituto Nacional de Ciencias, Médicas y Nutrición, Salvador Zubirán, Mexico
| | - Angel Ballinas-Sánchez
- Immunology and Rheumatology Department, Instituto Nacional de Ciencias, Médicas y Nutrición Salvador Zubirán, Mexico
| | - Virginia Pascual-Ramos
- Immunology and Rheumatology Department, Instituto Nacional de Ciencias, Médicas y Nutrición Salvador Zubirán, Mexico
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The effects of sitting Tai Chi on physical and psychosocial health outcomes among individuals with impaired physical mobility: A systematic review and meta-analysis. Int J Nurs Stud 2021; 118:103911. [PMID: 33751992 DOI: 10.1016/j.ijnurstu.2021.103911] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/18/2021] [Accepted: 02/21/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Impaired physical mobility refers to a limitation in independent and purposeful physical movement of the body or one or more extremities. Physical restrictions result in negative consequences on an individual's physical and psychosocial functions. Sitting Tai Chi, a derivative form of traditional Tai Chi, has been found to increase the flexibility of all joints involved and enhance the ability to perform physical activity. However, the evidence of sitting Tai Chi on physical and psychosocial health outcomes on individuals with impaired physical mobility is limited. OBJECTIVES To critically synthesize evidence that evaluates the effects of sitting Tai Chi on health outcomes among individuals with impaired physical mobility and to identify implementation strategies for the sitting Tai Chi intervention. METHODS Searches were performed across 11 English and two Chinese databases systematically from inception to January 2020. Randomised controlled trials and non-randomised controlled trials, written in English or Chinese were included. Two independent reviewers screened all eligible studies, appraised risk of bias, and extracted the data. Meta-analyses were conducted using Review Manager 5.4 and narrative syntheses were performed where meta-analysis was inappropriate. The certainty of evidence was assessed using Grades of Recommendation, Assessment, Development and Evaluation profiler Guideline Development Tool. This study was registered in PROSPERO. RESULTS A total of 1,446 records were generated and 11 studies were eligible for inclusion. Meta-analysis reported a statistically significant effect size favouring sitting Tai Chi on depressive symptoms (SMD: -1.53, 95% CI: -2.81 to -0.21, 2 studies; very low quality), heart rate (MD: -5.72, 95% CI: -11.16 to -0.29, 2 studies; low quality) and social domain of quality of life (MD: 1.42, 95% CI: 0.66 to 2.19, 3 studies; low quality). CONCLUSIONS Sitting Tai Chi was found to have favourable effects on depressive symptoms, heart rate, and social domain of quality of life of individuals with impaired physical mobility. Very low to low quality evidence does not support the effectiveness of sitting Tai Chi on dynamic sitting balance, handgrip strength, and the physical and psychological domains of quality of life. There was limited evidence to suggest the best implementation strategies for the sitting Tai Chi intervention. It is anticipated that more well-designed studies will continue developing high quality evidence in this field.
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Dan A, Attias S, Woitiz R, Arnon Z, Keshet Y, Ben-Arye E, Schiff E. Patterns of patient reluctance to receive complementary-medicine treatments in a hospital setting: A cross-sectional study. Complement Ther Med 2021; 58:102694. [PMID: 33639252 DOI: 10.1016/j.ctim.2021.102694] [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: 11/06/2020] [Revised: 02/03/2021] [Accepted: 02/20/2021] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE We aim to characterize the patient population that exhibits reluctance to undergo complementary medicine (CM) treatments in a hospital setting. METHODS We conducted a cross-sectional prospective study among patients prior to hospitalization using structured questionnaires in a single center in Israel. Participants were asked to rate their degree of consent to receiving CM treatments during hospitalization. RESULTS The CM-reluctant group was 7.1 % of the study cohort. The CM modalities most commonly refused were spiritual guidance, acupuncture, and energy and healing therapies. The CM-reluctant population showed a weaker relation to spiritual content and tended to value complementary medicine's effectiveness less in comparison to the CM-consenting group. The main reason for reluctance was skepticism of the perceived effectiveness of CM. CONCLUSIONS With skepticism playing a major role in decision making, we should question whether the Stakeholders in the field of CM and public health services are succeeding in explaining the benefits and risks of CM treatments.
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Affiliation(s)
- Asaf Dan
- Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel; Complementary and Integrative Medicine Service, Bnai-Zion Medical Center, Haifa, Israel.
| | - Samuel Attias
- Complementary and Integrative Medicine Service, Bnai-Zion Medical Center, Haifa, Israel; School of Public Health, University of Haifa, Haifa, Israel.
| | - Rachel Woitiz
- Complementary and Integrative Medicine Service, Bnai-Zion Medical Center, Haifa, Israel.
| | - Zahi Arnon
- Complementary and Integrative Medicine Service, Bnai-Zion Medical Center, Haifa, Israel; Yezreel Valley Academic College, Emek Yezreel, Israel.
| | - Yael Keshet
- Yezreel Valley Academic College, Emek Yezreel, Israel.
| | - Eran Ben-Arye
- Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel; Integrative Oncology Program, Haifa and Western Galilee Oncology Service, Lin and Carmel Medical Centers, Clalit Health Services.
| | - Elad Schiff
- Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel; Complementary and Integrative Medicine Service, Bnai-Zion Medical Center, Haifa, Israel; Internal Medicine Department B, Bnai-Zion Medical Center, Haifa, Israel.
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Thomas A, Thomas A. Patient Suffering in Chronic Digestive Diseases: Will Primary Care-Specialist Collaboration With Effective Interactive Communication and Integrative Medicine in the Plan of Care Improve Quality of Life? J Patient Exp 2021; 7:989-993. [PMID: 33457535 PMCID: PMC7786766 DOI: 10.1177/2374373520967798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Acute and chronic digestive diseases are causing increased burden to patients and are increasing the United States health care spending. The purpose of this case report was to present how nonconfirmatory and conflicting diagnoses led to increased burden and suffering for a patient thus affecting quality of life. There were many physician visits and multiple tests performed on the patient. However, the primary care physician and specialists could not reach a confirmatory diagnosis. The treatment plans did not offer relief of symptoms, and the patient continues to experience digestive symptoms, enduring this burden for over 2 years. The central theme of this paper is to inform health care providers the importance of utilizing evidence-based primary care specialist collaboration models for better digestive disease outcomes. Consistent with patient’s experience, the authors propose to pilot/adopt the integrative health care approaches that are proven effective for treating digestive diseases.
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Affiliation(s)
- Andrew Thomas
- Bharati Vidyapeeth Medical College, Pune, India.,Research Volunteer, All of US Research Program, University of Illinois Health Sciences System, Chicago, IL, USA
| | - Annie Thomas
- Marcella Niehoff School of Nursing, Loyola University Chicago, BVM Hall, Chicago, IL, USA
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Romeyke T, Noehammer E, Stummer H. Patient-Reported Outcomes Following Inpatient Multimodal Treatment Approach in Chronic Pain-Related Rheumatic Diseases. Glob Adv Health Med 2020; 9:2164956120948811. [PMID: 32913669 PMCID: PMC7444101 DOI: 10.1177/2164956120948811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 07/06/2020] [Accepted: 07/20/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Musculoskeletal disorders may cause chronic pain, which is associated with deterioration in physical well-being, functions, and quality of life. There are worldwide shortfalls in the care that is provided to the affected patients. Holistic, interdisciplinary care is rare. Monomodal therapeutic approaches dominate when health-care resources are scarce. In this study, we test the patient-relevant outcomes of multimodal treatment for rheumatic diseases that are associated with pain and check for remuneration. Methods We performed a retrospective data analysis of an inpatient multimodal treatment. The target parameter was the patient perspective, which we assessed by means of Patient-Reported Outcomes (PRO). We applied the Visual Analogue Scale (mental and physical condition), the Heidelberg Short Early Risk Assessment Questionnaire, the Pain Disability Index, and the pain grading according to Kohlmann/Raspe (N = 375 patients). We also investigated compensation for inpatient treatments with and without multimodal treatments. Moreover, we compared Diagnosis-Related Group remuneration with and without complex treatment. Results After implementing a multimodal treatment, improved mental (mood) status was significantly better (Wilcoxon signed-rank test, P < . 001), despite high levels of pain (Kohlmann/Raspe) reported on admission. Apart from the underlying rheumatic disease, 111 patients also reported chronic back pain, which was improved following the treatment (t test, P < . 001). Subjective impairments associated with pain were significantly lower at the end of the hospital stay (Wilcoxon signed-rank test, P < . 001). Compensation for inpatient treatments with multimodal treatments increased noticeably in German hospitals in 2016 to 2019, while remunerations for monomodal treatments show mixed results. Conclusion PROs regarding mood, pain, and perceived impairments improved following the multimodal complex treatment. Compensation of hospitals should take into account additional performance requirements of holistic treatments, whereby the promotion and further studies of PROs are recommended.
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Affiliation(s)
- Tobias Romeyke
- Institute for Management and Economics in Health Care, UMIT-Private University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria.,Waldhausklinik, Acute Hospital for Internal Medicine, Pain Therapy, Complementary and Individualized Patient Centred Medicine, Deuringen, Germany
| | - Elisabeth Noehammer
- Institute for Management and Economics in Health Care, UMIT-Private University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Harald Stummer
- Institute for Management and Economics in Health Care, UMIT-Private University of Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
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Jo E, Jang HJ, Yang KE, Jang MS, Huh YH, Yoo HS, Park J, Jang IS, Park SJ. Cordyceps militarisExerts Antitumor Effect on Carboplatin-Resistant Ovarian Cancer via Activation of ATF3/TP53 Signaling In Vitro and In Vivo. Nat Prod Commun 2020. [DOI: 10.1177/1934578x20902558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the effect of Cordyceps militaris extract on the proliferation and apoptosis of carboplatin- resistant SKOV-3 and determine the underlying mechanisms for overcoming carboplatin resistance in human ovarian cancer. We cultured the carboplatin-resistant SKOV-3 cells in vitro until the exponential growth phase and then treated with different concentrations of C. militaris for 24, 48, and 72 hours. We performed cell proliferation assay, cell morphological change assessment using transmission electron microscopy, apoptosis assay, and immunoblotting to measure the protein expression of caspase-3 and -8, poly (ADP-ribose) polymerase (PARP)-1, B-cell lymphoma (Bcl)-2, and activating transcription factor 3 (ATF3)/TP53 signaling-related proteins. As a result, C. militaris reduced the viability of carboplatin-resistant SKOV-3 and induced morphological disruptions in a dose- and time-dependent manner. The gene expression profiles indicated a reprogramming pattern of the previously known and unknown genes and transcription factors associated with the action of TCTN3 on carboplatin-resistant SKOV-3 cells. We also confirmed the C. militaris-induced activation of the ATF3/TP53 pathway. Immunoblotting indicated that cotreatment of C. militaris and carboplatin-mediated ATF3/TP53 upregulation induced apoptosis in the carboplatin-resistant SKOV-3 cells, which are involved in the serial activation of pro-apoptotic proteins, including Bcl-2, Bax, caspases, and PARP-1. Further, when the ATF3 and TP53 expression increased, the CHOP and PUMA expressions were upregulated. Consequently, the upregulated CHOP/PUMA expression activated the positive regulation of the apoptotic signaling pathway. In addition, it decreased the Bcl-2 expression, leading to marked ovarian cancer cells sensitive to carboplatin by enhancing apoptosis. We then corroborated these results using in vivo experiments. Taken together, C. militaris inhibits carboplatin-resistant SKOV-3 cell proliferation and induces apoptosis possibly through ATF3/TP53 signaling upregulation and CHOP/PUMA activation. Therefore, our findings provide new insights into the treatment of carboplatin-resistant ovarian cancer using C. militaris.
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Affiliation(s)
- Eunbi Jo
- Division of Analytical Science, Korea Basic Science Institute, Daejeon, Republic of Korea
- Department of Life Science and Research Institute for Natural Sciences, College of Natural Sciences, Hanyang University, Seoul, Republic of Korea
| | - Hyun-Jin Jang
- Division of Analytical Science, Korea Basic Science Institute, Daejeon, Republic of Korea
- Department of Biological Sciences, Sungkyunkwan University, Suwon, Republic of Korea
| | - Kyeong E. Yang
- Division of Analytical Science, Korea Basic Science Institute, Daejeon, Republic of Korea
| | - Min S. Jang
- Division of Biological Science and Technology, Yonsei University, Wonju, Republic of Korea
| | - Yang H. Huh
- Electron Microscopy Research Center, Korea Basic Science Institute, Cheongju, Republic of Korea
| | - Hwa-Seung Yoo
- East-West Cancer Center, Daejeon University, Republic of Korea
| | - JunSoo Park
- Division of Biological Science and Technology, Yonsei University, Wonju, Republic of Korea
| | - Ik-Soon Jang
- Division of Analytical Science, Korea Basic Science Institute, Daejeon, Republic of Korea
- Division of Analytical Science, University of Science and Technology, Daejeon, Republic of Korea
| | - Soo J. Park
- Department of Sasang Constitutional Medicine, College of Korean Medicine, Woosuk University, Jeonju, Republic of Korea
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Connor J, Buring JE, Eisenberg DM, Osypiuk K, Davis RB, Wayne PM. Patient Disclosure of Complementary and Integrative Health Approaches in an Academic Health Center. Glob Adv Health Med 2020; 9:2164956120912730. [PMID: 32206442 PMCID: PMC7079303 DOI: 10.1177/2164956120912730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/10/2020] [Accepted: 02/20/2020] [Indexed: 11/27/2022] Open
Abstract
Background Effective patient–doctor communication about complementary and integrative health (CIH) is crucial to coordinate multimodal treatment for complex conditions. While rates of patient disclosure of CIH use to physicians have increased in the United States over the last 30 years, many patients still do not disclose these facts. Integrating CIH approaches within academic medical centers may enhance the communication, but this has not been explicitly studied. Objective To examine rates of patient disclosure of CIH to physicians and reasons for nondisclosure. Methods We surveyed 1177 patients at an academic center’s CIH clinic regarding their CIH use and disclosure of CIH use to their physician. Results Of the 1067 who responded to the disclosure questions, 80.1% had discussed their CIH use with their physician, while 19.9% did not. Of those who did not disclose, lack of physician inquiry was reported by 58% as the principal reason. Discussion Within an academic center, there is still a need to improve communication about CIH use. Possible strategies might include continued education of both patients and physicians about CIH and communication skills and integration of CIH disclosure into routine patient health questionnaires.
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Affiliation(s)
- Julie Connor
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
| | - David M Eisenberg
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Kamila Osypiuk
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
| | - Roger B Davis
- Division of General Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
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15
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Cevik AB, Akinci AC, Baglama SS. The use of complementary and alternative medicine among lymphoma and cancer patients with a solid tumor: Oncology clinics at Northern and Southern Turkey. Complement Ther Med 2019; 47:102173. [PMID: 31780026 DOI: 10.1016/j.ctim.2019.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 07/03/2019] [Accepted: 08/06/2019] [Indexed: 01/07/2023] Open
Abstract
PURPOSE This study aimed to determine the prevalence and predictors of the use of Complementary and Alternative Medicine (CAM) and to examine the differences between patients who used CAM and those who did not among those who were being treated in oncology clinics in the northern and southern regions of Turkey. In order to collect the relevant data, 288 outpatients receiving chemotherapy were selected to participate in the study. MATERIALS AND METHODS The research was designed as a descriptive, relational and cross-sectional study. Data was collected by the researchers using a form which had already been developed in the literature. RESULTS As a result of our study, we found that 33.2% of the patients had stage 4 cancer and 22.9% of them had respiratory system cancer. The most commonly used form of CAM was herbal preparations, which were used by 48.4% and around 31 species of herbs were employed. 59.1% of the patients used CAM to support their conventional treatment. The prevalence of the CAM usage was determined as 32.3%. CONCLUSION Even though a wide range of different forms of CAM are currently used by oncology patients in the northern and southern regions of Turkey, further cooperation with health professionals is needed to obtain better information about both CAM usage and medical treatment. Better informing patients about how best to use CAM in conjunction with medical treatment is also crucial.
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Affiliation(s)
- Ayfer Bayindir Cevik
- Bartın University, Faculty of Health Sciences, Ağdacı Mahallesi, Ağdacı Köyü Yolu, 74110, Merkez/Bartın, Turkey.
| | - Ayse Cil Akinci
- Istanbul Medeniyet University, Faculty of Health Sciences, Dumlupınar Mahallesi, D-100 Karayolu No:98, 34000, Kadıköy/İstanbul, Turkey
| | - Sevgin Samancioglu Baglama
- Gaziantep University, Faculty of Health Sciences, Yamaçtepe Mahallesi, 56161. Cd., 27410, Şahinbey/Gaziantep, Turkey
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16
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Rodondi PY, Lüthi E, Dubois J, Roy E, Burnand B, Grass G. Complementary Medicine Provision in an Academic Hospital: Evaluation and Structuring Project. J Altern Complement Med 2019; 25:606-612. [DOI: 10.1089/acm.2019.0062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Pierre-Yves Rodondi
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
| | - Emmanuelle Lüthi
- Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
- Department of Anesthesiology, Center for Integrative and Complementary Medicine, Pain Center, Lausanne University Hospital, Lausanne, Switzerland
| | - Julie Dubois
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
| | - Edith Roy
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Bernard Burnand
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Geneviève Grass
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Náfrádi L, Kostova Z, Nakamoto K, Schulz PJ. The doctor-patient relationship and patient resilience in chronic pain: A qualitative approach to patients' perspectives. Chronic Illn 2018; 14:256-270. [PMID: 29096534 DOI: 10.1177/1742395317739961] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To study patients' perspectives about the role of the doctor-patient relationship in promoting the resilience process. METHODS We conducted in-depth interviews with 20 chronic pain patients. Using open-ended questions, the interviews explored aspects of the doctor-patient relationship that impacted the patients' perceptions of their resilience. Thematic analysis built on an inductive, adaptive approach to data coding was employed to organize a representation of key factors affecting resilience. RESULTS The themes emerging from the interviews inform us about how the different aspects of the doctor-patient relationship can promote patient resilience in chronic pain. Three main themes emerged: the doctor providing psychological support, promoting patients' health literacy related to chronic pain and its treatment, and empowering the patients to cooperate in finding the right treatment. This fosters patients' direct outcomes (feeling validated, health literate, and empowered), which, in turn, lead to adaptive coping responses and day-to-day disease management. These direct outcomes are crucial for patients to maintain socially and personally meaningful activities and their functional (physical) capacity. DISCUSSION A doctor-patient relationship following the precepts of the patient-centered care is a significant resource that can lead to increased patient resilience. Thus, future interventions promoting patient resilience might consider addressing the doctor-patient relationship.
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Affiliation(s)
- Lilla Náfrádi
- 1 Institute of Communication and Health, Universita della Svizzera Italiana, Università della Svizzera Italiana, Lugano, Switzerland
| | - Zlatina Kostova
- 2 Department of Psychiatry, University of Massachusetts Medical School, Worcester, USA
| | - Kent Nakamoto
- 1 Institute of Communication and Health, Universita della Svizzera Italiana, Università della Svizzera Italiana, Lugano, Switzerland
| | - Peter J Schulz
- 1 Institute of Communication and Health, Universita della Svizzera Italiana, Università della Svizzera Italiana, Lugano, Switzerland
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18
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Kim S, Lee SH, Kim MR, Kim EJ, Hwang DS, Lee J, Shin JS, Ha IH, Lee YJ. Is cupping therapy effective in patients with neck pain? A systematic review and meta-analysis. BMJ Open 2018; 8:e021070. [PMID: 30397006 PMCID: PMC6231582 DOI: 10.1136/bmjopen-2017-021070] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Neck pain is a significant condition that is second only to depression as a cause of years lived with disability worldwide. Thus, identifying and understanding effective treatment modalities for neck pain is of heightened importance. This systematic review aimed to investigate the effects of cupping on neck pain from the current literature. DESIGN Systematic review and meta-analysis of randomised controlled trials (RCTs). SETTING Nine databases, including Chinese, Korean and Japanese databases, were searched for data up to January 2018 with no restrictions on publication language. PARTICIPANTS Patients with neck pain. INTERVENTIONS Cupping therapy as the sole or add-on intervention compared with no treatment or active controls. PRIMARY AND SECONDARY OUTCOME MEASURES Pain severity, functional disability and quality of life. RESULTS Eighteen RCTs were selected. Compared with the no intervention group, the cupping group exhibited significant reduction in pain (mean difference (MD) -2.42(95% CI -3.98 to -0.86)) and improvement in function (MD -4.34(95% CI -6.77 to -1.19)). Compared with the active control, the cupping group reported significant reduction in pain (p=0.0009) and significantly improved quality of life (p=0.001). The group that received control treatment with cupping therapy (add-on group) displayed significant pain reduction compared with the active control group (p=0.001). Of the 18 studies, only 8 reported occurrence of adverse events, which were mostly mild and temporary. CONCLUSIONS Cupping was found to reduce neck pain in patients compared with no intervention or active control groups, or as an add-on treatment. Depending on the type of control group, cupping was also associated with significant improvement in terms of function and quality of life; however, due to the low quality of evidence of the included studies, definitive conclusions could not be drawn from this review. Future well-designed studies are needed to substantiate the effectiveness of cupping on neck pain. PROSPERO REGISTRATION NUMBER CRD42016047218.
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Affiliation(s)
- Seoyoun Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
- Graduate School of Public Health, Korea University, Seoul, Republic of Korea
| | - Sook-Hyun Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Me-Riong Kim
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Eun-Jung Kim
- Department of Acupuncture and Moxibustion, College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea
| | - Deok-Sang Hwang
- Department of Obstetrics & Gynecology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jinho Lee
- Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea
| | - Joon-Shik Shin
- Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
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19
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Warm-needle moxibustion for spasticity after stroke: A systematic review of randomized controlled trials. Int J Nurs Stud 2018; 82:129-138. [DOI: 10.1016/j.ijnurstu.2018.03.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 03/16/2018] [Accepted: 03/16/2018] [Indexed: 01/28/2023]
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20
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Romeyke T, Noehammer E, Stummer H. Interdisciplinary assessment-oriented treatment of fibromyalgia: a case report. Integr Med Res 2018; 7:200-205. [PMID: 29984181 PMCID: PMC6026349 DOI: 10.1016/j.imr.2018.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/25/2018] [Accepted: 02/08/2018] [Indexed: 11/28/2022] Open
Abstract
Patients with fibromyalgia (FM) have often tried many outpatient treatments, and breakthrough pain frequently stops them from performing everyday tasks and participating in society. FM-pain that has become chronic, therefore, affects quality of life. This case study describes the administration of interdisciplinary inpatient pain therapy due to a primary diagnosis of fibromyalgia with integrated complementary medicine. The female patient, who had several concomitant disorders and had been suffering from pain for many years, benefited from the holistic treatment approach in terms of a reduction in pain and an improvement in physical functions and mental health. The ability to have a positive effect on pain symptoms in the longer term is essential. Compliance with the treatments used should also be improved, so that a healthier lifestyle and better pain management can continue after discharge from hospital. These results are supported by other study results and should provide the impetus for major studies to evaluate holistic pain therapies in FM.
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Affiliation(s)
- Tobias Romeyke
- UMIT - University of Health Sciences, Medical Informatics and Technology, Institute for Management and Economics in Health Care, Austria
- Waldhausklinik Deuringen, Acute Hospital for internal medicine, pain therapy, complementary and individualized patient centred medicine, Deuringen, Germany
| | - Elisabeth Noehammer
- UMIT - University of Health Sciences, Medical Informatics and Technology, Institute for Management and Economics in Health Care, Austria
| | - Harald Stummer
- UMIT - University of Health Sciences, Medical Informatics and Technology, Institute for Management and Economics in Health Care, Austria
- Institute for Management and Innovation in Healthcare, University Schloss Seeburg, Seekirchen/Wallersee, Austria
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21
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The Needs and Priorities for Government Grants for Traditional Korean Medicine: Comparing the Public and Traditional Korean Medicine Doctors. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:2625079. [PMID: 27994629 PMCID: PMC5141328 DOI: 10.1155/2016/2625079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 09/29/2016] [Indexed: 11/17/2022]
Abstract
This study was conducted to compare the need for research and development (R&D) of Traditional Korean Medicine (TKM) perceived by the public and Traditional Korean Medicine doctor (KMD) in. Survey data from 2462 people and KMD were utilized for this study. Overall, 25.10% of the public and 90.91% of KMD answered that government grants for TKM R&D were "extremely necessary." The majority of respondents reported that grants were needed "for the advancement of science and technology in TKM" (public, 46.28%; KMD, 34.08%). Research regarding herbal medicine was the top priority of TKM R&D in both groups. However, "research facilities and training for researchers (27.85%)" was a close second priority of the public, but not KMD. Moreover, the public believed that safety from adverse effects and toxicity was a more important area of R&D in each discipline, but KMD did not find these to be important. The public and KMD generally agreed on the need for government grants for TKM R&D, but the public was more interested in safety than KMD. Therefore, government policy decision makers must consider opinions of both the public and KMD when planning government grants.
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22
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Setayesh M, Sadeghifar AR, Nakhaee N, Kamalinejad M, Rezaeizadeh H. A Topical Gel From Flax Seed Oil Compared With Hand Splint in Carpal Tunnel Syndrome: A Randomized Clinical Trial. J Evid Based Complementary Altern Med 2016; 22:462-467. [PMID: 27909031 PMCID: PMC5871162 DOI: 10.1177/2156587216677822] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
This study compared the therapeutic effect of flax seed oil topical gel and hand splint in the treatment of carpal tunnel syndrome. This study was a randomized clinical trial. Forty-nine patients, 96 hands, with mild to moderate idiopathic carpal tunnel syndrome were divided into 2 groups randomly. One group was treated by topical gel and the other group by hand splint. Intensity of symptoms and function before and after intervention was measured via Boston Carpal Tunnel Questionnaire. After intervention, the ANCOVA showed a significant difference between the symptom and function scores of the 2 groups. In both cases, recovery was higher in the gel group (P < .001). The topical use of flax seed oil gel is more effective in the improvement of symptoms and function of patients with mild to moderate carpal tunnel syndrome as compared with hand splint, and it can be introduced as an effective treatment.
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Affiliation(s)
- Mohammad Setayesh
- 1 School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Nozar Nakhaee
- 2 Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Kamalinejad
- 3 School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Rezaeizadeh
- 1 School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Griffin KH, Nate KC, Rivard RL, Christianson JB, Dusek JA. Referrals to integrative medicine in a tertiary hospital: findings from electronic health record data and qualitative interviews. BMJ Open 2016; 6:e012006. [PMID: 27456330 PMCID: PMC4964262 DOI: 10.1136/bmjopen-2016-012006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To examine patterns of, and decision-making processes, informing referrals for inpatient access to integrative medicine (IM) services at a large, acute care hospital. DESIGN Retrospective electronic health record review and structured qualitative interviews. SETTING A 630-bed tertiary care hospital with an IM service available to inpatients. PARTICIPANTS IM referrals of all inpatients aged ≥18 years between July 2012 and December 2014 were identified using the hospital's electronic health record. Fifteen physicians, 15 nurses and 7 administrators were interviewed to better understand roles and perspectives in referring patients for IM services. RESULTS In the study hospital, primary sources of referrals for IM services were the orthopaedic and neuroscience/spine service lines. While the largest absolute number of IM referrals was made for patients with lengths of stay of 3 days or fewer, a disproportionate number of total IM referrals was made for patients with long lengths of stay (≥10 days), compared with a smaller percentage of patients in the hospital with lengths of stay ≥10 days. Physicians and nurses were more likely to refer patients who displayed strong symptoms (eg, pain and anxiety) and/or did not respond to conventional therapies. IM referrals were predominantly nurse-initiated. A built-in delay in the time from referral initiation to service delivery discouraged referrals of some patients. CONCLUSIONS Conventional providers refer patients for IM services when these services are available in a tertiary hospital. Referral patterns are influenced by patient characteristics, operational features and provider perspectives. Nurses play a key role in the referral process. Overcoming cultural and knowledge differences between conventional and IM providers is likely to be a continuing challenge to providing IM in inpatient settings.
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Affiliation(s)
- Kristen H Griffin
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
| | - Kent C Nate
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Rachael L Rivard
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
| | - Jon B Christianson
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Jeffery A Dusek
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA
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Liu R, Chang A, Reddy S, Hecht FM, Chao MT. Improving Patient-Centered Care: A Cross-Sectional Survey of Prior Use and Interest in Complementary and Integrative Health Approaches Among Hospitalized Oncology Patients. J Altern Complement Med 2015; 22:160-5. [PMID: 26505257 DOI: 10.1089/acm.2015.0061] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To describe cancer inpatients' prior-year use of complementary and integrative health (CIH) therapies and interest in receiving CIH therapies while in the hospital. DESIGN Observational, cross-sectional survey of prior-year use of 12 different CIH approaches and interest in receiving any of 7 CIH services in the hospital. SETTING Surgical oncology ward of an academic medical center. PARTICIPANTS 166 hospitalized oncology patients, with an average age of 54 years. RESULTS The most commonly used CIH approach was vitamins/nutritional supplements (67%), followed by use of a special diet (42%) and manual therapies (39%). More than 40% of patients expressed interest in each of the therapies if it was offered during their hospital stay, and 95% of patients were interested in at least one. More than 75% expressed interest in nutritional counseling and in massage. CIH use and interest varied somewhat by demographic and clinical characteristics. CONCLUSION Rates of CIH use among patients with cancer were high, as were their preferences to have these services available in the inpatient setting. Hospitals have the opportunity to provide patient-centered care by developing capacity to provide inpatient CIH services.
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Affiliation(s)
- Rhianon Liu
- 1 Osher Center for Integrative Medicine, University of California , San Francisco, San Francisco, CA
| | - Alexandra Chang
- 2 Departments of Anesthesiology and Internal Medicine, Loma Linda University , Loma Linda, CA
| | - Sanjay Reddy
- 1 Osher Center for Integrative Medicine, University of California , San Francisco, San Francisco, CA.,3 Division of Hospital Medicine, University of California , San Francisco, San Francisco, CA
| | - Frederick M Hecht
- 1 Osher Center for Integrative Medicine, University of California , San Francisco, San Francisco, CA
| | - Maria T Chao
- 1 Osher Center for Integrative Medicine, University of California , San Francisco, San Francisco, CA.,4 Division of General Internal Medicine at San Francisco General Hospital, University of California , San Francisco, San Francisco, CA
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Arena R, Guazzi M, Lianov L, Whitsel L, Berra K, Lavie CJ, Kaminsky L, Williams M, Hivert MF, Franklin NC, Myers J, Dengel D, Lloyd-Jones DM, Pinto FJ, Cosentino F, Halle M, Gielen S, Dendale P, Niebauer J, Pelliccia A, Giannuzzi P, Corra U, Piepoli MF, Guthrie G, Shurney D. Healthy Lifestyle Interventions to Combat Noncommunicable Disease—A Novel Nonhierarchical Connectivity Model for Key Stakeholders: A Policy Statement From the American Heart Association, European Society of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation, and American College of Preventive Medicine. Mayo Clin Proc 2015; 90:1082-103. [PMID: 26143646 DOI: 10.1016/j.mayocp.2015.05.001] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 04/19/2015] [Accepted: 05/01/2015] [Indexed: 01/14/2023]
Abstract
Noncommunicable diseases (NCDs) have become the primary health concern for most countries around the world. Currently, more than 36 million people worldwide die from NCDs each year, accounting for 63% of annual global deaths; most are preventable. The global financial burden of NCDs is staggering, with an estimated 2010 global cost of $6.3 trillion (US dollars) that is projected to increase to $13 trillion by 2030. A number of NCDs share one or more common predisposing risk factors, all related to lifestyle to some degree: (1) cigarette smoking, (2) hypertension, (3) hyperglycemia, (4) dyslipidemia, (5) obesity, (6) physical inactivity, and (7) poor nutrition. In large part, prevention, control, or even reversal of the aforementioned modifiable risk factors are realized through leading a healthy lifestyle (HL). The challenge is how to initiate the global change, not toward increasing documentation of the scope of the problem but toward true action-creating, implementing, and sustaining HL initiatives that will result in positive, measurable changes in the previously defined poor health metrics. To achieve this task, a paradigm shift in how we approach NCD prevention and treatment is required. The goal of this American Heart Association/European Society of Cardiology/European Association for Cardiovascular Prevention and Rehabilitation/American College of Preventive Medicine policy statement is to define key stakeholders and highlight their connectivity with respect to HL initiatives. This policy encourages integrated action by all stakeholders to create the needed paradigm shift and achieve broad adoption of HL behaviors on a global scale.
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26
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Arena R, Guazzi M, Lianov L, Whitsel L, Berra K, Lavie CJ, Kaminsky L, Williams M, Hivert MF, Cherie Franklin N, Myers J, Dengel D, Lloyd-Jones DM, Pinto FJ, Cosentino F, Halle M, Gielen S, Dendale P, Niebauer J, Pelliccia A, Giannuzzi P, Corra U, Piepoli MF, Guthrie G, Shurney D, Arena R, Berra K, Dengel D, Franklin NC, Hivert MF, Kaminsky L, Lavie CJ, Lloyd-Jones DM, Myers J, Whitsel L, Williams M, Corra U, Cosentino F, Dendale P, Giannuzzi P, Gielen S, Guazzi M, Halle M, Niebauer J, Pelliccia A, Piepoli MF, Pinto FJ, Guthrie G, Lianov L, Shurney D. Healthy lifestyle interventions to combat noncommunicable disease-a novel nonhierarchical connectivity model for key stakeholders: a policy statement from the American Heart Association, European Society of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation, and American College of Preventive Medicine. Eur Heart J 2015; 36:2097-2109. [PMID: 26138925 DOI: 10.1093/eurheartj/ehv207] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Noncommunicable diseases (NCDs) have become the primary health concern for most countries around the world. Currently, more than 36 million people worldwide die from NCDs each year, accounting for 63% of annual global deaths; most are preventable. The global financial burden of NCDs is staggering, with an estimated 2010 global cost of $6.3 trillion (US dollars) that is projected to increase to $13 trillion by 2030. A number of NCDs share one or more common predisposing risk factors, all related to lifestyle to some degree: (1) cigarette smoking, (2) hypertension, (3) hyperglycemia, (4) dyslipidemia, (5) obesity, (6) physical inactivity, and (7) poor nutrition. In large part, prevention, control, or even reversal of the aforementioned modifiable risk factors are realized through leading a healthy lifestyle (HL). The challenge is how to initiate the global change, not toward increasing documentation of the scope of the problem but toward true action-creating, implementing, and sustaining HL initiatives that will result in positive, measurable changes in the previously defined poor health metrics. To achieve this task, a paradigm shift in how we approach NCD prevention and treatment is required. The goal of this American Heart Association/European Society of Cardiology/European Association for Cardiovascular Prevention and Rehabilitation/American College of Preventive Medicine policy statement is to define key stakeholders and highlight their connectivity with respect to HL initiatives. This policy encourages integrated action by all stakeholders to create the needed paradigm shift and achieve broad adoption of HL behaviors on a global scale.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Carl J Lavie
- University of Queensland School of Medicine, New Orleans, LA
| | | | - Jonathan Myers
- VA Palo Alto Health Care System, Palo Alto, CA, and Stanford University, Stanford, CA
| | | | | | | | - Ugo Corra
- Università degli Studi di Milano, Milan, Italy
| | | | | | | | | | | | | | | | | | | | | | | | - George Guthrie
- Center for Family Medicine at Florida Hospital, Winter Park, FL
| | - Liana Lianov
- American College of Lifestyle Medicine, Chesterfield, MO
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