Complementary Therapies in Clinical Practice

Title page/Editorial board

2012-02-01

Publisher’s note

2012-02-01

In order to improve our service to authors and reviewers, we are pleased to announce that Complementary Therapies in Clinical Practice has implemented a system for the electronic handling of research papers during the submission process. This Elsevier Editorial System (EES) is a web-based system with full online submission capabilities. EES allows you to upload files directly from your computer. As of now all authors and reviewers are invited to submit their manuscripts and their reviews electronically. We strongly encourage all authors and reviewers to use the Elsevier Editorial System when submitting papers to Complementary Therapies in Clinical Practice. The journal homepage, http://www.elsevier.com/locate/ctcp, contains details of the Elsevier Editorial System, including the Guide for Authors for manuscript submissions.

Age, sex, disease, ethnicity et al – Are complementary therapies reaching the parts?

Gavin Andrews, Peter Mackereth — 2011-11-07

A common criticism of private complementary therapy (CT) practice in developed countries is that the majority of its clients are the worried well who are predominantly middle class, middle aged, white and female. While wealth, high social class and a good education may reduce your risk of illness and increase your access to treatment and care; it does not protect you from cancer, old age or long-term conditions such as multiple sclerosis. Poverty, war, abuse and individual behaviours, for example smoking, add to the burdening costs and causation of illness. Working in clinical practice should expose practitioners to a wider patient experience and demand greater skill and knowledge to take us beyond the worried well.

Feasibility and effectiveness of massage therapy for symptom relief in cardiac catheter laboratory staff: A pilot study

2011-09-26

Abstract: A pilot study was conducted to assess the feasibility and efficacy of massage therapy for cardiac catheterization laboratory staff. Staff members (N = 50) were randomly assigned to 5 or 10 weekly 30-min massages, followed by outcomes assessment. A control group (n = 10) receiving no massage therapy underwent comparable assessment. Visual analog scales, the t test, and the repeated measures model evaluated fatigue, pain, relaxation, stress/anxiety, tension/discomfort, and scheduling ease at baseline, 5 weeks, and 10 weeks. The Aickin separation test was used to assess feasibility of further research. Overall, 90% (337/375) of massage appointments were used. No significant effects were observed, but the Aickin separation test supported further research on massage therapy for fatigue, pain, relaxation, and tension/discomfort. Conducting massage therapy in the workplace is logistically feasible. Larger, longitudinal trials are warranted to better evaluate its effects on staff.

Effect of an integrated support programme on the concerns and wellbeing of women with breast cancer: A national service evaluation

J.E. Harrington, B.S. Baker, C.J. Hoffman — 2011-06-23

Abstract: Purpose: To carry out a national service evaluation of the integrated cancer support programme offered by The Haven using the Measure Yourself Concerns and Wellbeing (MYCaW) outcome questionnaire.Methods: Breast cancer survivors who visited one of three Haven centres in the UK completed the MYCaW questionnaire before and after 6 one-hour complementary therapy sessions.Results: Statistically significant decreases in mean baseline scores (indicating improvement) for concerns and wellbeing were observed after treatment: concern 1 (5.09 ± 1.04 vs 3.17 ± 1.60, p < 0.0001, n = 402), concern 2 (4.69 ± 1.08 vs 3.08 ± 1.56, p < 0.0001, n = 372), and wellbeing (3.30 ± 1.41 vs 2.63 ± 1.28, p < 0.0001, n = 402). The therapies most commonly used were acupuncture, nutrition, massage and aromatherapy, shiatsu, counselling and reflexology. After therapy, 91% of reported scores (n = 328) rated the concern as being a little better, much better or gone.Conclusions: These findings suggest that women with breast cancer find the Haven integrated support programme valuable for addressing their main concerns and improving their feeling of wellbeing.

Complementary and alternative medicine use amongst Palestinian diabetic patients

Mohammed S. Ali-Shtayeh, Rana M. Jamous, Rania M. Jamous — 2011-10-03

Abstract: Objectives: To measure the frequency of herbal medicine use among patients with diabetes mellitus in Palestine; to determine demographic characteristics that may increase the likelihood of Complementary and Alternative Medicine (CAM) use and to find out how benefits, if any, were perceived by patients.Method: Cross-sectional survey of patients attending the outpatient diabetes departments at 7 Governmental Hospitals. The method was based on semi-structured questionnaires.Results: A total of 1883 patients with diabetes were interviewed. Of the participants, 51.9% (n = 977) reported taking herbs primarily bought from Palestine (98%) and used in crude form mainly as decoctions (44.1%). The five most common herbal products used were: Trigonella berythea (Fabaceae) (n = 191, 19.6%), Rosmarinus officinalis (Lamiaceae) (n = 132, 13.5%), Olea europaea (Oleaceae) (n = 131, 13.4%), Teucrium capitatum (Lamiaceae) (n = 111, 11.4%), and Cinnamomum zeylanicum (Lauraceae) (n = 105, 10.8%). Most CAM users were above 40 years old 79.6% (n = 778), predominantly female (53.2%) and residents of refugee camps and rural areas (59.3, and 53.5, respectively). The recommendations of a family member or friend was the main factor prompting the use of CAM (40.2 and 37.1%). Most CAM users (71.7%) were satisfied with the perceived effects. Interestingly, 68% of patients recruited in the study did not disclose CAM use to their physicians or pharmacists.Conclusion: Use of herbal therapies in diabetes is highly prevalent in Palestine. More than 70% of those using CAM (977, 51.9%) reported positive benefits including a feeling of slowing down disease progression, symptom relief, disease resolution or a reduction in the side effects of allopathic medication. Use of CAM should be explored with patients before clinical decisions are made. There is a need for health education relating to herbal use in conjunction with conventional medicines in diabetes.

Ginger to reduce nausea and vomiting during pregnancy: Evidence of effectiveness is not the same as proof of safety

Denise Tiran — 2011-09-19

Abstract: Ginger is a common traditional remedy taken by numerous women experiencing nausea and vomiting in pregnancy (NVP). There is considerable evidence to support its effectiveness as an anti-emetic, but also increasing concern over its safety. Ginger is a powerful herbal medicine which acts pharmacologically and thus has specific indications, contraindications, precautions and side-effects, the most notable of which is an anticoagulant action. Midwives and other professionals advising women in early pregnancy about strategies for coping with NVP should be aware of the risks and benefits of ginger in order to provide comprehensive and safe information to expectant mothers.This paper reviews some of the contemporary research evidence which demonstrates that ginger is not a universally appropriate or safe choice for women with NVP and offers a checklist for professionals advising expectant mothers.

Tai Chi effects on neuropsychological, emotional, and physical functioning following cancer treatment: A pilot study

Stephanie A. Reid-Arndt, Sandy Matsuda, Cathy R. Cox — 2011-03-14

Abstract: Objective: To examine the effects of a 10-week Tai Chi (TC) program on neuropsychological, psychological, and physical health of female cancer survivors.Design: Twenty-three women with a history of cancer participated in 60-min TC classes two times/week for 10-weeks.Main Outcome Measures: Before and after the intervention, participants completed neuropsychological tests (memory, executive functioning, language, and attention); 5 tests of balance; and self-report questionnaires of neuropsychological complaints, stress and mood, and fatigue.Results: After the 10-week session, participants evidenced fewer neuropsychological complaints and enhanced neuropsychological functioning. They also demonstrated improved balance and reported better psychological functioning.Conclusions: Results suggest that TC may promote gains in neuropsychological functioning, in addition to previously demonstrated improvements in physical and psychological health. These findings support the need for controlled trials examining the potential benefits of TC on neuropsychological functioning after cancer.

The healers journey: A literature review

Gerard Kenny — 2011-08-31

Abstract: While much important research has gone into identifying the efficacy and importance that healing interventions can make to healthcare this paper seeks to synthesise some of the core themes of the processes that healers go through in their journey to becoming a healer. Through the process of a literature review of seminal texts and current literature the paper identifies the key themes of, healer as facilitator, connecting to sources of healing, an appreciation of the healee, an expanded sense of spirituality, an acknowledgement of the wider archetypal significance of the healer, the importance of the wound and the role that these can play in the process of personal transformation and also acceptance. In doing so it hopes to offer that the journey of the healer plays a crucial role in guiding the quality of the healing that healers share in a healing encounter.

Delivering shiatsu in a primary care setting: Benefits and challenges

Zoë M. Pirie, Nick J. Fox, Nigel J. Mathers — 2011-08-04

Abstract: Aim: To pilot the delivery of shiatsu in primary care and investigate the non-clinical impact on the general practice, its patients and staff.Design: Ten patients, referred by four GPs, were each offered six shiatsu treatments with a qualified practitioner.Setting: An inner-city general practice in Sheffield, England.Methods: 36 semi-structured interviews, evaluated with Interpretative Phenomenological Analysis and practitioner research including a reflective journal.Findings: GPs welcomed having more options of care, especially for patients with complex, chronic symptoms, and patients appreciated the increased time and holistic, patient-centred approach during shiatsu consultations. Participants claimed the clinic increased equality of access to complementary medicine, improved perceptions of the general practice, reduced consultation and prescription rates, enhanced GP-patient relationships and the working practices of the GPs and shiatsu practitioner.Conclusion: The study successfully integrated a shiatsu clinic into a general practice and offers a model for future research on complementary medicine in primary care.

Place visualization: Conventional or unconventional practice?

Gavin J. Andrews, David Shaw — 2011-09-19

Abstract: This paper explores the traditional notion that two discrete forms of medicine exist. One being bio-medically led, the other being holistic in origin. A qualitative study of place visualization in nursing is used to illustrate how health care may not always fit neatly into one of these paradigms. It is suggested that, through the use of this practice, an organically occurring therapeutic intervention emerges that includes core elements of each category. Based on the findings of this small scale inductive study, it is suggested that greater attention be afforded to areas of practice shared by both health care approaches.

Use of complementary and alternative medicine by patients seen at the dermatology department of a tertiary care center

2011-06-27

Abstract: The use of complementary and alternative medicine (CAM) among patients with dermatologic conditions has not been well studied. The aim of this study was to evaluate the frequency and pattern of CAM use in patients referred to the dermatology department of a tertiary care center. Patients referred to the dermatology department of an academic tertiary referral center between February 2, 2010, and February 10, 2010, were invited to participate in an 86-question survey regarding CAM use during the previous year. A total of 300 patients completed the survey, of whom 154 (51%) were women. Eighty-two percent (n = 247) of the respondents had used some type of CAM during the previous year. The most frequently used treatment and technique was massage therapy (33%), and the most commonly used vitamin was vitamin C (31%). Herbs or other dietary supplements were used by 58% (n = 173) of patients. Seventy-eight percent (n = 235) of patients stated that physicians should consider incorporating CAM approaches into their treatment recommendations, and 89% of patients (n = 267) stated that our dermatology department should study CAM approaches in research studies. CAM utilization is high among patients at a large academic dermatology department. Patients indicated a strong preference for having CAM approaches incorporated into their treatment recommendations and believed in the value of clinical studies to further refine the role of CAM.

Exercise research on children and adolescents

Tiffany Field — 2011-05-05

Abstract: This paper is a review of studies published during the last several years on exercise effects on overweight, growth, chronic illnesses, depression and anxiety in children and adolescents. Although the lion’s share of the research involves aerobic exercise, studies on yoga and tai chi are also reviewed. Following exercise, body mass index and lipid profiles have improved in overweight children, and those with asthma, diabetes and depression have also benefited from exercise. The yoga studies reviewed here focused on ADHD and anxiety, and the tai chi studies involved children with ADHD and asthma.A potential underlying mechanism for the positive effects of exercise, yoga and tai chi may be the stimulation of pressure receptors leading to increased vagal activity, decreased stress hormones and increased production of anti-pain and antidepressant neurotransmitters such as serotonin. Further studies are needed using convergent behavioral, physiological and biochemical measures. Nonetheless, the current literature highlights the importance of adding exercise programs to clinics, schools and families for the physical and psychological well-being of children and adolescents.

Impact of self-administered relaxation and guided imagery techniques during final trimester and birth

Merete Gedde-Dahl, Egil A. Fors — 2011-09-09

Abstract: The objective of this study was to test if and how self-administered practice of relaxation techniques, positive affirmation and guided imagery, in the final part of pregnancy had an impact on giving birth. Further to see if the use of a simple method, a CD with a booklet, with no previous training or specific support of the participants (neither required nor delivered), affected the birth experience. Outcome measures were monitored both during and after delivery: During delivery, pain and anxiety were measured at different stages of birth. Post-delivery Wellbeing (Edmonton Scale 0–10, where 10 is the worst possible feeling of Wellbeing), pain, anxiety, Apgar score, duration of birth, complications and anesthesia/analgesic were recorded. Those in the CD-intervention group also reported how many times they had practiced the techniques.The study employed a randomized controlled trial. Results show that the CD-intervention group had a significantly better score on total Wellbeing, as measured by the ESAS (0–10) Edmonton Scale.

Episiotomy pain relief: Use of Lavender oil essence in primiparous Iranian women

2011-03-18

Abstract: Introduction: Post-episiotomy discomfort and its consequences can affect maternal quality of life and mental health as well as the mother and baby relationship. Complementary medicine is increasingly used and Lavender oil is frequently prescribed due to its antiseptic and healing properties.Method: This clinical trial involved 60 qualified primiparous women admitted for labor in Kamali Hospital in Karaj, Iran. They were randomly categorized into two groups: case (using Lavender oil) and control (usual hospital protocol). Participants pain and discomfort were recorded using a Visual Analogue Scale (VAS) and a Redness, Edema, Ecchymosis, Discharge Scale (REEDA). Pain was evaluated at 4 h, 12 h and 5 days following episiotomy. Collected data was analyzed in SPSS 14 using an independent t-test and chi-square.Results: There was a statistical difference in pain intensity scores between the 2 groups after 4 h (p = 0.002, and 5 days (p = 0.000) after episiotomy. However, differences in pain intensity between the two groups, at 12 h post-surgery, were not significant (p = 0.066). The REEDA score was significantly lower in the experimental group (Lavender oil group) 5 days after episiotomy (p = 0.000).Conclusion: According to these findings, use of Lavender oil essence can be effective in reducing perineal discomfort following episiotomy. It is suggested that Lavender oil essence may be preferably to the use of Betadine for episiotomy wound care.

A response to: The use of complementary and alternative medicine by Patients with cancer: A Turkey Survey, by Akyol and Öz. 17 (2011) 229–233

Erin E. Bailey, L. Lee Glenn — 2011-08-29

The study by Akyol and Öz (Vol.17: issue 4) aimed to discover the predominance of complementary and alternative medicine (CAM) use, but it lacks crucial information to support its main conclusion, as described below.