By Shabana Saleem Lalji & Khairunnissa Hooda
Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not generally considered to be part of conventional medicine (National Institutes of Health October 26, 2009). CAM is usually referred as mind-body medicine because it is an approach to heal that uses the power of thought and emotions to positively influence physical health.
Complementary medicine is used together with conventional medicine. An example of a complementary therapy is using aromatherapy (a therapy in which the scent of essential oil from flower, herbs, & tree is inhaled to promote health & well being) to help lessen a patient’s discomfort following surgery. Alternative medicine is used in place of conventional medicine. An example of an alternative therapy is using a special diet to treat cancer instead of undergoing surgery, radiation, or chemotherapy that has been recommended by a conventional doctor. Recently, the status of complementary and alternative medicine (CAM) has gained a lot of recognition worldwide may be because it is considered cost-effective, efficient, less invasive, and more accessible. Cited example acupuncture, naturopathy, herbalism, tradition Chinese’s medicines, yoga, biofeedback, homeopathy, diet-based therapies, energy healing therapy (Guided imagery, meditation).
According to NIH December 2008 data, In the United States, approximately 38 percent of adults (about 4 in 10) and approximately 12 percent of children (about 1 in 9) are using some form of CAM. People of all backgrounds use CAM. However, CAM use among adults is greater among women and those with higher levels of education and higher incomes. Nonvitamin, nonmineral natural products are the most commonly used CAM therapy among adults. Use has increased for several therapies, including deep breathing exercises, meditation, massage therapy, and yoga. The overall trend in Pakistan also shows that 51.7% chose CAM while 48.3% chose biomedicine. Like about half of the studied population used CAM and it reflects an increasing popularity of CAM in Pakistan as well. Sheikh, SH., Malik F, James H, Abdul H. (2009). During the last few decades’ complementary and alternative medicine (CAM) has received a great deal of attention and gained in popularity among patients. The prevalence of CAM use among patients was 90.4%; although a considerable proportion of patients using CAM did not disclose this information to nurses/doctors (39.9%) and 20.7% said they would report it as ‘‘only when needed/or if asked to’’. A high proportion of patients reported using non-herbal supplements (60.3%) and massage therapy (45%) while most forms of therapies were mainly used ‘‘only when needed’’. The CAM domain most frequently used was biologically based therapies (68.8%). Patients rated themselves as having ‘‘none’’ (24.4%) or ‘‘very little’’ (42.5%) knowledge about most CAM, although nearly half (46.4%) of them had a positive attitude towards CAM. Shorofi, S A., & Arbon P (2009). Caspi, Koithan & Criddle (2004) claim that the best evidence of the importance that CAM has achieved is seen in the increasing number of patients, medical students, health care practitioners, third party insurers, and health care policymakers who seek integration of CAM into conventional health care systems.
Classification of Complementary and Alternative Therapies
The use of CAM is very evident is neuroscience population, individuals with chronic illness and literature also suggests that certain individual characteristics like gender, age, cultural differences also influence CAM use. Linda N., (2006). While doing literature review about CAM therapies, I identified that a lot of martial is being published and it was good to know through the editorial of Complementary Therapies in Nursing and Midwifery (2004) that effective February 2005 the journal title has been changed to Complementary therapies in Clinical Practice. Therefore, I believe that this, itself a great achievement for the alternative therapist and complementary practioner which has increased the scope and use of CAM used by health professionals for different patient population.
While providing holistic approach, nurses face challenges when patient asked them to provide complementary therapies, because many of the complementary therapy (CT) does not have the scientific rationale which generates ethical dilemmas. An increasing number of nurses have been asking the College of Nurses of Ontario (CNO) whether it is appropriate for nurses to provide complementary therapies, and what criteria exist to guide nurses in their use of these therapies. College of Nurses of Ontario, CNO (2008). In lieu of this concern CNO has published a detailed guideline for nursing responsibilities in providing CAM which I found very useful when it comes to professional accountability in relation to scope of nursing practice while caring for patients. The foremost ethical consideration involved in integrating CAM therapy could be of patients and nurses value conflict which may end up having stressful times for both patient and the nurse. So for this nurses need to be responsible for assessing the appropriateness of the complementary therapy; they require to have enough knowledge of the action, risk benefit and effects of the therapy. In addition to that nurses need to make sure consent is required in any case if therapy is requested from patient or by health professional. In my view nurses vital role is to provide services that facilitate wholeness & healing. They need to understand all aspects of CAM, including costs, patient knowledge, and drug interactions, if they are to promote holistic strategies for patients seeking to achieve a higher quality of life.