<p>The aim of the present literature review was to describe and evaluate the effects and experiences within the complementary approaches such as aromatherapy, tactile massage and acupuncture amongst palliative care patients. Search through Medline (through Pub Med) database and additional manual search was conducted. In total 16 articles fulfilled the inclusion criteria and were reviewed. The result was presented under respectively category: aromatherapy, tactile massage and acupuncture. Physical and psychological effects as well as experiences from the treatments were also documented under the different complementary approaches. Aromatherapy and tactile massage were found to be more effective for reduction in anxiety and depressive mood whilst acupuncture had a greater impact on physical symptoms such as fatigue/insomnia, nausea/vomiting and chemotherapy induced emesis and also xerostomia. Not only did the patients experience relaxation and peacefulness but also feelings of comfort from the aromatherapy and tactile massage therapies. The result also showed that acupuncture felt invigorating and generated more energy for the patients to cope with more activities in their daily lives. In conclusion the complementary therapies aromatherapy, tactile massage and acupuncture are effective and alleviating and therefore very beneficial for patients in palliative care. The complementary therapies is a perfect and valuable tool for symptom management and strengthens the caregiver/patient relationship.</p>

The aim of the present literature review was to describe and evaluate the effects and experiences within the complementary approaches such as aromatherapy, tactile massage and acupuncture amongst palliative care patients. Search through Medline (through Pub Med) database and additional manual search was conducted. In total 16 articles fulfilled the inclusion criteria and were reviewed. The result was presented under respectively category: aromatherapy, tactile massage and acupuncture. Physical and psychological effects as well as experiences from the treatments were also documented under the different complementary approaches. Aromatherapy and tactile massage were found to be more effective for reduction in anxiety and depressive mood whilst acupuncture had a greater impact on physical symptoms such as fatigue/insomnia, nausea/vomiting and chemotherapy induced emesis and also xerostomia. Not only did the patients experience relaxation and peacefulness but also feelings of comfort from the aromatherapy and tactile massage therapies. The result also showed that acupuncture felt invigorating and generated more energy for the patients to cope with more activities in their daily lives. In conclusion the complementary therapies aromatherapy, tactile massage and acupuncture are effective and alleviating and therefore very beneficial for patients in palliative care. The complementary therapies is a perfect and valuable tool for symptom management and strengthens the caregiver/patient relationship.

Bakgrund: Migrän räknas till en av våra vanligaste folksjukdomar och förekommer hos cirka 10% av befolkningen. Patienter som provade akupunkturbehandling hade oftast positiva upplevelser och erhöll god smärtlindrande effekt. De upplevde en känsla av att återfå kontrollen över sitt liv. Syfte: Att belysa migränpatientens upplevelse av akupunkturbehandling vid migrän. Metod: Litteraturstudien baserades på totalt tio vetenskapliga kvantitativa och kvalitativa studier. Resultat: Två olika kategorier utkristalliserades, upplevelser av effekter vid akupunktur samt upplevelser under och av akupunkturbehandlingen. Patienterna beskrev färre och kortare migränattacker och för en del upphörde de helt. Den psykiska hälsan förbättrades. Det var svårt för patienterna att skilja på riktig akupunktur eller om de fick sham vid behandlingstillfällena och det visade sig att även sham akupunktur hade positiv effekt. Diskussion: Det behövs fler och bättre studier för att säkerställa akupunkturens vetenskapliga effekt och upplevelse av smärtlindring vid migrän. Akupunktur bör övervägas som behandling för de patienter som önskar eftersom goda effekter och upplevelser av smärtlindring finns. Slutsats: Flertalet patienter hade positiva upplevelser och var positiva till akupunktur som komplementär behandling. / Background: Migraine is considered one of our most common diseases and affects approximately 10% of the population. Patients who tried the acupuncture treatment had mostly positive experiences, and experienced good analgesic effect. Purpose: To highlight the migraine patient's experience of acupuncture treatment for migraine. Method: The study is based on totally ten scientific studies. Results: Two categories emerged, experiences the effects of acupuncture and experiences of acupuncture treatment. The patients described fewer and shorter migraine attacks and for some they ceased entirely. Mental health improved. It was difficult for patients to distinguish between real acupuncture or if they received the sham treatment sessions and it turned out that even sham acupuncture had a positive effect. Discussion: We need more and better studies to ensure acupuncture scientific impact and experience of pain in migraine. Acupuncture should be considered as a treatment for patients since good quality effects and experiences of pain relief are present. Conclusion: Most patients had positive experiences and were in favor of acupuncture as complementary treatment.

Diss. (sammanfattning)--Göteborg : Göteborgs universitet, 2009. / Härtill 4 uppsatser.

The research to date, of transcutaneous electric nerve stimulation on cutaneous blood flow, is equivocal. The purpose of this report is to review the TENS body of knowledge, in particular synthesizing the literature on acupuncture stimulation of cutaneous blood flow with the two fold goal of creating a protocol to increase skin blood flow through the exogenous application of electrical stimulation, as well as creating an engaging engineering challenge for high school anatomy and physiology students. The hypothesis developed was TENS stimulation with electrode placement on specific acupuncture points would influence cutaneous blood flow as measured using laser Doppler flowmetry. The findings of this project did not support the hypothesis of TENS or Interferential electrical stimulation, in combination with acupuncture points or not, influencing skin blood flow. Perhaps this is due to the physiological differences between glabrous and non-glabrous skin and the different electrical resistances of each dermal layer, nerve stimulation, age and gender of subject or some combination thereof. These equivocal findings may also be the result of inconsistencies in testing protocols, such as subject preconditioning or not, subject’s position during administration of stimulation, electrode size and placement to name a few. Ultimately, this report provides a summary of the research to date, as well as outlining how this research could be adapted to supply engaging bio engineering challenges in the classroom including challenges to develop a model for delivering current to muscle; develop a model for skin blood flow management to name a few. / text

published_or_final_version / Public Health / Master / Master of Public Health

Although Tianjiu Therapy in Sanfu Days (三伏天灸) is extensively being used for the treatment of asthma in Mainland China, there is a lack of convincing evidence to support its efficacy to expand its clinical application into asthma treatment. This study incorporated two related studies, the first was a randomized, double-blind, placebo-controlled trial with an aim to evaluate the efficacy of Tianjiu Therapy in Sanfu Days for patients suffering from chronic asthma. The second was a self-control clinical efficacy observation study aiming to compare the efficacy of 2 courses Tianjiu Therapy with 1 course such treatment in order to find the optimal duration of Tianjiu Therapy. In the first study, 323 patients with chronic asthma were randomly assigned to Tianjiu Therapy group (n=165), and placebo group (n=158). There was no significant difference in primary and secondary outcome as compared with placebo group at the end of 3rd treatment and four times follow ups. But sub-analysis of secondary outcome in four times follow ups showed that Tianjiu Therapy significantly reduced the proportion of participants who didn’t need medical treatment during asthma attack increased from 6% to 15% at 1st follow up and 0% to 7% at 3rd follow up (P<0.05). In addition, Tianjiu Therapy was significantly superior to placebo in reducing the percentage of participants who were susceptibly waken up by asthma symptoms from 27% to 14%, and the percentage of participants who had the symptom of running nose and sneezing before onset from 18% to 8% at 2nd follow up ( P<0.05). Improvements also occurred with treatment group, it reduced the proportion of participants who were spontaneous sweating at 3rd follow up (P<0.05). In the second study, totally 102 patients received two courses of Tianjiu Therapy (3 sessions Tianjiu Therapy in a year constituted one course of treatment). After treatment, the number of symptoms which were associated with Chinese Medicine added by 1.38 points (95% CI, 0.25 to 2.51), 2.93±0.41 in the 1 course group and 4.31±0.41 in the 2 courses group (P<0.05). The number of days with asthma-related symptoms increased by 3.05 points (95% CI, 0.37 to 5.73), 1.98±0.96 in 1 course group and 5.03±0.96 in 2 courses group (P<0.05). But both 1 course and 2 courses Tianjiu Therapy as compared with baseline (didn’t receive Tianjiu Therapy at this time point) have a significant improvement in the most outcome measurements. From study 1, it was found that Tianjiu Therapy significantly decreased the need for pharmaceuticals to control asthma and improved the quality of participants’ life after one course Tianjiu Therapy. Study 2 indicated that although 2 courses Tianjiu Therapy was not as effective as 1 course Tianjiu Therapy in the treatment of asthma, both 1 course and 2 courses Tianjiu Therapy provided a significant improvement as compared with baseline. It was still unknown the optimal duration of Tianjiu Therapy, so it was worth to conduct the third course or more Sanfutianjiu Thearpy in future. / published_or_final_version / Chinese Medicine / Master / Master of Philosophy

published_or_final_version / abstract / toc / Medicine / Doctoral / Doctor of Philosophy

This early phase study examined the effects of a series of ten standard-protocol acupuncture treatments over four weeks in 12 healthy, but symptomatic, menopausal women. Two biologic markers, heart rate variability to evaluate effects of acupuncture on the autonomic nervous system as it relates specifically to the heart, and interleukin 6, a proinflammatory cytokine, to capture physiologic impact of acupuncture on the immune-inflammatory response, were collected.Women who exhibited significant menopausal symptoms, as measured by a minimum score of 22 out of a possible 44 points on the Menopause Rating Scale (MRS), underwent 10 sessions of a standard acupuncture point protocol intervention over a four-week period. Symptoms were evaluated for 28 days using the MRS. After the intervention was complete, one final open-ended question was asked of each participant to explore subjective experiences not captured by the validated instrument. Physiologic measurements included a 30-minute continuous measure of electrocardiogram data before and during acupuncture, as well as pre and post acupuncture measures of serum interleukin 6 at the first and final acupuncture treatment. Heart rate variability was assessed using spectral analysis, and interleukin 6 changes were measured using ELISA. Analysis included linear regression, Wilcoxon Signed Ranks test and Spearman correlation coefficients.After the acupuncture intervention, menopausal symptoms improved significantly. Heart rate variability did not show consistent or predictable intra or inter-subject changes, however several components of HRV, interleukin 6 and symptoms were found to have significant correlations.A larger study was deemed feasible. Menopause symptoms improved. Heart rate variability showed no consistent changes or trends. Interleukin 6 decreased in seven subjects, between the first and tenth acupuncture treatment, but did not reach statistical significance.This small project suggests that heart rate variability, when measured at each acupuncture treatment, does not change in a consistent or predictable manner. Rather, acupuncture may provide a modulating influence that depends on the body's functional state at each treatment.

Bakgrund: Akupunktur har använts under tusentals år som behandling vid olika sjukdomstillstånd. I Sverige används metoden främst vid smärttillstånd. Författarna vill undersöka akupunktur som omvårdnadsåtgärd genom att belysa patientupplevelsen. Långvarig smärta är ett vanligt, utbrett och komplext problem som är svårbehandlat. Patienter upplever ofta bristfälliga resultat med behandlingen som traditionell medicin erbjuder. Då sjuksköterskan möter smärta dagligen i sitt arbete och har som främsta uppgift att lindra lidande och bör därför vara öppen för olika behandlingsalternativ. Syfte: Undersöka och beskriva patienters upplevelse av akupunktur som omvårdnadsåtgärd hos patienter med långvarig smärta. Metod: Arbetet är en litteraturstudie som består av 12 artiklar. Fem kvantitativa och sju kvalitativa artiklar har studerats med hjälp av innehållsanalys och tre huvudteman utformades. Patienterna över 14 års ålder och artiklar från hela världen inkluderades. Katie Erikssons omvårdnadsteori har använts som teoretisk referensram.  Resultat: Majoriteten av patienterna uttryckte positiva fysiska, psykiska och själsliga upplevelser efter akupunktur behandling, såsom upplevd smärtlindring, avslappning, välbefinnande och personlig utveckling. Patienterna rapporterade att vårdrelationen och det holistiska förhållningssättet var två betydelsefulla aspekter vid behandling. En minoritet av patienterna upplevde ingen förbättring och biverkningar som trötthet och utmattning. Diskussion: Placebons effekt och vårdrelationens betydelse för resultat har diskuterats, då det är otydligt vad den upplevda fysiska smärtlindringen beror på. Följderna för patienterna vid en bristande vårdrelation till vårdgivaren, är att vårdlidande kan uppstå. Vidare har det holistiska förhållningssättet visat på hälsofrämjande faktorer för människan som helhet. Författarna anser sig ha sett paralleller mellan akupunkturens grundtanke och Katie Erikssons omvårdnadsteori. / Background: Acupuncture has been used for thousands of years as treatment for various illness/diseases. In Sweden the method has been used primarily for treating pain. The authors want to examine acupuncture as a caring treatment by focusing on the patients experience. Longterm pain is common, wide spread and complexed problem which is hard to treat. The patient often experience unsatisfactory results with traditional treatments and medicine offered. As a nurse meets patients in pain on a daily bases in her work and her foremost task is to ease pain and it’s therefore necessary to be open to various treatment alternatives.     Aim: To examine and describe the experience of acupuncture as a nursing treatment in patients suffering from long term pain. Method: This analysis is a literature study consisting of 12 articles. Five of these are quantitative and seven qualitative articles have been studied with content analysis and three main themes emerged. Patients over 14 years old and articles from all the world are included. Katie Erikssons caring theory has been used as a theoretical frame of reference.   Results: The majority of patients has expressed positive physical, psychological and spiritual experiences after acupuncture treatment, such as perceived relief of pain, relaxation, well-being and personal growth. Patients reported that the caring relationship and the holistic approach was two important aspects in caring. A minority of patients did not experience improvement and side-effects such as tiredness and exhaustion. Discussion: The placebo effect and the significance of the caring relationship have been discussed as it is unclear what the experienced relief of pain depends on. The consequences for the patients when the caring relationship is lacking is suffering from the care given. Furthermore the holistic approach showed health improving factors for the human as a whole-being. The authors believe they detect parallels between the ground principles of acupuncture and Katie Erikssons caring theory.