The growing interest and use of complementary and alternative approaches by the general public has created pressure on many health care providers to broaden their traditional scope of practice and integrate complementary and alternative therapies into their repertoire. This study examined the knowledge, attitudes, and level of integration of complementary and alternative approaches by Canadian social workers. Due to limited literature on social work use of complementary and alternative approaches, a broad operational definition of Complementary and Alternative Medicine (CAM) was utilized in the study and a wide range of approaches were listed in the questionnaire. This cross-sectional, descriptive, quantitative research study included 311 Canadian social workers. A self-administered, web-based survey was developed for the study to examine social workers’ level of knowledge, use, as well as attitudes toward complementary and alternative medicine. Based on the findings of the study, Canadian social workers demonstrate general familiarity with CAM, however are less likely to be trained in the approaches. Despite lack of appropriate training, a significant number of social workers integrate complementary and alternative approaches into their practice. Overall, Canadian social workers hold a positive attitude toward complementary and alternative medicine. They express interest in broadening their knowledge in CAM as well as are open to integrating some approaches into their practice. Implications of the findings and further research suggestion are offered at the conclusion of the thesis. There are several implications from this study, most importantly the need for clear guidelines around integration of those approaches into social work practice and inclusion of complementary and alternative methods into social work educational curriculum. There exists number of external and internal threats to validity of the study. The limitations of the study include lack of participation from a number of Canadian provincial social work regulatory bodies. Also the use of web based, English only survey, and may have deterred some social workers. Self-selection process may have attracted those with extreme opinions about the topic. The descriptive nature of the study did not require manipulation of the variables, the analysis was bi-variate, and, therefore could not account for confounding factors.

The growing interest and use of complementary and alternative approaches by the general public has created pressure on many health care providers to broaden their traditional scope of practice and integrate complementary and alternative therapies into their repertoire. This study examined the knowledge, attitudes, and level of integration of complementary and alternative approaches by Canadian social workers. Due to limited literature on social work use of complementary and alternative approaches, a broad operational definition of Complementary and Alternative Medicine (CAM) was utilized in the study and a wide range of approaches were listed in the questionnaire. This cross-sectional, descriptive, quantitative research study included 311 Canadian social workers. A self-administered, web-based survey was developed for the study to examine social workers’ level of knowledge, use, as well as attitudes toward complementary and alternative medicine. Based on the findings of the study, Canadian social workers demonstrate general familiarity with CAM, however are less likely to be trained in the approaches. Despite lack of appropriate training, a significant number of social workers integrate complementary and alternative approaches into their practice. Overall, Canadian social workers hold a positive attitude toward complementary and alternative medicine. They express interest in broadening their knowledge in CAM as well as are open to integrating some approaches into their practice. Implications of the findings and further research suggestion are offered at the conclusion of the thesis. There are several implications from this study, most importantly the need for clear guidelines around integration of those approaches into social work practice and inclusion of complementary and alternative methods into social work educational curriculum. There exists number of external and internal threats to validity of the study. The limitations of the study include lack of participation from a number of Canadian provincial social work regulatory bodies. Also the use of web based, English only survey, and may have deterred some social workers. Self-selection process may have attracted those with extreme opinions about the topic. The descriptive nature of the study did not require manipulation of the variables, the analysis was bi-variate, and, therefore could not account for confounding factors.

De flesta personer i livets slutskede behöver palliativ omvårdnad före döden. Farmakologisk symtomlindring är den vanligaste behandlingen, dock medför detta flera biverkningar.  ntresset av komplementära behandlingar har ökat och både musik och massage kan påverka fysiologiska och psykologiska aspekter. Syftet var att belysa komplementära behandlingars betydelse i den palliativa omvårdnaden, med inriktning på massage och musik. Studien utfördes som en systematisk litteraturstudie. Det framkom att massage och musik kan ha betydelse inom flera användningsområden så som symtomlindring, avslappning,  sinnesstämning och känslor, andlighet och slutligen anhörigas delaktighet och upplevelser. Musiken hade inte alltid effekt och kunde i vissa fall påverka patienter negativt. De komplementära behandlingarna kan ha stor betydelse vid omvårdnad av patienter som kräver palliativ vård. Fysiologiska, psykologiska och andliga aspekter kan påverkas positivt samt hjälpa till att involvera och symtomlindra anhöriga, men patienter kan även påverkas negativt om inte behandlingarna blir individinriktade. Vidare forskning krävs för att kunna implementera komplementära behandlingar i den palliativa omvårdnaden samt bevisa deras betydelse. / Most people at the end of life needpalliative care before death.Pharmacologic relief of symptom is themost common treatment, though thiscauses several side effects. The interestin complementary treatments hasincreased lately and both massage andmusic can affect both physiological andpsychological aspects.The aim of this study was to illustratethe meaning of complementarytreatments in palliative care, with focuson massage and music.The study was performed as asystematic review.It appeared that massage and music mayhave significance in several usage areas,such as symptom relief, relaxation,mood and feelings, spirituality andultimately relatives participation andexperiences. It was also shown thatmusic did not always have any effect,and it may have a negative effect onpatients.The complementary therapies may havea significant meaning in the treatment ofpatients receiving palliative care.Physiological, psychological and spiritual aspects can be affected positively, aswell as help to involve family membersin the treatment of the ill and alleviatetheir symptoms, but unless thetreatments are individualized they mayhave a negative effect on patients.Further research is needed to implementcomplementary treatments in thepalliative care and provide evidence fortheir meaning.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Thesis (D.P.H.)--University of Michigan.

Thesis (D.P.H.)--University of Michigan.

Thesis (Ph. D.)--University of Wisconsin--Madison, 1954. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 392-407).

Made available in DSpace on 2015-04-17T15:02:26Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 841320 bytes, checksum: 14b4982d0634a7dfd09c8237ee2fa80c (MD5) Previous issue date: 2009-12-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The spiritual cures have been used by mankind since the most remote antiquity, in all eras and by all peoples. The spiritual surgeries occur under the claim that there is intervention of Spirits, with medical knowledge, as regard both the patient s biological and energetic organization. According to explanations given by the spiritual physicians the intervention occurs in what is called the spiritual body that, as a result, reorganizes the biological body. This dissertation aimed to investigate the surgeries, their consequences concerning health and the experiences lived by people who were assisted at União Espírita Diogo de Vasconcelos, in João Pessoa, Paraiba. The research analyzed three cases of people, presenting different pathologies, who were subjected to spiritual surgeries whose clinical histories were documented by means of complementary exams. The study involved a set of sequential procedures, having as starting point the project s elaboration, then the ethical processes, thirdly the meetings in order to inform about the subject and, finally, by defining the research s collaborators. After such phases, the interviews were accomplished, the recorded material was, then, transcribed, textualized, transcreated and identified the vital tone for each of the speeches. The thematic oral history was the chosen method for analysis of the recorded interviews with the collaborators and the medium who, once in a medianimic action, rendered voice to the spiritual physician. The results show a noteworthy improvement, originated from the spiritual treatment process in which the collaborators are impelled to change their habits and behavior, and this reflected on a global betterment of their health. / As curas espirituais têm sido utilizadas pela humanidade desde a mais remota antiguidade, em todas as épocas e em todos os povos. As cirurgias espirituais acontecem sob a alegação de que há intervenção de Espíritos, com conhecimentos médicos, na organização biológica e na organização energética do paciente. Segundo explicações dadas pelos médicos espirituais a intervenção ocorre no chamado corpo espiritual que, em conseqüência, reorganiza o corpo biológico. Esta dissertação teve por objetivo investigar, as cirurgias espirituais, suas conseqüências na saúde e as experiências vividas por pessoas atendidas na União Espírita Diogo de Vasconcelos Lisboa, na cidade de João Pessoa, Paraíba. Abordam-se três casos de pessoas com diferentes patologias que foram submetidas às cirurgias espirituais cujas histórias clínicas foram documentadas por exames complementares. O estudo envolveu um conjunto de procedimentos seqüenciais, iniciando-se pela elaboração do projeto, os processos éticos, continuou com as reuniões objetivando fornecer informações sobre o assunto e com a definição dos colaboradores da pesquisa. Após estas etapas, foram realizadas as entrevistas, o material gravado foi então transcrito, textualizado, transcriado e identificado o tom vital para cada uma das falas. A história oral temática foi o método escolhido para a análise das entrevistas gravadas com os colaboradores e com o médium, que em transe deu voz ao médico espiritual. Os resultados mostram uma melhora considerável, decorrente do processo de tratamento espiritual, onde os colaboradores são incitados a uma transformação em seus hábitos e comportamentos, o que se refletiu em uma melhora global de suas saúdes.

Submitted by Maria Suzana Diniz (msuzanad@hotmail.com) on 2015-11-24T13:18:42Z No. of bitstreams: 1 arquivototal.pdf: 3017534 bytes, checksum: e220f49ed8be20e1429d637337dee4e2 (MD5) / Made available in DSpace on 2015-11-24T13:18:42Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 3017534 bytes, checksum: e220f49ed8be20e1429d637337dee4e2 (MD5) Previous issue date: 2015-08-31 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Socioeconomic and cultural changes of society engineered in recent decades a culture of individualism and exclusion. These changes mainly affect women, causing them to helplessness, low self-esteem and loneliness. Such feelings are often embodied in the form of pain or disease. As a consequence of these social aggressions, women come seeking therapeutic resources that can respond to their physical, psychological and spiritual needs. Integrative and complementary practices bring this proposal for integral care and are being increasingly sought after by women. In this sense, the aim in this work was: analyzing stories of women who sought integrative and complementary practices. The study followed the precepts of Resolution 466/12, being approved by the Research Ethics Committee under CAAE: 39806114.0.0000.5188. This research was conducted according to a benchmark according to the anthropological and ethnographic method. For collection and production of the empirical material, there was used the technique of Oral History of life with 8 women users of the Center for Integrative and Complementary Practices, in the municipality of João Pessoa/PB. The analysis and interpretation of the material were made on the basis of units of meaning (themes) more evident and constants in the narratives and the vital tone of each story. Thus, the following categories have been developed: a) sources and manifestations of female suffering, b) therapeutic itineraries and rituals of care for women and c) reconstruction of identity and otherness: paths for the female protagonism. In the stories reported, it was observed that women have sought care, because they reported sadness, low self-esteem, loneliness, fatigue, pain, helplessness, anxiety and insecurity. These complaints were associated with the sufferings experienced in respect of affective loss, workload of care, migration, interruption of life projects, and family disputes. The paths in search for care were influenced mainly by the socio-cultural context of each contributor, so that many of them resorted primarily to biomedical services. While not all employees had been through these services before resorting to integrative and complementary practices, they showed differences between the approach of allopathic medicine and the PICs, especially with regard to the applied therapy, to the professional-user relationship and the belief in the therapeutic efficacy. Care through integrative and complementary practices provided to these women greater autonomy; favored the construction of bounds; the rescue of self-esteem; promoted the empowerment and took them to reassure their lives and their stories. / As transformações socioeconômicas e culturais da sociedade engendraram, nas últimas décadas, uma cultura de individualismo e exclusão. Essas mudanças atingem, principalmente, as mulheres ao lhes provocarem desamparo, baixa autoestima e solidão. Tais sentimentos são revelados, muitas vezes, sob a forma de dor ou doença. Como consequência dessas agressões sociais, as mulheres vêm buscando recursos terapêuticos que possam dar uma resposta as suas necessidades físicas, psicológicas e espirituais. As práticas integrativas e complementares trazem essa proposta de cuidado integral e vêm sendo cada vez mais procuradas pelo público feminino. Nesse sentindo, esse trabalho teve como objetivo principal: analisar as histórias de mulheres que buscaram práticas integrativas e complementares, ressaltando os aspectos que foram significativos para a compreensão e participação delas no processo de cuidado. O estudo obedeceu os preceitos da Resolução 466/12, sendo aprovado pelo Comitê de Ética em Pesquisa sob CAA:39806114.0.0000.5188. Esta pesquisa foi conduzida segundo um referencial antropológico e de acordo com o método etnográfico. Para a produção de material empírico, utilizou-se a técnica da História Oral temática com 8 mulheres, usuárias do Centro de Práticas Integrativas e Complementares, no município de João Pessoa/PB. A análise e a interpretação do material foram feitas com base nas unidades de significado (temas) mais evidentes e constantes nas narrativas e no tom vital de cada história. Assim, foram elaboradas as seguintes categorias: a) Fontes e manifestações do sofrimento feminino, b) Itinerários terapêuticos e rituais de cuidado das mulheres e c) A reconstrução da identidade e produção de alteridade: caminhos para o protagonismo feminino. Nas histórias relatadas, observou-se que as mulheres buscaram cuidados pois referiam tristeza, baixa autoestima, solidão, cansaço, dor, desamparo, ansiedade e insegurança. Essas queixas estavam associadas aos sofrimentos vivenciados relativamente às perdas afetivas, sobrecarga de cuidados, migração, interrupção de projetos de vida, sobrecarga laboral e conflitos familiares. Os caminhos traçados na procura de cuidados foram influenciados, principalmente, pelo contexto sociocultural de cada colaboradora, de modo que muitas delas recorreram, primeiramente, aos serviços biomédicos. Embora nem todas as colaboradoras tivessem passado por esses serviços antes de recorrerem às práticas integrativas e complementares, elas evidenciaram divergências entre a abordagem da medicina alopática e as PICs, principalmente no que se refere à terapêutica empregada, à relação profissional-usuária e à crença na eficácia terapêutica. O cuidado por meio das práticas integrativas e complementares propiciaram, a essas mulheres, uma maior autonomia; favoreceram a construção de vínculos; o resgate da autoestima; promoveram o emponderamento e as levaram a ressignificarem suas vidas e suas histórias.

A música erudita selecionada a partir de um repertório pré-determinado foi investigada neste estudo como terapia complementar no cuidado de mulheres com fibromialgia. Quarenta mulheres foram submetidas a duas sessões musicais, observando-se o intervalo de uma semana entre elas. A dor, bem como os parâmetros fisiológicos indicativos de relaxamento: freqüência cardíaca, freqüência respiratória, eletromiografia dos músculos trapézio e frontal, pressão arterial sistólica e diastólica e temperatura cutânea; complementados pela percepção das pacientes sobre a experiência musical foram avaliados antes e após cada sessão musical para verificação das alterações produzidas em sua decorrência. As pesquisadas apresentaram uma preferência musical que tendeu às músicas orquestrais em relação às de câmara e solo. Dentre os sinais fisiológicos observados, a freqüência respiratória, a eletromiografia, a temperatura cutânea e a pressão arterial sistólica apresentaram alterações estatisticamente significantes nas duas sessões. A pressão arterial diastólica apresentou alterações significativas apenas na segunda sessão. A dor avaliada pela Escala Analógica Visual apresentou redução significativa pós-sessão musical para a maioria das pacientes, ratificada pelo Questionário McGill em todas as dimensões da dor que este instrumento se propõe a analisar (sensitiva-discriminativa, afetiva-motivacional, cognitiva-avaliativa). A percepção da experiência musical relatada pelas pesquisadas evidenciou o potencial desta intervenção de Enfermagem (95% referiram que gostaram muito desta proposta terapêutica), pois além do alívio da dor, diversos aspectos subjetivos emergiram, tais como alterações nos estados de ânimo, facilitação da introspecção, visualização de imagens e sensações estéticas, dentre outros, demonstrando que sua utilização e compreensão merecem ser ampliados. / The selected erudite music starting from a predetermined repertory was investigated in this study as alternative therapy in the women care with fibromyalgia. Forty women were submitted for two musical sessions, we observed the interval of one week between the sessions. The pain as well as the physiological parameteres indicative of slackness: heart rate, respiratory rate, trapezius and frontalis muscle, systolic and diastolic blood pressure and cutaneous temperature and all of this parameters were completed by patients perception about musical experience and were appraised before and after each musical session for verification of produce alterations in their results. The enquired women have presented a musical preference that reached to the orchestral songs with reference to the camara music and solo. Among observed physiological signs, the respiratory rate, the electromyographic, the cutaneous temperature and the sistolic blood pressure presented alterations statistically significative on two sessions. The diastolic blood pressure presented significative alterations in the second only. The pain valued by Visual Analogic Scale presented significative reduction after musical session for most of patients, ratified by McGill Pain Questionnaire in all pain extensions that the instrument proposes to analyse (sensitive, affective, and cognitive). The perception of musical experience related by investigated women have evidenced the powerful from this Nursing intevention (95% from those women refered that they have liked very much this therapeutic approach) besides pain relief, many subjective aspects have emerged such as alterations of mood state, facility of introspection, visualization of images and esthetics sensations, among others aspects have demonstrated that their utilization and comprehension to must be amplified.