Introduction Traditional Chinese Medicine (TCM) is an ancient medical practice, performed since approximately 2000 B.C. Qigong constitutes one of five main pillars in TCM and is a method of meditation, exercise as well as self-medication. Basic tenets of TCM is the body existing in balance with Qi (life-energy) and its emphasis on holistic dynamic processes over material structure. A lot of research has been done on the positive health effects of Qigong, although it is unclear whether the evidence situation is judged to be sufficient to prove Qigong effective. Objective To investigate the arguments for and against acceptance of Qigong in Swedish Healthcare Methods This is a qualitative study that followed the hermeneutical method, as well as the normative ethical theory, of study-design and data analysis. Searches of grey literature and electronic databases (Pubmed, Cochrane) were performed, serving the purpose to collect different perspectives. The selection of sources was based on relevance to the aim. Data emerged was analysed in order to investigate the most relevant ethical arguments for and against integration of Qigong in the Swedish healthcare. Results Main arguments against acceptance of Qigong were: “Traditional Chinese Medicine’s underlying philosophy stand in opposition to scientific worldview”, “Lack of strong evidence”, “Complementary and Alternative Medicine lead people away from Evidence Based Medicine”, and “Economical incentive and bias in Complementary and Alternative Medicine and Qigong”.Main arguments for acceptance of Qigong were: “Extensive proven experience”, “Further acceptance and integration may increase patient safety and promote research”, and “Qigong is risk-free and highly available at low cost” Conclusion A strong argument against acceptance of Qigong is “lack of strong evidence”. Strong arguments for acceptance of Qigong are “further acceptance and integration may promote research” and “Qigong is risk-free and highly available at low cost”. Thus, strong arguments are found for, as well as against, integration of Qigong in Swedish established healthcare. The balance between these strong arguments, however, will have to be discussed further, as there is no obvious right answer.

Bakgrund Artros, som är en degenerativ ledsjukdom, är en av de vanligaste sjukdomarna i Sverige. Sjukdomen är vanligare hos äldre än hos yngre och det är fler kvinnor än män som utvecklar artros. Normalt sker en nybildning av brosk kontinuerligt i alla kroppens leder, men vid artros bryts brosket ner utan att någon nybildning sker. Artros kan förekomma i alla kroppens leder, men det är framför allt knä, höft och fingerleder som drabbas. Smärta är oftast det första symtomet på sjukdomen. Smärtan behandlas i första hand med paracetamol eller non steroid inflammatory drugs (NSAID). En annan typ av behandling som personer med artros använder sig av är Komplementär och Alternativ Medicin (KAM). KAM är per definition av National Center for Complementary and Alternative Medicine (NCCAM) en grupp av produkter, metoder och inrättningar som utövar dessa metoder som normalt inte inräknas i den traditionella vården. Dessa metoder och produkter indelas av NCCAM i större grupper. De fyra huvudgrupperna är naturliga produkter, mind-body, manipulation av vävnader och övriga KAM. Det har visats att personer med artros väljer att använda sig av KAM för att lindra sin smärta då de inte fått tillräcklig smärtlindring genom den traditionella vården. Vid artros är de vanligaste använda KAM metoderna kiropraktik, naturliga produkter (kosttillskott), massage och magnetterapi. Syfte Var att beskriva KAM metoder som används vid artros och i vilken utsträckning de ger smärtlindrande effekt. Metod Denna litteraturstudie syftade till att beskriva den forskning som gjorts på om olika KAM metoder hade smärtlindrande effekt vid artros. Sökord som användes vid databassökningen var osteoarthritis, pain, complementary therapies och alternative therapy. Förutom dessa användes mer specifika sökord för de olika KAM metoder som personer med artros använder sig av, till exempel massage. I studien har 17 artiklar inkluderats. Resultat I gruppen naturliga produkter var det Phytalgic®, purple passionfruit-peel, gurkmeja och ingefära som uppvisade smärtlindring. Mind-body metoder som studerades var tai chi och akupunktur. Smärtreducering erhölls av tai chi och effekten kvarstod i minst12 veckor. Två av tre akupunkturstudier visade att smärtlindring erhölls, men effekten kvarstod olika länge. Massage och kiropraktik studerades i gruppen manipulation av vävnader och även dessa metoder gav smärtlindring under varierande tid. Övriga KAM som studerades var magnetarmband, olika former av elektrisk stimulation och balneoterapi. Alla metoderna visade någon form av smärtreduktion, men magnetarmband visade enbart reduktion på sensorisk smärta. Slutsats Alla undersökta KAM metoder i samband med artros visade smärtreducering i varierande grad och effekten kvarstod under olika lång tid. Föreliggande studies resultat kan inte direkt användas för att rekommendera olika KAM-behandlingar för personer med artros. Mer forskning kring metoderna behövs för att utifrån vetenskap och beprövad grund få tillräckligt evidens för att integrera KAM med den traditionella vården. Då skulle personer med artros kunna ges ytterligare möjligheter till smärtkontroll. Nyckelord: Artros, smärta, komplementär och alternativ medicin och KAM

The thesis is comprised of three separate studies that each relate to one of the aforementioned therapy types: complementary, alternative, and integrative medicine (CAIM), natural health products (NHPs), and medical cannabis. Parallels can be drawn across these therapy types in general including patient preference and prevalence of use, quality of patient health information, and safety and effectiveness concerns. Knowledge of these parallels both informed the development of these three studies and emerged across findings. Chapter 1 provides a comprehensive introduction to these parallels in the context of CAIM, NHPs, and medical cannabis. Chapter 2 comprises a cross-sectional survey determining NHP use disclosure to primary care physicians among patients attending a Canadian naturopathic clinic. Chapter 3 comprises a qualitative interview study identifying attitudes towards medical cannabis among family physicians practicing in Ontario, Canada. Chapter 4 comprises a sentiment analysis of Twitter data to understand how CAIM is mentioned during the COVID-19 pandemic. Lastly, chapter 5 serves as the conclusion of this thesis, and summarizes the most important findings, addresses study strengths and limitations, and discusses future directions from this work. / Thesis / Doctor of Philosophy (PhD)

No description available.

Despite PPD’s global extent, scarce research that addresses culturally competent alternative interventions exists. The purposes of this thesis were to 1) analyze the existing literature on non-pharmacological treatment of PPD in the US and across selected cultures; 2) determine the effectiveness of cross-cultural non-pharmaceutical therapy; and 3) examine and suggest ways health care providers can integrate non-pharmacologic interventions into PPD treatment in the US. The systematic electronic search comprised the databases Cumulative Index to Nursing and Allied Health Literature, Medline, PsycINFO and SAGE Research Methods. Searches were limited to English language, peer reviewed, and research articles between 2007 and 2017. A second search was performed through global Healthcare Organizations websites. The World Bank’s country classifications by income level were adopted to present the findings. This review found that passing el calor to the newborn, yoga; and cognitive-behavioral, interpersonal, family, and bright light therapies are successful interventions. Further, seclusion periods were identified as adequate interventions only when women voluntarily adopt the practice and have family support, with less social restrictions. While other non-pharmacological treatments’ effectiveness was not ascertained, this thesis encourages healthcare professionals to integrate cultural traditions congruent with clients’ preferences. Recommended nursing interventions and suggestions for improvement of current practice are also discussed.

Bakgrund  Depression och ångest är två vanliga tillstånd som kan ha stor påverkan på individens livskvalitet. Idag erbjuds i första hand antidepressiva läkemedel och samtalsterapi, trots att det finns en relativt stor efterfrågan på komplementära och alternativa behandlingar hos patienterna. Sjuksköterskor har visat sig vara öppna för användningen av komplementär och alternativ medicin, men många saknar kunskap om hur det kan implementeras i omvårdnaden och behandlingen. Denna litteraturöversikt utforskar hur komplementär och alternativ medicin kan vara ett gynnsamt komplement till den konventionella vården. Syfte Syftet var att beskriva effekten av komplementär och alternativ medicin i behandling och omvårdnad av depression och ångest. Metod  Metoden som användes var en icke-systematisk litteraturöversikt. De 20 originalartiklar som inkluderades i litteraturöversiktens resultat hittades via databasen PubMed samt via manuell sökning. Artiklarna granskades i fulltext enligt Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering samt kvalitet avseende studier med kvantitativ och kvalitativ metodansats, modifierad utifrån Berg (1999) och Willman (2016). Slutligen användes en integrerad dataanalys för att analysera och sammanställa resultatet.  Resultat Denna studies resultat redovisades i två huvudkategorier med fyra subkategorier och visade på att komplementär och alternativ medicin har positiva effekter på den psykiska hälsan hos personer som lider av depression och ångest. Slutsats Litteraturöversikten studerade akupunktur, mindfulness meditation, yoga och örtterapi som visade sig ha god effekt på depression och ångest. Personerna som deltog i inkluderade studier skattade sig ha ett förbättrat mående efter interventioner och upplevde dessutom en ökad livskvalitet. Få eller inga biverkningar rapporterades av deltagarna och således anses komplementära och alternativa metoder i hög grad vara användbara både som komplement till en konventionell behandling och som behandling på egen hand. / Background Depression and anxiety are two common conditions that have a big impact on the quality of life. Today, antidepressants and psychotherapy are primarily offered even though there is a relatively large request for complementary and alternative options in treatment among patients. Nurses have proven to be open to the use of complementary and alternative medicine, but many lack knowledge of how it can be implemented in nursing and treatment. This review analyzes how complementary and alternative medicine can be used as a complement to conventional care. Aim The aim was to describe the effect of complementary and alternative medicine in the care and treatment of depression and anxiety. Method The method used was a non-systematic review. The 20 original articles that were included in the study were found via PubMed database as well as via a manual search. The articles were reviewed in full text according to Sophiahemmet University's assessment document for scientific classification and quality regarding studies with a quantitative and qualitative method approach, modified based on Berg (1999) and Willman (2016). Lastly, an integrated data analysis was used to analyze and compile the results. Results The result of this study was presented in two categories with four subcategories, and showed that complementary and alternative medicine have positive effects on the mental health of people suffering from depression and anxiety. Conclusions The literature review studied acupuncture, mindfulness meditation, yoga and herbal medicine which were found to have good effects on depression and anxiety. The people who participated in the studies estimated that they felt better after interventions and also experienced an increased quality of life. In addition, few or no side effects were experienced, which makes the CAM methods highly useful within the treatment of depression and anxiety; both as a complement to conventional care and as treatment on their own.

No description available.

BACKGROUND:Patients receiving complementary and alternative medicine (CAM) therapies often report shifts in well-being that go beyond resolution of the original presenting symptoms. We undertook a research program to develop and evaluate a patient-centered outcome measure to assess the multidimensional impacts of CAM therapies, utilizing a novel mixed methods approach that relied upon techniques from the fields of anthropology and psychometrics. This tool would have broad applicability, both for CAM practitioners to measure shifts in patients' states following treatments, and conventional clinical trial researchers needing validated outcome measures. The US Food and Drug Administration has highlighted the importance of valid and reliable measurement of patient-reported outcomes in the evaluation of conventional medical products. Here we describe Phase I of our research program, the iterative process of content identification, item development and refinement, and response format selection. Cognitive interviews and psychometric evaluation are reported separately.METHODS:From a database of patient interviews (n = 177) from six diverse CAM studies, 150 interviews were identified for secondary analysis in which individuals spontaneously discussed unexpected changes associated with CAM. Using ATLAS.ti, we identified common themes and language to inform questionnaire item content and wording. Respondents' language was often richly textured, but item development required a stripping down of language to extract essential meaning and minimize potential comprehension barriers across populations. Through an evocative card sort interview process, we identified those items most widely applicable and covering standard psychometric domains. We developed, pilot-tested, and refined the format, yielding a questionnaire for cognitive interviews and psychometric evaluation.RESULTS:The resulting questionnaire contained 18 items, in visual analog scale format, in which each line was anchored by the positive and negative extremes relevant to the experiential domain. Because of frequent informant allusions to response set shifts from before to after CAM therapies, we chose a retrospective pretest format. Items cover physical, emotional, cognitive, social, spiritual, and whole person domains.CONCLUSIONS:This paper reports the success of a novel approach to the development of outcome instruments, in which items are extracted from patients' words instead of being distilled from pre-existing theory. The resulting instrument, focused on measuring shifts in patients' perceptions of health and well-being along pre-specified axes, is undergoing continued testing, and is available for use by cooperating investigators.

Background: One in five households has a child with special health care needs (SHCN). Such parents report poorer mental health, greater depressive symptoms, and more restrictions in instrumental activities of daily living (IADL). The quality of mental and physical health of all family members' continuingly declines. Objectives: To evaluate the effects of the current ITK Healing Retreat Week program on familial well-being via introduction of CAM methods through assessment of 1) mood based on affect 2) self-efficacy 3) changes in coping skills 4) growth over time in parents/caregivers who have children with SHCN. Methods: A secondary analysis of data from sixteen parents/caregivers who participated in the ITK Healing Retreat Week July 13-19, 2014. Scores from Positive and Negative Affect Schedule (PANAS) with Serenity subscale, Post Traumatic Growth Inventory (PTGI), and Self-Efficacy Scale (SES) were analyzed using SPSS. Content analysis was performed on open-ended questions from post, three and six-month post retreat questionnaires. Results: Before to immediately after the retreat week there was a statistically significant decrease in negative emotions and increase in positive mood state, ability to feel calm/at peace, relate to others, see new possibilities, and confidence in ability to perform certain care needs (<.001). From post to three-month post retreat the families' confidence in ability to perform certain care needs did not change (<.001), but declined from three to six month post retreat in a statistically significant manner (.044). Content analysis indicated that the biggest benefit for the families was being in a supportive community and having an increase in positive emotional states. At six-months post retreat an increase in receptivity was additionally reported. Conclusion: The ITK Healing Retreat Week program positively impacted families who have children with SHCN in multiple positive ways: increased mood, more confidence, ability to relate better to others and ability to see new possibilities. In effort to make this program generalizable or even replicable, further research needs to be done on the mechanism of change, the structure that creates this change, and how to make such a change sustainable by investigating a new retreat format and alternative research tools, questions, and scales.

Ankylosing Spondylitis (AS) and Chronic Pain Syndrome (CPS) can be treated in many different ways. I found a problem in the balance of healing modalities surrounding diagnosis and care of illness and disease. This struggle is not singular to AS and CPS, but universal to physical and mental concerns. Some effective treatments and therapies are not recognized as such or are just beginning to become so. The scope of my work reflects on the course of my life. It was heavily influenced by the way my medical care was managed from an early age and how it evolved over the years. Through my educational program, I examined the necessity to bridge the gap between treatment paradigms and to expand on a broader, more inclusive, healing rubric. This rubric includes a broader emphasis on skill-based and complementary and alternative medicines. The viability to incorporate holistic health therapies earlier in life is explored through my use of the Scholarly Personal Narrative (SPN) qualitative research method. I chose this methodology because scientific fact could be argued either way for one therapeutic approach over another. By incorporating lived experience through SPN the union and cohesion necessary in all healing modalities, and their positive aspects, can be seen. The truth becomes self-evident. The results of this examination showed awareness earlier in life toward alternative and holistic treatments being paramount. Parents and educators lack information concerning modern therapeutic approaches. It also showed each situation will vary, but choice in treatment for ailments and illness of all kinds is not only viable, but highly recommended and researched. Access issues such as health insurance remain obstacles with some treatments and therapies, while others are a matter of cost prohibition, such as nutrition therapies. The implications of my work indicate a need for earlier incorporation of holistic healing programs and skill based therapies alongside perpetuated medical models in early childhood development and education. In conclusion, awareness towards medical concerns and how we as a society treat them can be improved upon by systemically incorporating less harmful therapies earlier in life. Fostering relations between medical providers, care providers and educators for students' wellbeing should be the foreground of any educational policy. Educators and parents alike should be made aware of and take advantage of effective skill-based treatments before a physical or mental condition surfaces or medication only approaches are authoritatively recommended. Integrating programs that build strong mental resilience and focus on youth development and education can reduce the necessity for more invasive treatments or medications should an ailment or illness develop.