In this thesis I examine the debate surrounding Therapeutic Touch, a controversial energetic healing modality being practiced by registered nurses in biomedical institutions across North America. The debate surrounding the therapy takes place within medical journals, popular media articles, and on the internet. Within the debate, definitions of illness etiology, appropriate treatment, patient management, and alternative therapy use are contested by Therapeutic Touch proponents and critics. Through discursive analysis, interviews with local participants in the debate, and participant observation within the TT community, I present an analysis of the issues being contested and of the discursive strategies used by proponents and critics within the debate. The debate is contextualized in two ways: first, as an instance of medical heresy, in which an alternative healing group arises within the orthodox medical community and struggles to maintain itself within biomedical discourse and institutions; second, I contextualize the debate as an example of the wider trend towards integrative medicine in North America. Integrative medicine sees alternative therapies being increasingly used within health care delivery systems, either by alternative practitioners, or by biomedical practitioners who have co-opted alternative techniques. I argue that Therapeutic Touch proponents have utilized several discursive strategies in presenting and arguing for their alternative healing model. These strategies surround the issues of professional legitimacy, scientific validity, and TT’s perception as religious or spiritual. Therapeutic Touch proponents manage their discourse by conforming it to orthodox biomedical discourse and by pursuing a strategy of professionalization. Through this management process, they have been able to maintain a marginal presence within biomedicine. / Thesis / Master of Arts (MA)

Submitted by Angela Maria de Oliveira (amolivei@uepg.br) on 2017-08-16T18:53:41Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Lima, Cinthia.pdf: 1054815 bytes, checksum: 5c7babe47287ad0cea477f3943ddbe49 (MD5) / Made available in DSpace on 2017-08-16T18:53:42Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Lima, Cinthia.pdf: 1054815 bytes, checksum: 5c7babe47287ad0cea477f3943ddbe49 (MD5) Previous issue date: 2017-02-20 / Os temas saúde, doença e formas de cura se constituem em objetos de interesse na historiografia atual, muito mais que apenas observações sobre como uma determinada população ou comunidade local. A abertura para tópicos que abordam temas ligados à saúde possibilitou o entendimento do poder e a força dos conhecimentos tradicionais e da cultura de uma comunidade no trato das mais diversas formas de doença. A OMS (Organização Mundial de Saúde) desde 1980 preconiza em todo o mundo a iimplementação de formas de medicina integrativa (acupuntura, homeopatia e fitoterapia) como forma de humanização no tratamento público, através do respeito das raízes culturais das distintas sociedades. Esta pesquisa teve como objeto geral a avaliação e o impacto de um projeto de medicina integrativa em que a fitoterapia foi disponibilizada na saúde pública através dos SUS (Sistema Único de Saúde) à população do município de Telêmaco Borba- PR no período de 1993 a 2008 através da Fabrimed (Fabricadora Municipal de Medicamentos), já extinta há quase uma década. A pesquisa concentra-se na análise histórica do funcionamento do projeto, a importância das agrovilas na estruturação e no funcionamento, desde a implantação, assim como se descreve a importância para a comunidade e a constituição de sua identidade. Faz-se uma análise qualitativa e quantitativa dos prontuários médicos do período de funcionamento do projeto e se observam as vivências percepções e significados que muitas vezes no contexto geral ficam silenciados, mas que acabam demonstrando a capacidade da medicina integrativa em intervir no sistema de saúde pública. / The themes health, disease and forms of healing are objects of interest in the current historiography, much more than just observations on how a particular population or community react in the search for the most diverse forms of healing intimately linked to the identity of a society. The opening to the topics that address health issues has made it possible to understand the power and strength of traditional knowledge and the culture of a community in dealing with the most diverse forms of disease. The World Health Organization (WHO) since 1980 advocates worldwide implementation of forms of integrative medicine (acupuncture, homeopathy and phytotherapy) as a way of humanizing public treatment by respecting the cultural roots of different societies. This research had as general object the evaluation and the impact of an integrative medicine project in which the phytotherapy was made available in the public health through the Unified Health System (SUS in Portuguese) to the population of the city of Telêmaco Borba-PR during the period of 1993 to 2008 through Fabrimed (Municipal Drug Manufacturers), already extinct almost a decade ago. The research focuses on the historical analysis of the operation of the project, the importance of rural villages in the structuring and operation, since the implantation, as well as the importance for the community and the constitution of its identity. It carries out a qualitative and quantitative analysis of the medical records of the project's period of operation and remarks perceptions and meanings that are often silenced in the general context, but which show the capacity of integrative medicine to intervene in the public health system.

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

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

Includes bibliographical references and index.

Includes bibliographical references and index.

Thesis (Ph.D.)--University of Waikato, 2006. / Includes bibliographical references (leaves 254-273) Also available via the World Wide Web.

BACKGROUND: Disparities in access to quality chronic pain treatment options disproportionately affect minorities. Although there is increasing evidence about the effectiveness of complementary and integrative medicine (CIM) to help in the treatment of pain, little is known about how low income minorities would benefit from having greater access to CIM. The Integrative Medical Group Visit (IMGV) model incorporates CIM in a medical group visit setting with the goal of increasing access to CIM. OBJECTIVE: The aims of this pilot study were to test 1) the feasibility of a Spanish language IMGV and 2) its effectiveness to reduce pain and improve function in Spanish speakers with chronic pain. METHODS: The study setting is the Family Medicine Clinic at Boston Medical Center. Adult Spanish speakers with chronic pain for at least 12 weeks were included; those pregnant, with psychosis, suicidal ideation or active substance abuse disorder were excluded. The intervention consisted of weekly, two-hour sessions for a total of 9 weeks. Main outcomes were pain level, pain interference, and physical and emotional function measured by the PROMIS 29 pre- and post-intervention, depression and stress, measured by PHQ-8 and PSS-10, respectively. Focus group participants discussed the feasibility of the intervention. Analyses involved t-tests to examine our outcome data, and qualitative thematic analysis for focus group data. RESULTS: This open study recruited 11 subjects, 10 women, average age of 51.9 years; 50% of participants attended more than four sessions. The outcomes showed a trend toward reduced depression, pain, fatigue, and anxiety. Qualitative themes of reduced pain, increased knowledge for healthier living, and improved access to pain treatment using an appropriately adapted intervention were found. CONCLUSIONS: It was feasible to implement the Latino IMGV model in the outpatient setting at BMC. Trends in reduction of pain and depression, as well as increased knowledge for healthier living and better access to CIM modalities were found. Future powered studies are needed to further implement this model.

Made available in DSpace on 2016-06-07T17:12:22Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-08-28. Added 1 bitstream(s) on 2016-06-07T17:17:01Z : No. of bitstreams: 1 000858853_20170228.pdf: 362685 bytes, checksum: e5a774922644840098fdbaf6347c49c5 (MD5) Bitstreams deleted on 2017-03-03T11:01:35Z: 000858853_20170228.pdf,. Added 1 bitstream(s) on 2017-03-03T11:02:43Z : No. of bitstreams: 1 000858853.pdf: 1043060 bytes, checksum: a9243ab60200ad48a08b2f5635374fb4 (MD5) / Embora a biomedicina seja indispensável à vida contemporânea, a crescente procura por Práticas Integrativas e Complementares (PIC) denuncia as fragilidades deste modelo em responder integralmente às diversas demandas de saúde da população. Apoiando-se na necessidade de efetivação do principio da integralidade no SUS e atendendo as diretrizes da OMS para implantação das medicinas tradicionais, alternativas e complementares nos sistemas nacionais de saúde, o governo brasileiro lançou em 2006 a Política Nacional de Práticas Integrativas e Complementares no SUS (PNPIC). O presente trabalho se propõe a caracterizar as produções científicas acerca das PIC no SUS antes e após a implantação da PNPIC, destacando as principais fragilidades, potencialidades e perspectivas apontadas pelas pesquisas em relação a este processo. Utiliza-se o método de revisão integrativa, considerando o período temporal entre 2000 e 2013. No período entre Agosto e Novembro de 2013, foram consultadas as bases de dados da Medline, Lilacs, Scielo e Scopus e incluídos 35 artigos, que atenderam os seguintes critérios: trabalhos completos publicados em periódicos, relevantes ao tema e escritos em português, espanhol e/ou inglês. Os dados foram analisados por meio de abordagem quali-quantitativa, apresentados em tabelas e em categorias temáticas e discutidos à luz da integralidade em saúde. Observou-se que a produção sobre PIC no SUS começa a crescer em 2007, que a maioria dos artigos são brasileiros e se concentram na base de dados da Lilacs. A região sudeste concentra o maior volume de artigos sobre o tema e, dentre as universidades, a Universidade Federal de Santa Catarina (UFSC). A maioria dos autores possui graduação na área da saúde e título de doutor. Em relação à abordagem metodológica, os estudos qualitativos possuem maior representatividade e em relação ao desenho de pesquisa destacam-se os estudos descritivos. Os sujeitos... / While biomedicine is indispensable to contemporary life, the growing demand for Integrative and Complementary Practices (ICP) denounces the weaknesses of this model to fully meet the diverse health needs of the population. Relying on the need for realization of the principle of comprehensiveness in SUS and meeting the WHO guidelines for deployment of traditional, complementary and alternative medicines in national health systems, the brazilian government launched in 2006 the National Policy on Integrative and Complementary Practices in the Unified Health System (UHS) (NPICP). This study aims to characterize the scientific production about the ICP in the UHS before and after the implementation of NPICP, highlighting the main weaknesses, potential and prospects indicated by the research regarding this process. We use the integrative review method, considering the time period between 2000 and 2013. Between August and November 2013, Medline databases were consulted, Lilacs, SciELO and Scopus and included 35 articles that met the following criteria: full papers published in journals relevant to the topic and written in Portuguese, Spanish and / or English. Data were analyzed using qualitative and quantitative approach, presented in tables and themes and discussed based on health comprehensiveness. It was observed that the production of ICP in UHS begins to grow in 2007, that most articles are Brazilian and are concentrated in the Lilacs database. The southeast region concentrates the largest number of articles on the subject and, among universities, the Federal University of Santa Catarina (FUSC) holds the biggest percentage of articles. Most authors hold a degree in health and doctor's degrees. Regarding the methodological approach, qualitative studies have greater representation and in relation to research design stand out from the descriptive studies. The most studied subjects were UHS users and professionals. It is observed that most of ...

Orientador: Nelson Filice de Barros / Tese (doutorado) - Univversidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-16T09:11:31Z (GMT). No. of bitstreams: 1 Siegel_Pamela_D.pdf: 6725081 bytes, checksum: 927fab05ed1e53b418d141d74f04658e (MD5) Previous issue date: 2010 / Resumo: O yoga é uma prática psico-física sistematizada por Patanjali, sábio hindu, que viveu no século II a.C.. Em 1893 o yoga chega às Américas com a vinda do Swami Vivekananda aos Estados Unidos e no Brasil, nos anos de 1940, Caio Miranda começa a ensinar a prática no Rio de Janeiro. Portanto, o yoga é praticado há sessenta anos no país e há, ainda, poucas pesquisas sobre o mesmo no campo da saúde coletiva, razão esta que justificou o nosso interesse. Além do que em 2002 a Organização Mundial de Saúde incluiu o yoga no conjunto das práticas mente-corpo e estimulou seus países membros a pesquisar e adotar esta prática nos seus sistemas de saúde pública. O objetivo desse trabalho é analisar as percepções dos líderes das principais tradições do yoga em São Paulo sobre a possibilidade da inserção dessa prática como política pública no Sistema Único de Saúde (SUS) e seus processos de formação e profissionalização. Foram identificadas 21 tradições principais, das quais 18 líderes foram entrevistados e três não o foram por diferentes razões. Foram realizadas entrevistas em profundidade em janeiro/fevereiro de 2006; em setembro/outubro de 2008 e abril de 2009, com roteiro construído em três secções: a) Identificação pessoal; b) A prática do yoga e c) Yoga e saúde. As entrevistas tiveram duração média de 1,5h e aconteceram em diferentes locais da cidade de São Paulo, de acordo com os apontamentos dos entrevistados. Todas foram gravadas, transcritas e analisadas com base na tradição da análise temática da pesquisa qualitativa. A maioria dos instrutores tem curso superior, formação em yoga adquirida no Brasil e em países estrangeiros, em cursos nos EUA e na Índia, viagens e retiros. Em relação à profissionalização, alguns dos entrevistados tiveram contato muito cedo com o yoga, seja através de leituras, influências familiares, inclinações místicas, estados de saúde delicados ou simples curiosidade. Outros entraram em contato com a prática na idade adulta e decidiram se dedicar à docência do yoga. Os entrevistados atuam em escolas particulares de yoga ou em organizações que promovem diferentes tradições do yoga, dando aulas, palestras, cursos de formação, cursos intensivos e de férias, bem como organizando retiros, viagens, seminários, e alguns escrevem artigos e traduzem livros sobre temas do universo do yoga. Todos os entrevistados aprovam a inclusão do yoga no SUS e elaboraram sugestões sobre: como a prática poderia ser ofertada, o público alvo, as técnicas de yoga a serem ensinadas, a duração das aulas, etc. Algumas áreas em que o yoga poderia fazer importantes contribuições seriam: vegetarianismo; correção postural e integração dos movimentos; cultura de paz; cultivo de valores; abstenção de vícios; consciência espiritual; integração do si; cultivo da atenção, oxigenação cerebral; cultivo de uma disciplina e melhoria da qualidade de vida. Conclui-se que o yoga é visto como um conjunto de práticas físicas, sociais e filosóficas úteis para o campo da saúde, todavia com muitos desafios para a sua integração no SUS, devido à sua identificação com a cultura alternativa e distanciamento das bases epistemológicas da medicina complementar e integrativa. / Abstract: Background: Yoga is a psycho-physical practice systematized by Patanjali, a Hindu sage, who lived in the second century BCE. In 1983, yoga was brought to America by Swami Vivekananda. In Brazil, around 1940, Caio Miranda began teaching the practice in Rio de Janeiro. Thus yoga has been practiced for the last sixty years in the biggest urban centers of the country and there are very few academic studies on the subject in the health field, which is the main reason to justify our interest in the study. Besides, in 2002, the World Health Organization included yoga in the group of the mind-body practices and stimulated its members to study and adopt these practices in the national health systems. Objective: This article explores the São Paulo yoga leaders' perceptions regarding the potential insertion of yoga as a public policy into the Brazilian National Health System, and their process of professionalization. Methods: Twenty one main traditions were identified, of which 18 leaders were interviewed, and the other three didn't participate for different reasons. Indepth interviews were carried out in January/February 2006; September/October 2008 and April 2009, through the application of a questionnaire divided into three sections: (a) personal identification; (b) yoga practice; and (c) yoga and health. The interviews lasted approximately 1.5 hr and took place in various locations in São Paulo city, according to appointments arranged by the interviewees and after they had signed a voluntary consent form. All the interviews were tape-recorded, transcribed, and analyzed according to the qualitative research tradition. Most yoga leaders have college education and acquired their yoga training in Brazil and in foreign countries, like USA and India, and through trips and retreats. Concerning their professionalization, some of the interviewees came in contact with yoga at a young age either through books, family influences, mystical inclinations, delicate states of health or simply curiosity. Others discovered yoga as adults and decided to become yoga teachers. They work in private yoga schools or for organizations which promote different yoga traditions, teaching, giving lectures, courses for teachers, intensive and vacation courses, and they also organize retreats, trips and seminars; some of them write articles and translate books on different themes pertaining to the yoga field. Results: All the interviewees approve the inclusion of yoga in the Brazilian National Health System and suggested how the practice could be applied, the main public, the yoga techniques, the duration of the classes, etc. Areas in which yoga was perceived as being able to make important contributions included: vegetarianism; postural correction and integration of movements; peace culture; the cultivation of virtuous values; abstention from addictive substances; spiritual consciousness; integration of the self; cultivation of awareness; brain oxygenization; cultivation of discipline and improved quality of life. Conclusion: Yoga is seen as a group of useful physical, social, and philosophical practices for the health field. However, challenges to its integration into the BNHS include its maintenance as an alternative culture practice and its distance from the epistemological bases of present complementary and integrative medicine. / Doutorado / Saude Coletiva / Doutor em Saude Coletiva