In this dissertation, I look to contemporary menopause management in the Southwest, United States, as an ideal case study of the 'real world' negotiation of a widespread contemporary conundrum--characterized by discourses of risk, proliferation of information and choice, chronic doubt, and personal responsibility for decision-making. While there have been previous studies of menopause in the US, this circumstantial ethnography seeks to understand contemporary menopause management in an era characterized by a massive shift in the biomedical risk discourses about menopause, the explosion of therapeutic choice in a burgeoning pluralistic health care environment, and the broad expansion of women's identities, body projects, and life priorities over the last several decades.I report on fourteen months of ethnographic fieldwork conducted in 2007 and 2008 with menopausal women and health care providers in the southwestern US. Research components included ethnographic interviews (N=60) and focus groups (6 groups with 27 participants) with midlife women, interviews with health care providers across a range of therapeutic modalities (N=20), and observation of emerging discourses of menopause in science, media and marketing.This dissertation illustrates that contemporary menopause management is a recursive process characterized by the ongoing re-evaluation of the impact menopause is having on one's life--in context. Participants described the unfolding of the lived-experience of menopause over time--even years beyond the end of menstruation. Risk discourses are not embodied en masse but reflect the concerns most salient in women's lives. While women access various expert and lay resources, they favor personal experts--sources deemed professionally sound and personally relevant--and their own embodied knowledge. For their part, health care providers described themselves as "normalizing" menopause and practicing patient-centered care aimed at empowering women to make their own decisions about how to manage menopause. Lacking an ideal choice, women make provisional treatment decisions that resonate with their current menopausal subjectivity. Despite abundant options, menopause management is increasingly stratified, with some able to access more information resources and afford more extensive decision-support. Among women with severe symptoms, bioidentical hormone therapy--productively positioned between biomedicine and complementary/alternative medicine--has emerged as a popular harm reduction strategy.

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This action research project examines the researcher’s journey of establishing a therapeutic relationship with a child with autism spectrum disorder during her practicum. Children with ASD present difficulty in communication and social relationship skills. As a student in training with a limited experience, the researcher had uncertainty and low confidence with regard to her clinical and professional skills which affected her work. In this project, the researcher has examined her own process of music therapy with a child with ASD and shows how she was able to improve her practice and therefore establish meaningful and effective therapeutic relationships with this client population and obtain valuable learning through the training. The study was conducted at a dedicated therapy centre in New Zealand where the researcher was in placement. A total of seven, thirty-minute weekly individual music therapy sessions and four supervision sessions were employed. This process was adapted into the design of action cycles which involved the repeated process of planning, action and evaluation. In-depth analysis of the researcher’s work was carried out throughout the cycles, using clinical notes, journal excerpts, supervision notes and video recordings of the sessions. The findings suggest that the researcher was able to improve her practice while attempting to build a therapeutic relationship with the client. Various clinical and personal issues arose such as uncertainty about improvisation, and lack of confidence in professional skills including communicating with parents, which led to disjunction and burnout symptoms. Discussions in supervision aided in in-depth reflection of the researcher’s work as well as emotional support. The researcher could ultimately develop ‘internal supervisor’ and was able to use independent strategies to help develop her work. Implications for training include making personal therapy a compulsory course requirement, providing training on professional skills, and student support groups. Future research may investigate the effectiveness of verbal input in music therapy and the emotional stages of parents.

Background: Globally the use of complementary and alternative medicine (CAM) has dramatically increased in the last few decades. In India CAM is used both as medical treatment and health care methods enhancing wellness. Aim: To explore nurse’s experiences of complementary alternative medical care as care methods in clinical settings in Karnataka, India. Methods: A qualitative interview study with semi-structured interviews was carried out. Four individual interviews were conducted with nurses working in two clinical settings in Karnataka, India. The data was analysed using a content analysis.  Results: Two main themes emerged from the content analysis: Caring as a challenge and Dealing with challenges. Discussions: The result is discussed using Travelbee’s’ theory on interactions.

Siekiant surinkti ir susisteminti duomenis apie onkologinėmis ligomis sergančių pacientų greta gydytojo paskirto gydymo vartojamas papildomas priemones, vykdytas tiriamasis interviu, kurio metu naudotas pagrindinis tyrimo instrumentas – trijų dalių klausimynas. Tyrimo dalyviai: Lietuvos sveikatos mokslų universiteto ligoninės Kauno klinikų Chemoterapijos dienos stacionaro pacientai bei Alytaus apskrities onkologinėmis ligomis sergančių žmonių asociacijos „Bendrakeleivės“ nariai. Iš viso – 90 respondentų, dažniausiai sergančių: krūties (30 proc.), kraujo (7 proc.), žarnyno (5 proc.), priešinės liaukos (4 proc.) vėžiu. Tyrimo rezultatai parodė, kad 73 proc. pacientų naudoja papildomas priemones. Apklausos metu nustatytos 134 natūralios kilmės papildomų priemonių rūšys, iš kurių 123 – vaistinių augalų rūšys, priklausančios 52 šeimoms. Citavimų kiekiu (proc.) išsiskiria 6 vaistinių augalų šeimos: astrinių (Asteraceae ) – 20 proc., erškėtinių (Rosaceae) – 9 proc., salierinių (Apiaceae) – 7 proc., bastutinių (Brassicacea) – 6 proc., aguoninių (Papaveraceae) – 6 proc., pupinių (Fabaceae) – 4 proc. Krūties bei žarnyno vėžiu sergantys respondentai dažniausiai naudoja vaistinę medetką (Calendula officinalis L.) ir paprastąją kraujažolę (Achillea millefolium L.) – 5 proc. citavimų skaičiaus. Paprastąją kiaulpienę (Taraxacum officinale F. H. Wigg. s. l.) ir tikrąjį margainį (Silybum marianum L.) paprastai renkasi kraujo vėžiu sergantys pacientai – 11 proc. citavimų skaičiaus. Nustatytos... [toliau žr. visą tekstą] / In order to collect and organize data from the use of complementary measures used in addition to a physician prescribed treatment among cancer patients, was conducted exploratory interviews during which was used the main research instrument – a three – part questionnaire. Study participants: patients of Lithuanian University of Health Sciences Kaunas Clinics Hospital Chemotherapy Day Care department and fellow members of Alytus County cancer patients association “Bendrakeleivės”. A total number of 90 respondents participated in this study, mostly with: breast (30%), blood (7%), intestine (5%), prostate (4%) cancer. The results showed that 73% patients use complementary measures. The survey established 134 additional measures types of natural origin. 123 from the previously mentioned were medicinal plant species, belonging to 52 families. Citations content (%) stands 6 medicinal plants of the family Asteraceae – 20%, Rosaceae – 9%, Apiaceae – 7%, Brassicaceae – 6%, Papaveraceae – 6%, Fabaceae – 4%. Breast and intestine cancer patients mainly use marigold (Calendula officinalis L.) and common yarrow (Achillea millefolium L.) – 5% of citation number. Ordinary dandelion (Taraxacum officinale F. H. Wigg. s. l.) and actual milk thistle (Silybum marianum L.) usually opt for blood cancer patients – 11% of citation number. 6 from the previously mentioned were animal species, of which most of the times (34%) was cited gray toad (Bufo bufo) used among breast (26% ) and prostate (8%)... [to full text]

Individuals are becoming more dependent on medication for conditions such as chronic-pain, anxiety, and depression. It is reported that patients are often overprescribed medication while health outcomes do not improve. The medicalization of society is distracting attention from the possibility of other therapies such as complementary or alternative medicine (CAMs) that can improve health outcomes if they were as supported as pharmacological research and better received by the medical community. Yoga and meditation, the components of Mindfulness Based Stress Reduction (MBSR) and yoga therapy, have been shown as effective CAMs for cases of anxiety and depression related to chronic illness or chronic pain. There is little agreement in research, among yoga practitioners, and in the medical community on how to prescribe the delivery of yoga therapy interventions to reduce pain, depression, or anxiety. The purpose of this quantitative study and, to address this gap in the literature, is to provide the medical community protocols for the delivery of yoga therapy and to discover a “dose response” for yoga therapy among 6 individuals suffering pain and related affective disorders such as anxiety and depression. The findings of this study showed no significant difference among individuals who practice yoga therapy at the rate of one or three times per week on reported levels of depression, anxiety, pain, perceived stress or quality of life depending on the rate of practice. This study could impact the over-prescription of medication and reduce the dependence on psychopharmacology for management of affective disorders

Introduktion/Bakgrund: En procent av världens befolkning är drabbade av den kroniska autoimmuna inflammatoriska sjukdomen Reumatoid artrit (RA) som kan orsaka värk, trötthet, stela leder, svullnad och som bidrar till minskad livskvalitet. I dagsläget är den farmakologiska behandlingen en central del av patienternas liv vilket kan bromsa sjukdomsförloppet men inte bota den. Litteraturstudien undersöker hur alternativa behandlingsmetoder upplevs av patienter med RA. Syfte: Syftet var att belysa patienters upplevelser av alternativa behandlingsmetoder vid RA. Metod: Litteraturstudien genomfördes utifrån Polit och Becks (2021) nio steg. Litteratursökningarna gjordes i databaserna Cinahl och PubMed. Tio artiklar var relevanta för litteraturstudiens syfte och granskades med hjälp av granskningsmallar. Resultat: Resultatet baseras på tio vetenskapliga artiklar, sju kvalitativa och två kvantitativa, samt att en artikel hade mixad metod. I sammanställningen framkom två teman: Positiva upplevelser och Negativa upplevelser. Slutsats: Alternativa behandlingsmetoder bidrog till att majoriteten av patienterna upplevde minskad smärta, ångest och depression. De upplevde även att socialt stöd från andra patienter bidrog till positivt välmående samt ökat självförtroende.

Människor med rygg- och nackvärk utgör en stor patientgrupp inom primärvården. Många blir inte hjälpta av de behandlingsmetoder som erbjuds. Samtidigt efterfrågas Komplementär och Alternativ Medicinska (KAM) behandlingar allt mer från allmänheten. Behovet att öka hälso- och sjukvårdens kunskap om KAM som behanlingsalternativ sågs. Studiens syfte var att beskriva människors erfarenheter i samband med rygg- och nackvärk och reflexologisk behandling. Metoden var kvalitativ ansats med semistrukturerade intervjuer som analyserades utifrån kvalitativ innehållsanalys. Urvalet omfattade sju klienter som sökt reflexologisk behandling pga rygg- och/eller nackvärk och identifierades genom tre olika reflexologer i Skåne län. I resultatet identifierades kategorin Vardagen med underkategorierna Smärta och värk, Försök till anpassning samt Söka vård och behandling. I Kategorin fysiska och psykiska sensationer sågs underkategorierna Personligt bemötande, Zonsmärta, Cirkulationsökning samt Avslappning. I Kategorin Förändring av vardagen ingick Symtomlindring, Hjälp till självhjälp samt Arbete och idrott. Slutsatsen dras att reflexologisk behandling kan erbjuda bra smärtlindring för människor med rygg- och nackvärk samt erbjuder en chans till avslappning, bättre sömn, vara aktiv i arbetslivet och få ny energi. Mer forksning inom reflexologisk behandling behövs. / People with back- and neck pain are common in primary care. Lot of patients don´t get the help needed. Meanwhile the public´s interest in Complementary Alternative Medicine (CAM) is growing. Need was identified to in the Healthcare system increase the knowledge about CAM´s options of treatment. The aim of this study was describing peoples experiences associated with back-and neck pain and reflexological treatment. The method was qualitative approach with semistructured interviews that analysed with contentanalysis. Sample included seven clients soughted reflexological treatment for back-and/or neck pain, wich identified through three flexologists in South Sweden. In The result the category Everyday life was identified with subcategories Pain and ache, Attempts to adapt and also Seek care and treatment. In the category Physically and mentally sensations subcategories Personal treatment, Zone pain, Increasing of circulation and also relaxation was identified. In the category Change in everyday life subcategories Symptom relief, Help to self-help and also work and sports were observed. Conclusion is that Reflexological treatment relief pain for people with back- and neck pain, it also provides chance for relaxation, better sleep, be able to work and to get new energy. More research about reflexological treatment is needed.

Orientador: Marilza Vieira Cunha Rudge / Resumo: Introdução: As práticas integrativas e complementares na saúde vêm ganhando cada vez mais espaço em diversos países, visto que um grande número de pessoas, especialmente mulheres, estão buscando abordagens mais naturais para solucionar uma variedade de problemas. O objetivo do estudo foi avaliar como as mulheres grávidas diagnosticadas com diabetes compreendem e aceitam o uso de práticas integrativas e complementares na saúde, especialmente Reiki, durante o atendimento pré-natal. Material e métodos: Trata-se de um estudo qualitativo exploratório e descritivo, utilizando entrevistas para 12 gestantes diabéticas atendidas no Centro de Investigação do Diabetes Perinatal da Faculdade de Medicina de Botucatu. Foram elucidados três temas que compreendem o conhecimento e a aceitação do paciente sobre práticas integrativas na saúde, assim como o conhecimento e aceitação da terapia Reiki. As entrevistas foram audiogravadas e transcritas para posterior análise. Resultados: A maioria das mulheres gestantes diagnosticadas com diabetes demonstrou conhecer algumas das práticas integrativas e complementares na saúde. Além disso, um grande número de entrevistadas receberia tais terapias se estas fossem disponíveis no Sistema Único de Saúde, porém a terapia reiki mostrou ser desconhecida entre as pacientes. Conclusão: O presente estudo serve como ponto de partida para profissionais de saúde introduzirem as terapias integrativas e complementares na saúde pública brasileira. Estudos adicionais ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: The use of complementary alternative medicine has increased in several countries; besides that, a great number of people, especially women, are seeking for more natural approaches during their life-span. Therefore, the current study aimed to assess the knowledge and acceptability of diabetic pregnant women toward complementary alternative medicine, especially Reiki, during antenatal care. Material and methods: A qualitative exploratory and descriptive study using in-depth interviews of a total of 12 pregnant women with diabetes attending the Perinatal Diabetes Centre (CIDP) of the Medical School of Botucatu Hospital (HCFMB). Topics included patient knowledge and acceptance toward complementary alternative medicine, especially Reiki. Semi-structured interviews were audio-recorded, transcribed verbatim and analyzed thematically. Results: Most pregnant women, who have been diagnosed with diabetes, demonstrated knowing some complementary alternative medicine. Moreover, most of them would receive such treatments whether they were available in the Brazilian public healthcare setting; while reiki therapy was unknown among them. Conclusion: The current study serve as focal points for both conventional and holistic health practitioners to introduce such practice in Brazilian public healthcare. Further studies in other populations are needed to enhance generalizability of the emergent theory. / Mestre

See title file for abstract / Educational Studies / D. Ed. (Psychology of Education)