Bakgrund: Det finns ingen enhetlig definition av komplementär alternativ medicin (KAM). Det visar sig att användandet av KAM ökar hos befolkningen i världen. Det finns ett stort informationsutbud på internet vilket kan leda till risker för patienter vid felaktig information. Syftet: Var att beskriva inställningar till och kunskaper om komplementär alternativ medicin bland omvårdnadspersonal. Metod: En allmän litteraturstudie baserad på kvalitativa och kvantitativa artiklar. Resultat: Det fanns inställningar om att KAM borde ha en plats i sjukvården. Det framkom att det fanns behov av riktlinjer, lagstiftning, stöd, ledarskap och evidens hos omvårdnadspersonal. Omvårdnadspersonal såg det som sitt ansvar att fråga patienters om deras användande. Omvårdnadspersonal ansåg att KAM hade effekt för patienter. Det visade sig att det fanns både viss kunskap och otillräcklig kunskap om KAM. Även efterfrågan om behov av kunskap och utbildning bland omvårdnadspersonal visade sig vara stor. Slutsats: Med tanke på den positiva inställningen till KAM hos omvårdnadspersonal, befolkningens ökande användande och avsaknad av ett tydligt regelverk gällande KAM. Är det en tidsfråga innan sjuksköterskor hamnar i situationer då de inte vet hur de ska hantera patienters frågor och användande av KAM. Det finns ett behov av tydligare riktlinjer gällande KAM och utbildning om vad KAM är. / Background: There is no uniform definition of complementary alternative medicine (CAM). It turned out that the usage of CAM is increasing in the population around the world. There is a range of information on the internet, which can lead to risks for patients when misinformed. Purpose: Was to describe the attitudes to and knowledge of complementary alternative medicine among nursing staff. Method: A general literature review. Results: There were attitudes that CAM should have a place in health care and a need for guidelines, legislation, support, leadership and evidence. Nursing staff saw it as their responsibility to ask patients about their use. Nursing staff felt that CAM was effective for patients. It turned out that there were both some knowledge and insufficient knowledge of CAM. There was also a great need for knowledge and education among the nursing staff. Conclusions: Given the positive approach to CAM among nursing staff, the increasing usage in the population and lack of a clear regulatory framework regarding CAM. Nurses might find themselves in situations where they do not know how to handle patients' questions and the use of CAM. Therefore there is a need for clearer guidance and education about CAM

This mixed methods study examined the association between the frequency of five lifestyle-related complementary and alternative medicine (CAM) practices and perceived quality of life (QOL) and stress among patients in Japan diagnosed with chronic disease, and also examined why patients decided to receive Okada purifying therapy [(OPT) biofield therapy]. Data from 1,190 patients were analyzed using bivariate and multiple regression analysis, followed by analysis of one-on-one in-depth interviews conducted among 25 patients on reasons why patients decided to practice OPT. Grounded theory methodology was used to analyze transcribed interview data. Results of multiple regression analysis indicated that engaging in arts and cultural activities and exercise was associated with a decrease in perceived stress, while arts and cultural activities, exercise, consumption of organic (additive-free) food, and practice of OPT were associated with increased QOL. Gender weakly moderated the effects of arts and cultural activities on stress but not on QOL, and gender did not have any moderating effects on the association of OPT with either stress or QOL. One theme, five clusters, and 13 categories emerged from the qualitative analysis. Feelings of desperation due to unrelieved symptoms of disease seemed to be the principal reason for most patients’ practice of OPT. Other reasons were perception of the limits of conventional medicine in being able to treat patients’ disease, dissatisfaction with conventional medicine, positive relationship with staff and doctors of the integrative medicine clinic providing OPT, and benefits of OPT, among others. Although many patients expressed feeling doubts towards the practice of OPT at first, many seemed satisfied with the results of the practice, mainly because they were able to manage their symptoms and gain a sense of control. This may have led to an increase in QOL. The mixed methods design was able to inform the interpretation of the association of OPT with reported increase in QOL in the quantitative phase of the research.

No description available.

Background: Religious involvement is widespread and may influence patient engagement with their healthcare (patient activation) and health outcomes. This dissertation examined the association between religiosity and patient activation, changes in health-related quality of life (HRQOL), readmissions, and survival after hospitalization for acute coronary syndrome (ACS). Methods: We recruited 2,174 patients hospitalized for ACS in Georgia and Central Massachusetts (2011-2013) in a prospective cohort study. Participants self-reported three items assessing religiosity – strength/comfort from religion, petition prayers for health, and awareness of intercessory prayers by others. Patient activation was measured using the 6-item Patient Activation Measure. Generic HRQOL was assessed with the SF-36®v2 physical and mental component summary scores. Disease-specific HRQOL was evaluated with the Seattle Angina Questionnaire Quality of Life subscale. Unscheduled readmissions were validated from medical records. Mortality status was obtained from national and state vital statistics. Results: After adjustment for several sociodemographic, psychosocial, and clinical variables, reports of strength/comfort from religion and receipt of intercessions were associated with high activation. Praying for one’s health was associated with low activation. Prayers for health were associated with clinically meaningful increases in disease-specific and physical HRQOL. Neither strength/comfort from religion, petition, nor intercessory prayers were significantly associated with unscheduled 30-day readmissions and two-year all-cause mortality. Conclusions: Most ACS survivors acknowledge religious practices for their health. Religiosity was associated with patient activation and changes in HRQOL. These findings suggest that religiosity may influence patient engagement in their healthcare and recovery after a life-threatening illness, buttressing the need for holistic approach in patient management.

Abstract Introduction & Background The role of dietary fiber in breast cancer etiology remains unclear. A negative correlation may be due to fiber’s ability to stave off obesity and aid in the extraction of serum estrogen, two known risk factors for the disease. Effects may differ by source, and type, of fiber. Most of the data available is from research with non-Hispanic white women. However, fiber intake may vary significantly across cultures. Purpose Statement & Question The research sought to investigate whether an increased intake of dietary fiber was associated with a corresponding decrease in the incidence of breast cancer. The question posed was: Among post-menopausal women of various cultures, what is the effect of high dietary fiber intake compared to low intake on the risk of developing breast cancer? Literature Review The search was for specific studies examining the effect of dietary fiber on breast cancer development. The university’s scholarly search engine was utilized to find five studies using key terms such as “dietary fiber” and “breast cancer”. Findings Results showed an overall protective effect from high (> 25 grams/day) total dietary fiber intake on developing breast cancer. Findings for soluble versus insoluble fiber were inconsistent, but evidence suggests that fiber from beans, vegetables, and fruit may have a greater effect than fiber from whole grains. Conclusion High total fiber consumption may reduce the risk of developing breast cancer. Future research should investigate whether results hold true across more diverse populations.

Background. Primary and secondary prevention trials have shown that implantable cardioverter-defibrillators (ICD) reduce the risk of cardiac death, but concerns have been raised regarding the psychological well-being of ICD patients. Anxiety can affect a significant proportion of these patients, but there is limited information about prevalence and determinants of anxiety after the implementation of the more recent guidelines for ICD implantation. Several behavioral interventions have been effective in improving anxiety in these patients, however the efficacy of mindfulness-based interventions (MBI) has not been investigated in ICD patients, and there is limited information regarding the characteristics of pre-intervention, “dispositional” mindfulness in patients with cardiovascular disease never exposed to mindfulness training. The aims of this dissertation project were: 1) To determine the feasibility of a randomized clinical trial of a phone-administered, mindfulness-based training program, as measured by recruitment and retention rates, treatment adherence and fidelity; 2) To evaluate the current baseline prevalence and determinants of anxiety in the study population and 3) To describe the correlates of dispositional mindfulness in the study population. Methods. The study was conducted at the Electrophysiology Service at the UMass Memorial Medical Center. All consecutive patients who recently underwent an ICD procedure or received ICD shocks were screened for eligibility to participate in a pilot randomized controlled trial in which an eight session, phone-delivered, weekly MBI was compared to a usual care condition. Assessments were performed at baseline and post-intervention. A cross-sectional design was used for aims 2 and 3. Anxiety was assessed using the Hospital Anxiety and Depression Scale; a shortened version of the Five Facets of Mindfulness questionnaire was used to evaluate mindfulness. Results. Thirty patients (21 M, 9 F; mean age 63.1 ±10.3 years) were enrolled in the study. The methods ultimately adopted to screen, recruit, and retain study participants were feasible to conduct and satisfactory to ICD outpatients, and the study intervention was safe. Phone delivery resulted in excellent retention rates and limited costs. Assessments of treatment fidelity showed that the content of the intervention was delivered as intended in almost 100% of cases. The study findings do not show a decrease in the overall prevalence of anxiety in ICD patients compared with earlier cohorts; anxiety was associated with young age, low socio-economic status and previous psychological morbidity, but not with ICD-related factors including prior shock delivery. Finally, baseline mindfulness was most strongly associated with previous psychological morbidity (in particular, depression), and current anxiety symptoms. Conclusion. Psychological morbidity appears to be the major determinant of anxiety in the patients currently enrolled in the study. Dispositional mindfulness is inversely associated with current anxiety and depression and with prior psychological morbidity, supporting the hypothesis of a modulating role of mindfulness on the processing of negative emotions. A phone-delivered, individual MBI is feasible, acceptable to patients and can be adequately delivered by trained instructors. The findings from this dissertation work support the need for larger clinical trials of MBI in ICD patients.

Purpose: The purpose of the study was to explore the use of virtual distant Reiki as a healing modality to influence the human environmental field patterning. Specific Aims: (1) To determine if it is feasible to recruit and retain participants (through expressions of human choice) to participate in a study comprised of two distant Reiki administrations on a virtual platform. (2) To investigate the preliminary influence of a distant Reiki intervention on pattern of the whole as manifested by participant response in stress and anxiety. (3) To explore the participant’s reflections on their virtual distant Reiki experience within the human environmental field pattern of their home environment as a healing space. Theoretical Framework: The theoretical framework is grounded in Martha Rogers’ Science of Unitary Human Beings. Design: This study incorporates a feasibility, mixed method design. Data was collected through pre and post intervention individualized interviews and two tools (State Trait Anxiety Inventory (STAI) and Impact of Events Scale-Revised (IES-R)). Results: Described changed in pattern manifestation supported the need for home-based interventions during covid 19 pandemic. Quantitative response indicated a statistically significant reduction in perceived stress and anxiety (p< 0.001). Conclusion: The preliminary study findings support the feasibility of a distant Reiki and suggest that nurses, who are Reiki practitioners, may be influential in interacting with the human environmental field to promote change and foster healing.

This study explores folk medical beliefs and practices regarding women's health issues and the female body, specifically menstruation, pregnancy, abortion and menopause, in the Southern Appalachian region. This research reveals what information was given to young girls, by whom was it given, and the effect this had on their self-image and on how they communicated about their bodies as they matured. Other key elements include the social restrictions surrounding menstruation and the ways these beliefs were communicated to young girls. In addition, this project presents information on the treatment of symptoms such as cramps, bloating, headaches, excessive bleeding, lack of flow, etc. and how this information was communicated.

Skin related injuries are some of the most dangerous forms of wounds. In addition to treating the wound itself, health care providers must be cautious of microbial infections. In this study, we evaluate a novel all-natural antimicrobial gel compound (AMG) designed to kill planktonic bacteria, penetrate bacterial biofilms, and accelerate wound healing. In -vitro experiments demonstrate that AMG is effective in inhibiting planktonic growth and biofilm development of eight common pathogens. LIVE/DEAD staining and confocal microscopy reveal that planktonic growth and three-dimensional structure of biofilms were significantly reduced. Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) was used to investigate a small panel of genes (PrsA, Sprx) and showed potential targets for future study. A physiologically relevant wound model was created for treating S. aureus infections by using AMG alone or in combination with a common topical antibiotic, Mupirocin. AMG is a safe and effective treatment option for skin related infection.

In the United States alone, there were 25.8 million people suffering from diabetes in 2010. The prevalence of diabetes is expected to markedly increase worldwide over the next 30 years, an estimated 2.8% in 2000 and 4.4% in 2030. For individuals diagnosed with type 2 diabetes mellitus (T2DM), treatment is essential to control adverse effects such as hypertension and diabetic neuropathy. The focus of this study is to examine various approaches to maintain and improve the lifestyle of individuals suffering from T2DM. A comparative approach has been used to evaluate the differences in the treatment of T2DM with the use of traditional Chinese medicine (TCM) and Western medicine. In Western society, pharmaceuticals are commonly used as a treatment method to manage hyperglycemia, along with life-style modifications. Furthermore, TCM views the human body and its functioning in a holistic way, stating that no single body part or symptom can be understood apart from its relation to a whole. Herbal medications and other treatments in TCM are targeted to treat underlying medical complaints that resulted in symptoms, instead of treating one specific manifestation. Data collection has been gathered through Qualitative over the phone interviews with patients suffering from T2DM, as well as TCM physicians. Interviews were conducted on patients that were diagnosed with T2DM (fasting plasma glucose levels of 126 or greater and HbAlc levels [greater than] 8%), and had continued treatment longer than three months prior to interviews. Collection of chart notes containing glucose levels, levels of pain, lifestyle changes, and vital signs were also used. A total of 21 patients from a family practice were interviewed, answering 23 constructed questions based on treatment of choice (TCM or western) and their personal input on treatment satisfaction. Patients varied in age, ethnicities, and gender, ranging from 39-70 years of age. Two traditional Chinese medicine physicians were also interviewed. Interviews with TCM physicians elaborated on course of treatment and steps taken to diagnose T2DM. Furthermore, prescription medications were also charted and documented to further analyze with secondary data. Upon completing the interviews, the data stated 21 patients (total population questioned) had not experienced alternative medicine and were exposed only to western medicine as treatment. A major concern for most patients were the pharmaceutical side effects, and 85.1% of patients stated they would be interested in an alternative treatment. Due to insufficient sources and knowledge on TCM treatment, 14.2% of patients stated they were satisfied with their western medicine treatment of choice and would not change treatment. The research's objective was to evaluate the differences in treatment of T2DM. Data collected supported the objective and showed the lack of sources to alternative treatments aside from western medicine. The researcher informed and educated interviewees about literature review on traditional Chinese medicine about alternative treatments available to treat T2DM.