Complementary and Alternative Medicine - Term Paper Example

? Does Complimentary and Alternative Medicine Provide Adequate Pain Relief Compared to Pharmacological Means Number and Number Name of Professor Date of Submission Number of Words: 1,559 Introduction The World Health Organization (WHO) defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (Stone & Katz, 2002, p. 144). For this reason health care practitioners should be able to satisfy the physical, mental, and social needs of their respective patients as part of rendering therapeutic care. Based on my personal encounter with a patient who went through a surgery for cardiac ablation, the patient was experiencing chronic pain which was unrelieved for 3 days. For temporary pain relief, I positioned the patient with pillows in the way she preferred, massaged the patient’s legs, and encouraged her to go through deep breathing exercises to make her less focused on her pain. After informing the doctor that the patient is complaining of irretractable pain and a history of osteoarthritis, the doctor changed her pain regime to include muscle relaxant and physical therapy to improve her range-of-motion (ROM). After a short period of time, the patient was able to get up and walk. Pain management is common health care practices that most primary nurses failed to master. Since it is common for primary nurses to deal with patients who are suffering from chronic pain, it is essential for nurses to increase their knowledge on how to effectively manage the patients’ pain. Based on the fact that nurses are not permitted to prescribe pharmacological drugs such as opioids in managing the patient’s pain, I find it very interesting to search for alternative ways that can effectively minimize the patients’ pain. Going through the research topic will not only enable me to improve the patients’ quality of life, it will also make me able to perform my duty which is to provide holistic care to the patients. Several studies revealed that the use of complementary and alternative medicine (CAM) can be considered either as a substitute for conventional medicine or be combined with the use of conventional medicine when managing pain (Wells et al., 2007). As compared to the use of pharmacological means, this study will focus on discussing whether or not CAM can provide adequate pain relief to patients with chronic pain. After discussing the differences between CAM and pharmacological-based drugs, this report will conduct a literature review in determining the health care benefits of incorporating the use of CAM in pain management. Eventually, the proposed change in the plan of care and how these changes can be initiated will be tackled in details. Differences between Complimentary and Alternative Medicine and Pharmacological-based Drugs Complimentary and alternative medicine is “a form of healing arts that is not taught in a traditional Western medical schools that could promote options to the use of conventional medicine” (MedicineNet.com, 2007). It is basically “a group of diverse medical and health care systems, practices, and products that are not currently considered to be a part of a conventional medicine” (Garrow & Egede, 2006). In most cases, the research study of Barnes, Powell-Griner, McFann & Nahin (2004) revealed that the commonly used CAM therapies includes: prayer for self (43%), natural products like herbal medicines, teas, and vitamins (18.9%), deep breathing exercises (11.6%), meditation (7.6%), chiropractic (7.5%), yoga (5.1%), massage (5.0%), diet-based therapies (3.5%), and acupuncture (1.1%). Pharmacological medicines are mostly chemical-based drugs. Often times, these drugs should be prescribed by the doctors. When treating pain, common drugs use includes opioids class drugs (i.e. morphine, hydromorphone, fentanyl, and oxycodone among others) which could provide the patients with analgesic effects to minimize the patient’s perceived pain (Mercadante et al., 2010; Murray & Hagen, 2005). Summary of Articles The research study of Wells et al. (2007) focused on describing the types and frequencies of specific CAM therapies used by women with lung cancer in managing its symptoms. Massage is classified as one of the most commonly used CAM therapies in US. In line with this, research study of Currin & Meister (2008) focused on assessing the impact of a 15-minute Swedish massage in managing the cancer patients’ pain, physical discomfort, emotional discomfort, and fatigue. To examine the demographic and clinical characteristic differences between CAM users and non-CAM users, Wells et al. (2007) conducted a cross-sectional descriptive study among the group of 189 women diagnosed with non-small cell lung cancer who agreed to participate in this study. In assessing the impact of a 15-minute Swedish massage in managing the cancer patients’ pain, physical discomfort, emotional discomfort, and fatigue, Currin & Meister (2008) conducted a non-randomized single-group repeated-measure pre- and post-massage study design for more than a 3-year period in southeastern Georgia among the 251 cancer patients (70% female and 30% male) who volunteered to participate in the study. Based on the Symptom Management Questionnaire results used in assessing the 8 symptoms of non-small cell lung cancer (i.e. pain, difficulty in breathing, fatigue, loss of appetite, weight loss, cough, sleep disturbance, and difficulty in concentrating), Wells et al. (2007) revealed that the best CAM therapy used in managing pain is prayer (45.2%) followed by massage (11.9%), meditation (9.5%), herbs (8.3%), tea (7.1%), and acupuncture (3.6%). Based on the 5-point Likert scale research survey result, Currin & Meister (2008) reported that the provision of 15-minutes Swedish massage on cancer patients is effective in terms of reducing the patients’ physical discomfort (F = 742.575, P = .000) followed by pain (F = 638.208, P = .000), fatigue (F = 597.976, P = .000), and emotional discomfort (F = 512.000, P = .000). Unlike the research study that was conducted by Wells et al. (2007) and Currin & Meister (2008), the study of Jablonski & Ersek (2009) was more focused on conducting a retrospective audit with regards to the actual practice and current best practice use in managing pain throughout the 14 long-term care facilities in the western part of Washington State. Upon examining the case of 291 residents between the age brackets of 57 to 103 years old living in 14 long-term care facilities in the western part of Washington State, Jablonski & Ersek (2009) revealed that only 85% evidence of pain assessment were noted in the patients’ medical records and that only 32% were documented on a weekly basis. Likewise, the authors revealed that “the basic components of comprehensive pain management assessment were often lacking” (i.e. effectiveness of prescribed medication, side-effects of prescribed medications, re-evaluation of newly prescribed medications, increase in prescribed drug dosages, or the use of non-pharmacological interventions) (Jablonski & Ersek, 2009, pp. 31 – 32). With regards to the use of pharmacological drugs in managing pain, Jablonski & Ersek (2009) revealed that most of the elderly patients are avoiding the use of propoxyphene and/or meperidine (99%) and that majority with 78% of the residents who were experiencing pain were not prescribed with opioid medications or were prescribed with opioid but on an ineffective dosage. Proposed Change in the Plan of Care and How these Changes can be Initiated It is beyond the duty of care on the part of the nurses to prescribe pain medications to patients. For this reason, nurses should focus on proper documentation of pain assessment on each patient. By carefully documenting the dosage of pain medication prescribed by the doctors, its side-effects, effectiveness or ineffectiveness of the pain medication, nurses can simply report directly to the doctor about the effectiveness of the prescribed pain medication. In case the doctors were not scheduled to make rounds, nurses can take advantage of using CAM therapies in helping the patients reduce their pain. In general, nurses can encourage the patients to pray in order to reduce their emotional pain or give them 15-minute body massage when there is a need to reduce their physical pain (Currin & Meister, 2008; Wells, et al., 2007). To initiate the proposed change in the care plan, the head nurse should make use of good leadership and effective communication skills to be able to persuade the nurses to strictly implement the proposed change (Reineck, 2007). By explaining to nurses why the proposed change has to be implemented, there is a bigger chance wherein the head nurse can persuade the team to support the changes in the patients’ care plan. Conclusion and Recommendations It is the duty of nurses to provide their patients with holistic care. For this reason, the duty of nurses does not end on assisting them with their prescribed medication. Likewise, it is unethical on the part of the nurses to simply ignore the pain or emotional burden the patients are experiencing each day. Although it is the duty of the doctors to prescribed pain medication to the patients, the nurses should also perform their duty by keeping the patients’ record intact. Through proper documentation, the nurses are able to assist the doctors with regards to examining whether or not the prescribed pain medication is effective in terms of reducing the patients’ chronic pain. In the absence of this information, the doctors would not know whether or not there is a need to change the prescribed pharmacological drug or increase its dosage. Since the nurses are the front-liners when dealing with the patients, it is highly recommended on the part of each nurse to make use of CAM therapies (i.e. prayer and 15-minute body massage) in order to reduce the patients’ physical pain and discomfort. By doing so, the nurses can play a significant role in increasing the patients’ quality of living. References Barnes, P., Powell-Griner, E., McFann, K., & Nahin, R. (2004). Complementary and alternative medicine use among adults: United States, 2002. In Wells, M. et al. (eds) "Use of Complementary and Alternative Medicine Therapies to Control Symptoms in Women Living With Lung Cancer" 2007. Cancer Nursing. 30(1): 45-55. Currin, J., & Meister, E. (2008). A Hospital-based Intervention Using Massage to Reduce Distress Among Oncology Patients. Cancer Nursing , 31(3): 214-221. Jablonski, A., & Ersek, M. (2009). Evidence-Based Pain Management Practices. Journal of Gerontological Nursing , 35(7): 28-34. Mercadante, S., Tirelli, W., Fabrizio, D., Arcara, D., Fulfaro, F., Casuccio, A., et al. (2010). Morphine Versus Oxycodone in Pancreatic Cancer Pain: A Randomized Controlled Study. Clinical Journal of Pain , 26(9): 794-797. Murray, A., & Hagen, N. (2005). Hydromorphone. Journal of Pain and Symptom Management , 29(5): 57-66. Reineck, C. (2007). Models of Change. Journal of Nursing Administration , 37(9): 388-391. Stone, J. (2002) 'An Ethical Framework for Complementary and Alternative Therapist' In Stone, Julie and Katz, Jeanne (eds) "Chapter 8 The therapeutic relationship and complementary and alternative medicine". Wells, M., Sarna, L., Cooley, M., Brown, J., Chernecky, C., Williams, R., et al. (2007). Use of Complementary and Alternative Medicine Therapies to Control Symptoms in Women Living With Lung Cancer. Cancer Nursing , 30(1): 45-55. Read More