Interventions for alterations in health and wellness vary among cultures. Interventions most commonly used in the United States have been labeled as conventional medicine by the National Institutes of Health (n.d.). Other names for conventional medicine were allopathy, Western medicine, regular medicine, mainstream medicine, and biomedicine. Interest in interventions that are not an integral part of conventional medicine prompted the National Institutes of Health to create the Office of Alternative Medicine (OAM) in 1992, and then to establish the National Center for Complementary and Alternative Medicine (NCCAM) in 1999.
The NCCAM grouped complementary and alternative medicine interventions into five main categories: alternative medical systems, mind–body interventions, biologically based therapies, manipulative and body-based methods, and energy therapies (National Institutes for Health, National Center for Complementary and Alternative Medicine, accessed 9/8/01).
- Alternative medical systems are defined as complete systems of theory and practice that are different from conventional medicine. Some examples are traditional Eastern medicine (including acupuncture, herbal medicine, oriental massage, and Qi gong); India’s traditional medicine, Ayurveda (including diet, exercise, meditation, herbal medicine, massage, exposure to sunlight, and controlled breathing to restore harmony of an individual’s body, mind, and spirit); homeopathic medicine (including herbal medicine and minerals); and naturopathic medicine (including diet, acupuncture, herbal medicine, hydrotherapy, spinal and soft-tissue manipulation, electrical currents, ultrasound and light therapy, therapeutic counseling, and pharmacology).
- Mind–body interventions are defined as techniques to facilitate the mind’s ability to affect symptoms and bodily functions. Some examples are meditation, dance, music, art therapy, prayer, and mental healing.
- Biologically based therapies are defined as natural and biologically based practices, interventions, and products. Some examples are herbal therapies (an herb is a plant or plant part that produces and contains chemical substances that act upon the body), special diet therapies (such as those of Drs. Atkins, Ornish, and Pritikin), orthomolecular therapies (magnesium, melatonin, megadoses of vitamins), and biologic therapies (shark cartilage, bee pollen).
- Manipulative and body-based methods are defined as interventions based on body movement. Some examples are chiropracty (primarily manipulation of the spine), osteopathic manipulation, massage therapy (soft tissue manipulation), and reflexology.
- Energy therapies are defined as interventions that focus on energy fields within the body (biofields) or externally (electromagnetic fields). Some examples are Qi gong, Reiki, therapeutic touch, pulsed electromagnetic fields, magnetic fields, alternating electrical current, and direct electrical current.
A patient may choose to seek an alternative to conventional medical or surgical therapies. Many of these alternative therapies are becoming widely accepted as feasible treatment options. Therapies such as acupuncture and herbal treatments may be recommended by a patient’s physician to address aspects of a condition that are unresponsive to conventional medical treatment or to minimize side effects associated with conventional medical therapy. Alternative therapy used to supplement conventional medicine may be referred to as complementary therapy. Physicians and advanced practice nurses may work in collaboration with an herbalist or with a spiritualist or shaman to provide a comprehensive treatment plan for the patient. Out of respect for the way of life and beliefs of patients from different cultures, it is often necessary that the healers and health care providers respect the strengths of each approach. Complementary therapy is becoming more common as health care consumers become more aware of what is available through information in printed media and on the Internet. As patients become more informed, they are more likely to participate in a variety of therapies in conjunction with their conventional medical treatments. The nurse needs to assess each patient for use of complementary therapies, remain alert to the danger of conflicting treatments, and be prepared to provide information to the patient regarding treatment that may be harmful. The nurse must, however, be accepting of the patient’s beliefs and right to control his or her own care. As a patient advocate, the nurse facilitates the integration of conventional medical, complementary, and
alternative medical therapies.