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  • purelibra 2:53 am on October 19, 2009 Permalink | Reply  

    Barriers to integration of CAM with orthodox medicine 

    Barriers to integration of CAM with orthodox medicine (Blog assignment)

    Integrative medicine was recently defined as “medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines (conventional and complementary) to achieve optimal health and healing” (MacPherson et al 2009).
    The above quote is taken from a recent paper, which in summary suggests that a lack of evidence is no good reason to render integrative medicine (IM) ineffective. Lastly, working towards closing the evidence gap may be achieved by using other research methods that can measure and evaluate complex interventions such as CAM.
    However, a rapid response by Ernst (2009) seriously refutes the paper. He argues that the biomedical model has always considered (before IM existed) the same core values that the above quote points out. (True perhaps in some respects, excluding informed evidence, but it could be said this attitude was ‘left at the door’ when Florence nightingale sadly departed. The NHS unfortunately cannot offer this kind of patient centered care, at least not all the time – many people through their own personal healthcare experience could identify this as truth, rising health costs are obvious to all).
    Ernst (2009) goes on to say that research in the CAM field more or less generates zero results!

    This is just one example of the barriers that exist for IM, misunderstandings, differences of opinions, and lack of respect for knowledge, be it proven or not.

    It is true that the diverse nature of CAM can be confusing, different systems and widely held beliefs do not necessarily overlap with each other. Therefore, it is no wonder that research is unable to identify the many useful elements that CAM therapies can individually offer.

    However, a paper by Verhoef et al (2005) propose, Complementary and alternative medicine whole systems research (WSR). The paper concludes, in order for such a system to work, one must look at conceptual and philosophical views in all their diversities, incorporating various research designs – new innovative approaches in analysis and teamwork, operating to help bring this vision forth.
    A ‘vision’ being the operative word, yet, does everything not stem from thought, vision, and ideas? I realise that the way forward for full IM is indeed a mammoth task, and as Tamara pointed out, it may be that the UK is playing a waiting game – looking to see how IM unfurls in other parts of the world. This of course would make sense given the myopic nature of political Britain at times.
    ‘Up and onwards’ they say – I for one do hope that there will be a substantial movement in my time concerning the area of IM.

    anji

    References

    MacPherson H, Peters D, Zollman C (2009) Closing the evidence gap in integrative medicine. BMJ: Vol 339

    Rapid Responses published: Integrative medicine. Edzard Ernst (2 September 2009)

    Verhoef M J, Lewith G, Ritenbaugh C, Boon H, Fleishman S, Leis A (2005) Complementary and alternative medicine whole systems research: Beyond identification of inadequacies of the RCT. Complementary Therapies in Medicine. Vol 13 pp 206-212

     
  • purelibra 7:58 pm on September 29, 2009 Permalink | Reply  

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  • purelibra 12:54 pm on September 19, 2009 Permalink | Reply  

    Discuss how the health promotion princip… 

    Discuss how the health promotion principles (in the WHO principles document) might be used to facilitate the provision of CAM within the health service. (Blog assignment)

    After reading the Declaration of Alma-Ata (1978) I am almost reduced to tears. What wonderful sentiments the paper contains concerning the worlds health. It reminds me a little of when I first watched the x-mass single ‘Do they know its x-mass?’ performed by leading musical artists of their time, their unification forming the group called ‘Band Aid’ in late 1985. The paper induced ‘feel good factor’ moments for me, similar to movies that make you loose yourself in a box of tissues. My heart aches for this beautiful vision to be realised in our world, who wouldn’t? I wonder who was present during the conference, and where they are now? I take my hat off to them for their collective vision and great intended thoughts concerning the health of all people on our planet. Surely they didn’t do it just for fun!
    The 1978 document suggests – people’s rights should include their own healthcare plans, with governments taking responsible action ensuring that adequate healthcare is provided. Primary healthcare being paramount, based on practical, scientifically and socially acceptable methods et cetera.

    Complementary and alternative therapies (CAM) could blend in beautifully within this idealistic framework. The declaration defines health as not only relating to illness as such, but also combining social well being, physical and mental health, further saying that the world’s population have these fundamental rights concerning their health. It would seem that holistic healthcare is a major concern for the World Health Organisation (WHO). Obviously CAM can help promote such health values due to the very fabric of it’s nature. Holistic care is an essential ingredient in order for this vision to be realised, CAM is definitely a winner in that department.

    anji

    References

    Declaration of Alma-Ata. International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September 1978

     
  • purelibra 6:52 pm on September 18, 2009 Permalink | Reply  

    Hello world! 

    What do you understand by the term “Integrated Health care”? (Blog assignment)

    “Lee – I loved your comments on “the school of Athens” – very ideal!

    I am in full agreement when it has been suggested that integrative health care is about patient choice, availability and accesability.  I also like to think that a patient can discuss with health care practitioners as to what they feel may be the right modality of treatment for them (bearing in mind that the patient may have already tried and found a treatment that works for them). Professional knowledge is needed in order to guide patients correctly be it their own choice or the practitioners choice. Patients should have good access to information concerning healing modalities and hopefully not be bounced from pillar to post undergoing too many different treatments in order to find one that helps them. Its important that a patient can recognise which treatment has been beneficial for them.
    I agree with Mike and Margaret’s comments at this moment in time.
    Integration of CAM within the NHS is hugely complex according to Smallwood (2005) further stating, that a model of integration must be well thought out before a choice of health care is delivered. Side-by-side practice is a model where CAM and general practitioners work under the same roof, whereas, a model of integration that throws up limitations concerning referrals and conventional and CAM practitioners working together is not so good. Moreover, ease of access and costs are a defining factor where local settings are concerned.
    Obviously there are huge implications that must be addressed before an ideal setting can evolve, the FIH are working on this as Mike mentioned.
    Sue spoke yesterday about four models of integration; I’m interested in finding out what they are. I have a hunch that the right models of integration are the way forward to achieving the right settings within Integrative Health care.

    anji

    Reference

    Smallwood C (2005) The Role of Complementary and Alternative Medicine in the NHS. London, PFIH

     
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