Even the most skilled and resourceful wound care provider encounters stagnation of wound healing from time to time. Patients with chronic, nonhealing wounds often display negative thought patterns and behavioral tendencies that, in turn, hinder biological and emotional healing. An increasing body of research supports the negative effect of stress on wound healing. The impact of deeper, emotion-based "wounds" as complicating factors in conventional wound healing are being further explored. It is theorized that emotions such as lack of self worth, guilt, and anger are strongly correlated to the chronic, nonhealing wound. Mind-body techniques such as affirmations, creative visualization, relaxation, and conscious breathing are suggested for incorporation into the treatment program. These techniques seek to empower and engage the patient by promoting greater personal awareness and assertion in the healing process. Wound care providers are seen as facilitators of the innate healing potential inside each individual. Mind-body techniques are offered as a complement for a more comprehensive wound healing strategy. (+info)
Mind-body medicine: state of the science, implications for practice.
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BACKGROUND: Although emerging evidence during the past several decades suggests that psychosocial factors can directly influence both physiologic function and health outcomes, medicine had failed to move beyond the biomedical model, in part because of lack of exposure to the evidence base supporting the biopsychosocial model. The literature was reviewed to examine the efficacy of representative psychosocial-mind-body interventions, including relaxation, (cognitive) behavioral therapies, meditation, imagery, biofeedback, and hypnosis for several common clinical conditions. METHODS: An electronic search was undertaken of the MEDLINE, PsycLIT, and the Cochrane Library databases and a manual search of the reference sections of relevant articles for related clinical trials and reviews of the literature. Studies examining mind-body interventions for psychological disorders were excluded. Owing to space limitations, studies examining more body-based therapies, such as yoga and tai chi chuan, were also not included. Data were extracted from relevant systematic reviews, meta-analyses, and randomized controlled trials. RESULTS: Drawing principally from systematic reviews and meta-analyses, there is considerable evidence of efficacy for several mind-body therapies in the treatment of coronary artery disease (eg, cardiac rehabilitation), headaches, insomnia, incontinence, chronic low back pain, disease and treatment-related symptoms of cancer, and improving postsurgical outcomes. We found moderate evidence of efficacy for mind-body therapies in the areas of hypertension and arthritis. Additional research is required to clarify the relative efficacy of different mind-body therapies, factors (such as specific patient characteristics) that might predict more or less successful outcomes, and mechanisms of action. Research is also necessary to examine the cost offsets associated with mind-body therapies. CONCLUSIONS: There is now considerable evidence that an array of mind-body therapies can be used as effective adjuncts to conventional medical treatment for a number of common clinical conditions. (+info)
Use of mind-body medical therapies.
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OBJECT: Research demonstrating connections between the mind and body has increased interest in the potential of mind-body therapies. Our aim was to examine the use of mind-body therapies, using data available from a national survey. DESIGN: Analysis of a large nationally representative dataset that comprehensively evaluated the use of mind-body therapies in the last year. SETTING: United States households. PATIENTS/PARTICIPANTS: A total of 2055 American adults in 1997-1998. INTERVENTIONS: Random national telephone survey. MEASURES AND MAIN RESULTS: We obtained a 60% weighted overall response rate among eligible respondents. We found that 18.9% of adults had used at least 1 mind-body therapy in the last year, with 20.5% of these therapies involving visits to a mind-body professional. Meditation, imagery, and yoga were the most commonly used techniques. Factors independently and positively associated with the use of mind-body therapies in the last year were being 40 to 49 years old (adjusted odds ratio [AOR], 2.03; 95% confidence interval [CI], 1.33 to 3.10), being not married (AOR, 1.78; 95% CI, 1.34 to 2.36), having an educational level of college or greater (AOR, 2.21; 95% CI, 1.57 to 3.09), having used self-prayer for a medical concern (AOR, 2.53; 95% CI, 1.87 to 3.42), and having used another complementary medicine therapy in the last year (AOR, 3.77; 95% CI, 2.74 to 5.20). While used for the full array of medical conditions, they were used infrequently for chronic pain (used by 20% of those with chronic pain) and insomnia (used by 13% of those with insomnia), conditions for which consensus panels have concluded that mind-body therapies are effective. They were also used by less than 20% of those with heart disease, headaches, back or neck pain, and cancer, conditions for which there is strong research support. Mind-body therapies were generally used concomitantly with conventional care: 90% of those using a mind-body therapy in the last year had seen a physician and 80% of mind-body therapies used were discussed with a physician. CONCLUSIONS: Although mind-body therapies were commonly used, much opportunity exists to increase use of mind-body therapies for indications with demonstrated efficacy. (+info)
Complementary and alternative medical therapies for chronic low back pain: What treatments are patients willing to try?
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BACKGROUND: Although back pain is the most common reason patients use complementary and alternative medical (CAM) therapies, little is known about the willingness of primary care back pain patients to try these therapies. As part of an effort to refine recruitment strategies for clinical trials, we sought to determine if back pain patients are willing to try acupuncture, chiropractic, massage, meditation, and t'ai chi and to learn about their knowledge of, experience with, and perceptions about each of these therapies. METHODS: We identified English-speaking patients with diagnoses consistent with chronic low back pain using automated visit data from one health care organization in Boston and another in Seattle. We were able to confirm the eligibility status (i.e., current low back pain that had lasted at least 3 months) of 70% of the patients with such diagnoses and all eligible respondents were interviewed. RESULTS: Except for chiropractic, knowledge about these therapies was low. Chiropractic and massage had been used by the largest fractions of respondents (54% and 38%, respectively), mostly for back pain (45% and 24%, respectively). Among prior users of specific CAM therapies for back pain, massage was rated most helpful. Users of chiropractic reported treatment-related "significant discomfort, pain or harm" more often (23%) than users of other therapies (5-16%). Respondents expected massage would be most helpful (median of 7 on a 0 to 10 scale) and meditation least helpful (median of 3) in relieving their current pain. Most respondents indicated they would be "very likely" to try acupuncture, massage, or chiropractic for their back pain if they did not have to pay out of pocket and their physician thought it was a reasonable treatment option. CONCLUSIONS: Most patients with chronic back pain in our sample were interested in trying therapeutic options that lie outside the conventional medical spectrum. This highlights the need for additional studies evaluating their effectiveness and suggests that researchers conducting clinical trials of these therapies may not have difficulties recruiting patients. (+info)
Migraine and tension headache--a complementary and alternative medicine approach.
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BACKGROUND: Migraine and tension headache are common--affecting up to 10% and 40% of the Australian population respectively--and result in significant reduction in social activities and work capacity for sufferers. OBJECTIVE: This article considers the evidence for the use of a range of complementary therapies and treatment in the prevention and management of both migraine and tension headache. DISCUSSION: Migraine and tension headache can have many precipitating factors. Considering dietary and environmental factors complements a migraine/headache consultation. There is evidence for the role of mind-body approaches, nutritional supplements such as riboflavin and magnesium, and acupuncture in the treatment of headache. By using a holistic approach we may be able to tailor a treatment program that is both effective and safe. (+info)
Factors associated with the use of mind body therapies among United States adults with musculoskeletal pain.
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OBJECTIVE: To determine the prevalence of mind body therapy use and correlates of use among adults with prolonged musculoskeletal pain, a group for whom mind body therapies are recommended. DESIGN: The U.S. 1999 National Health Interview Survey. Prolonged musculoskeletal pain was defined as any soft tissue, joint, or bony pain for at least 1 month. Analyses used SUDAAN and reflect national estimates. MAIN OUTCOME MEASURES: Use of mind body medicine (relaxation techniques, imagery, biofeedback, and hypnosis) and prayer in the previous year. RESULTS: Respondents (n=6079) with musculoskeletal pain were almost twice as likely as those without (n=24,722) to use mind body medicine (9% versus 5%, respectively, p<.0001) and prayer (20% versus 12%, respectively, p<.0001). After adjustment, men were less likely than women to use mind body medicine (odds ratio 0.55 [0.43-0.71]) and prayer (odds ratio 0.56 [0.48-0.66]). Those who had a high school education were less likely than those with training beyond high school to use mind body medicine (odds ratio 0.36 [0.28-0.47]) and prayer (odds ratio 0.61 [0.52-0.71]). CONCLUSIONS: Mind body therapies are not used commonly by adults with prolonged musculoskeletal pain. Understanding barriers to their use may facilitate wider application in this population. (+info)
Body-mind-spirit intervention for IVF women.
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BACKGROUND: Literature supports the efficacy of psychosocial intervention for infertile women. An eastern body-mind-spirit group intervention has been developed to help infertile women in the Chinese population cope with the distress arising from IVF treatment. METHODS: The eastern body-mind-spirit group intervention adopts a bio-psycho-social-spiritual health model, recognizing the strong association between mind, body, and spirit. Chinese philosophies and concepts of health will be integrated into the intervention, helping participants to regain balance and harmony both within themselves and between them and the environment. In this paper, a revisiting of assumptions, therapeutic goals, and the therapeutic process underlying this model are outlined. Program evaluation in terms of descriptive literary sketch done by the participants will be listed so as to illustrate the clinical process. CONCLUSIONS: It was shown and reflected that the eastern Body-Mind-Spirit approach could enhance the holistic health of IVF women. Further investigation on the program efficacy is then suggested. (+info)
Systematic review: Complementary and alternative medicine in the irritable bowel syndrome.
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BACKGROUND: Complementary and alternative medical therapies and practices are widely employed in the treatment of the irritable bowel syndrome. AIM: To review the usage of complementary and alternative medicine in the irritable bowel syndrome, and to assess critically the basis and evidence for its use. METHODS: A systematic review of complementary and alternative medical therapies and practices in the irritable bowel syndrome was performed based on literature obtained through a Medline search. RESULTS: A wide variety of complementary and alternative medical practices and therapies are commonly employed by irritable bowel syndrome patients both in conjunction with and in lieu of conventional therapies. As many of these therapies have not been subjected to controlled clinical trials, some, at least, of their efficacy may reflect the high-placebo response rate that is characteristic of irritable bowel syndrome. Of those that have been subjected to clinical trials most have involved small poor quality studies. There is, however, evidence to support efficacy for hypnotherapy, some forms of herbal therapy and certain probiotics in irritable bowel syndrome. CONCLUSIONS: Doctors caring for irritable bowel syndrome patients need to recognize the near ubiquity of complementary and alternative medical use among this population and the basis for its use. All complementary and alternative medicine is not the same and some, such as hypnotherapy, forms of herbal therapy, specific diets and probiotics, may well have efficacy in irritable bowel syndrome. Above all, we need more science and more controlled studies; the absence of truly randomized placebo-controlled trials for many of these therapies has limited meaningful progress in this area. (+info)