Combinatory and Complementary Practices of Values and Virtues in Design: A Reply to Reijers and Gordijn

There has been increasing interest in complementary health practices among patients, popular media, and even institutional health care providers. However, there is still surprisingly little information on the use of alternative medicine by patients undergoing treatment for prostate carcinoma. A prospective study of 50 consecutive patients undergoing radiation treatment for prostate carcinoma at a tertiary care referral center was conducted. Patients were surveyed after the initiation of radiation therapy whether they had used complementary health practices at any time. The authors found that a surprisingly high proportion of patients (37%) relied on complementary health practices not prescribed by physicians. In contrast, according to a separate survey of the treating physicians, the physicians believed that on average only 4% of their patients resorted to such practices. The use of complementary health practices usually continued even after the initiation of definitive treatment for prostate carcinoma. Patients who used complementary health practices tended to have higher levels of education and income, whereas there were no differences in age, religion, perception of health status, stage of prostate carcinoma, or prostate specific antigen level. Herbal remedies were the most frequently utilized, by 60% of those using complementary health practices, followed by old-time remedies (47%), high dose vitamins (41%), chiropractic/massage therapy and relaxation techniques (18% each), and special diets (12%). Patients undergoing radiation therapy for prostate carcinoma frequently rely on complementary health practices not prescribed by their treating physicians. Patients who do so tend to have higher education and income levels and continue their complementary practices during the conventional treatment. As the health implications of these practices are unclear, further research is clearly needed.

Appropriate complementary feeding practices have positive impact on health and growth of children aged 6-23 months. Little is known about complementary feeding practices among the pastoralists. The aim of this study was to document the influence of maternal knowledge on child feeding and complementary practices on the nutritional status of children aged 6-23 months amongst a pastoral community in Kenya. A WHO standard validated questionnaire was used to collect data from 289 randomly selected mothers/primary caregivers and their children aged 6-23 months. The interviews were conducted through face-to-face in a one-time household visit. The findings showed that half (50.2%) of the children received complementary foods at the age of six months. The proportion of breastfed and non-breastfed children that achieved the recommended Minimum Meal Frequency (MMF) was 28.7% and 2.6% respectively. About one-quarter (23.9%) achieved the recommended Minimum Dietary Diversity (MDD). A total of 5.9% achieved the Minimum Acceptable Diet (MAD). Majority of the mothers/caregivers (95.1%) knew that children should be encouraged to feed while 61.6% knew that children should be fed more frequently during and after illness. The timing of introduction of complementary feeding ([OR]=0.307, P=0.001) and child’s dietary diversity ([OR]=3.112, P=0.020 were predictors of wasting among the children while timing of introduction of complementary feeding ([OR]=0.226, P=0.000) and maternal knowledge on the duration of breastfeeding ([OR]=6.359, P=0.012) predicted child underweight.. Complementary feeding practices are not optimal and the nutritional status of the children is poor. Complementary feeding practices predicted child nutritional status whereas maternal/caregivers’ knowledge on complementary feeding practices had limited impact on child nutrition status.

Objetivo: Avaliar a produção científica associada à Política Nacional das Práticas Integrativas e Complementares após doze anos da sua implantação no Sistema Único de Saúde. Métodos: Estudo cienciométrico desenvolvido durante o primeiro semestre de 2019, utilizando o termo “Práticas Integrativas e Complementares”, os artigos foram selecionados por meio de títulos, depois de selecionados os filtros de busca foram encontrados 417 publicações, sendo 50 na base de dados Scielo, 115 na Lilacs e 252 na Biblioteca Virtual em Saúde. Após avaliação de títulos e resumos foram excluídos artigos duplicados e que não fizessem referência a política, resultando em 37 artigos. Os dados foram tabulados e organizados em planilhas do programa Microsoft Excel 2010. Resultados: Não houve publicações no ano de 2006, que foi o ano da implantação da política, os estudos começaram a serem publicados a partir do ano de 2007, ocorreram maiores publicações no ano de 2012 e 2016, das modalidades das Práticas Integrativas e Complementares, as mais relatadas foram a fitoterapia, a acupuntura e a homeopatia, 15 das 29 práticas integrativas complementares, não foram abordadas nos estudos. Considerações finais: A produção científica acerca da Política Nacional de Práticas Integrativas e Complementares é escassa, considerando sua importância para a saúde pública.

This study was conducted to determine the complementary and traditional-spiritual practices applied by individuals diagnosed with cancer when experiencing significant pain. This descriptive and cross-sectional study was conducted with 110 patients who were receiving chemotherapy treatment in a university hospital outpatient treatment unit (Chemotherapy Unit) between 1st March and 30th June 2019. The study sample size was calculated using the 'unknown-population sample selection formula' (n = t2·p·q·/d2). Study data were collected using a patient information form comprising 13 questions about the participants' sociodemographic characteristics, diseases, and complementary practices. The data were analyzed using descriptive percentage tests and the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) software. The study found that 45.5% of the cancer patients took a walk, 38.2% listened to music, 27.3% watched movies, 24.5% received massages, 20.0% read newspapers or books, 20.0% did sports, and 10.9% dreamed in painful situations. Spiritual practices used by the patients were determined as praying (46.4%), engaging in salat (the daily ritual prayers of Islam) (30.9%) and reading religious books (23.6%). The herbal practices applied by the patients include the use of garlic, mulberry molasses, pomegranate, green tea; furthermore, herbs such as honey, sage, lime, black cumin, ginger, centaury, thyme, nettle, flaxseeds, and rosehip were also used. Most of the patients learned complementary practices from television programs (62.7%); only 8.2% learned these practices from healthcare professionals. Nurses should investigate patients' use of complementary practices and provide them with the necessary evidence-based information to prevent unconscious use of these practices. Considering that determining patients' spiritual needs and practices is seen as the first step in the holistic care of patients, it is important to satisfy cancer patients by providing necessary healthcare services and help them improve their physical and mental health.

Complementary practice going mainstream? Many health care plans are proving it as they acknowledge the consumer interest in complementary practices and know that in this consumer-driven health care marketplace they must meet the needs of their current and future members. The focus needs to be on complementary, not alternative, and for true integration to happen a lot of hurdles still need to be overcome. One of the key tenets of complementary practice is prevention. The health care system is beginning to reshape benefit packages and membership offerings to meet the consumer need for wider health care choices. This article explains the beginnings of the integration of complementary health practices into managed care. We are headed for revolutionary changes in the use of complemen tary practices as the consumer demands a health care system where East meets West! This article provides resources so readers can access the data and experience of others as we move to widen the boundaries of the health care s...

First impressions in complementary practice: The importance of environment, dress and address to the therapeutic relationship

Objective: This study aimed to identify traditional and complementary medicine practices observed by nursing students in wound care. Method: This descriptive and cross-sectional study was conducted with nursing students. The sample consisted of 249 students. Data were collected through a sociodemographic questionnaire and a 15-item open-ended form designed to explore traditional and complementary medicine practices in wound care. Descriptive statistics were used for data analysis, and frequency (n) and percentage (%) distributions were calculated. Institutional and ethics committee approvals were obtained prior to the study. Results: Among the participants, 10.4% were male and 89.6% were female; the largest group was second-year students (32.5%). The most common practice for sunburn was applying yogurt (78.4%). For infection-related wounds, cologne (23.2%), onion juice (19.6%), and St. John’s wort oil (19.6%) were frequently observed. In burn injuries, cold-water application (47.9%), yogurt (11.8%), and ice (11.1%) were reported. For surgical wounds, St. John’s wort oil (65.2%) and Aloe vera (21.3%) were applied; in traumatic wounds, ice (53.6%) was preferred. Conclusion: The findings highlight culturally embedded practices in wound care, emphasizing the need to strengthen patient-centered approaches and distinguish non-evidence-based methods to promote evidence-based nursing care.

Homeopathy: A State of the Science Review With Recommendations for Practical Therapies in Midwifery Practice.

Purpose: Study in order to evaluate the use of complementary and integrative practices for leprosy-related pain. Cross-sectional, descriptive and quantitative research carried out at the University Hospital and Medical Specialties Center of Sergipe between February and June 2019. Methods: 170 people with leprosy pain contributed socio-demographic data, resources used for pain relief and factors that hinder adherence to practices. For pain assessment, the Verbal Pain Scales, Descriptor Scales and the tester Douler Neuropathic 4 were used. Results: Neuropathic pain was present in 119 individuals (70.0%) and the pain was assessed as severe in 85 (50.0%). Half of them (86; 50.6%) reported using pain relief: restricted diet (50, 29.4%), exercise (32, 18.8%), massage (31, 18.2%), among others. The factors that most influenced adherence to practices: lack of information (65, 38.2%), economic reasons (36, 21.2%), subjective characteristics (34, 20.0%). Women (45, 60.0%, p = 0.0427), patients with the borderline clinical form of the patient (23, 74.2%, p = 0.0014), reporting a burning sensation on the skin (70, 55, 5%, p = 0.0437), and those monitored by a physiotherapist (11, 84.6%, p = 0.0178) showed greater adherence to the practices. Conclusion: It is concluded that several complementary and integrative practices are being used for pain relief, but sociodemographic, clinical and care factors can influence adherence to these interventions.

Purpose – Although outsourcing has emerged as a key business practice in global supply chain management it has not always been successfully adopted. Since the reasons for outsourcing success and failure are underexplored this research aims to investigate the role of contractual completeness and complementary enforcement practices such as cooperation and monitoring and sanctioning practices under varying risk scenarios. Critically, these relationships are examined in the context of two serious risks: legal risk in the guise of rule of law and supplier non-conformance risk. Design/methodology/approach – Cross-country, survey data was collected through the global manufacturing research group and combined with secondary data from the World Bank. The authors carried out a series of regression analysis to explore their research questions. Findings – The results indicate that risk is a critical component of outsourcing success with legal risk reducing outsourcing performance on both cost and quality and supplier risk reducing outsourcing performance on quality. The results also indicate that these outcomes can be mitigated in some settings via complete contracts and complementary practices. These findings are likely to be generalized throughout the supply chain and are of relevance beyond the dyad. Originality/value – In the realm of supply chain practices this study presents a comprehensive attempt to assess the importance of risk and complementary practices for the success of outsourcing contracts. Furthermore, it assesses the role of contextual factors such as risk and the rule of law.

Introduction: “(R)existing” in the face of biomedical hegemony makes the offer of Integrative and Complementary Practices in Primary Health Care even more challenging, even with the existence of a national policy that establishes its implementation. The current political and institutional scenario disfavors what moves away from the “conventional”. The primacy of maintaining the status quo results in resistance to the “different”. This influences care practices, so that Integrative and Complementary Practices can suffer obstacles and reveal tensions regarding their realization. Objective: To understand, from the perspective of professionals, the factors that contribute to the production of social humiliation and public invisibility of Integrative and Complementary Practices in Primary Health Care. Methods: This is a descriptive, exploratory study with a qualitative approach. Semi-structured interviews were carried out with 20 professionals from 14 Primary Health Care services in three cities in the Metropolitan Region of Goiânia, between January and August 2018. The interviews recorded, transcribed, and treated with thematic content analysis. Results: From the analysis, two categories emerged: the social humiliation of professionals in Integrative and Complementary Practices in Primary Health Care and the production of public invisibility of Integrative and Complementary Practices in Primary Health Care. Professionals suffer different forms of social humiliation with the lack of support for their work and the Integrative and Complementary Practices suffer from public invisibility due to insufficient discussion about their offer in team meetings and inconsistency in the registration in the users' charts. Conclusion: Integrative and Complementary Practices have faced a partial and precarious inclusion in Primary Health Care.

ABSTRACTOBJECTIVE:To identify the possible repercussions of the COVID-19 pandemic on the workers’ health, the care strategies used, and the provision of Integrative and Complementary Practices in health services in the context of COVID-19.METHOD:Descriptive study, with a qualitative approach, which used a focus group for data collection and content analysis according to Bardin.RESULTS:Eleven health professionals from the city of Registro (SP) participated and, based on the information analysis, four categories emerged: (1) Changes in work routine caused by the pandemic and the feelings they generate in health professionals; (2) Integrative and Complementary Practices as a self-care strategy in the pandemic; (3) Provision of Integrative and Complementary Practices during the pandemic; and (4) Occupational health as the focus and strategy motivator to resume the provision of Integrative and Complementary Practices in the municipality.CONCLUSION:This study allowed the identification of the impact of the pandemic, especially on workers’ mental health, which influenced the search for care strategies that included the Integrative and Complementary Practices. Professionals with this training began to offer the Integrative and Complementary Practices in the service to other workers, given the interruption of their provision to the population due to the COVID-19 pandemic.

The objective of this study was to analyze the process of professional training and qualification for Integrative and Complementary Practices and to propose strategies for permanent health education, aiming at the continuity and integrality of care in Primary Health Care (PHC) and at home. This is an integrative review, carried out in the Virtual Health Library and in the PubMed, Scopus, SciELO, Web Of Science and CINAHL databases. The sample consisted of 13 studies. The results were grouped into four categories: professional training and qualification education on Integrative and Complementary Practices; the knowledge and advantages of training to offer Integrative and Complementary PracticesS; the most used Integrative and Complementary Practices; and, the predominant professional areas in the process of applying for Integrative and Complementary Practices. The state of the art on the process of training and application of Integrative and Complementary Practices in Primary Health Care can be known, by professionals graduated in the health area, filling knowledge gaps and providing suggestions for health permanent education strategies.

Introdução: o stress é um dos fatores de risco para hipertensão, e dentre os benefícios da prática da yoga encontra-se sua redução, bem como o aumento da capacidade de concentração e de criatividade, o equilíbrio do sono, a promoção da reeducação mental, dentre outros, proporcionando qualidade de vida. Além disso, a Política Nacional de Práticas Integrativas e Complementares no Brasil, visando prevenção de agravos e promoção da saúde. Objetivo: identificar as evidências científicas sobre a prática da yoga no tratamento para hipertensos. Metodologia: trata-se de uma revisão integrativa acerca da yoga como prática complementar em saúde para hipertensão. A busca deu-se por meio de consulta a artigos científicos no período de março a julho de 2019 em bases de dados eletrônicas, incluindo artigos publicados na íntegra entre os anos de 2013 e 2019. Resultados: dos 279 estudos inicialmente identificados, somente sete publicações compõe esta revisão, envolvendo um total de 508 pacientes, os quais participaram na maioria de estudos clínicos randomizados. Conclusão: os estudos apontam que a prática de yoga por hipertensos como prática complementar traz evidências de eficácia.

AimIntegrative and complementary practices (PICs) can be important health care strategies, mainly because they consider the integrality of the person. The objective of this article was to verify the inequality in the access to PICs of the Brazilian population based on data from the National Health Survey (PNS).Subject and methodsThis is a population-based cross-sectional study, with data from the 2019 PNS. The use of PICs in the past 12 months was investigated. Adjusted analysis was performed using Poisson regression and the Slope Index of Inequality (SII) and the Concentration Index (CIX) were used to assess absolute and relative inequality.ResultsThe prevalence of PIC use in Brazil was 5.4% (95%CI 5.3; 5.5). Individuals from the richest quintile, with higher education and with health insurance were more likely to use PICs in general, except for medicinal plants/herbal medicine. When observing the magnitude of inequalities, this was more positively accentuated in those with higher education and who had a private health plan.ConclusionThe results reveal social inequalities in the access to integrative practices, where the most elitist are more accessed by people with better socioeconomic conditions.