ANSWER:

                                                   Complementary and Alternative Medicine (Acupuncture) and Palliative Care

The use of alternative therapies has seen a rise in palliative care despite the absence of intense scientific research on the existing therapies. Acupuncture is among the leading treatment modalities in Chinese culture that has gained a lot of traction globally. Acupuncture involves combined techniques characterized by needle insertion into the skin with manual manipulation or electrical stimulation to provide a remedy. This technique is sometimes used alongside other therapies like acupoints injection, moxibustion, and transcutaneous electrical nerve stimulation (Lau et al., 2016). This technique has been used for over 2000 years in managing pain, fatigue and improvement of the quality of life. The technique is highly used in the palliative care of cancer patients. The World Health Organisation indicates that palliative care should have the primary objective of improving patients’ quality of life with life-threatening diseases by managing existent symptoms. Palliative care for cancer patients not only focuses on cancer-related symptoms like pain and insomnia but also reduces the side effects of chemotherapy and radiotherapy (Wu et al., 2015). This paper aims at discussing acupuncture and its use in the palliative care of cancer patients while identifying the challenges nurses provide in providing the therapy to patients. The paper will also discuss integrating complementary and alternative medicine into palliative care and the ethical implication of the act. Lastly, the paper will elaborate on the existent shared role of patients and nurses in developing care plans.

                                       Challenges Associated with Nurses Role in Providing Alternative Therapies for Patient Care

The first challenge is the lack of awareness among the stakeholders. The patient may lack knowledge on the applicability of the therapy or lack proof of its use in managing symptoms. This may result in the therapy’s dismissal, which may greatly benefit the patient’s quality of life. As a result, the nurses have to educate the patient about the approaches and use scientific literature and other care professionals to convince them of the approach’s efficacy. It is also a challenge when the other care professionals who help provide a patient’s palliative care are less informed of the patient’s recommended therapy. This calls for the review and sharing of scientific literature and the inclusion of professional on-site staff to educate and carry out the approaches (Lopes-Junior et al., 2020).

The affordability of the therapy is also a great challenge, especially for low-income earners. In most cases, well-studied and recommend alternative therapy are usually used as a complement to mainstream medicine. The patient is usually charged for both, which raises the cost of treatment. As such, the patient may not be ready to accept the therapy. Similarly, in some cases like palliative care, it is quite challenging to have the patient manage themselves, eliminating the possibility of self-efficacy and self-care (Abuelgasim et al., 2018).

Availability of the approach is also a challenge that prevents patients from getting the therapies despite recommendations. In most cases, you find that health facilities lack the qualified care professionals in providing the therapy or lack the necessary equipment to facilitate the therapy. Similarly, the care may only be available in the high-end facility and absent in communities where they are needed the most (Abuelgasim et al., 2018; Lopes-Junior et al., 2020).

                                                                 Integration of CAM in Palliative Care-Acupuncture.

The primary action is identifying the technique and supporting evidence. In return, the nurses need to demonstrate to the management and other care professionals how the intervention helps manage patient symptoms, thus enhancing the technique’s incorporation in a quality improvement process. In this case, several studies indicate that acupuncture is effective in palliative care of cancer patients; it has been found to reduce pain, fatigue, and improve quality of life, primarily when used as a complement of conventional medicine. Furthermore, acupuncture and related therapies have therapeutic effects in managing chemotherapy-induced nausea and vomiting, and leukopenia. Available studies do not indicate any serious adverse effects on treatment, thus proving to be relatively safe. On approval of the use of  CAM, the nurses can educate the patient in need of the therapy and their family members to thus help them decide on incorporating the therapy into their existing treatment without any fear of adverse effects. A lot of ethical concerns arise with the use of CAM. It is hard to know if the patients’ parents on palliative care are allowed to decide on the recommended therapy to improve their quality of life.

In most cases, the available options are usually exhausted, and the only result is using the therapies, which significantly impacts patient autonomy. Similarly, if the therapy fails to provide the intended results, the compensation scheme is quite unclear. Furthermore, the inability to evaluate the therapy’s progress or outcome makes it difficult to rely entirely on the methods. Another ethical issue is whether children undergoing palliative care can decide independently using CAM or only their parents (Jacobson and Cain, 2009).

                                        Elements to Include When Teaching Nurses on Use of CAM (Acupuncture) In Palliative Care

The first thing to include is patient and family education. It is vital to have the patient understand the technique and the expected outcome and provide existing evidence. Secondly, it is necessary to ensure that nurses follow the conventional ethical practice in all CAM approaches. This, at least, reduces any chances of harm and proves to the patient that the desired effect is the improvement of quality of life. Lastly, it is essential to understand that the approach should always be used as a complementary medicine and not alternative medicine. This is because the data from the use of the technique have not been entirely accepted and approved and may have different results.

                                                                 Shared role of Nurse and Patients in Developing Care Plans

One shared role is the aspect of decision making. Progress of the therapy will be based on the therapy’s outcome and availability of sufficient information for the patient and his/her family members. The patient can decide to opt-out, and the nurse can also inform the patient to opt-out if no desired result is being achieved. The patient and nurse have a role of ensuring that the selected therapy is the one that the patient is more comfortable with at their current state of health. For example, The nurses can use a different approach for a patient who dreads needles. Lastly, it is the patient and the nurse’s role to evaluate and record the progress of treatment continually.

                                                                                                  Conclusion

CAM approaches are quite useful when used together with conventional medicine in palliative care. This is true for acupuncture, which has been studied vastly compared to other techniques with limited or lack of entirely scientific evidence. However, the absence of regulations, lack of extensive awareness, and ethical implications limit the use of CAM. There is a need for intense research on the approaches to prove the techniques’ efficacy before they are incorporated into different health facilities.

 

                                                                                                  References

Abuelgasim, K. A., Alsharhan, Y., Alenzi, T., Alhazzani, A., Ali, Y. Z., & Jazieh, A. R. (2018). The use of complementary and alternative medicine by patients with cancer: a cross-sectional survey in Saudi Arabia. BMC complementary and alternative medicine, 18(1), 88. https://doi.org/10.1186/s12906-018-2150-8

Jacobson, G. M., & Cain, J. M. (2009). Ethical issues related to patient use of complementary and alternative medicine. Journal of oncology practice, 5(3), 124–126. https://doi.org/10.1200/JOP.0938501

Lau, C., Wu, X., Chung, V., Liu, X., Hui, E. P., Cramer, H., Lauche, R., Wong, S., Lau, A., Sit, R., Ziea, E., Ng, B., & Wu, J. (2016). Acupuncture and Related Therapies for   Symptom Management in Palliative Cancer Care: Systematic Review and Meta-Analysis. Medicine, 95(9), e2901. https://doi.org/10.1097/MD.0000000000002901

Lopes-Júnior, L. C., Rosa, G. S., Pessanha, R. M., Schuab, S., Nunes, K. Z., & Amorim, M. (2020). Efficacy of the complementary therapies in the management of cancer pain in palliative care: A systematic review. Revista latino-americana de enfermagem, 28,         e3377. https://doi.org/10.1590/1518-8345.4213.3377

Wu, X., Chung, V. C., Hui, E. P., Ziea, E. T., Ng, B. F., Ho, R. S., Tsoi, K. K., Wong, S. Y.,   & Wu, J. C. (2015). Effectiveness of acupuncture and related therapies for palliative care of cancer: overview of systematic reviews. Scientific reports, 5, 16776. https://doi.org/10.1038/srep16776

 

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QUESTION:

Holistic Care and Treatments

 

The use of complementary and alternative therapies in the treatment of cancer patients, terminal patients, and many other types of patients is steadily increasing. The Resources also contain much information about the various alternative therapies currently being used.

 

For this Discussion, you will consider alternative therapies and discuss the challenges associated with them.

 

To prepare for this Discussion:

• Review the Resources pertaining to alternative therapies.
• Select one of the following areas where alternative therapies are being used:

o             Cancer treatment

o             Cancer symptom management

o             End-of-life care

o             Palliative care

• Find at least one scholarly journal article discussing alternative therapies in your chosen subtopic.

 

Respond to the following:

• Identify at least one challenge associated with the nurse’s role in providing alternative therapies for patient care.
• Explain how the nurse might integrate the use of Complementary and Alternative Medicine (CAM) approaches in your chosen subtopic and discuss the ethical issues nurses may face.
• What are the main elements you would include in a teaching plan for nurses on the use of CAM in your chosen subtopic?
• What is the shared role of the nurse and patient in developing care plans?

 

Support your response with references from the professional nursing literature.