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Reference section
Reference section The following references were provided by the i n f o r m a t i o n service o f the Research Council for C o m p l e m e n t a r y Medicine ( R C C M ) . T h e i n f o r m a t i o n was obtained f r o m C I S C O M , a bibliographic database o f research in c o m p l e m e n t a r y medicine. Listing o v e r 30000 references to papers published w o r l d w i d e since the m i d - s i x ties, C I S C O M contains a w i d e variety o f data o n c o m p l e m e n t a r y medicine, m u c h o f w h i c h is o f interest to nurses, m i d w i v e s and other health professionals. Literature searches o f C I S C O M can be organised b y R C C M staff for a m o d e r a t e fee, typically between s T o organise a search o f C I S C O M , call the R C C M o n 0171 833 8897 and ask for the ' I n f o r m a t i o n Service'. Milne B, J o a c h i m G, Niedhardt J 1986 A stress management programme for inflammatory bowel disease patients. Journal of Advanced Nursing 11(5): 561-567. This randomized controlled trial was designed to determine whether practising stress management techniques would decrease activity and promote psychosocial functioning in inflammatory bowel disease patients. Eighty ambulatory adults received a pre-intervention interview, at which time baseline data about disease activity and psychsocial functioning were collected. They were then randomly assigned to either the intervention or control group. The intervention group received six classes on stress management which included autogenics, personal planning skills and communication techniques. All 80 subjects were followed up at 4month intervals for 1 year by interviewers who were blind to group designation. The data collection instruments, which were used at all assessment points, comprised three questionnaires: the Crohn's Disease Activity Index (CDAI) and the Inflammatory Bowel Disease (IBD) Stress Index. These instruments produced scores which decreased with improvement in physical and psychosocial well-being. At all assessment points, both the CDAI and IBD Stress Index scores dropped significantly (P less than 0.05) from baseline in the treatment group. However, there was no significant change in the scores of the control group throughout the study year. There were no sigComplementaryTherapies in Nursing & Midwq~ery(I 996) 2, 27-28 9 1996PearsonProfessionalLid
nificant changes in medications at any assessment point in either group that could account for changes in the scores. The results of this study indicate that stress management techniques may have therapeutic benefits for IBD patients.
Tsai SL, Crockett MS 1993 Effects o f relaxation training, combining imagery, and meditation on the stress level of Chinese nurses working in modern hospitals in Taiwan. Issues in Mental Health Nursing 14(1): 51-66. The purpose of this study was to test the effectiveness of relaxation training, which was based on the cognitive-behavioural model and specifically focused on helping Chinese registered nurses employed in large teaching hospitals to reduce their work stress in Taiwan, Republic of China. The study design was a pretest-posttest control design with two posttest points. The 137 subjects were selected randomly from three firstranked teaching hospitals. Twenty-three subjects in the experimental group and 23 in the control group from each hospital participated in the study. The treatment of the experimental group consisted of two sessions of relaxation training based on Smith's (1988) cognitive behavioural model of relaxation at weeks 1 and 2, with a follow-up session in the fifth week. The control group had the same sequence of sessions with a presentation by the researcher on theory analysis in nursing. The mean scores on the Nurse Stress Checklist (NSC) and the Chinese General Health Questionnaire (CGHQ) differed significantly between the experimental and control group in posttest 2 at week 5. These results supported the hypotheses that the relaxation training decreased the Chinese nurses' self-reported work stress as measured by NSC and increased the Chinese nurses' self-reported psychophysiologic health as measured by C G H Q . The significant difference on means of the C G H Q in posttest 1 at week 2 showed that the self-reported psychophysiologic health level responded to the relaxation training earlier than to the self-reported work stress level. In the relaxation treatment, duration o f practice was an important factor of the effectiveness of the treatment on the dependent variable of NSC. It is suggested that even brief teaching of relaxation techniques may reduce work stress levels and promote a sense of psychophysiologic health in Chinese nurses who are employed in large teaching hospitals in Taiwan. O w e n MJ, H o l m e s C A 1993 'Holism' in the discourse of nursing. Journal of Advanced Nursing. 18(11): 1688-1695. Holism is a turbid, amorphic term, of Quixotic character, the meaning of which alters accord-
28 Complementary Therapies in Nursing & Midwifery ing to the context in which it is located. C o m i n g to grips with holism has been likened to trying to hold ice, because it disappears in the attempt. This paper assesses the variety o f meanings attached to the term, and the extent to which the distinctive features ofholism have melted away in the hands o f nursing.
not a strict comparison o f acupuncture and conventional analgesia, since Entonax was available to all and used by the majority in the study, acupuncture was proved to have other advantages in the process o f labour.
Gerdner LA, S w a n s o n E A 1993 Effects o f
therapy in adult atopic dermatitis. Lancet 4: 340(8810): 13-17.
individualized music on confused and agitated elderly patients. Archives o f Psychiatric Nursing 7(5): 284-291. The progressively lowered stress threshold model in conjunction with an identified theoretical basis provides a framework for the use o f individualized music in individuals with dementia o f the Alzheimer's type (DAT). The effects o f individualized music is explored in five elderly patients who are confused and agitated and residing in a long-term care facility. The modified Cohen-Mansfield agitation inventory is used to measure the outcome. The immediate and 1-hour residual effects suggested the potential o f individualized music as an alternative approach to the management o f agitation in confused elderly patients.
Skelton IF, F l o w e r d e w M W 1988 Acupuncture and labour - a summary o f results. Midwives Chronicle 101 (1204): 134-138. The authors, a senior midwife and a member o f the International Society o f Biophysical Medicine, claim that all the evidence suggests that control o f labour pains has changed little over the last 20 years. W i t h the concern over the use o f drugs and their effect on the neonate, the author (IFS) ran a two-year study to investigate the comparative effectiveness o f conventional analgesics and acupuncture. T w o groups o f 85 women, matched for social class, parity and age, received either electro-acupuncture or conventional analgesia, including" epidural block, during labour. 37 women in the first group needed additional analgesia, and were classed as acupuncture-plus. The w o m e n receiving acupuncture reported a feeling o f calmness and well-being and in control o f their own labour and delivery; this did not necessarily correlate with a marked decrease o f pain relief. However, there was evidence that acupuncture resulted in a shorter first stage o f labour. The authors conclude that, although the study was
Sheehan MP, Rustin MH, Atherton DJ et al. 1992 Efficacy o f traditional Chinese herbal
There has been considerable interest in traditional Chinese herbal therapy ( T C H T ) a s a new treatment for atopic dermatitis. To establish the efficacy and safety o f this treatment, a daily decoction o f a formula containing ten herbs that has been found to be beneficial in open studies was tested in a double-blind placebo-controlled study. 40 adult patients with longstanding, refractory, widespread, atopic dermatitis were randomised into two groups to receive 2 months' treatment o f either the active formulation o f herbs ( T C H T ) or placebo herbs, followed by a crossover to the other treatment after a 4week washout period. The main outcome measures were extent and severity o f erythema and surface damage as j u d g e d by standardised body scores. The patients' o w n assessments o f the overall response to treatment were also sought. The geometric mean score for erythema at the end o f active treatment was 12.6 (95% confidence interval [CI] 5.9-22.0) and at the end o f the placebo phase was 113 (65-180). The geometric mean score for surface damage was 11.3 (5.8-21.8) and 111.0 (68 to 182), respectively. The 95% CI for the mean geometric ratio for the two values with active treatment was 0.04 to 0.22 for erythema (p<0.0005) and 0.04 to 0.27 for surface damage (p<0.0005). O f the 31 patients who completed the study and expressed a preference, 20 preferred that phase o f the trial in which they received T C H T whereas 4 patients preferred placebo (P<0.02). There was a subjective improvement in itching (P<0.001) and sheep (P<0.078) during the T C H T treatment phase. N o side-effects were reported by the patients although many c o m mented on the unpalatability o f the decoction. T C H T seems to benefit patients with atopic dermatitis. Palatability o f the treatment needs to be improved and its safety assured.
nificant changes in medications at any assessment point in either group that could account for changes in the scores. The results of this study indicate that stress management techniques may have therapeutic benefits for IBD patients.
Tsai SL, Crockett MS 1993 Effects o f relaxation training, combining imagery, and meditation on the stress level of Chinese nurses working in modern hospitals in Taiwan. Issues in Mental Health Nursing 14(1): 51-66. The purpose of this study was to test the effectiveness of relaxation training, which was based on the cognitive-behavioural model and specifically focused on helping Chinese registered nurses employed in large teaching hospitals to reduce their work stress in Taiwan, Republic of China. The study design was a pretest-posttest control design with two posttest points. The 137 subjects were selected randomly from three firstranked teaching hospitals. Twenty-three subjects in the experimental group and 23 in the control group from each hospital participated in the study. The treatment of the experimental group consisted of two sessions of relaxation training based on Smith's (1988) cognitive behavioural model of relaxation at weeks 1 and 2, with a follow-up session in the fifth week. The control group had the same sequence of sessions with a presentation by the researcher on theory analysis in nursing. The mean scores on the Nurse Stress Checklist (NSC) and the Chinese General Health Questionnaire (CGHQ) differed significantly between the experimental and control group in posttest 2 at week 5. These results supported the hypotheses that the relaxation training decreased the Chinese nurses' self-reported work stress as measured by NSC and increased the Chinese nurses' self-reported psychophysiologic health as measured by C G H Q . The significant difference on means of the C G H Q in posttest 1 at week 2 showed that the self-reported psychophysiologic health level responded to the relaxation training earlier than to the self-reported work stress level. In the relaxation treatment, duration o f practice was an important factor of the effectiveness of the treatment on the dependent variable of NSC. It is suggested that even brief teaching of relaxation techniques may reduce work stress levels and promote a sense of psychophysiologic health in Chinese nurses who are employed in large teaching hospitals in Taiwan. O w e n MJ, H o l m e s C A 1993 'Holism' in the discourse of nursing. Journal of Advanced Nursing. 18(11): 1688-1695. Holism is a turbid, amorphic term, of Quixotic character, the meaning of which alters accord-
28 Complementary Therapies in Nursing & Midwifery ing to the context in which it is located. C o m i n g to grips with holism has been likened to trying to hold ice, because it disappears in the attempt. This paper assesses the variety o f meanings attached to the term, and the extent to which the distinctive features ofholism have melted away in the hands o f nursing.
not a strict comparison o f acupuncture and conventional analgesia, since Entonax was available to all and used by the majority in the study, acupuncture was proved to have other advantages in the process o f labour.
Gerdner LA, S w a n s o n E A 1993 Effects o f
therapy in adult atopic dermatitis. Lancet 4: 340(8810): 13-17.
individualized music on confused and agitated elderly patients. Archives o f Psychiatric Nursing 7(5): 284-291. The progressively lowered stress threshold model in conjunction with an identified theoretical basis provides a framework for the use o f individualized music in individuals with dementia o f the Alzheimer's type (DAT). The effects o f individualized music is explored in five elderly patients who are confused and agitated and residing in a long-term care facility. The modified Cohen-Mansfield agitation inventory is used to measure the outcome. The immediate and 1-hour residual effects suggested the potential o f individualized music as an alternative approach to the management o f agitation in confused elderly patients.
Skelton IF, F l o w e r d e w M W 1988 Acupuncture and labour - a summary o f results. Midwives Chronicle 101 (1204): 134-138. The authors, a senior midwife and a member o f the International Society o f Biophysical Medicine, claim that all the evidence suggests that control o f labour pains has changed little over the last 20 years. W i t h the concern over the use o f drugs and their effect on the neonate, the author (IFS) ran a two-year study to investigate the comparative effectiveness o f conventional analgesics and acupuncture. T w o groups o f 85 women, matched for social class, parity and age, received either electro-acupuncture or conventional analgesia, including" epidural block, during labour. 37 women in the first group needed additional analgesia, and were classed as acupuncture-plus. The w o m e n receiving acupuncture reported a feeling o f calmness and well-being and in control o f their own labour and delivery; this did not necessarily correlate with a marked decrease o f pain relief. However, there was evidence that acupuncture resulted in a shorter first stage o f labour. The authors conclude that, although the study was
Sheehan MP, Rustin MH, Atherton DJ et al. 1992 Efficacy o f traditional Chinese herbal
There has been considerable interest in traditional Chinese herbal therapy ( T C H T ) a s a new treatment for atopic dermatitis. To establish the efficacy and safety o f this treatment, a daily decoction o f a formula containing ten herbs that has been found to be beneficial in open studies was tested in a double-blind placebo-controlled study. 40 adult patients with longstanding, refractory, widespread, atopic dermatitis were randomised into two groups to receive 2 months' treatment o f either the active formulation o f herbs ( T C H T ) or placebo herbs, followed by a crossover to the other treatment after a 4week washout period. The main outcome measures were extent and severity o f erythema and surface damage as j u d g e d by standardised body scores. The patients' o w n assessments o f the overall response to treatment were also sought. The geometric mean score for erythema at the end o f active treatment was 12.6 (95% confidence interval [CI] 5.9-22.0) and at the end o f the placebo phase was 113 (65-180). The geometric mean score for surface damage was 11.3 (5.8-21.8) and 111.0 (68 to 182), respectively. The 95% CI for the mean geometric ratio for the two values with active treatment was 0.04 to 0.22 for erythema (p<0.0005) and 0.04 to 0.27 for surface damage (p<0.0005). O f the 31 patients who completed the study and expressed a preference, 20 preferred that phase o f the trial in which they received T C H T whereas 4 patients preferred placebo (P<0.02). There was a subjective improvement in itching (P<0.001) and sheep (P<0.078) during the T C H T treatment phase. N o side-effects were reported by the patients although many c o m mented on the unpalatability o f the decoction. T C H T seems to benefit patients with atopic dermatitis. Palatability o f the treatment needs to be improved and its safety assured.