traditional chinese medicine background conceptual ba sis acupuncture acupuncture for pain...

Acupuncture

Overview:Traditional Chinese Medicine

BackgroundConceptual basis Acupuncture

Acupuncture for Pain Management: an evidence based review

PurposeReview of LiteratureNursing Theory

Traditional Chinese Medicine

AcupunctureMassageTraditional Herbal RemediesMoxibustion(heat application)Tai chi, qi gong

The vital energy force Qi: The vital life force

~361 acupoints along 12 meridians ~

Our Paper:

Acupuncture: An Option for Pain Management in Primary Care

PurposeReview acupuncture studies found in the

literature

Examine theoretical frameworks that support acupuncture

Review cultural, ethical & legal issues surrounding acupuncture

Consider incorporation of acupuncture into advanced nursing practice

Review of Literature

CINAHL & Proquest databases searched

Search narrowed with keywords: Acupuncture & Pain Management

8 studies selected and analyzed

Review of LiteratureAUTHOR

SSTUDY SUBJECTS METHODS RESULTS

Martin, Sletten, Williams, & Berger,2006

50 Fibromyalgia patients: (25 in control group, 25 in acupuncture group)

Sham acupuncture vs. true acupuncture(6 bilateral points)

FIQ score improved with acupuncture group (p=.01) & MPI scores improved, (most in fatigue & anxiety scales)

Spira, 2008

132 sailors in Iraq Acupuncture offered w/ medical treatments for sprains, fractures, etc.

Return to duty 2 days (avg) sooner than conventional therapy group

Tam, Leung, Li, Zhang, & Li, 2007

36 patients from Prince of Wales Hospital w/ RA

Randomized, double-blind, placebo-controlled trial analyzing effects of EA, TCA, & sham acupuncture

EA group: Reduced physician global assess. scores (p=0.04) & # of tender joints (p=0.03); TCA group: reduced pt global assess. scores & # of tender joints (p=0.01)

Review of LiteratureAUTHORS STUDY SUBJECTS METHODS RESULTS

Prady, Thomas, Esmonde, Crouch, & MacPherson, 2007

105 of 239 original ‘back pain trial’ participants

36-item quality of life questionnaire addressing pain

No significant differences after 7 years, although 90.8% (treatment group) would recommend acupuncture (62.1% of control group)

White, Foster, Cummings, & Barlas, 2007

2362 patients with chronic knee pain

Meta-analysis of 13 randomized control studies

Suggests that acupuncture is superior to sham treatment, but need more large, quality trials

Vas, Aguilar, Perea-Miller, Mendez, 2007

Patients @ Pain Treatment Unit in Spain (wide variety of non-onc pain complaints)

Retrospective review of 5981 records of patient treatment programs

Overall favorable responses; no severe adverse events, reduced analgesic & anti-inflammatory drug consumption

Review of LiteratureAUTHORS STUDY

SUBJECTSMETHODS RESULTS

Lind et al, 2005 302 patients with migraine headaches in Germany

Randomized control trial: acupuncture vs. sham acupuncture vs. none

# of days with HA decreased in acupuncture group (from 5.2 to 3 days) and sham group (from 5 to 2.2 days)

Reynolds, Bland & MacPherson, 2008

30 IBS patients: (20 in control group & 10 in acupuncture group)

Exploratory randomized control trial: general practitioner care w/ & w/o acupuncture treatment

No acupuncture group: scores down 322 to 287Acupuncture group: scores down 343 to 128.

Nursing Theory & AcupunctureSimultaneity Paradigm:

Human being as unitary wholeMutual, simultaneous, non-linear human-

environment interaction

Health=pattern of the whole

Nursing: attempts to stimulate re-patterning

Nursing Theory & AcupunctureExamples:

Martha Rogers’ Science of Unitary Human Beings

Rosemarie R. Parses’ Theory of Human Becoming

Susan K. Leddy’s Theory of Energetic Patterning

Cultural, Legal & Ethical Considerations

Cultural: Understand individual beliefs & needs; understand the philosophy behind healing

Legal: Referrals should be to practitioners who are board certified

Ethical: Balancing beneficence & patient autonomy

Incorporation into ANPType Indication

Respiratory Allergic rhinitis

GI Biliary colic, dysentery, epigastralgia (in peptic ulcer,

acute and chronic gastritis and gastrospasm

Pain Facial Pain, headache, knee pain, low back pain, neck

pain, dental and TMJ pain, periarthritis of the shoulder,

postoperative pain, rheumatoid arthritis, sciatica,

sprain, tennis elbow

Gynecologic

al and Renal

Renal colic, primary dysmenorhhea, induction of labor,

correction of malposition of fetus

Cardiovascul

ar

Hypertension, hypotension, stroke

General Adverse reactions to radiotherapy and/or

chemotherapy, depression (including depressive

neurosis and depression following stroke), leukopenia,

morning sickness, nausea and vomiting

ContraindicationsPatients on anti-

coagulation therapy should not participate in acupuncture due to risk of bleeding

Acute emergency cases should seek Western medical attention (ex. Shock, septicemia, hemorrhage, MI, surgical emergencies)

THE END