Compassionate Medicine
September 16, 2009 Written by JP [Font too small?]At this very moment in the United States there is a monumental debate going on about health care reform. Some citizens and politicians are proposing significant changes to the current paradigm while others are generally in favor of maintaining the system that’s already in place. I think there’s at least one issue that all sides can hopefully agree on – health care can and should be improved, in part, by the efforts made by individuals. One way to accomplish this is to take steps to improve personal health. Another important strategy is to help others enjoy better health. It may seem far-fetched, but simple acts of compassion and kindness can sometimes be a profound and essential adjunct to virtually any medical treatment.
21st century medicine provides us with medical and surgical options that were unimaginable in the recent past. There is virtually no part of the body that can’t be viewed or otherwise accessed by way of computer assisted technology. But the truth is that all of these scientific breakthroughs can never completely fulfill the core needs of every patient. There are parts of the mind or, as some might say, the “heart” or “spirit”, that are better touched in decidedly simple and traditional ways.
Two recent studies demonstrate the absolutely vital role that one’s mindset can play in supporting physical health. An upcoming meta-analysis in the journal Cancer looked at the role that depression plays in the quality of life and survival outlook for those with malignancies. A total of 25 studies were evaluated. Over 9,400 patients were taken into account for this summary.
- The researchers found that “death rates were up to 25% higher in patients experiencing depressive symptoms”.
- They also noted an even higher figure (39%) when looking at patients with clinically diagnosed depression.
A different study evaluated the effects of “profound loss” on cardiovascular health. 160 individuals were included in this research. Half of the group had recently experienced the loss of child or mate. During the first 6 months of the evaluation, the grieving group demonstrated a 6 times higher risk of having a heart attack. This elevated risk did not seem to be age-related, as individuals as young as 30 were vulnerable. By the completion of the 2 year examination, the additional threat appeared to fade. The authors of this research suspect that temporarily elevated stress hormones may be the cause of this phenomenon. (1,2)
There are many pharmaceutical agents that could help address the depression and stress related to the passing of a loved one or the onset of a life-threatening illness. In certain circumstances, such measures may be necessary. But it’s also important to consider that these physically damaging reactions are provoked by a specific change in life. The feelings involved are as justifiable as can be. Therefore, perhaps a more humanistic approach may be called for in these types of situations.
My initial reaction was to assume that offering a “sympathetic ear” would be the best form of comfort. The scientific term for this is “expressed emotion” and it has been shown to afford benefits to those with cardiovascular disease and in oncology patients. But not everyone feels comfortable sharing their innermost feelings at these sensitive times. Fortunately, there are other alternatives that may prove equally effective. (3,4)
- Healing Touch – A supportive back rub or a heartfelt hug could be just the ticket to reduce the depression and stress relating to physical illness. A published trial just conducted at the Wake Forest University School of Medicine attests to that fact. In this instance, the benefits were found in a group of young cancer patients. Another recent study concluded that, “therapeutic touch may be effective for management of symptoms like restlessness coupled with stress reduction. At a time when cost containment is a consideration in health care, therapeutic touch is an intervention that is non-invasive, readily learned, and can provide a non-pharmacologic alternative for selected persons”. (5,6,7)
- Music Therapy – A big part of the success of any healing protocol is knowing the individual who’s being treated. Many studies demonstrate that enjoyable music can help lift spirits. Music can literally stimulate parts of the brain that are incapacitated during anxious and depressive episodes. The key, of course, is to select the music based on the preferences of the person you wish to help. It’s not often that a physician or psychiatrist will prescribe a CD to promote recovery. This is a fact that’s unlikely to change. But a musical gift from a caring soul can be delivered without the assistance of a prescription pad or pharmacist. (8,9,10)
- Warmth Therapy – The idea of warming up to lighten up may be foreign to most of us. But this is the basis for some very exciting research from the University of Colorado at Boulder. Dr. Christopher Lowry was recently granted $500,000 by the National Science Foundation to further his study of this theory. According to Dr. Lowry, “Whether lying on the beach in the midday sun on a Caribbean island, grabbing a few minutes in the sauna or spa after work, or sitting in a hot bath or Jacuzzi in the evening, we often associate feeling warm with a sense of relaxation and well-being.” He goes on to explain that, “One mechanism through which sensations of warmth may modulate neural circuits controlling cognitive function and mood is the activation of temperature-activated transient receptor potential (TRP) ion channels, including TRPv3 and TRPv4 which are active in the non-noxious thermal range, 27–42 °C”. So maybe sharing a blanket or asking a struggling family member or friend to join you in the hot tub or sauna could help them through a particularly rough stage in their life. It’s an unconventional approach to be sure, but that doesn’t mean it won’t be effective. (11,12,13)
There is a certain set of skills that doctors and nurses possess that are beyond those of laypeople. But there is a level of caring and concern that we cannot expect the medical community to provide for our loved ones. It’s not unreasonable to expect a medical staff to treat their customers (patients) with compassion and dignity. However, it is unrealistic to depend on them to have all the answers and to provide enough attention to fully nurture the human spirit. That’s our job, as family, friends and neighbors.
Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!
Be well!
JP
Tags: Cancer, Depression, Heart Health
Posted in Alternative Therapies, Heart Health, Mental Health
September 18th, 2009 at 2:34 am
Nice graphical representation.It is in maintaining stable position.
September 18th, 2009 at 11:42 am
Thank you!
Be well!
JP
September 20th, 2009 at 10:58 am
I love how you think outside the box.
September 20th, 2009 at 4:30 pm
Thanks, Angie! 🙂
Be well!
JP
June 30th, 2015 at 11:42 pm
Update 06/30/15:
http://www.explorejournal.com/article/S1550-8307%2815%2900032-4/abstract
Explore (NY). 2015 May-Jun;11(3):208-16.
The effects of healing touch on pain, nausea, and anxiety following bariatric surgery: a pilot study.
CONTEXT: Given the growth in the number of bariatric surgeries, it is important for healthcare practitioners to maximize symptom management for these patients, including the option of complementary therapies such as Healing Touch.
OBJECTIVE: A quasi-experimental study was conducted to determine the feasibility of a Healing Touch intervention for reducing pain, nausea, and anxiety in patients undergoing laparoscopic bariatric surgery.
DESIGN: Following surgery, a nurse administered the Healing Touch intervention once daily. Study participants reported levels of pain, nausea, and anxiety immediately before and after the Healing Touch intervention using separate numeric rating scales.
RESULTS: Significant decreases in pain, nausea, and anxiety were observed immediately following the intervention on post-operative days one and two, and in pain and anxiety on post-operative day three compared with pre-intervention levels. These findings indicate that the Healing Touch intervention is feasible and acceptable to patients undergoing bariatric surgery, and significantly improved pain, nausea, and anxiety in these patients.
Be well!
JP
May 23rd, 2016 at 6:53 pm
Updated 05/23/16:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4860206/
Med Arch. 2016 Apr;70(2):142-7.
Effect of Therapeutic Touch in Patients with Cancer: a Literature Review.
BACKGROUND: The use of complementary and alternative medicine (CAM) techniques has been growing. The National Center for Complementary and Alternative Medicine places therapeutic touch (TT) into the category of bio field energy. This literature review is aimed at critically evaluating the data from clinical trials examining the clinical efficacy of therapeutic touch as a supportive care modality in adult patients with cancer.
METHODS: Electronic databases (PubMed, Scopus, Scholar Google, and Science Direct) were searched from the year 1990 to 2015 to locate potentially relevant peer-reviewed articles using the key words therapeutic touch, touch therapy, neoplasm, cancer, and CAM. Additionally, relevant journals and references of all the located articles were manually searched for other potentially relevant studies.
RESULTS: The number of 334 articles was found on the basis of the key words, of which 17 articles related to the clinical trial were examined in accordance with the objectives of the study. A total of 6 articles were in the final dataset in which several examples of the positive effects of healing touch on pain, nausea, anxiety and fatigue, and life quality and also on biochemical parameters were observed.
CONCLUSION: Based on the results of this study, an affirmation can be made regarding the use of TT, as a non-invasive intervention for improving the health status in patients with cancer. Moreover, therapeutic touch was proved to be a useful strategy for adult patients with cancer.
Be well!
JP
June 30th, 2018 at 7:03 pm
Updated 06/30/18:
https://www.ncbi.nlm.nih.gov/pubmed/29957370
Eur Psychiatry. 2018 Jun 26;53:66-73.
Effectiveness of watchful waiting versus antidepressants for patients diagnosed of mild to moderate depression in primary care: A 12-month pragmatic clinical trial (INFAP study).
BACKGROUND: Although mild to moderate major depressive disorder (MDD) is one of the main reasons for consulting a general practitioner (GP), there is still no international consensus on the most appropriate therapeutic approach.
METHODS: The aim of this study is to evaluate the clinical effectiveness of watchful waiting (WW) compared with the use of antidepressants (ADs) for the treatment of mild to moderate depressive symptoms in 263 primary care (PC) usual-practice patients in a 12-month pragmatic non-randomised controlled trial. Both longitudinal and per-protocol analyses were performed, through a multilevel longitudinal analysis and a sensitivity analysis.
RESULTS: We observed a statistically significant time x treatment interaction in the severity of depression (Patient Health Questionnaire, PHQ-9) and disability (World Health Organization Disability Assessment Schedule, WHODAS) in favour of the AD group at 6 months but not at 12 months. The effect size of this difference was small. No statistically significant differences were observed between groups in severity of anxiety (Beck Anxiety Inventory, BAI) or health-related quality-of-life (EuroQol-5D, EQ-5D). Sensitivity analysis and per-protocol analysis showed no differences between the two groups in any of the evaluated scales.
CONCLUSIONS: Superiority of either treatment (WW and AD) was not demonstrated in patients treated for depression in PC after one year of follow-up.
Be well!
JP
September 26th, 2018 at 3:22 pm
Updated 09/25/18:
https://www.liebertpub.com/doi/full/10.1089/acm.2018.0192
J Altern Complement Med. 2018 Sep/Oct;24(9-10):968-973.
Cancer Pain Relief After Healing Touch and Massage.
OBJECTIVES: To establish and compare the effectiveness of Healing Touch (HT) and Oncology Massage (OM) therapies on cancer patients’ pain.
DESIGN: pretest/post-test, observational, retrospective study.
SETTINGS/LOCATION: Outpatient oncology setting at an academic hybrid, multisite, community-based cancer institute.
SUBJECTS: n = 572 cancer outpatients.
INTERVENTIONS: Patients reported pain before and after receiving a single session of either HT or OM from a certified practitioner.
OUTCOME MEASURES: Pain scores from 0 = no pain to 10 = worst possible pain.
RESULTS: Two hundred ninety-one patients (50.9%) receiving HT and 281 (49.1%) receiving OM reported pretherapy and post-therapy pain. Pretherapy mean pain was higher in HT patients (M = 5.1, ±2.2) than OM (M = 4.4, ±2.2), p < 0.001; post-therapy mean pain remained higher in HT patients (M = 2.6, ±2.1) than OM (M = 2.0, ±1.8), p < 0.001. Both HT (p < 0.01) and OM (p < 0.01) significantly reduced pain. Unadjusted rates of clinically significant pain improvement (defined as ≥2-point reduction in pain score) were 0.68 HT and 0.71 OM. Adjusted for pretherapy pain, OM was associated with increased odds of pain improvement (odds ratio [OR] 1.49 95% confidence interval (1.02-2.19); p = 0.041). For patients with severe pretherapy pain, OM was not more effective in yielding clinically significant pain reduction (p = 0.236) when adjusting for pretherapy pain score.
CONCLUSIONS: Both HT and OM provided immediate pain relief. Future research should explore the duration of pain relief, patient attitudes about HT compared with OM, and how this may differ among patients with varied pretherapy pain levels.
Be well!
JP