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CAM is an acronym for complementary and Alternative Medicine from National Center for Complementary and Alternative Medicine (NCCAM), CAM is defines as a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. Conventional medicine which is also known as Western medicine is medicine practiced by registered MD or doctors of medicine and allied health practitioners like physical therapists, psychologists and others.  Some examples of CAM applications are acupunctures, yoga, herbal medicines and other forms of massage like reflexology and other muscles and nerves massage.

Describe the patient who uses CAM the most.

In the research conducted by Dr. David Eisenberg, MD in 1993 shows that 33% of Americans of the respondents in his study practiced CAM. Another finding is that the highest use of complementary and alternative medicine was reported by people between 25 to 49 years of age who had relatively more education and higher incomes. The majority used unconventional therapy for chronic, as opposed to life-threatening, medical conditions. Another interesting finding of the study is that CAM is used by 83% of respondents as a treatment being treated by a doctor. A continuing study conducted by the same person on 2002 using 31,044 respondents, found out that factors associated with highest rates of CAM use were ages 40-64, female gender, non-black/non-Hispanic race, and annual income of $65,000 or higher.  In Asia, particularly Singapore of which a multiracial study was conducted in 2005 by M.K. Lim, et al , it was found that 84% of Chinese, 69% of Indian, and 95% of Malays. Traditional Chinese medicine was the most widely used form of CAM.

List some common misconceptions about CAM.

In as much as CAM is not highly empirical in terms of study using the western standards the following are the most common misconceptions:

It is unscientific. Though we always say that western medicine or orthodoxy medicines involved empirical evidence, it was shown that 84% of being practiced using this mode of administration does not undergo rigorous testing. Undoubtedly, CAM is in a shaky foundation but this is back up by hundred of years of practice of which except that no proper documentation was done.

CAM is not effective. This misconception is due to the facts that most results are undocumented. CAM is mostly used with conventional medicines that its effects are not given importance.

 The 'philosophies of CAM are so obviously wrong that scientific testing would be a waste of time. This misconception is because the theoretical foundation of CAM is not according to the theoretical model followed by western medicine. The hypothetico-deductive model is not generally practice for rigorous testing, nevertheless, the different approach of expansion in learning is not necessarily wrong.

CM Is used only by a small minority. This misconception is stereotyping the groups that generally practice it. It is to be noted that acupuncturists in China is so many that it is considered a very effective mode of curing and prevention of some common diseases. In the previous discussions, we had seen that so many patients are practicing it in tandem with conventional medicines.

Identify some methods of including the use of CAM in patient education

CAM Methods and practices involved different forms. These are the following:

Biologically based method – this method involved the use of herbal medicines and supplements for the dietary deficiency and for additional nutrients in the body.

Manipulative and body-based therapies – massage and chiropractic activities in which muscles, bones and other structural parts of the body are involved here with kneading and rubbing are done.

Mind-body interventions – CAM involved healing not only of the body but also of the spirit. Yoga, meditations and biofeedback are only some of its most common examples.

Discuss the safe use of CAM

CAM is not a panacea. When done improperly, it may also have debilitating effect on the patients. The following are some of the recommendations when using CAM.

Be careful in selecting CAM practitioners. A background investigation must be done before a patient select a particular CAM Practitioner.

Some dietary supplements may have adverse effects on the body. It must be taken with caution and small dosages first in order that the body can adjust. Pregnant mothers, nursing mothers and children should exhibit extra caution.

An open discussion with the health providers must be done when the patient is using CAM. Doctors must know what is being administered while he is treating the patient.

Give a list of ways conventional medicine and CAM can be integrated

The following are some of the ways in which conventional medicine and CAM can be integrated:

A clear verification that there was no contraindications to the use of CAM therapies, or need for further evaluation or treatment by conventional methods.

Fostering of open communication between the patients, the doctors and the CAM practitioners in creating an environment in which patients can feel comforts and openness in accepting the two mode of treatments.5

Discussions of patients’ preferences and expectations to clarify the reasons patients seek CAM, and provide clues for improving the integration of CAM into their conventional health care.

When two treatments will complement each other like when treatment involved cure while the other is pain management then the two modes can be integrated.

Define ethical theories, ethical principles, and values.

Ethical theories refer to the body of accepted tenets of which individuals in society must follow. It is a set of dogma accepted anchored on what is deemed and perceived to be right and correct in the way of living or manner of application in a particular profession or vocation. Ethical principles are guiding generalizations of which good moral conduct is defined when it is being followed. Ethical values are sets of things or principles which we held precious and given importance when making decisions.

Give examples of some ethical issues in patient education and compliance, and describe a proper and a poor health professional/patient relationship.

Some examples of ethical issues in patient education and compliance are the following:

The patience sometimes exhibits some degrees of autonomy of which decisions are rendered solely by him. However, some decisions and the corresponding actions  he made are contra indicatory of the treatment given to him.

Sometimes treatment involved lots of discomforts and pains on the part of the patients that patients adversely hate the treatment itself.

Patients do not accept the gravity of the illness he has that treatment is not totally complied with.

Receiving gifts from patients that are under treatment. This may come in many form. However, the gestures whether given with gratitude may later cloud the decisions of the health practitioners.

Difference in health beliefs. Some patients have different health beliefs contrary to the intended treatment. This will create an ethical issue of whether the treatment shall be administered or not.

Some examples of poor health professional/patient relationship:

The health professional action involved condescension that the patient is treated with inferior attitudes.

One party or both act outside the boundary of therapeutic relationships .This boundary violation is a sign that the parties have poor health relationships.

Explain what is meant by ethical patient education practices

Ethical patient education practices refer to proper ways in which patients through his own volition and proper information made decisions regarding compliance, concordance and acceptance of the preferred treatment. It is a way in which the patients are convinced that after discussions with the health practitioners as guided by values of openness, honesty and acceptance the patients choose the treatments offered to him6.

Explain the purpose of informed consent

Informed consent is a process between the provider and patient that relates to a specific medication or form of treatment and not just controlled substances (Bolen, 2008).7

The following are its purposes:

The goals of treatment are properly articulated.

Potential benefits and realistic outcomes are discussed with the patients.

The risks involved are known by the patients.

Alternative treatment options are considered before the treatment,

Discuss what factors determine the patient's ability to give informed consent.

Age  - the patients must be legal age capable of making decisions.

Not mentally incapacitated – the patients are not mentally ill and of clear mind. The patients is capable of making decisions based on his knowledge and capacity to understand the treatment and has the capacity to ask other opinions from other persons.

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