Complementary and Alternative Medicine (CAM) refers to a group of medical and health-care systems, practices, and products that are not considered to be part of conventional medicine. Medical therapies that are used in addition to or instead of traditional (mainstream) therapy are referred to as alternative medicine. It is sometimes referred to as "integrative" or "complementary" medicine. More than half of all adults in the United States say they utilize complementary and alternative medicine. The aim of the current report is to describe setup and the services and treatment selection of the complementary medicine clinic in Fayoum city, Egypt. The ethnographic approach utilized in this study was inspired by Spradley's method. Ethnography is the most venerable of qualitative research methods. The authors concluded that Complementary alternative medicine is very important effective treatment branch usually in simple complaints as headache, obese patients and bone ache and symptoms at start of disease, but is not work alone especially in chronic or debilitating diseases, and have useless outcomes in patients with late stage diseases, over age patients and acute emergency cases, so that complementary therapy complete treatment with medical therapy in variety of cases, not rather than or alternate the medical treatment.
Complementary and Alternative Medicine (CAM) is a term that refers to a collection of medical and health-care systems, practices, and products that are not regarded to be part of conventional medicine. Alternative medicine refers to medical treatments that are utilized in addition to or instead of standard (mainstream) therapy. Some people call it "integrative" or "complementary" medicine. More than half of all adults in the United States claim to use alternative medicine [1].
Many folk traditions in medicine, hospitalization, and treatment are practiced in countries all over the world. It is sometimes referred to as (folk medicine), but it is also known as authentic medicine, parallel medicine, natural medicine, comparative medicine, traditional medicine, and alternative medicine or supplemental medicine [2]. Folk medicine is the legacy of parents and grandparents, and it is used to treat diseases by nearly three-quarters of the world's population. It relies on treatments and methods that are supposed to be safe, are believed by those who use it, and have been tested on millions of people for thousands of years [3].
According to the World Health Organization (WHO), complementary and alternative medicine is "a group of health professions based on a separate medical science for each of them, based on accurate diagnosis through comprehensive examination, and taking into account the psychological and mental state in addition to the physical condition, applying the therapeutic principles of each of them." Water, electricity, rays, lasers, heat, massage, chiropractic, herbs, medicinal oils, and natural pharmaceuticals are all used." [4].
The National Center for Complementary and Alternative Medicine (NCCAM) in the United States defines complementary alternative medicine as "a varied medical group of health care systems, procedures, and products that are not considered part or extension of modern medical practice [5]." Complementary medicine is used in conjunction with modern medicine, but alternative medicine is never used in conjunction with contemporary medical. Some health-care practitioners may employ complementary and alternative medicine in addition to contemporary treatment [6.]
Complementary and alternative medicine or traditional folk medicine is widespread and represents a health system of qualitative economic importance. In Africa, 80% of the population uses it to achieve possible health care for them, and in China, the uses of folk medicine represent 40% of the total uses of health care [7]. Complementary and alternative medicine use at least once 48% in Australia, 70% in Canada, and 42% in the USA. The popularity and spread of complementary and alternative medicine depend mainly on several factors such as availability, relative safety, cost, and the alternative opportunity available in the face of serious and chronic diseases [8].
CAM services are frequently used in conjunction with and in addition to traditional treatment. As a result, practically every country has a sizable informal and unregulated health-care sector. There is currently no complete picture of this sector in any country. There is a lack of data on the efficacy of numerous complementary and alternative therapies when used alone or in combination. People utilize complementary and alternative medicine (CAM) to manage chronic ailments that are costly to society, such as chronic pain and arthritis, as well as more life-threatening diseases like heart disease and cancer [9].
Most physicians and the general population in Egypt, Saudi Arabia, as well as most Arab and Islamic countries, accept and practice Tibbu Nabawi, or prophetic medicine. According to the National Center for CAM in Saudi Arabia, more over 70% of the population has employed prophetic medicine techniques at some point in their lives.
So, the aim of this report is to describe setup and the services and treatment selection of the complementary medicine clinic
Research Question
What are the setup and services of the complementary medicine clinic (CMC)
What are the principles of complementary treatment selection for each patient
Design
The ethnographic approach utilized in this study was inspired by Spradley's method. Ethnography is the most venerable of qualitative research methods. Individuals, families, and groups live out the meanings of health and illness as nursing research advances. Ethnography has gotten a lot of attention recently since it pertains to individuals' cultures, and more specifically, how they experience their cultures throughout times of health and disease. Without any interpretation or critique, the researcher recounted the actual circumstance as it was. Observations and field notes analysis. Observation of the physical setup, resident services, and participant participation.
Ethical Consideration
Getting Permission: There is no organizational permission because it is a private place. However, we took an oral permission from participants to make and record unstructured interview with them and to take tape record but the participant refused to take any picture to the place and complete tape record.
Participants’ Confidentialityand Anonymity
The researchers promise of confidentiality and anonymity for participants. Any information participants provide would not be publicly reported and their named would not be mentioned.
Making Descriptive Observation
The researchers made descriptive observations without having specific questions in mind “Grand tour questions”. There are nine dimensions in any social situation useful in guiding observation, and questions. These dimensions are time, place, personnel, activities and nurse role.
Setting of the Study
This study was conducted at private alternative medicine clinic. It was selected purposively. is not for profit administrated by the governmental organizations but have licensure of aroma therapy selling because there is no direct license for alternative medicine in Egypt, so he provide these treatment under the umbrella of selling treatment not provide intervention itself. It depends financial on the subscription taken from the patients and money spent by clinic owner for development of the clinic
It provides care for all males and females patients seek for alternative medicine and need these type of treatment. It accepts all patients and start to select treatment type according to many factors take in consideration as general patient health, incidence time of disease, type of disease if acute or chronic, type of treatment and disease prognosis
Name: Private alternative medicine clinic called
Address: Fayoum city- Matertares village in front of wasma mosque with work hours all day week. Clinic schedule time at summer start from 1 pm to 12 am, at winter start from 1 pm to 12 am with call time after 2 pm clock for patients appointments
Activities
Clinic provide variety of activities and types of treatment for patients as, aroma therapy and massage therapy, also variety of procedures as acupuncture, in addition to patient teaching about diet therapy and referral of cases to outpatient clinic according type of disease if alternative treatment is not effective or not proper to patient condition.
Description
Place
Clinic present in 3rd floor consists of three rooms consists of waiting room on the left side, on the right side is, examination clinic, then pharmacy as all oils and plants types and needed for alternative treatment in which is office of secretary in addition to small kitchen room and bathroom in middle of the clinic
Examination clinic in which office of treatment specialist is present and all interventions and treatment was made
Visitors are waiting in waiting room till time of examination , it contain 8 chairs
On the wall a lot of picture of photos to indicate types of different alternative medicines and its effect, and purchor about services of the clinic, in addition to clipboard contains variety of plants
When we entered the clinic reception of the clinic we found a very comfortable atmosphere, soft lightening, very good smell, talk in low voice and appear welcome to provide us with all data and services about clinic
Aim of the Study
The aim of this report is to describe setup and the services and treatment selection of the complementary medicine clinic in Fayoum city.
Research Question
What are the setup and services of the complementary medicine clinic (CMC)
What are the principles of complementary treatment selection for each patient
Introduction
Complementary Medicine (CM) includes techniques such as acupuncture, herbal medicine, massage, support groups, and yoga. Sometimes called holistic medicine, complementary medicine typically addresses how disease affects the whole person: physically, emotionally, spiritually, and socially
Many complementary therapies concentrate on relaxation and reducing stress. They might help to calm emotions, relieve anxiety, and increase general sense of health and wellbeing. Many doctors, cancer nurses and researchers are interested in the idea that positive emotions can improve health
Types of Complementary Medicine
Traditional alternative medicine as acupuncture, homeopathy, naturopathy, and Chinese medicine
Body techniques are often combined with those of the mind. Examples of body therapies include, chiropractic and osteopathic medicine, massage, body movement therapies, tai chi, and yoga
Dietary and herbal approaches may include, dietary supplements, herbal medicine, and nutrition/diet
Therapies using the mind may include, meditation, biofeedback, and hypnosis
Therapies incorporating the senses include, art, dance, and music, visualization, and guided imagery
Anticipated Benefits
Increase awareness of people about clinic setup and equipment's used in CMC. In addition to identify complementary services provided to patients seek these type of treatment
Identify principles of complementary treatment selection for each patient
Study Design
Ethnography
Ethnography is considered to be the oldest of the qualitative research. As a nursing research develops, so the methods that are available to discover the meanings of health and illness are lived by individuals, families, and groups
Ethnography has received particular attention because it relates to the culture of individuals, and specifically how they experience their culture in time of health and illness. The researcher described the real situation as it was without any interpretation or critique. Drawing upon observations, and the analysis of field notes. Observing the physical setup, services provided to residents and participant observation
Steps of Conducting Ethnographic Research
After deciding the aim of inquiry and the scope of the study, the next step was to gain access to the culture through visiting the complementary clinic and stated the study purpose for the study participants and how the researchers will protect the participants’ confidentiality before observation started.
Ethical Consideration
Getting Permission: There is no organizational permission because it is a private place. However, we took an oral permission from participants to make and record unstructured interview with them and to take tape record but the participant refused to take any picture to the place and complete tape record.
Participants’ Confidentialityand Anonymity
The researchers promise of confidentiality and anonymity for participants. Any information participants provide would not be publicly reported and their named would not be mentioned.
Making Descriptive Observation
The researchers made descriptive observations without having specific questions in mind “Grand tour questions”. There are nine dimensions in any social situation useful in guiding observation, and questions. These dimensions are time, place, personnel, activities and nurse role.
Setting of the Study
This study was conducted at private alternative medicine clinic called المركز العلمي للطب النبوي وعلوم الأعشاب)). It was selected purposively. is not for profit administrated by the governmental organizations but have licensure of aroma therapy selling because there is no direct license for alternative medicine in Egypt, so he provide these treatment under the umbrella of selling treatment not provide intervention itself. It depends financial on the subscription taken from the patients and money spent by clinic owner for development of the clinic
It provides care for all males and females patients seek for alternative medicine and need these type of treatment. It accepts all patients and start to select treatment type according to many factors take in consideration as general patient health, incidence time of disease, type of disease if acute or chronic, type of treatment and disease prognosis
Name: Private alternative medicine clinic called
Address: Fayoum city- Matertares village in front of wasma mosque with work hours all day week. Clinic schedule time at summer start from 1 pm to 12 am, at winter start from 1 pm to 12 am with call time after 2 pm clock for patients appointments
Activities: Clinic provide variety of activities and types of treatment for patients as, aroma therapy and massage therapy, also variety of procedures as acupuncture, in addition to patient teaching about diet therapy and referral of cases to outpatient clinic according type of disease if alternative treatment is not effective or not proper to patient condition
Do Participant Observation
While in the setting , researchers look to the clinic, its structure and buildings, and people in it and their activities, listen to used language and way of verbal communication between people , ask question broad question such as what about complementary medicine? Then go to specific narrow questions, and analyze data collection in cyclic manner.
Personnel
Examiner is well trained, educated person and have baccalaureate degree in plant therapy, he was trained under supervision of physicians specialist in complementary alternative medicine, attended to variety of national and international complementary treatment conferences in aroma therapy and other types of complementary treatments
Have continuous reading and updating his knowledge in researches and new evidences related to complementary medicine
Making an Ethnographic Record
On completion of each observation, immediately the experience (field notes) documented by hand writing and taking to recording the two unstructured interviews.
Data Collection
Was observed through unstructured observation. Field notes written by the observers. The period of researchers visited the setting twice for four hours. The first visit was on 10/12/2019, and the second visit was on 12/12/2019. The duration of each visit was about 2 hours
Focused observation field notes were written immediately after the period of observation so that no valuable information would be lost or forgotten. Also the tape recording helped in written the observation on the structure of the setting, daily activities, services provided, nature of people in the setting and people who visiting the setting and social interaction between people within the setting was done by the researchers
Unstructured interviews (informal conversations) with the owner of clinic asking him a general then specific questions about the used and new treatment equipment's, every day activities were conducted
After reading all field notes we start to focus the analysis depend on the purpose of evaluation and how he will use the results. Data collection and analysis occurred parallel. Observation and interview typed into transcript. The researchers read transcript twice and assign multiple code to segment of data. After that data were clustered into sub themes that were grouped into the themes
Making Domain Analysis
Researchers analyzed activities they observe that refers to the stream of behavior (activities) as all alternative treatment types done through sterile organized field carried out by people (therapist) with variety of equipment's as (acupuncture doll or hand, air cups, spurious instruments and sterile equipment's that cleaned between patient and another as rubber sheet but beneath to the patient during treatment, gloves and surface of equipment's that separated and sterilized to each patient that prepared close to patient site , in a particular location (clinic) to discover the cultural scene. The researcher created a list of possible categories and subcategories to assist the researcher in discovery. Discover Cultural ThemesPatient Health History is the Concern: Patient before attending to clinic, firstly must be call clinic for appointment to determine date and time of examination, that is important to order patients day list is enough to give proper time to each patient for examination in this day or not, also to remind the patient to attend all diagnostic results and prescribed treatment with him in the day of examination. Examiner start to take patient demographic data and health history about disease onset and medication type and regimen to:
Decide if complementary medicine is needed or not
Determine what proper complementary treatment as plants, bee sting or acupuncture must be start with medical treatment to help for effective treatment of disease
Determine number of sessions and proper equipment's used in treatments
Complementary Medicine not Alternative to Medical Treatment
The patients with chronic illness rather than acute cases usually seek complementary treatment after medical treatment failed to treat or manage the disease symptoms, so the patient is go to the examiner after stop medical treatment or missed doses, but that is not true or forbidden because the importance of medical patient treatment to control disease progress. So that examiner start to emphasize on use appropriate complementary therapy according patient disease prognosis and age based on all patient medical records in addition to keep drugs dose prescription by physician.
Not all Examiner well Trained or Based on Scientific Training
Complementary medicine cannot work correctly with no basic knowledge because of closely relation to patient body and his health, without scientific information's and studies that can lead to some of complications, also rise of
Nurse have Important Role in Alternative Medicine Clinic
The role of nurse is very important to work as assistant to therapist in complementary medicine field rather than any personnel just imitate not educated, in which nurse understand human body in health and illness condition.
Complementary Alternative Should be Under Ministry of Health Umbrella
To provide effective treatment under supervision and qualification of well-trained therapist in complementary medicine field and provide better services within follow up and correct decisions to avoid complications and undesired effects from untrained personnel world without observation in society.
Writing Ethnography
ResearcherInterpretation: Complementary alternative medicine is very important effective treatment branch usually in simple complains as headache, obese patients and bone ache and symptoms at start of disease, but is not work alone especially in chronic or debilitating diseases, and have useless outcomes in patients with late stage diseases, over age patients and acute emergency cases, so that complementary therapy complete treatment with medical therapy in variety of cases, not rather than or alternate the medical treatment.
So the role of the nurse in this branch of treatment is very effective because she/he have knowledge and information's about disease process can take action based on scientific base to achieve better patient outcomes.
Rather than importance to permit to put this type of treatment under umbrella of ministry of health to be more benefits to all public and to be supervised to avoid persons mistakes they work in this field by chance without training or knowledge.
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