Scope of Practice and Principles of Care of Naturopathic Medicine in North America: A Commentary

Naturopathic medicine is a growing profession in North America that provides expertise in complementary and alternative, or integrative care to pediatric patients. It is imperative that healthcare providers have an understanding of the training and scope of other health professionals in order to effectively make decisions regarding research, collaborative clinical care, and policy. Given the prevalence of use of complementary and alternative medicine by children and families in North America, and the growing interest in “integrative” medicine, we aim to offer an overview of naturopathic care for children. This document describes the principles, training, and scope of naturopathic medicine, including health promotion, disease prevention, and illness management. It describes the process by which naturopathic doctors create an integrative healthcare plan for children, evaluate and apply evidence, and integrate ethical issues in practice management, and speaks to the role naturopathic doctors have regarding advocacy for community and planetary health as it relates to pediatrics.

EXPERIENCE OF PATIENTS WITH CHRONIC DISEASES IN COMPLEMENTARY MEDICINE AND INTEGRATIVE HEALTH SEEKING BEHAVIORS

Background: Chronic diseases, including heart disease, cancer, COPD, and DM, are the main causes of death worldwide. Nearly half of all global deaths are caused by such diseases. Complementary medicine and integrative health are believed to have great potential in providing benefits to public health. This research aims to determine the experience of patients with chronic diseases in seeking for complementary medicine and integrative health. Method: This research is a qualitative research with a phenomenological approach. The data collection method used is the in-depth interview with 8 patients with chronic diseases (heart disease, cancer, COPD, and DM). Result: In this study there were 5 themes found related to the experience of patients with chronic diseases in the behavior of seeking complementary medicine and integrative healthcare which includes economic factors and doubts to the conventional medicine, as well as the values of traditional medicine that were being the reasons in the process of seeking complementary medicine and integrative healthcare. Seeking the Complementary medicine and integrative healthcare is strongly influenced by support of family, community, and social media. That suggest more positive than the negative impacts after undergoing the complementary medicine and integrative healthcare. Participants perception that traditional medicine is better than the conventional one. Closed minded participants to seek to doctors after undergoing the traditional medicine. Conclusion: Besides as a medical treatment, the use of traditional medicine for patients with chronic diseases also manifests the beliefs of patients that need to be facilitated by providing assistance hoping that possible dangerous risks can be avoided.

Quality Indicators of Pharmaceutical Care in Palestinian Integrative Healthcare Facilities: Findings of a Qualitative Study among Stakeholders

Background. Recently, there has been shifts from providing large volumes to providing higher quality of healthcare services. This qualitative exploratory study was conducted to explore the views of different stakeholders on activities and services that could serve as quality indicators of pharmaceutical care in Palestinian integrative healthcare facilities. Methods. A judgmental sampling technique was used to invite and recruit stakeholders for this study. Semistructured in-depth interviews were conducted with the stakeholders. Data collected during the interviews were qualitatively analyzed using the interpretive description methodology. Themes, subthemes, and patterns were recognized using the Qualitative Analysis Guide of Leuven. The data were coded using RQDA software. Results. Interviews (n = 22) were conducted with 9 complementary and alternative medicine practitioners, 8 pharmacists, 2 physicians, 2 nurses, and 1 risk/quality assurance manager. The interview median duration was 41 with an IQR of 22 min. Following the thematic analysis adopted to achieve the objectives of this study, six major themes emerged from the data collected from the interviews. The themes emerged from the data were (1) provision of collaborative, direct, and comprehensive patient care services; (2) common services and activities at the time of admission, during stay, at transition between wards/services/hospitals, and at discharge to home or community care; (3) screening for, identifying, and resolving problems; (4) collaboration with other healthcare providers; (5) professional development; and (6) performance and efficiency. Conclusions. Quality indicators are invaluable for informing decisions relevant to justifying allocation of scarce resources, securing funds, and demonstrating value in activities and services within integrative healthcare facilities. Further studies are still needed to develop a set of measurable indicators to measure the impact of pharmaceutical care in integrative healthcare facilities.