Developing and implementing a complex Complementary and Alternative (CAM) nursing intervention for breast and gynecologic cancer patients undergoing chemotherapy--report from the CONGO (complementary nursing in gynecologic oncology) study.

PURPOSE/OBJECTIVES: The purpose of this study was to develop a complex nursing intervention including complementary and alternative medicine (CAM) for breast and gynecologic cancer patients during chemotherapy to improve quality of life. METHODS: Data sources Theoretical framework and concepts, practical nursing knowledge, and evidence-based studies were compiled in interprofessional meetings. Data synthesis The final complex intervention consists of three autonomous, but interacting components: (1) CAM nursing package, (2) resource-oriented counseling, and (3) evidence-based information material on CAM. CAM interventions include acupressure, aromatherapy, compress, and massage, targeting 14 clinically relevant symptoms during chemotherapy. Participants receive these interventions during chemotherapy with instructions for self care. During a counseling interview, the patient's needs and preferences are assessed by trained nurses. Furthermore, participants are equipped with evidence-based information material (booklet and DVD). Prior to study start, nurses attended training modules for administering CAM therapies and for communicating and counseling within the salutogenic approach. CONCLUSIONS: It was possible to design a multimodal CAM nursing intervention based on a theoretical concept, evidence-based studies, and practical nursing experience targeting the prevention or relief of side-effects women suffer during chemotherapy. The systematic analysis of the CONGO study will contribute to evidence-based CAM nursing care within supportive cancer care. IMPLICATIONS FOR INTEGRATIVE CANCER CARE: Oncology nurses play an important role in supportive CAM care of breast and gynecologic cancer patients in daily clinical practice. Within oncology outpatient services, the implementation of evidence-based CAM nursing interventions and counseling may contribute to understand the impact of nursing on patient quality of life and symptom relief. This can lead to a new understanding of the nurse's professional role.

Multicentre prospective observational study on professional wound care using honey (Medihoney™).

In recent years, the treatment of wounds with honey has received an increasing amount of attention from healthcare professionals in Germany and Austria. We conducted a prospective observational multicentre study using Medihoney™ dressings in 10 hospitals - nine in Germany and one in Austria. Wound-associated parameters were monitored systematically at least three times in all patients. Data derived from the treatment of 121 wounds of various aetiologies over a period of 2 years were analysed. Almost half of the patients were younger than 18 years old, and 32% of the study population was oncology patients. Overall, wound size decreased significantly during the study period and many wounds healed after relatively short time periods. Similarly, perceived pain levels decreased significantly, and the wounds showed noticeably less slough/necrosis. In general, our findings show honey to be an effective and feasible treatment option for professional wound care. In addition, our study showed a relationship between pain and slough/necrosis at the time of recruitment and during wound healing. Future comparative trials are still needed to evaluate the extent to which the positive observations made in this and other studies can definitely be attributed to the effects of honey in wound care.

Medical honey for wound care--still the 'latest resort'?

While the ancient Egyptians and Greeks used honey for wound care, and a broad spectrum of wounds are treated all over the world with natural unprocessed honeys from different sources, Medihoney has been one of the first medically certified honeys licensed as a medical product for professional wound care in Europe and Australia. Our experience with medical honey in wound care refers only to this product. In this review, we put our clinical experience into a broader perspective to comment on the use of medical honey in wound care. More prospective randomized studies on a wider range of types of wounds are needed to confirm the safety and efficacy of medical honey in wound care. Nonetheless, the current evidence confirming the antibacterial properties and additional beneficial effects of medical honey on wound healing should encourage other wound care professionals to use CE-certified honey dressings with standardized antibacterial activity, such as Medihoney products, as an alternative treatment approach in wounds of different natures.

Effects of rhythmic embrocation therapy with solum oil in chronic pain patients: a prospective observational study.

BACKGROUND: Chronic pain is one of the most frequent physical symptoms worldwide and requires intervention on many levels. Complementary therapies in particular are becoming increasingly relevant and popular in the treatment of chronic pain. The present study evaluates the therapeutic effects of rhythmic embrocation with a lavender/peat extract [Solum Oil (German: Solum Ol)]. MATERIALS AND METHODS: In a prospective observational study 100 patients with chronic pain were treated three times (T1-T3) within 24 days by rhythmic embrocation with Solum Oil. Main active constituents per 10 g of Solum Oil: aqueous peat extract (1:5) 1.96 g, and Lavandulae aetheroleum 0.5 g. The Mood Scale (Bf-S) and Pain Perception Scale (sensory PPS, affective PPS) were measured before the first and after each of the 3 treatments. To measure the therapeutic effects, effect sizes were calculated. RESULTS: Patients were mainly female (89%), mean duration of chronic pain (low back pain): 8.8 years; 1 drop-out due to urticaria. Bf-S was reduced from 25.8 [95% confidence interval (CI); 22.8-28.1] before T1 to 13.3 (95% CI; 11.7-15.0) after T3; sensory PPS from 18.8 (95% CI; 17.7-19.8) to 15.2 (95% CI; 14.1-16.4), affective PPS from 29.8 (95% CI; 27.9-31.7) to 21.3 (95% CI; 19.4-23.0) (all P<0.01). Effect sizes (d): Bf-S: d=0.81; affective PPs: d=0.85; sensory PPS: d=0.55. CONCLUSIONS: The high effect sizes indicate that repeated rhythmic embrocation with Solum Oil may improve mood, pain perception (sensory PPS), and the ability to cope with pain (affective PPS) in patients with chronic low back pain. To further assess the efficacy of this method, a randomized clinical trial is recommended.

Wound care with antibacterial honey (Medihoney) in pediatric hematology-oncology.

The physiologic process of wound healing is impaired and prolonged in pediatric patients receiving chemotherapy. Due to profound immunosuppression, wound infection can easily spread and act as the source of sepsis. Referring to in vitro studies, which confirmed the antibacterial potency of special honey preparations against typical isolates of nosocomially acquired wound infections (including Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant enterococci) and considering the encouraging reports from other groups, Medihoney has now been used in wound care at the Department of Pediatric Oncology, Children's Hospital, University of Bonn for 3 years. Supplemented with clinical data from pediatric oncology patients, this article reviews the scientific background and our promising experience with Medihoney in wound care issues at our institution. To collect and analyze the available experience, we prepare an internet-based data documentation module for pediatric wound care with Medihoney.

Antibacterial honey (Medihoney) for wound care of immunocompromised pediatric oncology patients.

The physiologic process of wound healing is impaired and prolonged in paediatic patients receiving chemotherapy. Due to profound immunosuppression, wound infection can easily spread and act as the source of sepsis. Referring to in vitro studies, which confirmed the antibacterial potency of special honey preparations against typical isolates of nosocomially acquired wound infections (including MRSA and VRE) and considering the encouraging reports from other groups, Medihoney has now been used in wound care at the Department of Pediatric Oncology, Children's Hospital, University of Bonn for three years. Supplemented with exemplary clinical data from pediatric oncology patients, this presentation reviews the scientific background and our promising experience with Medihoney in wound care issues at our institution.