ALTERNATIVE MODALITIES OF CARE AND SYSTEM OF HEALTH

INTRODUCTION
A variety of terms have been used to describe health-related approaches that are considered
outside the mainstream of the dominant system of health care. The terms currently used in
Western cultures to describe such approaches include alternative, intergrative , nontraditional,
unconventional ,holistic and natural.Currently ,the most frequently used term to refer to such
modalities and practices is complementary and alternative therapies.

BASIC TERMS / CONCEPTS

 Holism : It refers to the whole of the sick person including his mind , body,and the
way of his living meaning that all these to considered while treating the sick person
and not just the symptoms of the disease.
 Humanism : A system of thought that considers solving of the human problems with
the help of religious beliefs. It emphasizes that the basic nature of humans is good.
 Balance: A situation in which all the things exist in equal , correct or good amount.

DEFINITIONS
o Alternative/Complementary modalities have been defined as treatment techniques
whose goals are to evoke healing, taking into account the body-mind-spirit connection
of every individual . (Dossey,1995).

o It is a group of diverse medical and health care system, practices, therapies and
procedures that are not presently considered to be part of conventional medicine.

CLASSIFICATIONS
According to the National Centre for Complementary and Alternative Medicine(NCCAM),
Complementary and alternative medicine therapy is classified into following Categories :-

1. Whole Medical System

o Ayurveda
o Traditional Chinese Medicine (TCM) :Acupunture and acupressure
o Unani
o Siddha
o Homeopathy
o Naturopathy
2. Mind – body interventions
o Meditation
o Relaxation
o Imagery
o Biofeedback
o Hypnosis
 o Yoga
o Aromatherapy

3. Biologically –based Therapies

o Dietary supplements
o Foods
o Natural substances
o Herbs
o Vitamins
4. Manipulative and Body –based Methods
o Chiropractic
o Osteopathy
o Massage
o Tai chi
5. Energy Therapies
o Biofield therapy
o Bioelectromagnetic therapy
6. Other important modalities
o Humor
o Pet therapy
o Music therapy
o Hydrotherapy
1. WHOLE MEDICAL SYSTEM
Alternative medical system involves complete methods of health- related theory and practice
that have been developed within a specific culture.

It includes the following:

 AYURVEDA-

It is a system of traditional medicine native to India and practiced in other parts of the
world as a form of alternative medicine. In Sanskrit, the word ayurveda consists of the
words ‘ayus’, meaning ‘longevity, and ‘veda’ meaning ‘related to knowledge’ or’
science.’ Its focus is on the balance of mind,body and spirit. Disease is viewed as an
imbalance between a person’s life force (prana) and basic metabolic condition (dosha).

Over the following centuries, ayurvedic practitioners developed a number of medicinal

preparations and surgical procedures for the treatment of various ailments. Interventions
used include diet, medicinal herbs, detoxification, breathing exercises, medication and
yoga. Ayurveda stresses the use of plant-based medicines and treatments. Hundreds of
plant –based medicines are employed, including cardamom and cinnamon.

Some animal products may also be used ,for example, milk ,bones ,and gallstones . In
addition, fats are used both for consumption and for external use. Minerals, including
sulfur, arsenic, lead ,copper sulfate and gold are also consumed as prescribed. This
practice of adding minerals to herbal medicine is known as rasa shastra.

 UNANI
Unani Medicine is based on the Greece philosophy. According to Basic Principles of
Unani, the body is made up of the four basic elements, i.e. Earth, Air,Water,Fire which
have different Temperaments,i.e. Cold ,Hot,Wet ,Dry.

 Treatment dependent on the Temperament (Mizaj) ,hereditary effects, signs and

symptoms, external observation, examination of the pulse (Nubz),urine and stool.
 Dietotherapy (ilaj- bil- Ghiza), Climate therapy (Ilaj- bil- Hawa), regimental
therapy (Ilaj-bit-Tadbir;includes
venesection,diaphoresis,dieresis,massage,cauterization,emesis,exercise).
 Pharmacotherapy (Ilaj –bid –Dawa) :Local herbal drugs.Only minor surgery is in
vogue in this system.

 TRADITIONAL CHINESE MEDICATION (TCM)

It is one of the most comprehensive medical systems. Practitioners of TCM view human
beings in terms of five dimensions. These include Qi (energy resulting from interaction
between Yin (cold, heavy,moist and negative) and Yang (hot ,dry, light and positive),Jing
(genetic material of physical body),Shen (spirit),blood and Yin Ye fluids (lubricates the
organs) . Additionally, the body is considered to be a series of energetic pathways known
as Meridian system. Specific points along the pathways referred to as acupoints.

Treatment includes acupuncture, Chinese herbal medicines ,diet, physical

therapy,exercise and meditation.The most commonly used is acupuncture.

ACUPUNTURE: It is an alternative medicine that treats patients by insertion and

manipulation of needles in the body.Its proponents variously claim that it relieves
pain,treats infertility,treats disease,prevents disease,promotes general health,or can be
used for therapeutic purposes.The term ‘acupuncture’ is sometimes used to refer to
insertion of needles at points other than traditional ones,or to applying an electric current
to needles in acupuncture points.

There are numerous theories about how acupuncture works:

 It stimulates the release of pain-relieving endorphins.

 It influences the release of neurotransmitters
 It influences the autonomic nervous system
 It stimulates circulation
 It influences the electrical currents of the body
Conditions that are benefitted from Acupuncture:

 Neurologic disorders:- migraine headaches,peripheral neuropathy and trigeminal

neuralgia
 Gastroinstestinal disorders: Colitis ,constipation,gastritis,ulcers
 Respiratory conditions:- Asthma,Bronchitis,rhinitis
 Eye disorders :- Myopia,conjunctivitis
 Musculoskeletal disorders: Tennis elbow,sciatica

ACUPRESSURE:- It s an ancient healing art that uses the fingers to press key points on the
surface of the skin to stimulate the body’s natural self-curative abilities.When these points are
pressed,they release muscular tension and promote the circulation of blood and the body’s
life force to aid healing.Acupunture and Acupressure use the same points,but acupuncture
employs needles,while acupressure uses the gentle but firm pressure of hands(and even feet).

 HOMEOPATHY

Homeopthy is a form of alternative medicine in which practitioners trat patients using

highly diluted preparations that are belived to cause healthy people to exhibit symptoms
that are similar to those exhibited by the patient.The basic principle of homeopathy
,known as the “law of similar” is “let like be cured by like”.It was first stated by German
Physician Samuel Hahnemann in 1976.His “law of similar “is taken on his word as an
unproven assertion,and is not a true law of nature based on the scientific method.

Homeopathic remedies are prepared by serial dilution with shaking by forceful striking
on an elastic body,which homeopaths term succession.Each dilution followed by
succession is assumed to increase the effectiveness.Homeopaths call this process
potentization.Dilution often continues until none of the original substances
remains.Aparts from the symptoms,homeopaths examine aspects of the patient’s physical
and psychological state,then homeopathic reference books known as repertories are
consulted,and a remedy is selected based on the totality of symptoms.

 SIDDHA

Siddha medicine is a form of medical treatment of diseases using substances of all possible
origins in way that balances the possible harmful effect of each substance. This form of
medicine was professed and practiced by siddhars who wrote their recipes on palm leaves for
the use of future generations.Siddha medicine was developed by outstanding
Dravidians(ancient Tamils),locally called Cittars.

Preparations are made mainly out of the parts of the plants and trees such as
leaves,bark,stem,root,etc, but includes also minerals and some animal substances. This form
of medicine is still today well-known in South India. The use of metals like gold,silver and
iron powders (Sanskrit bhasma) in some preparations is a special feature of siddha
medicine,which claims it can detoxify metals to enable them to be used for stubborn
diseases.This claim is especially relevant in the mercury which is relatively often used in the
system;medicine containing purified mercury should only be received ,if at all,from a highly
qualified practitioner of the art.

 NATUROPATHY

Naturopathy is a system of man building in harmony with the constructive principles of

Natureon physical,mental,moral and spiritual planes of living.

According to the manifesto of British Naturopathic Association,”Naturopathy is a system of

treatment which recognizes the existence of the vital curative force within the body.”It
therefore ,advocates aiding human system to remove the cause of disease,i.e.toxins by
expelling the unwanted and unused matters from human body for curing diseases.

2. MIND BODY INTERVENTION

Mind-body medicine uses the power of thoughts and emotions to influence physical
health.As Hippocrates once wrote,”The natural healing force within each one of us is the
greatest force in getting well”.This is mind-body medicine in a nutshell. Methods by which
an individual can, independently or with assistance, consciously control some functions of the
sympathetic nervous system(e.g.heart rate, respiratory rate, blood pressure.)

Leading mind-body technique are:

a. Meditation

It often involves invoking or cultivating a feeling or internal state, such as compassion,or

attending to a specific focal point.Meditation is generally an internal,personal practice and
done without any external involvement,except perhaps prayer beads to count prayers,though
many practitioners of meditation may rely on external objects such as candle flames as points
on which to focus their attention as an aid to the process.It is quieting of the mind by focusing
attention on sound or image or own breathing.

Health Benefits of Meditation include:

 Decreased respiration
 Decreased blood pressure
 Improved mood
 Heightened awareness
 Relaxation
 Improved functioning of the immune system
 Slowed heart rate
 Efficient and effective oxygen consumption
 Spiritual relief
 Reduced level of lactic acid
b. Relaxation

Stands quite generally for a release of tension,a return to equilibrium .It is any
method,process, procedure, or activity that helps a person to relax;to attain a state of
increased calmness;or otherwise to reduce levels of anxiety,stress or anger. Relaxation
techniques are often employed as one element of a wider stress management program and can
decrease muscle tension,lower the blood pressure and slow heart and breath rates,among
other health benefits. It is therapeutic process incorporating the basic elements of meditation.

Basic elements of relaxation technique are :

 A quit environment
 A comfortable position
 Focused attention
 A passive attitude, practice

It involves progressive muscle relaxation. Progressive relaxation is the alternate tensing and
relaxing of muscles. Nurses can use relaxation techniques to reduce pain and stress in clients.

c. Imagery

A technique of using theimagination to visualize a smoothing,pleasant image.Benefits of this

technique include: decreased physical tension,decreased anxiety,and decreased the adverse
effects of chemotherapy.

d. Biofeedback

In this, people are trained to control certain bodily processes that normally occur
involuntarily, such as heart rate or blood pressure.these processes can be measured and
displayed on a monitor that the person watches. The monitor provides feedback about
theinternal working of your body. You can then use this display to gain control over these
“involuntary” activities lowering your blood pressure.

It measures physiological responses such as muscle tension,skin temperature,and heart rate to

improve health by using signals from client’s own body. It is effective for a number of
conditions,including headaches,urinary incontinence,hypertension etc.

e. Hypnosis

The earliest definition of hypnosis was given by Braid,who coined the term” hypnotism” as
an abbreviation for “neuro –hypnotism,or nervous sleep,which he opposed to normal
sleep,and defined as:”a peculiar condition of the nervous system,induced by a fixed and
abstracted attention of the mental and visual eye,on one object,not of an exciting nature.

Therapeutic hypnosis: It induces an altered state of consciousness or awareness resembling

sleep during which the person is more receptive to suggestion.Hypnosis also enhances clint’s
ability to form images(for guided imagery).

Uses of Hypnosis:

 Pain management
 Anesthesia
  Skin disease
 Habit control
 Quit smoking
 IBS
 Weight loss
 Smoothing anxious surgical patients
 Sports performance.

f. Yoga

Traditional physical and mental disciplines in India.Sanskrit root “yuj” meaning “to control
,to unite,joining,uniting,conjunction and means.” Outside India ,yoga is typically associated
with asanas(postures) or as a form of exercise. Goals – improving health to achieving
moksha; liberation from all worldly suffering and the cycle of birth and death (samsara),at
which point there is a realization of identity with the supreme Brahman. In Mahabharata,yoga
is described as entering the world of brahma, as Brahman.

g. Aromatherapy
 Uses volatile plant materials (essential oils) and similar aromatic compounds
for the purpose of improving a person’s mood,cognitive function or health.
 Aroma therapist
 Generic term; used by manufactures (of personal care and hygiene
products),massage therapists,chiropractors,nurses and doctors.
 OTC products that make use of essential oils (menthol) include
mouthwashes,liniments and rubbing ointments (Vicks Vaporub)
 Essential oils useful in the treatment of infectious disease
 Used as medicines,with other herbal preparations,by doctors in
France(commonly)
 Used in pain management,anxiety/depression ,and Alzheimer’s disease.

3. BIOLOGICALLY- BASED THERAPIES

Most common among the biologically –based therapies are:-

a. Diet Therapy

According to this therapy,the food must be taken in natural form. Fresh seasonal fruits,fresh
green leafy vegetables and sprouts are excellent. These diets are broadly classified into three
thypes which are as follows:

 Eliminative Diet
o Liquids –Lemon ,Citric juices, Tender coconut water, Vegetable soups,Butter –
milk etc.
 Smoothing Diet
o Fruits,salads,Boiled /Steamed vegetables ,Sprouts,Vegetable chutney etc
  Constructive Diet
o Wholesome flour, Unpolished rice, Little pulses,Sprouts,Curd etc.

Macrobiotic diet:

Predominantly a vegan diet (no animal products except fish).Initially used in the management
of a variety of cancers. Emphasis placed on whole cereal grains, vegetables and unprocessed
foods.

Orthomolecular medicines:

Increased intake of nutrients such as Vitamin C and beta carotene. Diet used in treatment of
cancer, schizophrenia and certain chronic diseases such as hypercholesterolemia and
coronary artery disease.

b. Ayurvedic Herbs

Traditional Hindu system of herbs used for over 2000 years. The herbal products are used in
the form of powder, tonic, etc. These could be a single herb or a mixture of many herbal
products, depending on the disease and the treatment required. Some common herbal
remedies include the following:

o Garlic
o Peppermint
o Chamomile

Phytochemicals:

These are non-nutritive ,physiologically active compounds present in plants in very small
amounts. They protect against cancer and prevent heart disease,stroke ,and cataracts. Main
source for phytochemicals is fruits and vegetables.

c. Antioxidants and Free Radicals

Antioxidants: Substances that prevent or inhibit oxidation, a chemical process whereby a

substance is joined to oxygen.

Free radicals : Antioxidants prevent tissue damage related to these ,which are unstable
molecules that alter genetic codes and trigger the development of cancer growth.

4. MANIPULATIVE AND BODY-BASED METHODS

These methods use techniques of manipulating or moving various body parts to achieve
therapeutic outcomes.

It includes:

Chiropractice: It emphasizes diagnosis, treatment and prevention of mechanical disorders of

the musculoskeletal system, especially the spine, under the hypothesis that these disorders
affect general health via the nervous system. The main Chiropractice treatment technique
involves manual therapy, including manipulation of the spine, other joints, and soft tissues;
treatment also includes exercises and health and lifestyle counseling. It is based on the
principle that the brain sends vital energy to every organ in the body via the nerves
originating in the spinal column. The body is rebalanced and realigned using “spinal
adjustment” techniques.

Massage : It is use of the hands to direct or redirect the flow of the body’s energy fields and
enhance balance within those fields. It includes touch,therapeutic touch or healing touch,
acupressure, and reflexology. The means of perceiving or experiencing through tactile
sensation.

Touch in Nursing Practice

 An integral part of assessment

 Promotes bonding
 An important means of communication
 Assists in soothing, calming, and comforting
 Helps keep the client oriented.

Cultural Considerations of Touch

 Ask permission before touching a client.

 Tell the client what is going to happen.
 The meaning of touch and the body areas acceptable to touch vary from culture to
culture.

Therapeutic Massage

 The application of hand pressure and motion to improve the recipient’s well-being.
 A back rub or massage results in relaxation ,increased circulation of the blood and
lymph ,and relief from musculoskeletal stiffness, spasm,pain.

Therapeutic Touch

 Based on the ancient practice of the laying on of hands and using the hands to direct
energy to achieve a balanced state
 Non –contact Therapeutic Touch (NCTT) , “Healing Touch ,” or Distance
Healing.
 It is an energy therapy, practitioners say,promotes healing and reduces pain and
anxiety . Practitioners of therapeutic touch state that by placing their hands on, or
near, a patient ,they are able to detect and manipulate the patient’s energy field.

Reflexology

 Art and science of enervating ovder 7,000 nerves in the feet believed to correspond to
every muscle system and organ in the body
  Promotes health by relieving pressures and accumulation of toxins in the
corresponding body part.
 Reflexology , or zone therapy is an alternative medicine involving the physical act of
applying pressure to the feet, hands ,or ears with specific thumb,finger ,and hand
techniques without the use of oil or lotion. It is based on what reflexologists claim to
be a system of zones and reflex areas that they say reflect an image of the body on
the feet and hands, with the premise that such work effects a physical change to the
body.
5. ENERGY THERAPIES
These are alternative therapies that involves the use of purported energy fields. These are two
main types – biofield therapies, and bioelectromagnetic –based therapies.

They are intended to affect energy fields that purportedly surround and penetrate the human
body. Some forms of energy therapy manipulate biofields by applying pressure and /or
manipulating the body by placing the hands in, or through ,these fields. Examples include
Qigoing, Reiki, and Therapeutic touch.

Reiki is a spiritual practice developed in 1922 by Japanese Buddhist Mikao Usui. It uses a
technique commonly called palm healing as a form of complementary and alternative
medicine and is ,sometimes ,classified as oriental medicine by some professional bodies.

Steps of palm healing

 Recipients lay down on a massage table and relax with loose, comfortable clothing.
 Practitioner enters a calm state of mind and mentally prepared for the treatment
without talking.
 Practitioner placing his hands on the recipient in various positions.
 Hands kept still for 3 to 5 minutes before moving to the next position.
 General coverage of the head , the front and back of the torso, the knees,and feet.
 12-20 positions are used ,with the whole treatment lasting 45 to 90 minutes.
 Some use a fixed set of hand positions ,while others use their intuition to guide them
as to where treatment is needed,sometimes starting the treatment with a” scan”.
 Recipient often feels warmth or tingling ,even when a non- touching approach is used.
 Instantaneous “cures” of specific health problems are not usually observed.

Electromagnet therapy :
It is a pseudoscientific alternative medicine practice involving the use of static magnetic
fields.Practitioners claim that subjecting certain parts of the body to magnetostatic fields
produced by permanent magnets has beneficial health effects. In this process ,the different
positive forces of a magnet are taken into account to cure any kind of diseases. It is used to
counter wrought by bleeding and for countering infertility among women. Products includes
magnetic bracelets and jewelry; magnetic straps for wrists,ankles,knees ,and the back; shoe
insoles ; mattresses; magnetic blankets (blankets with magnets woven into the material );
magnetic creams: magnetic supplements; plasters /patches and water that has been
“magnetized”.Application is usually performed by the patient.

6. OTHER IMPORTANT MODALITIES

 Aromatherapy: Therapeutic use of concentrated essences or essential oils
extracted from plants and flowers. Aromas cause physiological, psychological ,
pharmacological reactions. These oils should be used intelligently and with
caution.
 Humor: It determines the client’s perception of what is humorous. It can relieve
anxiety , improve respiratory function, promote relaxation,enhance immunological
function , and decrease pain by stimulating endorphin production.
 Pet therapy: It has many applications including overcoming physical
limitations,improving mood,loweing blood pressure,and improving socialization
skills and self- esteem.
 Music therapy: Pleasurable sound and music reduce stress, perception of pain,
anxiety ,and feelings of isolation.
 Hydrotherapy: Hydrotherapy ,formerly called hydropathy, involves the use of
water for pain-relief and treating illness. It continues to be widely used for burn
treatment, although shower –based hydrotherapy techniques have been
increasingly used in preference to full immersion methods,partly for the ease of
cleaning the equipment and reducing infections due to contamination.

AYUSH AND NRHM (MAINSTREAMING AYUSH UNDER NRHM)

Age – old acceptance and first line of treatment
Recognized systems of medicine and integrated into the national health delivery
system.
Ayush medications included in the drug kit of ASHA
At CHC two rooms provided for Ayush practitioner and pharmacist.
Two doctor PHCS with Ayush practitioner.

Objective:-

Mainstreaming of Ayush in the health care service delivery system to strengthen the existing
public health system.

Strategies:-

 Integrate and mainstream ISM and H in health care delivery system including
National Programs
 Encourage and facilitate setting up of speciality centers and ISM clinics
 Facilitate and strengthen quality control laboratory
 Strengthening Research Activities on Ayush
 Develop Advocacy for Ayush
 Establish sectoral linkages for Ayush activities.
Activities :-
 Availability of Ayush faculities and integrating it with the existing Health Care
Service Delivery System
 Integration of Ayush services in CHC /PHC with appointment contractual Ayush
Doctors.
 Appointment of a Data assistant to support the ISM and H Directorate.
 Strengthening of Ayush dispensaries
 Making provision for Ayush drugs at all levels
 Establishment of specialized therapy centers in district hospitals.
 Ayush doctors to be involved in all National Health
Programs(IMR,MMR,JSY,Malaria,Filaria etc.)
 Training of Ayush doctors in PHC
 All Ayush institutions will be strengthened with necessary infrastructure
 Block level School Health Programs to be conducted twice in ayear in two groups
consisting of 100 students in each group.

Integration of Ayush with ASHA

o ASHA and ANMs training to be updated to incorporate Ayush.

o Necessary training material to be modified and provided accordingly
o Drug kit of ASHA will contain one Ayush preparation (iron supplement)
o But other drugs for treatment of common diseases,control of communicable
diseases,drugs promoting the maternal and child health and improving quality of life
could be included subsequently.

DRAWBACKS OF ALTERNATIVE MEDICINE

1. Not subjected to testing. Attempts to disprove this fact sometimes use the
appeal,ie.”That which is natural cannot be harmful.”
2. Homeopathic remedies are extremely dilute,thus considered safe,but their
products are exempt from goods manufacturing practice requirements(expiry date
and identity and strength of products and their alcohol concentration).
3. Treatment delay
4. Danger increased when used as a complement to standard medical care.

THEORY APPLICATION
Ludwig Von Bertalanffy General System Model

System Theory was proposed in the 1940’s by the biologist Ludwig von Bertalanffy and
furthered by Ross Ashby (1964). The system theory focuses on the organization as a
whole,its interaction with the environment, and its need to achieve equilibrium.
 I have applied Ludwig General System theory for reducing hypertension through yoga
therapy.

Input

In this input refers to the demographic variables such as age ,sex, educational status,
occupation ,duration of illness, family history ,food pattern.

Through put

In this throughput refers to the yoga therapy

Output

Output is any information that leaves the system and enters the environment through
system boundary.

In this output refers to the reduced blood pressure level.

INPUT Throughput Output

DdDemograhic variables PpPre assessment of YoYoga therapy Post asessment

agea blood pressure
 Age
level
 Gender
dd
 Educational status
 Occupation
 Duration of
hypertension Pain reduced
 Food pattern Pain not reduced
 Family history

Reassessment

JOURNAL ABSTRACT REALTED STUDY:-

Shilpa Babbar MD,Karen.B. Williams PhD,Dev Maulik MD PhD , Journal of

Evidence–Based Integrative medicine, October 5 2016.
Complementary and Alternative Medicine Use in Modern Obstetrics: A Survey of the
Central Association of Obstetricians & Gynecologists Members.
The use of complementary and alternative medicine during pregnancy is currently on the
rise. A validated survey was conducted at the Central Association of Obstetrician and
Gynecologists annual meeting to evaluate the knowledge, attitude, and practice of general
obstetricians and gynecologists and maternal-fetal medicine specialists in America. We
obtained 128 responses: 73 electronically (57%) and 55 via the paper survey (43%).
Forty-five percent reported personally using complementary and alternative medicine and
9% of women respondents used complementary and alternative medicine during
pregnancy. Overall, 62% had advised their patients to utilize some form of
complementary and alternative medicine in pregnancy. Biofeedback, massage
therapy,meditation, and yoga were considered the most effective modalities in pregnancy
(median [semi- Interquartile range] = 2 [0.5]). Maternal-fetal medicine specialists were
significantly more likely to disagree on the use of complementary and alternative
medicine for risk reduction of preterm birth compared to obstetricians and gynecologists
(P = .03). As the use of complementary and alternative medicine continues to rise in
reproductive-age women, obstetricians will play an integral role in incorporating
complementary and alternative medicine use with conventional medicine.

CONCLUSION :-

We thus observe that the people are shifting their allegiance to the Indian alternative
therapies, because these therapies are natural and have no side-effects. The western
medicine has failed to deal with the chronic diseases as well as new, antibiotic resistant
bacteria. Ancient therapies, by contrast, have an excellent record of curing the chronic
diseases that do not respond well to western medicine.
MAR BASELIOS COLLEGE OF NURSING , BHOPAL

SUBJECT: ADVANCE NURSING PRACTICE

SEMINAR ON
ALTERNATIVE MODALITIES OF CARE AND
SYSTEMS OF HEALTH

SUBMITTED TO: SUBMITTED BY:

Mrs. Blesson Thomas Mrs. Mariet Abraham
Associate Professor M.SC. Nursing I Year
Date : 18 / 03 /2019
 BIBLIOGRAPHY

BOOKS :-

1. Basheer,P. Shabeer “ Text book of Advance Nursing Practice”, India: EMMESS

Medical Publisher. (2015), Page.no.355-364

2. Brar, Kaur Navdeep. & Rawat,HC , “A text book of Advanced Nursing practice.”
Jaypee Brothers medical Publishers Ist edition, Daryaganj ,New Delhi (2015):
page.no.933- 944.

3. K .Park , “Textbook of Preventive And Social Medicine “ , M/s Banarsidas Bhanot

Publishers Jabalpur, 17 th Edition, 2002: 1-7.

JOURNAL:-
 Shilpa Babbar MD,Karen.B. Williams PhD,Dev Maulik MD PhD ,” A Survey of the
Central Association of Obstetricians & Gynecologists Members,” Complementary
and Alternative Medicine Use in Modern Obstetrics” Journal of Evidence–Based
Integrative medicine, October 5, 2016.

INTERNET:-

1. https://www.slideshare.net/FIROZQURESHI/alternative-modalities-of-care

2https://www.slideshare.net/jalpaJalpa/alternative-modality-of-care