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Integrative Approach to Pulmonary Hypertension Symptoms Management

Tania Von Visger

Beth Steinberg

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Conference: 2015 PH Professional Network Symposium

Release Date: 09.17.2015

Presentation Type: Abstracts

File Download: 2015 Symposium Abstract - 1028

File Size: (243 kb)

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Purpose

Persons living with pulmonary hypertension (PH) are required to manage the disease condition effectively in order to achieve a satisfactory quality of life. The psychological distress such as depression and anxiety may further impede their ability to address the daily management of a complex drug delivery system, side effects, and symptoms. Despite medical advances in PH treatment, symptom management integrating complementary therapies into the medical regimen has not been extensively studied in this population. The purpose of this presentation is to introduce a unique integrative approach for symptom management in adults with PH. Clinical case exemplar will describe how these complementary therapies can be implemented in hospitalized PH patients.

Background

The Urban Zen Integrative Therapy Program (UZIT) features a combination of complementary modalities tailored to specific patient symptoms, commonly pain, anxiety, nausea, insomnia, constipation, sadness and exhaustion (PANIC-SE). The UZIT program encompasses three healing modalities, offered in a layered approach, to patients in a variety of settings. Individual components of UZIT (yoga therapy, Reiki and essential oil therapy) have demonstrated therapeutic benefits in several chronic conditions. A quasi-experimental study comparing 2 independent patient groups before and after UZIT implementation in an oncology nursing unit showed improvements in mood states and sub-domain of current health state. Patients who received UZIT reported significantly less tension, less depression, more vigor, less fatigue, increased mobility, and less overall mood disturbance. Even though there was no statistically significant difference in reported pain/discomfort level between the two groups, a statistically significant difference was observed in the change in pain/discomfort from admission to discharge among those who received UZIT.

Methods

The complementary modalities are provided by certified therapists and are available throughout the medical center. A UZIT session begins with symptom assessment and review of any contraindications to movement or use of an essential oil. The session averages 30 to 45 minutes and is then tailored to patient symptoms with a goal of enhancing circulatory, respiratory and digestive systems while promoting relaxation and rest. Symptoms are assessed at session end with documentation in the patient’s medical record.

Results

Two patients received UZIT and reported improvements in pain, anxiety and nausea. Patients also reported satisfaction with the therapy stating they felt “relaxed and more in control.” In both cases, restorative postures, including supported side-lying and constructive rest poses, in-bed movements to promote circulation, breath practices, guided body scan meditations and Reiki were used along with lemon and peppermint essential oils. All components of UZIT were successfully tailored to patients’ symptoms without any reported adverse side effects.

Conclusion

UZIT has demonstrated preliminary benefit among hospitalized PH patients. Feasibility and acceptability of UZIT will be evaluated in community-dwelling persons with PH as an integrative approach to reduce symptom burden. A randomized control trial demonstrating UZIT efficacy and effectiveness will fill scientific knowledge gaps. It is with great hope that complementary therapies integrated into the medical regime may become a part of the standard of care that can reduce symptoms burden and improve quality of living for persons with PH.