Introduction

According to Marriner-Tomey (1994), theory is defined as the purpose of providing knowledge to improve practice by describing, explaining, predicting and controlling phenomena. As cited by Perry (2001), a nursing theory is a conceptualization of some aspect of nursing communicated for the purpose of describing, explaining, predicting nursing care. All nursing practice is based on nursing theories as theory provides nurses with a perspective to view client situations, a way to organize data and a method to analyze and interpret information (Perry, 2001). Hence, the study of theory helps develop analytical skills, challenge thinking, clarify values and assumptions and determine purposes for nursing practice, education and research.

With the emphasis that nursing professions are evidence based, nursing theories provide a distinctive nursing focus on practice, facilitate communication among nurses, and foster the development of common goals for patient care (Keen et al., 1998). A careful selection of theory that will help nurses to be critical and innovation in practice is important. For such theory to be specifically related to a clinical environment, a rigorous, and systematic analysis of it is essential (Wotton, 2000).

There are many nursing theories which all the nurses are quite familiar with, such as Orem’s self-care deficit theory, Roy’s adaptation theory and Watson’s caring theory. Orem’s self-care deficit theory viewed self-care is a development and the use of personal health practices and coping skills. These two individual factors are important determinants of health (Federal, Provincial and Territorial Advisory Committee on Population Health, 1994).

The notion of self care is central to Orem’s model and is appealed to me as it fits my belief that the nurses help patient to meet their self-care needs. According to Gantz (1990), nursing work in self-care focuses on identifying and assessing self-care needs and abilities, intervening in ways that meet these needs and evaluating the effectiveness of the interventions with clients. Hence, this model was chosen for this paper to enable me to relate closely to a number of areas within my hospital settings where patients are encouraged and educated to care for themselves.

Orem’s emphasis on self-care is similar to Henderson’s (1996). From a nursing perspective, the object of self-care is through the collaboration of clients, their families and support networks  to assist the individual, sick or well, in the performance of activities contributing to health or its recovery (or to peaceful death) that he would perform unaided them gain independence as rapidly as possible (Henderson,1966). The objective of nursing, therefore, is to help that person live despite the illness (Blanchet 1996).

According to Fawcett (1995) and McKenna (1997), each nursing model is built around defining the four principal theoretical elements of nursing theory: person, environment, health and nursing. This paper will discuss concepts of Orem’s self-care deficit theory and its relationships between concepts of metaparadigm.

Person

Patients are individuals that constantly act to maintain a balance between their abilities to achieve self-care and the various therapeutic self-care demands (Orem, 1991) that are needed for their self-care abilities. Orem (1991) believes that an individual or client is a biological, psychosocial being with the potential for self-care, meaning a capacity or willingness to provide care for themselves towards the maintenance of life, health and well-being. They may or may not be dependent on others. An imbalance between therapeutic self-care demands and self-care agency, by self or meaningful other leads to a self-care deficit. When this occurs nursing intervention is required. However, Orem does not appear to extend her model to address the nurse-society relationship and lacking in the area of public education (Goodwin, 1990).

Majority of our patients in my ward belong two the following groups. Those who do not experience any changes in their physical structure, for example, admitted for hypertension, hyperglycemia, etc. This group of clients is usually middle age group and most independent. The area of my working is to meet the needs of nursing care by them. The clients’ anxiety level are assessed, adequate education of disease process are rendered, treatment plan, outcomes and discharge plan are all performed during their admissions.

On the extreme, we also have clients who are experiencing changes in their physical structure, for instance, those who have undergone surgeries, like total hip replacement, below knee amputation, etc. Nursing interventions are only required when the patients or their significant others are not able to take charge of their well-beings. Any self-care deficit will be identified preoperatively and postoperatively. Clients will also be continuously assessed and areas that needed to be advocated are identified. Nursing care will be applied in respect of ethical consideration to promote the concepts of cliet autonomy, nursing autonomy, advocacy and paternalism (Yeo, 1989 as cited in Wotton, 2000).

Environment

According to Fawcett, (2005, p.5), “environment refers to the person’s significant others and physical surroundings, as well as to the setting in which nursing occurs, which ranges from the person’s home to clinical agencies to society as a whole. It also refers to all the local, regional, national, and worldwide cultural, social, political, and economic conditions that are associated with the person’s health”.

Any individuals became ill and admitted to a hospital can no longer control their surroundings and it added stresses and demands on their self-care capabilities. In our ward, efforts were being made to ensure that patients were not deprived of a safe and comfortable environment. Nurses are also part of this environment and their role is to help the clients when appropriate. Nurses work closely with the housekeeping, maintenance and support services to provide environment that is conducive and to provide protection for the clients from hazards and hostile surroundings, like poor lighting, slippery floor, etc. Hence, it will bring out positive experiences and makes the clients feel comfortable and respected in the abilities to care for themselves.

There is a lost of control whenever the clients left the ward. A nurse from our hospital will work closely with them and their caregivers to ensure that their home environment is conducive for the development and encouragement of self-care. For example, home visits were made to ensure that modifications to be made in the homes so that the clients’ daily activities were not compromised.

Health

Health is often viewed as “dynamic and ever changing” (George, 1990, p.109), and Orem (1980) sees health as perfect when living things are structurally and functionally in whole. The description of health incorporates physical, psychological, interpersonal and social elements towards a state of wholeness and human integrity (Orem, 1991).

Health is achieved through a process of self-care which is one’s actions directed “to regulate one’s functioning in the interests of one’s life, integrated functioning and well-being” (Orem, 1985, p.31). However, when a person experienced injuries, disease or illness, he or she will likely to have additional demands for self-care.

The idea of collective responsibility towards health is sympathetic to the ideal of collaborative action within primary health care. As such, our nursing practice in the ward involves (1) Health maintenance, which involves nursing activities, such as, smoking cessation programme that will help patients to remain healthy. (2) Health promotion which aims to encourage patient to take charge of their own health and well being. It involves activities such as talks on various exercise programmes, healthy lifestyle programme, etc. (3) Health restoration which involves nursing activities to help to improve health. For instance, teaching on the effects of medications, teaching on the exercises to get patients to higher level of fitness, etc.  

Nursing

The metaparadigm concept nursing in Orem Self Care model refers to “the actions taken by nurses on behalf of or in conjunction with the person, and the goals or outcomes of nursing actions. Nursing actions typically are viewed as a systematic process of assessment, labeling, planning, intervention, and evaluation” (Fawcett, 2005, p.5). The role of the nurse in the ward is a complementary one and it is closely related to the individual client’s need and his ability to undertake self-care. Effective and efficient nursing actions can contribute to the accomplishment of a person’s usual and therapeutic self-care by compensating for or aiding in overcoming the physical or psychic conditions or disabilities that hinder one from rendering self-care effectively (Orem, 2001).

According to Meleis’s (1997) views of Orem’s theory of nursing system which include wholly compensatory nursing, partly compensatory nursing and supportive-educative or development nursing. In wholly compensatory nursing, client will be provided with total nursing care, such as elimination, hydration , nutrition, pain management, wound management, etc., to prevent any complications. The partly compensatory nursing will involves both the nurse and the client in meeting self-care needs. This is will be delivered in conjunction with supportive-educative or development nursing, which involves a system to assist the client in decision making, behaviour control, and acquire knowledge and skills.

In the ward, nursing actions evolves around assisting in decision making; checking, adjusting and meeting self-care needs. This is only made possible when nurses are made to go through various training in both basic and advanced nursing skills. It is necessary to equip the nurses with the relevant skills to help their clients. On many occasions, nurses will also need to work hand in hand with clients’ families’ members in conjunction with supportive-educative or developmental nursing. It will ensure that the client is coping well and complying with safety measure education after discharge.

Conclusion

Orem’s theory encourages a more responsible and independent wellness of an individual as a whole. The model may result in shorter lengths of stay for the clients and a reduction in unnecessary expensive hospital care. The theory has also emphasised on home care with support systems and specifications as to when nursing is needed. By working on this assignment, it has allowed me to appreciate the holistic nursing care provided by my hospital in relation with the four aspects of metaparadigm for my client who has self-care deficit. The application of Orem’s theory in my clinical setting has also included clients’ significant others while focusing on enhancing and restoring individual optimum health.

In times of growing budget restraints and the hospital funding based on case mix, Orem’s model may provide attractive factors for the nursing administrators to consider the model serious. It is undisputable that it has the potential to be cost effective and at the same time encourages a more responsible and independent client population.

Reference

Blanchet, S. (1996). Dernier hommage à Virginia Henderson. L’infirmière du Québec 3(6): 12-14.

Fawcett, J. (1995). Analysis and Evaluation of Conceptual Nursing. (3rd ed.), Philadelphia: F.A.Davis Co.

Fawcett, J. (2005). Contemporary nursing knowledge: Analysis and evaluation of nursing models and theories. (2nd ed.), Massachusetts: F.A. Davis Co.,

Federal, Provincial and Territorial Advisory Committee on Population Health. (1994). Strategies for population health: Investing in the health of Canadians . Prepared for the meeting of the Ministers of Health, Halifax, Nova Scotia, September 14-15, 1994. Ottawa: Minister of Supply and Services Canada.

Gantz, S.B. (1990). Self-care: Perspectives from six disciplines. Holistic Nursing Practice 4(2):1-12.

George, J. (1990). Nursing theorist: The base for professional nursing practice. (3^rd ed.). Connecticut: Appleton & Lange.

Goodwin, M. (1990). St. vincent’s nursing monograph 1990: Is if feasible for the nursing division at st. vincent’s to adopt dorothea orem’s model of nursing? Retrieved: March 26, 2007, from http://www.ciap.health.nsw.gov.au.

Henderson, V. (1966), The Nature of Nursing: A Definition and its Implications, Practice, Research and Education, New York. McMillian and Co.

Keen, M., Breckenridge, D., Frauman, A. C., Hartigan, M. F., Smith, L., Butera, E., & Hooper, S. T. (1998). Nursing assessment and intervention for adult hemodialysis patients: Application of Roy’s adaptation model. ANNA Journal, 25(3), 311-319.

Marrinner-Tomey, A. (Ed) (1994). Nursing theorists and their work. (3rd ed.). St Louis : The C V Mosby.

McKenna, H. (1997) Nursing Theories and Models. London: Routledge.

Meleis, A.I. (1997). Theoretical nursing development and progress. (3^rd ed.). Philadelphia: Linppincott.

Perry, A. G. (2001). In J. Crisp, P. P. Potter & A. G Perry (Ed.s), Fundamentals of nursing. Sydney: Mosby Harcourt Health Sciences Company.

Orem, D. (1980), Nursing: Concepts of Practice. (2nd ed.). New York: McGraw-Hill.

  Orem, D. (1985) Nursing: Concepts of Practice. (4th ed.). New York: McGraw Hill..  

Orem, D. (1991) Nursing: Concepts of Practice. (5th ed.). Mosby: St. Louis.

Wotton, K. (2000). Nursing theory in Australia: Development and application (ed.) NSW: Pearson Education Australia.

Pain Management.
I saw this advertsiement about a basketball player who was selling some sort of heat releasing plasters for relieving pain. I found that the phase “When the heat is on the pain in gone!”, is very meaning and has a very insightful concept of the way how Traditional Chinese Medicine treats pain. This concept has been adopted by the Chinese for more than three thousands years and till now the fort still holds .

There are many ways of managing pain. You can take some pain killers which will numb your nerves so that your brain will not be able to sense the pain. You can also try other traditional treatments like acupuncture and acupressure. Both techniques were once considered as a unorthodox treatments until the use of the gate control theory of pain, which was put forward by Ronald Melzack and Patrick Wall (1962, 1965), which explained theory behind these treatments. Ronald Melzack and Patrick Wall (1962, 1965), believed that pain was perceived by interaction between different neurons.

By rubbing the pain area or using some invasive methods, like acupuncture, will help to “distract” the interactions between the neurons and hence lessen the pain. This will also activate the nonnociceptive fibers that inhibit the firing of nociceptive fibers (Kandel et al., 2000).

The using transcutaneous electrical stimulation (TENS), which selectively stimulate the nonnociceptive fibers by using electrodes, will also help to lessen pain.Besides using the above scientific theories as the foundation for pain management, we can also use heat to relieve pain too. Heat will can stimulate the flow of blood and stimulate the nonnociceptive fibers in the affected area. Hence, when I treat my patient for pain, I will try to relax the muscles and then continuously stimulate the nonnociceptive fibers around the painful area. It is indeed has helped me to manage the pain effortlessly and cost effectively.

Using heat to manage pain. When the “Heat is on the Pain is gone” is what acupuncturist has also been adopting to treat chronic pain for about three thousands of years. The using of moxibustion together will acupuncture are both essential techniques for relieving pains. Chronic pains that were caused by bad flow of qi or trauma require heat to go into the deeper tissue to increase the blood flow to nourish fibers. Heat will also help to stimulate the nonnociceptive fibers as well. A Chinese Medicine practitioner will and must try to find out the underlying causes of the chronic pain when the systematic problems have been addressed. He must then renders cost effective method to treat the underlying problems and take the miseries from the patients.

It is important to note that to be able to manage pain is very important. According to McGill University, those who is suffering from chronic pain will affect their choice of friends, activities, lifestyle and profession. They believes that failure to take up the challenges that their bodies faced can be seen as a mental illness (McGill University). So, the next time someone told you that he/she was in pain, please pay attention!


Reference:
1. P.D. Wall, R. Melzack, “On nature of cutaneous sensory mechanisms,” Brain, 85:331, 1962.
2. R. Melzack, P.D. Wall, “Pain mechanisms: A new theory,” Science, 150:171-9, 1965.3.
3. Kandel E.R., Schwartz, J.H., Jessell, T.M. 2000. Principles of Neural Science, 4th ed., pp.482-486. McGraw-Hill, New York.

Tag: Acupressure,Acupuncture,chinese medicine,gate theory, Kandel,nonnociceptive fibers,pain management,Patrick Wall,Ronald Melzack,unorthodox treatments

I was at the Diabetic Centre one late afternoon trying to solve some thin client issues when I heard an angry old man telling a diabetes nurse off.

“This is my problem, you don’t have to tell me what to do. I am fit and I have not other medical problems!”.

“Sir”, explained the nurse, “It is my responsibility to educate you on how to care for your feet.” “I don’t want to see your leg gets amputated”, she cried.

“What the hell you’re talking about…..”, he screamed at her.

I could see her eyes were turning red and I really felt sorry for her. As a nurse in Singapore, we are frequently have to due with many such unreasonable patients. They are not interested in taking care of their health and have no knowledge or interested to know about diabetes is all about. To them, as long as you do not take any sweet food, you are ok. We all know that this is not true at all!

“You must always treat wounds seriously. Never leave any wounds untreated.” The diabetic nurse raised her voice.

“For small wounds, clean the wound with clean water dry it with gauze and cover with a sterile gauze or plaster. Inspect the wound daily. If it does not improve in 2 days, see a doctor immediately. Do not treat the wound yourself with medications or ointments, if they are not recommended by a medical practitioner.

If you have an ulcer, dress the wound according to professionals’ recommendation. Seek help immediately.

If you are experiencing any pain on your legs, you may and if you have fever or chills.It could be signs of infection and should be treated immediately.” She stood up in front of that patient and told him everything that she was trained to do and fired at him; like she was firing a General Purpose Machine Gun. Then she walked quickly into the treatment room.

“You idiot. Get out of my sight! I want to see the medical social worker NOT you!”.

On average, we have about few hundreds of major lower limb amputations occur in Singapore in a year. Most of these procedures can be avoided if the patients know how to take proper care of their feet and seek medical assistance early. 

The need for an amputation was usually due to delay in treatment. In fact, not everyone with diabetes will need their legs to be amputated. It is your choice to keep your legs.

My observation while working in the wards: most patients with diabetes love to eat processed food such as white rice and white bread. I often told them to cut down these carbo but was told numerous times that these are the most accessible food that they can have readily to fight their hunger.

Well, it is a chicken and egg issue. If you do not cut down these carbo, your diabetes will not be able to keep under control. A balanced or healthy diet is very important for diabetic patients to fight diabetes too and not just medications.

Page Tags: diabetes, leg, amputate, nurse, scolding, idiot, medical social worker

This essay attempts to provide critical analysis in response to the article “What’s in a name?” which was written by Chiarella (2001). It will define what nursing is, and the role of a professional nurse. The difference between the nurse and carer will be discussed and with an overview of nursing as a profession.

What is a nursing?

According to Ellis & Hartley (2001), defining nursing can be difficult and nurses cannot agree on a single definition. Much of it is due to the history of nursing as there is little known about the work of the nurse in pre-history. Diers (2001) also agrees that the word nursing is derived from the word nurse. So, according to Ellis & Hartley (2001), a nurse is someone who nourishes, fosters, and protects a sick, injured, and aged. Indeed, a nurse is “a person, especially a woman who takes care of the sick or infirm…” (Diers, 2001 p.5). But is a mother who gives care to a sick child a nurse?

Public attitude has very mixed view about nursing and what nurses do. According to Chiarella (2001), many lay people and doctors have stereotyped images of what nurse are and do. To address this concern, Chiarella (2001) suggested that it would be better for us to define nursing through research. Hopefully, there will be fewer misconceptions from the public on the role of nurses.

Nursing as a profession

Nursing has for many years struggled with an inner hunger, a deep need for professional congruency and effectiveness (Thupayagale & Dithole, 2005). So, is nursing a profession?  Accordingly to Kozier, Erb & Blais (1997), Pavalko’s eight criteria of a profession shows to determine whether an occupation is a profession. They include theory, relevancy to social values, training period, motivation, autonomy, commitment, senses of community and code of ethics. However, some of the characteristics are not highly developed in nursing as they are in other profession. Kelly & Joel (1999) had commented nursing theory’s base was still developing, that the public did not always see the nurses as a professional.

It is perceived that not all nurses are educated in institutions of higher learning, not all nurses consider nursing a lifetime career and that in many practice settings, and nursing does not control its own policies and activities (Kelly & Joel, 1999). Lack of autonomy is considered as most serious weakness. On the contrary, the nursing profession is autonomous as the Nursing Board in each State has set up rules and guidelines that nurses are required to adhere to strictly.  

In Singapore, the Singapore Nursing Board requires its nurses to abide by the Code of Ethics and Professional Conduct. It also stipulated the Standards of Practice for Nurses and Midwives (SNB, 1999). For nurses to re-register their license currency of practice is required, hence, nurses need to make sure that they are constantly upgrading themselves by attending talks, seminar or courses to achieve the required number of hours stipulated by the Singapore Nursing Board.

Role as a Professional Nurse

In the past, nurses were generally believed to join the industry due to their low level of education and are not a subcategory of medicine. The doctors had little idea about what nursing entailed. Nurses were believed to follow the orders delegated (Chiarella, 2001). It is also the general acceptance that much of nursing work is of a routine or domestic nature, and requires no special skill (Chiarella, 2001).

However, according to Koch (1999), today’s nurses have more liberty to explore and create job opportunities and should be encouraged to exercise their influence to develop and support new nursing roles. In Singapore, we more nursing courses are available to nurses to upgrade themselves. For example, there are advanced nurse practitioners who are graduates from local masters program, can prescribe and make diagnoses in the absence of doctors. However, people debated that medical diagnosis and prescribing are not the focus of nursing knowledge whether the additional roles will diminish the role of nursing as a nurse (Donnelly, 2003).

Lindberg, Hunter & Kruszewski (1998) mentioned that caring nurses assist persons to foster growth and independences and enhancement of their client’s abilities to manage their own health needs. However, Chiarella (2001) mentioned that the nursing role is being eroded and there are certain nursing care is being delivered by non-nurses. It is better to acknowledge that others also do it but with the instruction and support of professional nurses. Care given by non-nurses must be done with a “nursing mind. 

Conclusion

It is necessary for nurses to protect our name, we needed to be able to describe what we did (Chiarella, 2001). Nursing must continue to work to become completely professional. The better way to differentiate nursing profession and nursing behavior by non-nurse is by examining the intent behind the action.  

References 

Chiarella, M. (2001). What’s in a name? Australian Nursing Journal,8(6), 39. 

Diers, D. (2001). What is nursing? In J.. McCloskey, Dochterman & H. Grace (eds.). Current issues in nursing (6^th ed.). St Louis: Mosby. 

Donnelly, G. (2003). Clinical expertise in advanced practice nursing: a Canadian perspective. Nurse Education Today, 23, p168-173. 

Ellis, J. R. & Hartley, C. L. (2001). Nursing in today’s world: Challenges, issues, and trends (7^th ed.) Philadelphia: Lippincott. 

Kelly, L. Y., & Joel, L. A. (1999). Dimensions of professional nursing (8^th ed.). New York: McGraw-Hill 

Koch, R. (1999). Contemporary nursing roles. In B. Cherry & S. Jacob (eds.). Contemporary nursing: Issues, trends and management. St Louis: Mosby. 

Kozier, B., Erb, G. & Blais, K. (1997). Professional nursing practice: concepts and perspectives (3^rd ed.). California: Addison Wesley.  

Lindberg, T., Hunter, M., & Kruszewski, A. (1998). Introduction to nursing: concepts, issues and opportunities (3ed ed.). Philadelphia: Lippincott.  

Singapore Nursing Board (1999). Code of ethics and professional conduct. Standards of Practice for Nurses and Midwives.  Thupayagale, G., & Dithole, K. (2005). What is in a name: the case of nursing. Nursing Forum, 40(4), p141-144.

Is Acupuncture an althernative way to produce endorphins?

As a Traditional Chinese Medicine (TCM) practitioner, I believe that I must keep my medicial knowledge up-to-date and must be able to bring up TCM concepts to support my diagnoses. No matter what we do, we must exercise due deligence and duty of care to our patients. Remember, “Do No Harm”!

Chinese medicine is based on thousands of years of documented case studies and careful analyses. It is definitely not a mystical concept. Do you agree with me?In the video that you will be watching, it will talk about pinching of rabbit buts. I do not see the point of pinching rabbit butts to prove the production of endorphins. The research should be focusing on proving whether or not there is a measurable difference in patient’s health and well-being from the acupuncture treatments.

Page Tags: Acupuncture, acupuncture clip, mystical concepts, tcm, traditional chinese medicine clip, video

Acupressure: How Much Pressure To Apply?

I always believe that Acupressure is one of the most effective treatments for relieving pain and stress. In the Acupressure point therapy, it releases tension, increases the circulation of blood, and improves the body’s life energy to improve health.

Acupressure does not only help to maintain good health through self-care but also strengthens resistance to disease and promotes wellness through the relaxing of the body and relieving of stress.

When a muscle is chronically tense or in spasm, the muscle fibers will contract. This could be due to the imbalance of Ying and Yan in the body. The body will secret lactic acid which is the result from fatigue, chemical imbalances, stress, and qi stagnation. Tensions formed and tended to concentrate around the related acupressure points.

The pressure applied on these Acupressure points must be gradual, and steady with penetrating pressure for approximately a few minutes. A rule of thumb, it will be about three minutes. The ideal pressure to any points depend on how fit your clients are and their health conditions.

To elaborate on the penetrating pressure, it should be firm enough so that your clients are feeling the pleasant and firm pressure. If they feel extremely sensitive or pain, release the pressure gradually until your client verbalized a balance between pleasure and pain.

How to learn the proper Acupressure techniques and to give professional acupressure sessions for releasing stress effectively? There is no institution that will teach you the skills without you attending series of lessons and certifications.

Those who wish to learn the techniques for self-care purposes, and wish for a quick and easy to learn path, studying at home can be an ideal way to so. However, the lessons can be too demanding. You may want to consider to buy some books that are used by classroom students.  Not knowing what are the textbooks to get? Well, I have explored some self study products and identified the following books that you can use Acupressure for Pain Management and Stress Management. Click here for the list of textbooks that get you started.

I am in the mid of writing a manual on some techniques and tricks on Acupressure and Tui Na techniques that I have learnt from a few masters in China and Singapore. The manual will show you step-by-step basic effective Acupressure and Tui Na techniques that anyone can learn easily. You can use the techniques that you have learnt from my manual to impress and surprise your friends immediately. Most important of all, the techniques work!

My manual will include several methods that you can use for relieving headaches, insomnia, chronic fatigue, anxiety, etc. If you wish to be updated on my progress, please provide me your name and email address. I will keep you informed.

Why after taking Glucosamine and Chondroitin the blood sugar level will increase?

The other day, my mom called to seek my advise. She told me that her blood glucose was high and asked me what to do. Without a second thought, I asked her, how many tablets did you take? “I followed the doctor’s instruction, to take the tablets 3 times a day”, she replied. “Can I ask you to stop taking them because it is causing your blood sugar level to go high? Btw, have you noticed any thing wrong with you?” 

“I did not notice any changes in my body except today when I met your aunty, she told me that I had lost a lot of weight!”.
My mother’s left knee was swollen and in pain for weeks after she came back from her trip to China. The doctor prescribed some NSAID (pain killer) and Glucosamine (formation and repair of cartilage). She could not take the NSAID as it had caused her stomach to feel uncomfortable, so, she continued with the Glucosamine. A shortage of cartilage was what the doctor suspected to have caused her joint to be painful.

Glucosamine, which is an amino sugar that help to promote the formation and repair of cartilage. Glucosamine is derived from marine exoskeletons or is manufactured synthetically. It is also an important building block of many glycosaminoglycans, which are molecules that form the matrix of cartilage. Glucosamine is believed to stimulate the metabolism of chondrocytes in articular cartilage and of synovial cells in synovial tissue. As according to Kala Health in Australia, Glucosamine can increase fasting blood sugar levels and worsen glucose tolerance. This is because glucosamine activates a metabolic pathway in the body, called the hexosamine pathway, to cause insulin-producing cells in the pancreas to deteriorate and causes insulin resistance. This sounds like the factors associated with diabetes. Isn’t it?

Researchers at Johns Hopkins have also found that activation of this pathway causes proteins to be coated in sugar, hence insulin is unable to regulate the blood glucose.This side effect has not been officially published and researchers claimed that it may affect only certain people. Until then, people taking Glucosamine sulfate should have their blood glucose monitored closely.

Another important point to note: Glucosamine has been used in combination with Chondroitin. Chondroitin sulfate is manufactured from shark or bovine cartilage and is taken orally for the treatment of OA. It is usually used in combination with other compounds, such as manganese ascorbate, glucosamine sulfate or glucosamine hydrochloride Chondroitin sulfate is manufactured from shark or bovine cartilage and is taken orally for the treatment of OA. It is available alone or in combination with other compounds, such as manganese ascorbate, glucosamine sulfate, or glucosamine hydrochloride.

Chondroitin protects cartilage from breakdown and also stimulates the synthesis of new cartilage, important for healthy joints.  It attracts fluid into the cartilage and with this fluid, cartilage would become nourished, and stimulates the synthesis of new cartilage.Users of Chondroitin must be warned that if they experience asthma exacerbation and gastrointestinal discomfort stop taking it and consult your doctor immediately.

In Chinese Medicine, medicine that is derived from marine exoskeletons is “cold” in nature. Long term use of such medicine will reduce the absorption of nutrients by the stomach. Usually, users will complain about the lost of appetite and feeling weak.

My experiences have shown that by strengthening the stomach, improve the absorption of nutrient, and to increase the heart’s yang to improve the blood circulation can be used to control drug induced diabetes. Of course, there are theories about harmonizing the three burners and preventing blood stasis which can also be adopted to help to achieve equilibrium in the body (Yin and Yang balanced) as well.

Post Tags: Glucosamine, Chondroitin, diabetes, blood sugar, glucose, increase, health, yang, yin, equilibrium

Technique: Smacking your way to fitness and health. 

I talked to Ong about Mary Chong’s presentation today. He gave me a big starred and then threw me some statistics. He told me that study showed that adults watching about 3 hours of TV per day will be twice likely to be obese. Those who watch 4 hors or more per day will be 4 times more likely to be obese.

He told me that with normal ageing, my metabolic rate will reduce approximately 3% per year and my weight will slowly “creep” from my increase food intake. “You have increased physical inactivity!”

I was stunned by his sudden remarks. He went on to tell all the things about developing a healthy relationship with food and to increase my physical activity from now on.

Ong also agreed with Mary that a combination of dieting and exercise is the most effective ways for losing weight and maintaining weight loss in the long term.

I told him that I am a food lover but I want to keep my tummy trimmed. “No way! You must do these form of exercises: aerobic, resistance and flexibility exercises.” Blar…blar… he went on and on.

“There must be a better way to keep my tummy trimmed”, I thought to myself. That made me went through a whole piles of Chinese Medicine textbooks tha I bought from China.

Of all the books that I had. none of them talked about losing weight. Suddently I stumbled upon a video tape that I bought from a tui na master. I played the tape and it was about using a unique finger tapping technique for opening the qi channels.

Trying to recall why I bought this video, I suddenly remembered the master told me that a student from the Western asking him for help to trim her stomach. He called it the “Smacking your way to fitness and health”.

It was such a simple technique that anyone will know what to do after seeing the video. All, right I shall use this “Smacking your way to fitness and health” technique for a while to see if it is effective.

Page tages: fitness, health, obese, metabolic rate, physical activity, exercise, losing weight

Energy Balance Theory

A presentation was done by a Dietitian, Mary Chong , a couple of months ago on energy balance weight of maintaining your weight. She said that the Energy Balance theory was derived from the following formula:
   Energy intake  = Energy expenditure

Mary mentioned in her presentation that an extra 100 kcal intake  per day will be equivalent to 5.2 kg  per year. She also highlighted that “Fat loss is a slow process. It probably took a while to put it on. Likewise, it will take time to take it off.”

What will happen to our bodies if there is a severe reduction in calories? Mary showed a flow chart to explain that body will look to stores of CHO to replace lost energy. Water along with CHO will be lost with the depletion of store.

Body’s metabolic rate will begin to slow down,fat use is slowed and body uses protein stores. As a result, the muscle mass drops and you will also experiece further reduction in metabolic rate.

So what do Mary recommend for a desirable Weight Loss Programme? “Reducing kcal + Exercise = BEST METHOD”, was what she suggested. By kcal reduction, it should be 0.5 – 1 kg per week. Any thing more than that is probably fluid loss, lean tissue loss and some fat loss. Daily intake should be no less than 1200 kcal for women and 1500 kcal for men.

Indeed, Mary was right and I agreed strongly that Reducing kcal + Exercise is something that we should do to reduce or maintain our weight, In relation to that I feel that a nutritionally Sound Weight-Loss Programme should satisfies all nutrient needs except energy. The diet must be able to meet individual’s tastes and habits and we must be able to minimizes hunger and fatigue.

Traditionally, many people who has some knowledge about Chinese herbs will use Senna leaves (”fang xei” leaves) to loose weight. Even in the Western medicine, doctors are also seen prescribing Senna in discretly to many patients who complained about constipations. I had always pleaded to my doctors to stop prescibing such drug and instead give patient a fleet.

Senna should not be taken over long period of time as it will cause stomach cramps, nausea, vomitting, and electrolyte disorders. In Chinese medicine, Senna is a cold medicine that will affect the stomach’s absorption of nutrients significantly.

Page tags: weight lost, energy balance theory, energy intake, energy expenditure, maintaining

Uniquely to Singapore: Chinese Culture Values and Cultural Portability.

The Chinese in Singapore cover a diversity of communities and individuals but the cultural values that are of major importance are “hard work, acceptance of what life brings, respect for and harmonious coexistence with nature, family before individual welfare, education, self-control, self-actualisation, interdependence, respect for elders, collectivism and loyalty to the family (Australian Centre for International and Tropical Health, 2003).”

According to Singapore Minister, Mr Yeo, G. (2001), Chinese culture has two seemingly contradictory aspects; one is the expectation of strong central rule which arose out of the experience of the Chinese people over the centuries, the other is one of “cultural portability”. In the former, one would also be able to observe a record of strong prosperous dynasties with prolonged periods of anarchy. Mr Yeo (2001), also pointed out that there is a strong impulse within the Chinese towards central rule as evidence by history that over the past two thousands years, the Chinese Empire had collapsed then regrouped, collapsed again then regrouped again. That social DNA had deeply embedded in the Chinese mind.

In the aspect of “cultural portability”, the Chinese are able to maintain their values and transmit their traditions to subsequent generations, without state support. This is in line with the Confucianist ideal of a centralized realm where everything finds its proper place (Yeo, 2001). Chinese people are seen to be bounded up with these two impulses – family-centered cultural portability and central rule. Hence, Chinese people tend to be partial towards family members and relatives and to treat those who are further away rather selfishly (Yeo, 2001).

Values, Social Structure and Religion

The social structure among Chinese throughout history is the centrality of the family (Kim et al, 2001). Many Chinese in Singapore list their family name first, and their given name last. Nuclear families are common and family structure is traditionally hierarchal and patriarchal. Families tend to be very private, and few are willing to discuss family issues or conflict with non-family members.

According to Tong & Spicer (1994), the family is often the first and sometimes only source of health care. Health decisions may be made by the family based on what is best for the family instead of what is best for the patient. The oldest adult male is the decision-maker in health and other matters. However, when come to family matters, there is obvious influence from elders, including women. It is also common to see that older children have precedence over younger children and male children over female (Chang, 1999).

Chinese religion blends religious beliefs and practices with philosophical systems. It is difficult to understand or one without the other (Kagawa-Singer & Blackhall, 2001). According the 2000 census, 42.5% of Singapore’s population was Buddhist, 8.5% Taoist, 14.6% Christian and 14.8% non-religious. The Chinese form the vast majority in these four groups, due in part to their dominance in Singapore. Most of the Chinese have retained the belief of Buddhism or Taoism However; younger generations have either switched to modern, more orthodox versions of Buddhism, Christianity or have become non-religious.

Reference:

Australian Centre for International and Tropical Health (2003), Community Health Profile – Chinese. Queensland Health. Retrieved on 18th January 2007, from http://www.health.qld.gov.au/multicultural/cultdiv/chinese.asp

Chang, K. (1999). Chinese Americans. In J.N. Giger & R.E. Davidhizer (Eds.), Transcultural nursing: Assessment & intervention (pp. 385-401). St. Louis: Mosby.
Kagawa-Singer, M. & & Blackhall, L.J. (2001). Negotiating cross-cultural issues at the end of life. JAMA, 286(23), 2993-3002.

Kim, B.S., Yang, P.H., Atkinson, D.R., Wolfe, M.M., & Hong, S. (2001). Cultural value similarities and differences among Asian American ethnic groups. Cultural Diversity and Ethnic Minority Psychology, 7(4), 343-361.

Tong, K.L. & Spicer, B.J. (1994). The Chinese palliative patient and family in North America: A cultural perspective. Journal of Palliative Care, 10(1), 26-28.

Yeo, G. (2001, May 17). Interview with BG (NS) George Yeo, Minister for Trade and Industry by Dr Albert Bressand and Catherine Distler of Promethee in Paris. Retrieved January 05, 2007, from https://app.mti.gov.sg/default.asp?id=148&articleID=333&intViewCat=1&intCategory=3&txtKeyword=&txtStart=&txtEnd=&
intOrderBy=1&intYear=&intQuarter=0


Author: Maurice Wong