Ayurveda and Holistic Nursing

¶ … Ayurvedic health care system, which is a 2000-year-old comprehensive and holistic system of health care with roots in the Indian subcontinent. Ayurvedic medicine includes various phytocompounds (plant-based medicines) that can be used internally or topically. While research has yet to use sufficient randomly selected clinical trials, empirical evidence does support the use of some Ayurvedic preparations and treatments in nursing. The specific implications for evidence-based practice are discussed in this paper.

The Vedas refer to a canon of Hindu spiritual texts penned about 2000 years ago, and the Ayurveda is located within this canon. However, the Ayurvedic system of medicine evolved over time and is not contained in a single compendium any more than allopathic medicine is. Rather, a "systematic development" of Ayurveda can be traced throughout Indian history until the postmodern era (Narayanaswamy, 1981). As nurses look increasingly to expend the content and quality of complementary care, Ayurveda is becoming part of the repertoire of holistic healing. Among the specific applications of Ayurveda as a complementary medical practice include wound care and pain relief. The use of Ayurvedic care in nursing can also be viewed as a wise choice for cross-cultural and trans-cultural domains of healthcare.

Holistic nursing is increasingly recognized as an established branch of patient care, especially when viewed alongside conventional medical interventions under the rubric of complementary care. The history of holistic nursing is linked directly with the history of nursing itself, as the origins of nursing predate modern medical practice. Indeed, holistic nursing as an evidence-based practice has been established with Florence Nightingale, who provided "blueprints for transpersonal meaning" in nursing care (Watson, 2010). Holistic nursing care is a broad umbrella term referring to interpersonal relationship building, a view of the patient as a "whole person," the taking into account of spiritual purpose and spiritual values, and the use of safe, mild, plant-based medications and topical applications. Yoga, meditation, and other lifestyle practices that promote health and overall well-being can be considered part of holistic nursing practice. The holistic nurse listens to patient needs, goals, and interests to make suggestions. Because Ayurvedic medicine is a comprehensive and multidimensional system, it fits well within the holistic nursing framework. There is nothing about Ayurvedic medicine that would proscribe the use of pharmaceuticals or surgical interventions alongside it. Likewise, there is little about Ayurvedic interventions that should counteract the positive effects of doctor-prescribed interventions, medications, and surgeries. Of course, doctors are part of the healthcare team and consultations with primary care physicians are always recommended when using complementary care like Ayurveda. Ayurveda fits in with holistic nursing because Ayurvedic philosophy includes spiritual, mental, and physical practices that promote health.

The value of holistic nursing can sometimes be quantified, but there remain significant gaps in empirical studies related to complementary care interventions. Qualitative research and emerging clinical trials do provide some foundation for a comprehensive holistic nursing practice that includes Indian Ayurvedic healing techniques.

Specific Applications

Ayurvedic medicine has a wide number of specific health care applications. One application of Ayurvedic medicine in holistic nursing care is in the realm of wound dressing. In an experimental research design, Gulati et al. (2011) compared the efficacy of traditional Ayurvedic honey dressings for wounds vs. A Povidone iodine dressing. Although there are some flaws in the research design, the results are significant. Seven out of the twenty-two participants using honey dressing achieved "complete healing," but none of the twenty subjects in the iodine group experienced complete healing. The authors conclude that, "honey dressing is highly effective in achieving healing in chronic wounds as compared to Povidone iodine dressing," (p. 1). The problem with the study is that different wounds might have responded to the different treatment modalities, but the authors did try to control for variances and individual wound differences in the participants.

Honey for wound care has been one of the most widely studied Ayurvedic applications. Falling under the rubric of phytochemical (plant-based) care, honey dressings have proven "antioxidant, anti-inflammatory, angiogenic, and cell synthesis-modulating components," (Sivamani, Ma, Wehrli & Maverakis, 2012, 213). However, the properties of honey may also yield allergic side reactions to the topical applications of the phytochemicals.

Ayurveda in conjunction with physical techniques of yoga and breathing practices like pranayama has been shown to reduce symptoms of depression among a population of seniors (Krishnamurthy & Telles, 2007). Using the Geriatric Depression Scale, the researchers evaluated three different groups of seniors in a residential care facility. Participants were evaluated prior to the intervention, after three months, and again after si months. The three experimental groups included a yoga program with physical postures and breathing exercises, and a separate condition receiving only Ayurvedic herbal preparations. A control group was also included. The group receiving the yoga techniques and training exhibited significant decreases in depression scores, whereas the other groups reported no change. This indicates that Ayurvedic interventions must be viewed as genuinely holistic care treatments. Phyto-based applications are not necessarily effective on their own. In fact, yoga and other interventions that are thematically and culturally linked with Ayurvedic herbal products can be considered part of the holistic nurse's repertoire.

When used as a method of pain relief in conjunction with allopathic interventions, Ayurveda offers significant hope for patients. Although a comprehensive evidence-based Ayurvedic practice has yet to be established, the most promising test results come from the application of Ayurvedic medicine on patients suffering from arthritis (Chopra, Saluja & Tilu, 2010). When using Ayurvedic treatment interventions as part of holistic nursing care, it is important to realize that it functions differently from allopathic interventions. Patients should be made aware of the core differences, so that expectations are commensurate with the potential results of Ayurvedic treatments. Ayurveda is a system of care based on principles of the body, mind, and soul that are completely different from the Western European and North American medical models. The allopathic models view the human body much as a machine or giant supercomputer; the Ayurvedic model views the body more as a complex energy system. Terminology such as heat and coolness are commonly used in Ayurvedic diagnosis and care. Ayurvedic medicine also promotes self-awareness via an examination of one's dosha, or constitution. The constitution provides insight into the types of diseases a person may be prone to, the types of mental health issues the person might encounter, and also the types of treatments that might be most appropriate.