COMPLEMENTARY

THERAPY: TERAPI
ENERGI DAN MEDAN
BIOLOGIS
MARIDI M DIRDJO
PENDAHULUAN

• Therapies in this category use energy originating in or near the body as

well as energy coming from other sources.
• The concept of energy and its use is universal.
• Most cultures have a word to describe energy:
• Qi (pronounced chee) is a basic element of traditional Chinese
medicine (TCM); ki is the Japanese word for it; in India it is prana; the
Dakota Indian word is ton; and the Lakota Indians term it waken.
• Scientists and consumers tend to have the greatest skepticism about
the efficacy of energy therapies, primarily because of the difficulty in
measuring such “personal” energy.
• Therapies based on energy are not new to nursing. Krieger began investigations of
therapeutic touch in the 1960s.
• Healing touch, a term used to encompass (mencakup) a large variety of techniques, is
used by nurses around the globe.
• Healing touch techniques may or may not involve actual physical touching of the body.
• The nurse seeks to bring energy into the patient or to balance the energy within the
person.
• Although nonnurses also use these therapies, nurses remain the leaders in research on
and use of healing touch techniques.
• An energy therapy originating in Japan, Reiki, is becoming more widely used in the
United States.
• Acupressure and reflexology focus on the qi, which is transmitted through the seven
meridians that are the basis of TCM.
• Many insurance companies now reimburse for the administration of acupuncture,
another TCM therapy.
• Use of bioelectromagnetic therapies is also increasing. These therapies, based on the use of
electromagnetic fields, utilize magnets, crystals, transcutaneous nerve stimulation, and
pulsed fields.
• Transcutaneous electrical nerve stimulation (TENS) has been used for several decades in the
management of pain.
• Light therapy and sound energy therapies are also included in the category of energy
therapy.
• Use of light for treating seasonal affective disorder has received considerable media
attention. Sound energy includes vibrational therapies, use of wind chimes, and the voice.
• Although music could be classified in this category, we have elected to discuss it under the
umbrella of mind–body–spirit therapies.
• Research on energy therapies is increasing & Development of appropriate research designs
and of measurements that can detect changes in energy fields is occurring.
• Kirlian photography, aura imaging, and gas exchange are some of the methods being used to
measure outcomes from energy studies. Solid studies will help to decrease the skepticism
about these therapies that persists in both professional and lay circles
TERAPI CAHAYA
HISTORY OF LIGHT THERAPY

• Since the beginning of time, people have realized the healing power of light.
• The history of light therapy goes back to ancient Egypt, in which sunlight was used for medical
treatments.
• Healing temples were built with colored crystals built into stone walls so that they were aligned
with the sun’s rays.
• People would lie down on benches and their bodies would be immersed with pure or colored lights
(Curtis-King, 2008).
• Later, Hippocrates described the use of sunlight to cure various medical disorders.
• Although ancient Romans and Arab physicians had no scientific explanation for light therapy at the
time, they knew that the healing power of light was helpful for medical treatments (Curtis-King,
2008)
DEFINISI TERAPI CAHAYA

• Light therapy is defined as daily exposure to full-spectrum or bright

light to treat conditions such as seasonal affective disorder (SAD).
• This needs to be differentiated from phototherapy, which is used
to treat conditions such as hyperbilirubinemia or psoriasis (Lam,
1998).
KEGUNAAN
• In the early 1980s, researchers discovered that specialized bright light (20
times brighter than normal indoor light) was the most effective treatment for
winter depression (Kripke, 1998a).
• Now research is confirming that this light is effective in improving the
symptoms of nonseasonal depression as well (Kripke, 1998b).
• In fact, a systematic review of 62 reports on the efficacy of light therapy on
nonseasonal depression found it to be effective and an excellent criterion to
include in treatment of nonseasonal depression today (Even, Schroder,
Friedman, & Rouillon, 2008). Light therapy has been reported to have a 70%
positive response (Miller, 2005).
• Research has demonstrated that individuals with SAD are positively affected by light (Flory, Ametepe, &
Bowers, 2010; Golden et al., 2005; Gordijn, Mannetje, & Meesters, 2012; Meesters, Dekker, Schlangen,
Bos, & Ruiter, 2011), sometimes as immediately as after even one light therapy session (Reeves et al.,
2012).
• Light plays an important role in secretion of melatonin, as well as serotonin.
• Melatonin is a natural hormone produced by the pineal gland, a peasized structure located at the center
of the brain.
• Melatonin synthesis is stimulated by darkness. When light enters the retina, it stimulates the
hypothalamus and inhibits the pineal gland from converting serotonin to melatonin (Miller, 2005).
• It is important to note that the impact of melatonin on circadian rhythms is compromised by
cardiovascular and neurodegenerative diseases as well as aging (Altun & Ugur-Altun, 2007).
• Although studies suggest that administering melatonin supplements at night may help individuals with
disrupted circadian rhythms, in a recent meta-analysis of the impact of melatonin on sleep, the authors
suggested that melatonin results in only a 2% to 3% improvement in sleep efficiency (Brzezinski et al.,
2005).
• Lewy and colleagues (1995) report that taking melatonin supplements and exposure to bright light may
change the circadian rhythm and melatonin secretion. The authors suggest that light therapy and
melatonin administration could be helpful for winter depression, and shift work.
TEKNIK PENGGUNAAN

• The recommended device for provision of light therapy is a fluorescent light box that produces light intensities
of greater than 2,500 lux (Westrin & Lam, 2007).
• Lux is a unit of illumination intensity that corrects for the photopic spectral sensitivity of the human eye.
• To better understand the concept of lux, indoor evening room light is usually less than 100 lux, whereas a
brightly lit office is less than 500 lux. In contrast, outdoor light is much brighter: a cloudy, gray winter day is
around 4,000 lux and a sunny day can be 50,000 lux to 100,000 lux or more (Westrin & Lam, 2007).
• The most effective dose has been reported to be 10,000 lux for 30 minutes daily; lower intensities (i.e., 2,500
lux) can also be effective, however, they require longer durations of 2 to 3 hours (Terman & Terman, 2005).
• It is recommended that broad-spectrum white light from fluorescent lamps in which the ultraviolet (UV) and
infrared (IR) light are being filtered be used because UV and IR wavelengths are 386 V. enerGY tHeraPIes
potentially damaging to the eyes (Howland, 2009).
• Although earlier studies indicated that bright light therapy did not benefit non depressed individuals without
history of SAD (Avery et al., 2001; Kasper et al., 1989), a recent study reported improved mood and vitality
more than 1 month after using 1 hour of bright light exposure daily in healthy individuals. This effect was
enhanced by the addition of physical exercise to light exposure (Partonen & Lönnqvist, 2000).
PENELITIAN LEBIH LANJUT

• Future research should focus on light therapy as

preventive strategy for SAD as well as other conditions
such as nonseasonal affective disorder, bipolar disorder,
premenopausal syndrome, and premenstrual depression.
AKUPRESURE
AKUPRESURE
• Acupressure is defined by Gach (1990) as “an ancient healing art that uses the fingers to press certain points on
the body to stimulate the body’s self-curative abilities” (p. 3)
• Acupuncture—“[a] procedure used in or adapted from Chinese medical practice in which specific body areas are pierced
with fine needles for therapeutic purposes or to relieve pain or produce regional anesthesia” (Freedictionary, 2009).
• Auriculotherapy—“also called ear acupuncture, applies the principles of acupuncture to specific points on the ear”
(Firsthealth, 2009).
• Jin Shin Jyutsu—“a non-massage form of shiatsu—using pressure points to ‘harmonize’ the flow of ‘energy’ through the
body” (Heall, 2006).
• Meridians—“specific interconnected channels through which Qi circulates” (Answers.com, 2006).
• Moxibustion—“[t]he burning of moxa or other substances on the skin, to treat diseases or to produce analgesia”
(Freedictionary, 2009).
• Qi (pronouncedchee)—“[t]he vital force believed in Taoism and other Chinese thought to be inherent in all things. The
unimpeded circulation of chi and a balance of its negative and positive forms in the body are held to be essential to good
health in traditional Chinese medicine” (Freedictionary, 2009).
• Shiatsu—“A form of therapeutic massage in which pressure is applied with the thumb and palms to those areas of the
body used in acupuncture. Also called acupressure” (Freedictionary, 2009)
TITIK AKUPRESURE
• There are 12 bilateral meridians and eight extra meridians. All meridians have an exterior and an interior pathway and
are named according to the organ system.
• Located on the meridians are specific points. In the 12 major meridians, the points are bilateral and in the West are
called acupuncture points.
• This nomenclature implies that the points are designated for needle insertion and does not fully reflect the TCM
concept of the point.
• Acupuncture points are also used for acupressure. The points do not have a corresponding anatomic structure but are
described by their location relative to other anatomical landmarks.
• This contributes to the skepticism of many Western-trained scientists about their existence.
• In Chinese, the name of the point usually is descriptive of its function or location.
• Mistranslation over the years has often limited the substantial amount of the anatomical basis for the nomenclature of
points and the apparent knowledge of anatomy of Chinese scholars (Schnorrenberger, 2006).
• There are 365 (Kaptchuk, 1983) to 700 (Yang, 2006) major points on the meridians.
• Dr. Yang, Jwing-Ming stated that 108 points could be stimulated using the fingers. In a traditionally formulated TCM
treatment plan, whether the modality is needles or pressure, the points are combined to achieve maximum benefit for
the patient.
• Rarely is only one point used. There are also points that should not be stimulated, especially during pregnancy, which
are referred to as “forbidden points.”
DASAR ILMIAH

• The therapeutic effect that seems to be produced by stimulation of the points

with needles or with pressure may be due to the following:
• Conduction of electromagnetic signals that may start the flow of pain killing
biochemicals, such as endorphins, and of immune system cells to specific sites in
the body that are injured or vulnerable to disease (Dale, 1997; Takeshige, 1989).
• Activation of opioid systems, which also reduces pain (Han, 1997).
• Changes in brain chemistry, sensation, and involuntary responses by
changing the release of neurotransmitters and neurohormones in a health
promoting way (Wu, 1995; Wu, Zhou, & Zhou, 1994)
KEGUNAAN AKURESURE

• Acupuncture is effective in the treatment of adult nausea and vomiting

in chemotherapy and probably pregnancy and in postoperative dental
pain.
• An indication that acupuncture may be helpful in the treatment of
addiction, stroke rehabilitation, headache, menstrual cramps, tennis
elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain,
carpal tunnel syndrome, and asthma, in which acupuncture may be
useful as an adjunct treatment or an acceptable alternative or be
included in a comprehensive management program. (NIH, 1997)
REFLEKSIOLOGI
REFLEKSIOLOGI

• Reflexology is defined as a holistic healing technique aimed at treating the individual as an entity,
incorporating the body, mind, and spirit.
• It is a specific pressure technique that works on precise reflex points of the feet that correspond to
other body parts
• Because the feet represent a microcosm of the body, all organs, glands, and other body parts are laid
out in a similar arrangement on the feet (Dougans, 1999).
• Different definitions have been put forth, but they all express the basic principle behind reflexology,
which is that the soles of the feet and the palms of the hands are connected to all parts of the human
body, including its internal organs, and that by applying specific pressure techniques to the soles of the
feet, healing effects can be wrought over the entire body
• In reflexology, the whole body has been mapped
out in the hands and in the feet and can be
manipulated directly using specific massage
techniques.
DASAR ILMIAH
• The foundations of reflexology can be traced to two different theories or schools of thought documented in the
reflexology literature.
• The first theory originated in traditional Chinese medicine (TCM) and the second one in a Western technique
known as zone therapy.
• In a healthy person with energy in balance, the feet feel soft when palpated and should have the same texture in
every area.
• When an area is felt to be empty or is lacking in texture when palpated, it is an indication of deficiency in the
energy of that particular organ or area in the body.
• If an area feels stiff and hard in texture when palpated, it indicates an excess of energy. If a lack of energy is found
in one area, this means that some other area has too much energy because the energy must be in balance.
• On empty areas, it is necessary to slowly build aggressive pressure to increase the energy flow, and more
vigorous, light but firm pressure is applied on the area that has too much energy to direct the flow out and away
from this area.
• In that way, reflexology redirects excess energy from one area into another where there is an apparent deficiency,
so as to supplement a deficiency or to subdue an excess pattern.
PENGGUNAAN
REFLEKSIOLOGI
BIOFEEDBACK
biofeedback
• Biofeedback is the process of gaining greater awareness of many 
physiological functions primarily using instruments that provide information
on the activity of those same systems, with a goal of being able to
manipulate them at will. Some of the processes that can be controlled
include brainwaves, muscle tone, skin conductance, heart rate and pain
 perception.
• Biofeedback may be used to improve health, performance, and the
physiological changes that often occur in conjunction with changes to
thoughts, emotions, and behavior.
• Eventually, these changes may be maintained without the use of extra
equipment, for no equipment is necessarily required to practice biofeedback.
Aplikasi biofeedback
• Guideline for Biofeedback-Assisted Relaxation A protocol for using biofeedback with
cognitive–behavioral interventions for relaxation and stress management.
• This technique could be used for hypertension, anxiety, asthma, headache, or pain
because muscle relaxation improves these conditions.
• The protocol should be tailored to the patient, condition, and type of feedback.
• Various types of relaxation exercises, such as autogenic phrases or systematic relaxation,
may be used.
• To increase patient awareness of the relaxed state versus the state of tension, progressive
muscle relaxation with alternate contraction and relaxation may be helpful. Imagery may
relax patients by distracting the mind and reducing negative or stressful thoughts.
• Hypnosis and self-hypnosis also produce an alternative state of mind.
• Soft music relaxes and distracts and may be used with relaxation or imagery
protokol
protokol
protokol
Biologically Based
Therapies
 Aroma terapi
• Styles (1997) defined aromatherapy as the use of essential oils for
therapeutic purposes that encompass mind, body, and spirit, a
broad definition that is consistent with holistic nursing practice.
• Clinical aromatherapy in nursing is defined as the use of essential
oils for expected and measurable health outcomes (Buckle, 2000).
• Because aromatherapy clinical research is still in its infancy in the
United States, the evidence base for using aromatherapy in nursing
practice sometimes may be difficult to establish.
 Tinjauan Ilmiah Aroma terapi
• Essential oils processed by any of the above methods are
highly volatile, complex mixtures of organic chemicals
consisting of terpenes and terpenic compounds.
• The chemistry of an essential oil largely determines its
therapeutic properties. There are 60 to 300 separate chemicals
in each essential oil, with the proportions of the constituents
within plant species varying naturally, depending on a host of
genetic and environmental factors.
 Physiology Aroma terapi
• When inhaled, the many different molecules in each essential oil act as olfactory
stimulants that travel via the nose to the olfactory bulb, and from there
impulses travel to the limbic system of the brain.
• Of the limbic system regions, the amygdala and the hippocampus are of
particular importance in the processing of aromas. The amygdala governs
emotional responses.
• The hippocampus is involved in the formation and retrieval of explicit memories.
• The limbic system interacts with the cerebral cortex, contributing to the
relationship between thoughts and feelings; it is directly connected to those
parts of the brain that control heart rate, blood pressure, breathing, stress
levels, and hormone levels (Kiecolt-Glaser et al., 2007).
 Intervention aroma terapi
• The choice of application method—inhalation, topical
application, ingestion—depends on the condition being treated
or the desired effect, the nurse’s knowledge and practice
parameters, the available or desired time for the action to
occur, the targeted outcome, the chemical components of the
essential oil, and the preferences and psychological needs of
the patient.
Mind–Body–Spirit
Therapies
 Imagery
• Imagery is the formation of a mental representation of an
object, place, event, or situation that is perceived through the
senses.
• It is a cognitive– behavioral strategy that uses the individual’s
own imagination and mental processing and can be practiced
as an independent activity or guided by a professional. Imagery
employs all the senses—visual, aural, tactile, olfactory,
proprioceptive, and kinesthetic.
 Dasar Ilmiah Imagery
• Imagery can be understood as an activity that generates physiologic and
somatic responses. It is based on the cognitive process known as mental
imagery.
• Mental imagery is a central element of cognition that operates when mental
representations are created in the absence of sensory input.
• Functional magnetic resonance imaging (fMRI) has demonstrated that the
mental construction of an image activates the same neural pathways and
central nervous system structures as are engaged when an individual is actually
utilizing one or more of the senses (Djordjevic, Zatorre, Petrides, Boyle, &
Jones-Gotaman, 2005; Formisano et al., 2002; Gulyas, 2001; Kosslyn, Ganis, &
Thompson, 2001; Kraemer, Macrae, Green, & Kelley, 2005).
 Terapi musik
• the art of arranging sounds in time so as to provide a continuous,
unified and evocative composition, as through melody, harmony,
rhythm, and timbre.”
• Alvin (1975) delineated five main elements of music
– Frequency or pitch
– Intensity - creates the volume of the sound
– Tone colorortimbre is a nonrhythmical, subjective property that results from
harmony.
– Intervalis the distance between two notes related to pitch
– Durationcreates rhythm and tempo.
 Dasar Ilmiah
• Music is complex and affects the physiological, psychological,
and spiritual dimensions of human beings. Individual responses
to music can be influenced by personal preferences, the
environment, education, and cultural factors
 Terapi humor
• Any intervention that promotes health and wellness by
stimulating a playful discovery, expression, or appreciation of
the absurdity or incongruity of life’s situations.
• This intervention may enhance work performance, support
learning, improve health, or be used as a complementary
treatment of illness to facilitate healing or coping, whether
physical, emotional, cognitive, social, or spiritual.
(www.aath.org)
 Perawat dan Humor
• “any communication which is perceived by any of the
interacting parties as humorous and leads to laughing, smiling
or a feeling of amusement” (p. 193).
Thank you