Holistic Nursing: Healing with Heart for Optimal Heart Health

In the intricate dance of life, the heart plays a leading role, tirelessly pumping life’s essence to every corner of the body. Yet, it is often only when the harmony within is disrupted—manifested through elevated blood pressure, high cholesterol levels, or the shock of a heart attack—that the critical importance of heart health is fully realized. Healing with heart, a holistic approach prioritizes not just physical health but emotional and spiritual well-being, offering a comprehensive strategy to prevent heart disease and heal the heart. This concept has gained traction as a more compassionate and effective way to manage and prevent coronary heart disease, emphasizing the need for a healthy lifestyle that includes stress management, cholesterol control, and overall physical health.

Holistic Nurses can help patients find natural and alternative ways to help with heart health

This article delves into the core of holistic nursing and its application to heart health, providing a blueprint for those seeking to improve their heart function and prevent common cardiovascular issues. Through a lens that views the individual as an interconnected whole, this holistic approach to health care is dissected, uncovering how lifestyle choices impact heart health and the empirical evidence supporting emotional wellbeing as a critical component of physical health. Readers will explore holistic interventions for heart health, from dietary adjustments to emotional support, highlighting case studies that showcase the success of a holistic nursing approach. Furthermore, this piece will outline practical steps for nurses and healthcare practitioners, touching upon the challenges and future directions in the field, aiming to equip professionals with the knowledge they need to heal the heart effectively.

Please also review AIHCP’s Holistic and Integrative Healthcare Practitioner Program for nurses.  The Holistic Nursing Program is online and independent study and offers a four year certification for qualified professionals.

The Concept of Holistic Nursing

Historical Background

Holistic nursing, as a concept, has been deeply rooted in the nursing profession since its inception in the 1700s. Early nursing practices commonly incorporated natural remedies and healing therapies, utilizing a variety of medicinal herbs through compresses, poultices, and teas. These practices were well-documented in American nursing texts up to the mid-1900s, reflecting a longstanding tradition of integrating plant medicine theory into nursing education.

Florence Nightingale, often regarded as the founder of modern nursing, emphasized the critical relationship between a person’s health and their environment. She advocated for the essentials of pure air, water, and cleanliness, asserting that nature played a pivotal role in the healing process. She famously stated, “It is often thought that medicine is the curative process. It is no such thing … nature heals the wound.” This perspective underscored the belief that nursing should facilitate the natural healing processes of the body by optimizing environmental conditions.

However, the latter half of the 20th century saw a shift in nursing as technology began to overshadow human connections, transforming healthcare into a for-profit business. This change led to a diminished emphasis on the caring and healing aspects fundamental to nursing, sparking frustration among nurses who felt unable to provide holistic care. In response, the American Holistic Nurses Association was formed, revitalizing the holistic principles in nursing practice.

Core Principles

The core of holistic nursing is defined by its goal to heal the whole person, a principle officially recognized by the American Nurses Association in 2006 when it designated holistic nursing as a distinct specialty. Holistic nurses employ a variety of integrative therapies including imagery, relaxation techniques, aromatherapy, and energy therapies, which are applied across diverse settings from hospitals to private practices.

Holistic nursing is not confined to the application of conventional medical practices but includes understanding and coordinating with non-conventional health providers. This approach is crucial in managing the complexities of modern healthcare, ensuring that patients receive comprehensive care that addresses not only physical ailments but also emotional and spiritual well-being.

The practice is underpinned by several key principles:

  • Respect for the patient’s subjective feelings and experiences.
  • Recognition of the interconnectedness of mind, body, spirit, and environment.
  • Commitment to patient autonomy and empowerment.
  • Acknowledgement of each individual’s innate healing capabilities.

These principles guide holistic nurses to not only treat diseases but also to foster overall well-being, thereby enhancing the efficacy of medical treatments through a balanced approach that considers the entire spectrum of human health. Holistic nursing thus represents a shift towards a more empathetic, patient-centered approach to healthcare, where the focus extends beyond symptoms to encompass the whole person in their journey towards health and wellness.

Heart Health: An Overview

Heart health should be a priority for everyone. Please also review AIHCP’s Holistic and Integrative Healthcare Practitioner Certification

Heart disease, encompassing a range of conditions that impact the heart and blood vessels, is the leading cause of death globally. It claims approximately 17.9 million lives annually, with a significant proportion of these deaths occurring prematurely in individuals under 70 years of age. The spectrum of heart diseases includes coronary artery disease, cerebrovascular disease, rheumatic heart disease, and other conditions, many of which can lead to heart attacks and strokes.

Prevalence of Heart Disease

Cardiovascular diseases (CVDs) are alarmingly prevalent, particularly in low- and middle-income countries where over three-quarters of CVD deaths occur. These conditions are largely driven by a combination of behavioral, environmental, and physiological risk factors. Unhealthy diets, physical inactivity, tobacco use, and harmful alcohol consumption significantly elevate the risk of heart disease. Environmental factors like air pollution also play a crucial role. The effects of these risk factors may manifest as raised blood pressure, elevated blood glucose levels, increased blood lipids, and obesity, all of which are measurable in primary care settings and indicate heightened risk for severe cardiovascular events.

Common Heart Conditions

Among the various heart conditions, coronary artery disease (CAD) is the most prevalent. This condition affects the major blood vessels that supply the heart muscle, often due to the buildup of cholesterol deposits known as plaques. This buildup, known as atherosclerosis, can significantly reduce blood flow and lead to complications like heart attacks and strokes. Symptoms of CAD can vary between individuals; men are more likely to experience chest pain, while women might suffer from shortness of breath, nausea, and extreme fatigue.

Heart valve diseases, arrhythmias, and cardiomyopathy are other common heart conditions. Valve diseases can strain the heart by preventing proper blood flow, leading to symptoms such as chest pain and fainting. Arrhythmias, which involve irregular heartbeats, can manifest as palpitations, dizziness, or even syncope. Cardiomyopathy affects the heart muscle itself, potentially leading to heart failure if the heart becomes too weak to pump effectively.

Congenital heart defects, present from birth, can range from minor issues to severe malformations that affect the heart’s function. These defects may require surgical interventions or lifelong management depending on their severity.

Understanding the prevalence and types of heart conditions is crucial for developing effective prevention and treatment strategies. Addressing the underlying risk factors through lifestyle changes, medication, and in some cases, surgical interventions, can significantly improve heart health and reduce the burden of cardiovascular diseases globally.

Impact of Lifestyle on Heart Health

Lifestyle choices play a pivotal role in maintaining heart health, influencing various risk factors associated with cardiovascular diseases. Two major lifestyle components that significantly impact heart health are nutrition and physical activity.

Role of Nutrition

Nutrition is a cornerstone of heart health, with dietary habits directly affecting the development and progression of cardiovascular diseases. A heart-healthy diet typically includes a balance of whole grains, fruits, vegetables, and lean proteins, while limiting the intake of unhealthy fats, sugars, and sodium. Research supports that adopting heart-healthy dietary patterns, such as the Mediterranean diet (MED) and Dietary Approaches to Stop Hypertension (DASH), can substantially lower the risks of heart disease. These diets emphasize the consumption of plant-based foods and low-fat dairy, which have been shown to improve heart function and reduce cardiovascular risks. Additionally, managing portion sizes and integrating a variety of nutrient-rich foods can prevent common heart conditions like myocardial infarction by significantly reducing factors like blood pressure and bad cholesterol levels.

Physical Activity

Regular physical activity is another crucial element in the prevention and management of heart disease. Engaging in both aerobic and resistance exercises helps strengthen the heart muscle, improves circulation, and reduces the risk of coronary heart disease, hypertension, and stroke. Activities such as brisk walking, cycling, and swimming enhance cardiovascular fitness by improving the heart’s ability to pump blood efficiently throughout the body. Moreover, physical activity helps in maintaining a healthy weight, reducing the likelihood of developing obesity-related heart conditions. It is recommended that adults accumulate at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity activity each week to maintain optimal heart health. For individuals with existing heart conditions, tailored exercise programs prescribed by healthcare professionals can aid in managing symptoms and improving overall heart function.

In conclusion, the impact of lifestyle on heart health cannot be overstated. Both nutrition and physical activity are integral to preventing and managing heart disease, underscoring the importance of incorporating healthy eating habits and regular physical activity into daily life.

Holistic Interventions for Heart Health

Yoga and Tai Chi

Yoga and Tai Chi are prominent holistic interventions that significantly benefit heart health. These mind-body practices not only enhance physical well-being but also improve mental health, which is crucial for cardiovascular health. Tai Chi, described by Dr. Peter Wayne of Harvard Medical School, involves gentle, flowing movements paired with cognitive focus and breathing, which collectively foster cardiovascular health. The practice is adaptable, allowing participants to adjust the intensity to fit their physical capabilities, making it suitable even for those with limited flexibility.

Studies have consistently shown that Tai Chi improves blood pressure and may serve as an alternative to traditional cardiac rehabilitation, especially for heart attack survivors and individuals with heart failure. The practice’s ability to reduce stress through the enhancement of sympathetic-vagal balance is particularly beneficial for heart health.

Similarly, Yoga offers comprehensive benefits that extend to heart health. According to Dr. Hugh Calkins from Johns Hopkins, yoga has been recognized for its positive impact on various aspects of cardiovascular health, including lowering blood pressure, cholesterol, and blood glucose levels. The deep breathing and mental focus inherent in yoga practice help mitigate stress, which is a significant contributor to heart disease. Research has also indicated that yoga can reduce the frequency of atrial fibrillation episodes and improve the quality of life and exercise capacity in heart failure patients.

Herbal Therapies

There are varieties of different cultures that have herbal and dietary remedies for better heart health

Integrating herbal therapies into daily routines can provide a natural boost to heart health. Various herbs have been recognized for their cardiovascular benefits. Garlic, for instance, is renowned for its ability to reduce cholesterol and triglyceride levels, lower blood pressure, and enhance circulation. Its consumption is straightforward, as it can be added to various dishes or taken raw.

Hawthorn is another herb celebrated for its cardiovascular properties. It improves blood flow to the heart muscle by dilating the coronary arteries and offers antioxidant protection, which is vital for maintaining heart health. Similarly, the consumption of turmeric and green tea has been linked to improved heart health outcomes. Turmeric helps reduce inflammation in heart tissues, while green tea is known for its high antioxidant activity, which aids in lowering LDL cholesterol and triglyceride levels.

However, it is crucial to approach herbal therapies with caution due to potential interactions with conventional medications and the risk of toxic effects. Healthcare providers should be consulted before integrating new herbal remedies into treatment plans, especially for individuals with existing heart conditions.

Incorporating these holistic interventions—Yoga, Tai Chi, and herbal therapies—can significantly enhance heart health by addressing both physical and emotional well-being, thereby offering a comprehensive approach to cardiovascular care.

Emotional Wellbeing and Heart Health

Stress, whether short-term or chronic, plays a significant role in cardiovascular health, impacting both the body and mind. Chronic stress, in particular, is known to contribute to inflammation, which can lead to plaque buildup in the arteries, potentially resulting in coronary artery disease, heart attacks, and heart failure. This condition is exacerbated by increased levels of catecholamines, such as adrenaline, which raise blood pressure and heart rate during stressful situations. Over time, these physiological changes can cause significant damage to the cardiovascular system. Additionally, cortisol, another stress hormone, contributes to elevated blood sugar, cholesterol, and triglycerides, further compounding the risk of heart disease.

Impact of Stress

Chronic stress not only affects the heart directly by influencing physiological mechanisms but also indirectly through behavioral changes. Individuals experiencing high stress often adopt unhealthy behaviors such as poor diet, smoking, and excessive alcohol consumption, all of which are significant risk factors for heart disease. The psychological burden of stress can manifest physically, presenting symptoms like chest pain, irregular heartbeats, and shortness of breath, which significantly increase the risk of cardiovascular events. Furthermore, acute stress can trigger severe cardiac events, such as heart attacks, by causing a surge in adrenaline that may lead to plaque rupture in already vulnerable arteries.

Therapeutic Techniques

Addressing stress is crucial for maintaining heart health, and various therapeutic techniques can be employed. Mindfulness-based interventions, for instance, have shown promising results in improving a range of health outcomes, including stress reduction, depression, anxiety, and overall quality of life. These interventions often involve activities like yoga and meditation, which help manage stress by fostering a state of mental and physical relaxation. Positive psychological interventions are also effective, particularly among patients with cardiovascular disease or those at risk. These programs often encourage practices that enhance optimism and self-regulation, which can mitigate the adverse effects of stress and promote better cardiovascular health.

Incorporating regular physical activity is another effective strategy for stress management. Exercise not only helps reduce stress but also improves heart health by lowering blood pressure and enhancing overall cardiovascular fitness. Additionally, establishing a supportive social network and engaging in psycho-educational programs can provide emotional support and practical strategies for managing stress, thereby improving both emotional wellbeing and heart health.

By understanding the profound impact of emotional wellbeing on heart health and implementing comprehensive therapeutic techniques, individuals can significantly enhance their cardiovascular health and overall quality of life.

Case Studies Showcasing Holistic Nursing Success

Study One: Denise’s Journey through the CINEMA Program

Denise’s case exemplifies the success of holistic nursing in managing complex health conditions intertwined with cardiovascular risks. Initially considering bariatric surgery, Denise opted for a lifestyle overhaul through the Center for Integrated and Novel Approaches in Vascular-Metabolic Disease (CINEMA) at UH Harrington Heart & Vascular Institute. Facing type 2 diabetes, high blood pressure, and a strong family history of coronary artery disease, Denise was on a precarious path toward severe cardiovascular complications.

Under the CINEMA program, Denise received a comprehensive initial health assessment that included screenings for kidney disease, heart disease, and management of related risk factors such as blood pressure, cholesterol, and lifestyle habits. The multidisciplinary team provided integrated treatment recommendations, focusing on a plant-based diet, regular physical activity, and prescribed medications like Ozempic and Jardiance, known for reducing heart disease risks.

The holistic approach of the program, emphasizing patient engagement and a multidisciplinary strategy, facilitated Denise’s steady progress. She adopted sustainable lifestyle changes, such as increasing physical activity and improving dietary habits, which were crucial in managing her metabolic issues and reducing the risk of heart disease. Denise’s success story highlights the effectiveness of holistic care in empowering patients to take control of their health, leading to improved outcomes and quality of life.

Study Two: Ornish Lifestyle Medicine Program’s Impact on Heart Disease

The Ornish Lifestyle Medicine Program at Straub Medical Center provides another compelling example of holistic nursing success. This program integrates nutrition, fitness, stress management, and psychosocial support to manage and reverse coronary heart disease. Samantha Buxbaum, a stress management facilitator with the program, emphasizes the significant impact of stress and emotions on physical health.

Research from Duke University revealed that heart disease patients who felt isolated had a markedly higher mortality rate compared to those with social support. Moreover, a study tracking 1,623 heart patients found a 230% increased risk of heart attack associated with anger episodes. The Ornish program addresses these psychosocial factors by encouraging patients to engage in meditation, communicate effectively, and foster healthy relationships, which are vital for emotional and heart health.

The comprehensive approach of the Ornish program not only helps patients manage physical symptoms through lifestyle changes but also enhances their emotional well-being. The success of the program is evident as nearly 90% of participants continue to lead healthier lives long after completing the program, demonstrating the enduring benefits of holistic nursing practices in heart health management.

Practical Steps for Nurses

Holistic Nurses play a key role in educating patients and helping implement better alternative options for individuals seeking holistic and natural ways to keep one’s heart healthy

Implementing Holistic Practices

Nurses play a pivotal role in integrating holistic care into daily clinical practice, respecting the dignity and whole being of each patient. This approach involves viewing patients not just as cases but as individuals with diverse needs encompassing their physical, emotional, and spiritual health. Nurses are encouraged to facilitate therapeutic consultations, which foster hope, dignity, self-discipline, and vitality. By establishing educational systems and promoting practices that enhance self-awareness and confidence, nurses can significantly improve the quality of care provided.

Holistic care also includes the use of non-invasive home telemonitoring systems, which allow patients to monitor their weight, blood pressure, heart rate, and other vital signs daily. This technology supports patients in maintaining control over their health by enabling nurses to track their progress remotely and intervene promptly when necessary.

Monitoring Patient Progress

Regular monitoring of patient progress is crucial, especially for those with heart conditions. The CardioMEMS™ Heart Failure System exemplifies advanced technology that aids in this process by allowing real-time monitoring of pulmonary artery pressures. This system provides valuable data that can indicate the progression of heart failure, enabling nurses to adjust treatments before conditions worsen. Such monitoring has proven effective in reducing hospitalizations and improving patients’ quality of life.

Moreover, nurses should conduct regular reviews of factors that could exacerbate heart conditions, such as non-adherence to dietary restrictions, medication schedules, and lifestyle choices like smoking and alcohol consumption. Regular physical examinations, including assessments of jugular venous pressure and heart sounds, are essential. These should be complemented by routine laboratory tests to monitor plasma electrolytes, renal function, and complete blood counts to detect early signs of complications like anemia or electrolyte imbalances.

Incorporating educational programs that cover nutrition, exercise, and medication adherence can further empower patients to take an active role in managing their heart health. Nurses should ensure that these educational opportunities are available not only at discharge but also during follow-up visits, enhancing patient compliance and understanding of their health conditions.

By adopting these practical steps, nurses can effectively implement holistic care strategies that not only treat the heart but also the whole person, leading to better health outcomes and enhanced patient satisfaction.

Challenges and Future Directions

Possible Barriers

The journey towards holistic heart health care faces several substantial barriers. A critical issue is the lack of knowledge and understanding about heart disease, compounded by prevalent myths and beliefs. These misconceptions not only hinder effective management but also affect patient attitudes, leading to non-adherence to prescribed lifestyle changes and medications. The chronic nature of cardiovascular diseases (CVD), coupled with financial constraints and the absence of national guidelines, further complicates effective management and treatment protocols.

Physicians themselves face challenges, with many attributing poor disease control to patient non-compliance with medications. However, a significant underlying issue is that many physicians do not adhere to specific guidelines, which exacerbates the problem. This situation underscores the urgent need for simple, clear, and accessible treatment algorithms for managing conditions like hypertension and diabetes, which are major risk factors for heart disease.

Future Research

Looking ahead, there is a clear need for further exploration of interventions that can effectively eliminate barriers and enhance facilitation in reducing CVD risk factors. This includes structured physician counseling that goes beyond mere information sharing to incorporate robust behavioral change strategies, such as goal setting and enhancing self-efficacy.

Research should also focus on the challenges posed by frailty and aging, especially among women, as these factors are linked with increased mortality, disability, and cognitive decline in older populations. The growing issue of polypharmacy, particularly among the elderly with multiple comorbidities, requires attention to ensure that the benefits of medications outweigh the risks, and that adverse drug reactions are minimized.

Furthermore, the integration of palliative care with standard cardiovascular care from the point of diagnosis is essential for managing advanced CVD symptoms holistically. Addressing cultural, socioeconomic, and gender inequalities in heart health care is crucial to ensure equitable access to treatment and to improve outcomes across diverse populations.

By addressing these challenges and directing future research towards these ends, the holistic approach to heart health can be refined and optimized, leading to better health outcomes and a higher quality of life for patients with cardiovascular diseases.

Conclusion

Throughout this exploration of holistic nursing and its pivotal role in promoting optimal heart health, we’ve traversed the realms of holistic practices, emotional wellbeing, and the significance of lifestyle changes. By integrating traditional and innovative healthcare strategies, holistic nursing not only addresses the physical dimensions of heart health but also emphasizes the emotional and spiritual facets, offering a comprehensive pathway towards healing and prevention. Case studies and practical steps for nurses underscore the transformative potential of holistic care in cardiac health management, demonstrating its effectiveness in fostering patient empowerment, enhancing quality of life, and reducing the risk of heart disease.

Please also review AIHCP’s Holistic and Integrative Healthcare Practitioner Program and see if it matches your academic and professional goals

As we consider the journey forward, it is clear that the holistic approach to nursing presents a promising avenue for addressing the complexities of heart health. By prioritizing patient-centered care, adopting a multidisciplinary strategy, and embracing the interconnectedness of physical and emotional wellbeing, holistic nursing can significantly contribute to the prevention and management of heart disease. As research continues to unmask the depth of this approach’s impact, it is incumbent upon healthcare practitioners to incorporate these insights into practice, thereby advancing the frontiers of heart health care for the benefit of all.

Please also review AIHCP’s Holistic Nursing Certification and see if it matches your academic and professional goals.  The certification program is online and independent study and open to qualified professionals seeking a four year certification as a Holistic Nurse.

FAQs

1. What are holistic methods to manage heart failure?
Holistic management of congestive heart failure involves several strategies. Key among these are dietary adjustments, such as adhering to a low-sodium diet to help reduce fluid retention—a frequent issue in CHF. Additionally, increasing your consumption of magnesium and omega-3 fatty acids can improve overall heart health.

2. What are three practices cardiologists recommend for maintaining a healthy heart?
Cardiologists suggest several habits to keep the heart in good shape:

  • Avoid smoking, as it’s linked to one-third of heart disease deaths.
  • Engage in daily physical activities like walking.
  • Skip fast food to avoid unhealthy fats and excessive salt.
  • Practice stress-reducing techniques such as meditation.
  • Regularly visit a healthcare provider for check-ups to monitor heart health.

3. What are some alternative therapies for heart health?
Alternative therapies that may benefit heart health include yoga and tai-chi, which are particularly useful for individuals with heart failure. Omega-3 polyunsaturated fatty acids also offer potential heart benefits. However, caution is advised with certain over-the-counter remedies and supplements, such as vitamin D, blue cohosh, and lily of the valley, due to safety concerns.

4. How can you quickly enhance your heart health?
To rapidly improve heart health, regular physical activity is essential. Adults should aim for at least 150 minutes of moderate-intensity aerobic exercise each week, which can include activities that increase your heart rate, such as walking, dancing, and biking. If you are new to exercise, start slowly and gradually build up intensity and duration.

 

Additional Resources

Functional Heart. (2024). “How Can a Holistic Approach Improve Heart Health? The Benefits of Personalized, Comprehensive Care”. Campanile Cardiology.  Access here

Baum, I. (2022). ‘I’m a Cardiologist Certified in Holistic Integrative Medicine, and These Are My Favorite Heart-Healthy Activities’. Well and Good. Access here

Nall, R. (2022). “30 Ways to Improve Your Heart Health Quickly and Naturally”. Healthline.  Access here

Alternative Medicine. “Top Tips to Maintaining a Healthy Heart”. Alternative Medicine. Access here

 

Holistic Health and Holistic Nursing Needs More Publicity

AIHCP offers a Holistic and Integrative Health Care Certification to qualified professionals who seek to utilize the use of herbs and other complimentary and alternative practices of medicine in conjunction with Western Medicine.  Through this certification, healthcare professionals who specialize in Holistic Nurses can give holistic health more publicity it needs.  This is important because holistic health helps individuals take more personal control over their health. It helps them understand the inner dynamics of the body, how organs function, how systems interact and how herbal and alternative methods while working with Western medicine can grant greater well being.

Holistic Nurses can direct individuals on what herbs are complimentary or not to a prescription drug

 

Publicity to this is imperative.  In the article, “Alternative medicine needs more publicity” by Sonali Whittle, the importance of more publicity to natural medicine is encouraged.  She points out that with higher pharmaceutical prices, restrictions on certain medications, adverse side effects of certain medications and overall lack of sound guidance on general health, individuals need to be more aware of holistic health itself.   She states,

“According to the Cleveland Clinic, Western medicine can be understood as the traditional health care that is received in the U.S. Whether a visit to urgent care due to a fever or a yearly wellness check, almost everyone in the U.S. has come in contact with Western medicine. The techniques are based on empirical scientific work, and thus, there is a major emphasis placed on Western medicine as the golden standard of care. Although Western medicine helps many, there should be alternative healthcare methods such as holistic, herbal and complementary medicine instead of letting people think that they do not have options beyond traditional Western treatments.”

“Alternative medicine needs more publicity” Whittle, Sonali. (2023). The Highlander

To review the entire article, please click here

Holistic Nurses and Holistic and Integrative Health Care Professionals can be important influences on making alternative and herbal medication more public to patients.  Most, however, are not trained in these fields.  Those in mental health and healthcare seem to adhere to Western only medications or procedures.  While this may work for some, the importance of herbal remedies in prevention as well as helping overcome acute issues is very important.  Individuals need to be aware but also guided.  For instance, a person who is facing depression and is prescribed a SSRI, should never seek over the counter herbal remedies for depression such as St John Wort or Hypericum, or even 5-HSP, since these substances and herbs produce Serotonin.   If already on an SSRI, the added Serotonin level can lead to a toxic increase for the body and mind.  Hence, it is so important that whether facing diabetes, cholesterol, depression or any issue, that one consult healthcare professional to properly diagnose if a particular herb can co-exist with an existing pharmaceutical drug.

The benefits can be great and also free individuals over safe and regulated time from a particular drug for ADHD or OCD and allow one to have a more natural approach with the same results.  The issue is knowing about it and also having someone trained to guide individuals in utilizing it.  This is why the certification in Holistic Nursing for AIHCP is important to making public the benefits of alternative medicine and also providing the public with certified professionals to guide the patients through the process.

We will below quickly highlight benefits and downfalls of holistic medication.  Bear in mind,  we are looking at both, Western Medicine and Holistic Medicine being used complementary and under guidance of a healthcare professional

Benefits of Holistic Health

One can find less expensive ways to face minor issues such as OCD, ADHD, or even depression through the use of Holistic Medication or herbs.  These less expensive routes include less need of prescriptions and also can supplement an existing prescription. Caution must be taken though with certain SRRI as not to double dose through an herb.  This is why these less expensive remedies should be utilized through the guidance of a healthcare professional.  While online blogs and resources are available from reputable sources such as Cleveland Clinic or WebMed, it is still important to consult health care professional before ever discontinuing a prescription or supplementing.  For the most part, information can be found on many herbs, what they do, and which ones are complimentary with each other or with certain prescriptions and which one do not mix well.

There are numerous benefits to Holistic Health and herbs. Taking control of health and being preventative with disease are two important ones.

 

In addition, Holistic Health introduces the person to a higher level of personal accountability for health.  Individuals study and learn more about body systems, organ functions and how the herb helps heal the body or promote overall wellness.  Individuals are then more likely to make better health decisions as they build a health blue print for themselves in regards to their mental and physical health.

Holistic herbs and methods are also preventative.  If family history has diabetes, then certain herbs can be utilized to help protect the body prior to entering into diabetes.  The same can be true for mood and mental health, ADHD, OCD, as well as depression.  Many herbs also have preventative characteristics for cancer prevention, heart health, and so forth.  Prevention is an important key in health.  Holistic health is not reactive but proactive.  It looks for harmony in all the systems of the body instead of a more narrow look found in Western Medicine.  Holistic Health looks to prevent, prepare and coordinate between body systems for overall health in mind, body and spirit.

Finally, there are also many less side effects with herb than pharmaceutical drugs.  While certain herbs can cross each other out or cause damage if used with a drug or different herb, if one is able to work with a healthcare professional with education in holistic health, one will be able to create a far superior health plan for overall health without side effects of pharmaceutical drugs.

Downfalls of Holistic Health

This title is slightly misleading because there are truly no downfalls to Holistic Health, but when individuals misuse it, play doctor, or mix things that should not be mixed, then downfalls can emerge.

Holistic Health is empowering if studied and under care of a professional but it can become a dangerous endeavor for individuals who play doctor or think they know best.  These individuals do not understand the universal nature of holistic health that is more preventative in nature.  In some cases, these individuals may stop taking a prescription which may cause withdraws, or even worst, cease treating the issue, while supplementing with another drug.  An example may be someone who immediately goes off a Statin for cholesterol and replaces it with an herbal remedy.  This can be extremely dangerous.  As stated earlier, it can also be dangerous if someone starts to take St John Wort with SSRIs.  Hence it is important to be empowered in health but also educated and follow the advice of a healthcare provider in regards in discontinuing a medication or supplementing one with an herb.  It is important to also note, some Western Drugs are needed for more severe or acute situations.  Drugs for cancer care may be more powerful for acute diseases despite side effects.  In addition,  herbs that may ease minor OCD or ADHD, may need the stronger pharmaceutical for severe and extreme cases of mental health, despite side effects.  Again, playing doctor with Holistic Medicine without knowledge and a healthcare expert can be dangerous.

In addition, it is important to remember that many Holistic medications are not placed under the tighter scrutiny of the empirical verification and approved case studies.  Many are known to work and do, but many are not pressed under the same case study regulations found in pharmaceuticals.  They are more known through time and culture to provide certain advantages.  There has been more work and progress to understand the nature of the herb, its make up and ability to proceed with some fact, but again herbs are not regulated.  This again does not mean they are not beneficial and work, but it does point to some lack of in-depth study.  With more publicity, the more scientific data can be gathered in promoting the benefits of Holistic medicine.

Conclusion

Holistic mediation needs to be made more public, but within a restrained and protective way.  Individuals must know what Holistic offers and what it cannot offer.  Individuals must understand how to supplement or not supplement with pharmaceuticals.  This involves an educated and trained base of healthcare professionals who do not only see medication under a Western prism, but also under a Holistic one.  Holistic Nurses can better guide individuals and educate individuals through the process of utilizing alternative and holistic medications to better their lives.

Understanding and utilizing Holistic Health is key. Please also review AIHCP’s Holistic Nursing Certification

 

Please also review AIHCP’s Holistic and Integrative Healthcare Specialist Program. Also known as Holistic Nursing, the program is online and independent study and offers a four year certification in Holistic Nurses.

Additional Resources

“When medicines and supplements don’t mix”.  (2020). Mayo Clinic.  Access here

“6 Tips: How Herbs Can Interact With Medicines”. National Center for Complementary and Integrative Health. NIH.  Access here

“A holistic approach to integrative medicine”. (2023). Mayo Clinic.  Access here

“MERGING conventional and complementary medicine in a clinic department – a theoretical model and practical recommendations”. Perard, M. et. al. (2015). National Library of Medicine. Access here

 

 

 

 

 

Finding the Right Integrative and Holistic Healthcare Professional for You

Integrative health is becoming more and more popular with various holistic therapies and herbs available for individuals to utilize.  It is very important though for individuals who wish to use holistic and integrative practices, therapies and medicines to consult a healthcare professional to ensure things interact properly and safely.  Dosing, interactions with other medications and safety for particular individuals are key in determining if something is right for a particular individual.  This is is why it is important to find the right Holistic and Integrative Healthcare Specialist to help guide oneself and even work in unison with one’s primary healthcare provider.

Learn more about becoming a certified Holistic and Integrative Healthcare Specialist with AIHCP’s online certification program for qualified professionals

 

The article, “5 Things to Know When Selecting an Integrative Healthcare Provider” by Lauren Bedosky looks at important aspects one should review in finding the guidance of a Holistic and Integrative Healthcare Specialist.  She states,

“Complementary and integrative medicine practitioners often provide services and therapies in conventional healthcare settings such as hospitals and clinics. Practitioners can also be found in private practice and at wellness centers. Unfortunately, finding a qualified complementary and integrative medicine practitioner to provide safe and effective care isn’t always easy. But it’s essential to choose carefully, as some complementary therapies may have adverse effects if performed incorrectly.”

“5 Things to Know When Selecting an Integrative Healthcare Provider”.  Lauren Bedosky.  April 17th, 2023. EveryDayHealth.

To review the entire article, please click here

Commentary

Due to the numerous possible complications and wrong directions one can take with integrative care, it is hence a prerequisite for good health to have proper guidance from a holistic and integrative healthcare specialist.

 

Introduction to Holistic and Integrative Health Practitioners

Healthcare professionals trained in Holistic and Integrative practices can help guide individuals in a safe and informative way with alternative care

 

Integrative health practitioners are professionals who use a holistic approach to wellness. They look at the whole person, not just their symptoms, and aim to address the root cause of health issues. Integrative health practitioners combine conventional medicine with alternative and complementary therapies to help their patients achieve optimal wellness. They focus on prevention and education, empowering patients to take control of their health.

What is Holistic and  Integrative Health and How Does it Differ from Conventional Medicine?

Integrative health is a patient-centered, holistic approach to wellness that combines conventional medicine with alternative and complementary therapies. Integrative health practitioners look at the whole person, not just their symptoms, and aim to address the root cause of health issues. They focus on prevention and education, empowering patients to take control of their health.

Conventional medicine, on the other hand, typically focuses on treating symptoms rather than addressing the root cause of health issues. It tends to rely heavily on pharmaceuticals and other medical interventions. While conventional medicine can be effective in treating acute conditions, it often falls short when it comes to chronic conditions and overall wellness.

Benefits of Working with an Holistic and Integrative Health Practitioner

Working with an integrative health practitioner can have many benefits. Here are just a few:

Holistic Approach

Integrative health practitioners take a holistic approach to wellness. They look at the whole person, including their physical, emotional, and spiritual health, and aim to address the root cause of health issues. This can lead to a more comprehensive and effective treatment plan.

Personalized Care

Integrative health practitioners provide personalized care. They take the time to get to know their patients, their health history, and their goals for wellness. This allows them to tailor their treatment plan to each individual.

Emphasis on Prevention

Integrative health practitioners focus on prevention and education. They work with their patients to identify risk factors and develop strategies to prevent illness and maintain optimal wellness.

Reduced Reliance on Pharmaceuticals

Integrative health practitioners aim to reduce their patients’ reliance on pharmaceuticals. They use a variety of alternative and complementary therapies, such as acupuncture, massage, and herbal medicine, to help their patients achieve optimal wellness.

Improved Quality of Life

Working with an integrative health practitioner can improve your quality of life. By addressing the root cause of health issues and developing a comprehensive treatment plan, they can help you feel better and live a healthier, more fulfilling life.

How to Choose the Right Holistic and  Integrative Health Practitioner

Choosing the right integrative health practitioner is an important decision. Here are some tips to help you find the right practitioner for you:

Credentials and Experience

Look for a practitioner who is licensed, certified, or registered in their field. They should also have experience working with patients with your specific health concerns.

Philosophy and Approach

Find a practitioner whose philosophy and approach align with your own. Do they take a holistic approach to wellness? Do they focus on prevention and education? Do they use a variety of alternative and complementary therapies?

Communication and Rapport

It’s important to find a practitioner with whom you feel comfortable communicating. Look for someone who listens to your concerns, answers your questions, and explains things in a way that you can understand.

Referrals and Reviews

Ask for referrals from friends, family, or other healthcare professionals. You can also look for reviews online to get an idea of what other patients have experienced.

Holistic and Integrative Health Practitioner Techniques and Treatments

There are numerous safe and effective therapies and medications one can utilize for numerous chronic conditions. Holistic and Integrative Healthcare Specialists can help find what is best for you

 

Integrative health practitioners use a variety of techniques and treatments to help their patients achieve optimal wellness. Here are some examples:

Acupuncture

Acupuncture is a traditional Chinese medicine technique that involves inserting thin needles into specific points on the body. It is used to treat a variety of conditions, including pain, anxiety, and digestive issues.

Massage

Massage therapy involves manipulating the muscles and soft tissues of the body to promote relaxation and alleviate pain. It is often used to treat stress, tension, and musculoskeletal conditions.

Herbal Medicine

Herbal medicine involves using plant-based remedies to treat a variety of conditions. It can be used to alleviate symptoms, boost the immune system, and promote overall wellness.

Mind-Body Therapies

Mind-body therapies, such as meditation and yoga, aim to promote relaxation, reduce stress, and improve overall wellness. They can also be used to treat a variety of conditions, such as anxiety and depression.

Examples of Conditions Treated by Integrative Health Practitioners

Integrative health practitioners can treat a wide range of conditions, including:

Chronic Pain

Integrative health practitioners can help manage chronic pain through acupuncture, massage, and other therapies.

Anxiety and Depression

Integrative health practitioners can help alleviate symptoms of anxiety and depression through mind-body therapies, such as meditation and yoga, as well as herbal medicine and other treatments.

Digestive Issues

Integrative health practitioners can help treat digestive issues, such as irritable bowel syndrome (IBS) and acid reflux, through dietary changes, herbal medicine, and other therapies.

Autoimmune Disorders

Integrative health practitioners can help manage autoimmune disorders, such as rheumatoid arthritis and lupus, through dietary changes, supplements, and other therapies.

Holistic and Integrative Health Practitioner vs Other Healthcare Professionals

Integrative health practitioners differ from other healthcare professionals, such as medical doctors and naturopathic doctors, in their approach to wellness. While medical doctors tend to focus on treating symptoms and rely heavily on pharmaceuticals, integrative health practitioners take a holistic approach and use a variety of alternative and complementary therapies. Naturopathic doctors also take a holistic approach, but they focus more on natural remedies and may not use conventional medicine.

Integrative Health Practitioner Success Stories

Integrative health practitioners have helped many patients achieve optimal wellness. Here are a few success stories:

Chronic Pain

A patient with chronic back pain had tried many conventional treatments without success. After working with an integrative health practitioner, who used a combination of acupuncture, massage, and herbal medicine, the patient experienced significant pain relief and improved mobility.

Anxiety and Depression

A patient with anxiety and depression had been taking medication for many years with limited success. After working with an integrative health practitioner, who used mind-body therapies and herbal medicine, the patient was able to reduce their medication and experienced significant improvement in their symptoms.

Digestive Issues

A patient with IBS had tried many conventional treatments without success. After working with an integrative health practitioner, who used dietary changes and herbal medicine, the patient experienced significant improvement in their symptoms and was able to reduce their reliance on medication.

Holistic and Integrative Health Practitioner Resources

There are many resources available to help you find an integrative health practitioner, including:

Professional Associations

Please review AIHCP’s certification program in Holistic and Integrative Healthcare and see if it meets your academic and professional goals

 

Professional associations, such as the American Association of Integrative Medicine and the Integrative Health Policy Consortium, can provide information on integrative health practitioners in your area.

Also look for individuals who may be certified with AIHCP and its Holistic and Integrative Healthcare Specialist Program.

Referral Services

Referral services, such as the National Certification Commission for Acupuncture and Oriental Medicine and the American Massage Therapy Association, can help you find integrative health practitioners who are licensed, certified, or registered in their field.

Online Directories

Online directories, such as HealthProfs and Zocdoc, allow you to search for integrative health practitioners by location, specialty, and insurance coverage.

Conclusion

Working with an integrative health practitioner can have many benefits, including a holistic approach to wellness, personalized care, emphasis on prevention, reduced reliance on pharmaceuticals, and improved quality of life. When choosing an integrative health practitioner, look for someone with credentials and experience, whose philosophy and approach align with your own, with whom you feel comfortable communicating, and who has positive reviews and referrals. Integrative health practitioners use a variety of techniques and treatments to help their patients achieve optimal wellness, and they can treat a wide range of conditions, from chronic pain to autoimmune disorders. Resources are available to help you find the right integrative health practitioner for you.

AIHCP offers a four year certification for qualified professionals seeking a certification in Holistic and Integrative Healthcare.   The program is online and independent study and open to qualified professionals.  Please review and see if it matches your academic and professional goals and needs.

 

 

 

Integrative and Holistic Specialist Program Blog on Adaptogens

Adaptogens are great and natural herbs and supplements to help one manage stress and anxiety.  They are natural but still need to be utilized under care of a specialist due to the fact certain levels can be counter productive or mix poorly with other medications.  Integrative Holistic Specialists can help one find the best herbal supplement for an individual when dealing with stress.

Adaptogens help individuals with stress. Please also review AIHCP’s Integrative and Holistic Health Specialist Program

 

The article, “What Are Adaptogens and Are They Healthy?” from Cleveland Clinic’s Healthessentials takes a closer look at a variety of adaptogens.  The article states,

“Adaptogens can affect how much cortisol is released in your body when you’re stressed. Less cortisol can mean less of a physical stress reaction. As stress is connected to your nervous, endocrine and immune systems, it can cause physiological changes like an increased heart rate. Again, adaptogens can help how your body responds physically to stress.”

To read the entire article, please click here

Please also review AIHCP’s Integrative and Holistic Specialist Program, as well as AIHCP’s Stress Management Program.  The programs are online and independent study and open to qualified professionals seeking a four year certification as a Holistic Nurse or Stress Management Consultant.

Holistic Integrative Specialist Certification Article on Holistic Herbs

Herbs are important to over all in health.  In Asia, older herbs are consistently used to help aid, and in Europe, they have found their way into mainline medicine.   Many herbs are prescribed before synthetic drugs.  This change recognizes the value of herbal medicine when used in concert with Western medicine.

Just because an herb is natural does not mean it is safe though and this is why it is imperative to have professional guidance in use of herbs for daily life and issues.   Some herbs can be toxic if used in excess or long duration and some herbs can also have bad counter reactions with synthetic drugs.  A Holistic Integrative Specialist trained in healthcare is the best person to guide you through the multitude of herbs.

While there are many acute diseases such as cancer that individuals have and lead them to alternative treatments, many look to herbs for basic cures for everyday issues.   Herbs when used properly can help alleviate issues without the negative side effects.   However, this is usually best for mild cases.  When more severe issues arise, doctors and physicians or mental health experts usually turn to synthetic drugs.

Eastern Medicine looks for overall healthy balance. Please also review AIHCP’s Holistic Integrative Specialist Program

 

Herbs also prove to be excellent for overall health.  They can help the body over time be stronger and more resistant to certain conditions as well as treat the entirety of the body.  Instead of treating one symptom, herbs can look for the cause and help the overall body from a holistic view.

A holistic view that looks at the overall function does not need to be at odds with Western medicine but can be interwoven with each other.  Both are equally important in what they bring to the table.  Western Medication utilizes a variety of synthetic drugs and procedures that sometimes can be evasive and produce side effects but in many extreme cases, these more severe responses are key, but this does not mean, less evasive and more holistic practices can be utilized.

Chinese medicine sees health as balance.  Yin and Yang when mismatched or imbalanced causes illness.  Balancing the inner body’s energy and functions is key.  This can be accomplished via herbs, or other alternative practices, including acupuncture or massage.  In addition, Ayurvedic medicine of India looks not just to eliminate symptoms but to restore balance to the body and treat the entirety of mind body and spirit.  This philosophy is indeed correct.  Balance of body systems and finding root causes of issues is critical for long term health.

With these things in mind, this blog will look at a few herbs that can help with basic issues.  Again, these herbs are best used for mild conditions and always under the supervision of a healthcare professional.  Self treating and utilizing herbs without direction can be dangerous and lead to side effects if on other medications.  It can also cause issues if uses too much or too little over a certain period of time.  Some herbs require strict adherence to when to take it and how long to take it , as well as if to take it with food or not.  Hence it is important to remember that when utilizing herbs, one listen and follow directions to achieve maximum results and safety.

 

Various herbs with time held success are sometimes under valued by Western medicine. Please also review AIHCP’s Holistic Integrative Specialist Certification

 

Anxiety is one of the most common mental issues.  Anxiety is due to stress but is an over reaction to stress.  It can exist also when the stressor is no longer present and cause worry and fear when no issues exist.   Most Western doctors may prescribe a variety anti depressants such as Luvox, Prozac or Zoloft.  Others may prescribe benzodiazepines.  Overprescription of these drugs for mild anxiety is unfortunate when herbs that are more holistic and mild on the body exist.

Kava is the natural anxiety reliever.  Kava reduces anxiety, improves functioning and has no addictive properties.  Most take 100 to 250 mg three times daily to deal with anxiety, however long term use of Kava can is not good for the body. Kava should not be combined with any benzodiazepines.  This natural remedy derived from the Pepper Trees of Fiji and South Pacific Islands should be the first choice for mild anxiety before any hard synthetic medications.

Hypericum or St John’s Wort is another effective herb against anxiety and as well as depression.  Again, when utilized for mild episodes, this herb can prove to be beneficial but should only be applied under professional supervision.  This herb possesses at its very substance extracts that can enhance three neurotransmitters in the brain, namely serotonin, norepinephrine, and dopamine.  It also lowers cortisol.   The herb takes 4 to 6 weeks to start to take effect and any lowering of doses on synthetic drugs should be withdrawn only at the supervision of a healthcare professional as one looks to replace synthetic with herbal treatment.

Anxiety creates a tense state.  It causes the adrenal glands to produce adrenaline and cortisol which in turns increases blood pressure, heart rate and muscle tension.  These reactions are necessary during fight or flight but can cause long term issues.  Activating a calmer state, or the para sympathetic nervous system is key. Hence, many look to sedative to find a more relaxed state.  The herb Valerian plays a key role in helping people find that natural relaxed states without the synthetic side effects.  Valerian Can help one sleep, reduce anxiety and nightmares and reduce the need of sleeping pills.  Chamomile also like Valerian can help one find relaxation and sleep and is commonly used as a tea.

Chronic stress kills and those seeking a better life style against stress look to a variety of ways to negate its negative effects.  Meditation and other stress management strategies are important but also herbs can play a key role in helping manage stress and strengthening the body.  Adaptogens are types of herbs that can help the body fight chronic stress and maintain overall health that stress eventually deteriorates.   As an Adaptogens, herbs must meet three requirements.  First, they must be harmless over long term use.  Second, they must increase resistance to stress and third, it increases mental and physical performance.  It helps balance give overall holistic health.

Fitting this description is Ginseng.  Ginseng has a long time reputation for anti aging.  Ginseng is also key in improving oxygen and blood sugar metabolism and immune function.  Ginseng also helps lower cholesterol and can help prevent heart attacks.  It helps stimulate the adrenal gland and cortisol functions that are burned out due to stress.  Ginseng hence is not good for those suffering from anxiety.  Asian Ginseng is the strongest of the Ginsengs are recommended for older individuals, while American Ginseng is meant for younger individuals who are over worked or burned out.  American Ginseng is considered “cooler” on the body.

Aging is an issue for everyone.  Organs and physical functions cease to work as well as we get older but herbs can play a key role.  Ginseng as shown plays a role in helping one age, but also in Chinese medicine, Ginkgo.  Ginkgo is derived from some of the oldest trees on earth remaining unchanged in China for thousands of years.    Ginkgo helps blood flow to the brain and has many properties that help the restore functions to the nervous system.  Studies have shown it help minimize effects of Alzheimer Disease.  Ginkgo hence is great for the mind and memory.

Herbs are can play a key role in one’s long term health if used properly. Please also review AIHCP’s Holistic Nursing Program

 

A holistic view on life with herbs and other alternative practices is becoming more mainstream everyday.  Double blind studies have been done with all the herbs discussed above with promising conclusions.  The history of these herbs have never been doubted but when tested via empirical scientific methods, they still prove the test of time.  They, as in Europe, should be utilized more in the United States.  Western medicine should not feel threatened by alternative health views or application of other herbs or strategies.  They can only complement Western medicine and help for a better fullness of life for all.

If you would like to learn more about holistic medicine or would like to earn a Holistic Integrative Specialist Certification, then please review the program and see if it matches your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification as  Holistic Integrative Specialist.  Most who enter are nurses or healthcare professionals who look to harmonize Eastern and Western ideals in medicine and help others make wise choices in utilizing the benefits of Holistic Medicine.

It is extremely important to find trained healthcare professionals in this field to help guide individuals who are seeking cures or better ways of life through herbs or other alternative therapies.  Guidance is key to protect the patient and give them the proper and professional guidance in understanding how these herbs work in unison with Western methods.

 

To learn more, please review these articles

Please review AIHCP’s Video on Holistic Nursing

Please review the article from Health Line on Kava Kava

Please review the article from Nourish by WebMD on Ginseng

 

 

 

Holistic Health: Breakfast linked to ‘healthy heart’

Holistic health
Holistic health says eat a health breakfast.

The article, “Breakfast linked to ‘healthy heart'”, source; BBC News states

“People should eat breakfast in order to look after their hearts, according to researchers in the US.”

American Institute Health Care Professionals’ insight:
Holistic health and breakfast is important.  But how important is breakfast to your heart?  This article looks at the importance of breakfast and overall health.
#nursingandholistichealth

See on www.bbc.co.uk

Holistic Health: Alternatives to Soda

Holistic health care is all about finding ways to improve your life and keep you healthy.   So holistic nutrition is always looking for ways to substitute the unhealthy for the healthy.   Today holistic nutritionists have found ways for you to replace the sugary, HFCS heavy, caffeine loaded sodas with healthy, nutritional, and holistic health care approved alternatives.

Two cute girls drinking ice tea outside in a garden
Holistic health should start young! Give your children ice tea instead of soda.

From Huffington Post

Holistic Health News: Replacing Summer Sodas!

Especially in summer months, when we should up our liquid consumption to avoid dehydration, it’s important to keep drink choices healthy and plentiful, but also enticing. And if New York City Mayor Michael R. Bloomberg is able to pass his proposed ban on supersized sodas, at least one city’s residents will need a low-cal alternative come the dog days of August.
Liquid sources of added sugar are especially dangerous in our diet, explains HuffPost blogger Dr. Mark Hyman in an exploration of the dangers of high-fructose corn syrup (or HFCS), the type of full-calorie sweetener that is found in many sugary drinks:
For the full article please go here.

Holistic health professionals strongly suggest that you avoid high-fructose corn syrup.   With plenty of healthy options like ice tea, fresh juice, and infused waters available it is about time we cut the soda habit.    Holistic living does not have to be hard and honestly cold ice tea on a hot day cannot be beat!
If you are interested in an online holistic health care certificate program or you simply want to take a few online holistic health care courses then you should visit our website for more information.