Guest Editorial: Alternative Therapies and Symptom Management

Abstract

Symptoms, from the perspective of the health professional, indicate that something is amiss. This "something" could simply be our body telling us that we require rest, nourishment, or fluid, or it could be a complex response from an etiology of known or unknown origin. As health professionals, we are compelled to investigate the nature of symptoms when they are presented to us, verbally or non-verbally, by those for whom we provide care. Based on our assessment, we can generate hypotheses that can be further investigated to determine the cause of the symptom. When it is of an objective nature, such as fever, we are able to measure it accurately in well-established measurement units (i.e., degrees) that correctly indicate the degree of severity. The severity of the symptom provides further information that will aid in the search for the cause of the underlying dilemma. However, when the symptom is of a subjective nature, such as pain, fear, or anxiety, accurate measurement can be a problem, particularly if the individual is unable or unwilling to provide an accurate verbal description. Because these subjective symptoms are all somewhat familiar, our assessment of them frequently is laden with personal opinions, beliefs, attitudes, and expectations about what will effectively eliminate them. Unfortunately we often bring these value-laden biases into new patient situations, thus influencing what we hear from and/or see in those we are caring for. While we are attempting to assess symptoms in an accurate manner, we are also trying to "manage" the symptom using the safest and most efficacious intervention we can. But what do we really mean by "manage"? Ideally, we manage a symptom by instituting an intervention that will eliminate it and prevent its return, or, if this is not possible, by striving to provide a therapy that will relieve, reduce, ameliorate, or simply make whatever is amiss better. Based on this ideology, symptom management should be broad in scope, encompass all types of safe and effective therapies, and be based on the best and most current research evidence available. In reality, however, we frequently