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Theses and dissertations (Health Sciences)

Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/12

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    The perceptions and management of ADD/ADHD by homoeopathic practitioners in KwaZulu-Natal
    (2012-08-27) Medina, Megan; Botha, Izel
    INTRODUCTION Attention-Deficit/Hyperactivity Disorder (ADD/ADHD) is a multifactorial and clinically heterogeneous disorder that is associated with tremendous financial burden, stress to families and adverse academic and vocational outcomes (Bierderman, 2005). ADD/ADHD is currently one of the most researched childhood conditions, yet there is still much controversy and misunderstanding surrounding it. It is also one of the most commonly diagnosed disorders of childhood development (Picton, 2005) and the prevalence of this disorder in adults is increasingly recognized (Bierderman, 2005). Parents are seeking alternatives, as they are concerned with the side effects of Methylphenidate hydrochloride and other conventional medication used to treat the symptoms of ADD/ADHD. AIM The aim of this research was to document the current practices of registered homoeopathic practitioners, with regard to ADD/ADHD. In addition, their perceptions regarding aetiology, treatment, management and success rate was investigated. This research took the form of a qualitative survey targeting homoeopaths practicing within the KwaZulu- Natal region. METHOD A total of 42 practitioners were contacted, 35 practitioners initially agreed to participate in the study, and the questionnaires were electronically sent to them via email. Of these 35 homoeopaths, 22 participated in the survey, i.e. giving an overall response rate of 62 percent. The questionnaires were electronically distributed and collected via email. The raw data was coded and captured by Google docs and the results were analysed by utilizing the SPSS for Windows version 18 SPSS/PASW 2009. RESULTS The majority of the responding homoeopaths practiced in the more urban areas of KwaZulu-Natal, more specifically within the eThekwini Durban area. The majority of these homoeopaths had qualified from the Durban University of Technology, were English speaking females and were between the ages of 25-35 years old. The homoeopaths within this study found that most patients who present with ADD/ADHD symptoms are previously diagnosed by paediatrician’s neurologists or psychologists. According to the homoeopaths participating in the study, the general consensus is that the diagnosis of ADD/ADHD is given far too easily, and without proper assessment, 86 percent of the homoeopaths are of the opinion that ADD/ADHD is misdiagnosed, and ninety one percent stated that ADD/ADHD is over diagnosed. The majority of the practitioners prescribe a simplex remedy, or the Simillimum, whereas only a few practitioners prescribe a complex remedy. It was found that the most common complex prescribed is Nervoheel®. Some practitioners prefer to make up their own complexes, which would be patient specific. In this study it was found that 68 percent of the practitioners reported the sycotic miasm to be most common, and 54 percent of the practitioners reported the tubercular miasm to be the second most common presenting miasm. The homoeopaths in this study stated that they prefer to use a holistic approach to obtain optimal well being, thus advice, lifestyle adjustments, education and counselling all form part of the treatment and management of a patient with ADD/ADHD, making it unique and specific to each case. Of the adjunctive therapies, Vitamins, supplements, and nutritional changes are recommended, especially if a deficiency has been identified. The most commonly prescribed supplements for ADD/ADHD are the Essential Fatty Acids (EFA’s) followed by Vitamin B Complexes, Multi-vitamins and Magnesium, Zinc, and Calcium. CONCLUSION The majority of the homoeopaths in this study reported that they are having a moderate to great success in treating and managing patients with ADD/ADHD. Many of these practitioners thought there to be no single cause for ADD/ADHD, however many of them found there to be a few significant contributing factors to the development or aetiology of ADD/ADHD. These factors include; genetics, environment, diet, vaccinations and family dynamics. The majority of the practitioners believe that ADD/ADHD is far too easily diagnosed and that further assessment of the mental, emotional, and physical symptoms of the patient need to be taken into consideration. The majority of the homoeopaths in this study prefer to use Simplex treatment, and consider diet, lifestyle changes, and phytotherapy the most successful adjunctive therapies when treating and managing a patient with ADD/ADHD. Many of the practitioners within this study reported that homoeopathy should be considered a primary treatment option for patients with ADD/ADHD, as the focus of the treatment is on determining the cause of the symptoms, and then managing the patient as a whole, focusing on changing the diet, altering the lifestyle, and treating the totality of the mental, emotional and physical symptoms.
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    The efficacy of homoeopathic simillimum in the treatment of attention-deficit/hyperactivity disorder (AD/HD) in schoolgoing children aged 6-11 years
    (2009) Jones, Megan; Couchman, Ingrid; Hall, Cornelia Maria
    INTRODUCTION The aim of this study was to evaluate the efficacy of homoeopathic simillimum in the treatment of attention-deficit/hyperactivity disorder (AD/HD) in schoolgoing children aged 6-11 years. AD/HD affects approximately 3-5% of children worldwide. It is thus a highly prevalent childhood disorder characterised by hyperactivity, impulsivity and restlessness. There are 3 subtypes of the condition, namely combined type, predominantly inattentive type and predominantly hyperactive-impulsive type (DSM-IV-TR, 2000 pg 90). OBJECTIVE The objective of the study was to determine the efficacy of homoeopathic simillimum in the treatment of this disorder, and thus promote homoeopathy as a safe alternative to conventional AD/HD treatments. METHODOLOGY The study was conducted as a double-blind placebo-controlled study. The sample group consisted of 30 participants. There was an experimental group of 16, which was compared to a placebo control group of 14. Participants were recruited from the greater Durban area. They had to satisfy clear inclusion and exclusion criteria. Participants and parents/guardians were required to attend 3 consultations with the researcher at The Homoeopathic Day Clinic over a 2-month period. The ADHD Rating Scale-IV Home and School Versions (Appendices B and C) had to be completed by the participant’s parent/guardian and teacher respectively. One was filled in at the initial consultation to serve as a baseline reading, and thereafter, every month. Remedies were dispensed at the first 2 consultations and these remedies were decided upon after thorough case-taking, use of Radar 9.0 Homoeopathic Software and discussion with 1 of 2 selected clinicians. Those on placebo were given free treatment at the end of the study. RESULTS Statistical analysis was conducted on the ADHD Rating Scales-IV Home and School Versions (Appendices B and C), completed by the parent/guardian and teacher respectively. Improvement was based on a decrease in the rating scale score. On analysis, the results (Table 4.8, 4.9 and 4.10) showed no statistically significant effect of treatment (i.e. no difference between treatment and placebo group), but across the whole trial and within each group (particularly the treatment group) subjects had significant reductions in symptoms (i.e. the reductions in symptoms were large enough that there was less than 5% chance that they were random fluctuations/effects). This was seen in both the treatment and placebo groups, as indicated by Table 4.11, 4.12 and 4.13, but more significant reductions were seen in the treatment group, indicated by Table 4.14. As discussed in Chapter 5, this by no means rules out the efficacy of homoeopathic simillimum for the treatment of AD/HD. CONCLUSIONS A large number of parents, teachers and doctors are seeking a safe, effective way to treat this highly prevalent disorder (Soreff & Chang, 2008) and, although the study did not satisfy the hypothesis that homoeopathic simillimum is an effective treatment for AD/HD in schoolgoing children, it did aid in creating awareness of the use of homoeopathy as a treatment option for this condition and highlighted the need for more extensive research to be undertaken for this treatment option. It is the researcher’s opinion that larger, longer duration studies, employing quantitative analysis, as well as qualitative analysis would yield more significant results.