Research group Integrative Care

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The concept of integrative medicine/care - referred to as the new medicine by British Medical Journal - entails a sound combination of safe and effective ancient traditional medicine (TM) or complementary and alternative medicine (CAM) practices, with state-of-the-art conventional health care.

Research group leader

Senior researcher

B Torkel Falkenberg

Phone: 83868
Organizational unit: Division of Nursing- Nursing 2

Lecturer senior

Maria Arman

Phone: +46-(0)8-524 839 73
Organizational unit: Division of Nursing- Nursing 2

Research area

Such integration, which is sensitive to the patients' freedom of choice as well as safety and effectiveness and acknowledges health and wellness of the whole person including biological, psychological, social and existential aspects, is recommended by the World Health Organisation (WHO). The objective of the integrative care research constellation is to increase academic knowledge about the potentials and pitfalls of integrative care from different stakeholder perspectives and to explore its relevance for different health care professions including nursing. A long-term objective is to contribute to integrative care health sector reform and best practice development based on findings from broad and multidisciplinary research projects where qualitative and quantitative research findings are combined to inform decision making. Our research group partners often include a range of researchers from various disciplines including nursing, midwifery, medicine, medical anthropology, philosophy of science and technology, as well as (when relevant) health care planners and decision makers. Research challenges with TM/CAM and integrative care include limited evidence of efficacy, concerns of patient safety and potential adverse effects on one hand, and patient satisfaction, growing demands and emerging evidence of improved genomic integrity (telomeres), holistic caring and cost effectiveness, on the other hand. Current research involving our PhD students and post-docs, includes health systems research and caring research approaches in randomised clinical trials which combine qualitative and quantitative methods to explore integrative care services; explore cost-effectiveness and existential caring in anthroposophical hospital care provision; developing and evaluating mindfulness interventions for depression management; elucidating cost-effectiveness, care giver perspectives and collaboration in integrative care services and; academic exploration of placebo and the meaning response as well as various CAM therapies. 

A project group in the research group has developed under the leadership of Maria Arman, associate professor of caring science at KI. The idea is to approach the people's own subjective experiences of "Patients’ world". Previous projects have studied and evaluated the patients' experiences of anthroposophic healthcare in the short and long term in patients with various diseases, such as cancer, pain and burnout. Since 2013 the project team work with qualitative methods to investigate different aspects of living with chronic pain and experience in rehabilitation. Data is collected from anthroposophic care and conventional rehabilitation clinics. The data is qualitative interviews and cognitive interviews with patients and caregivers with experience of rehabilitation. Cognitive interviews are also being made to develop a new holistic questionnaire.

Scientific methods in the studies are interpretive, using phenomenology and hermeneutics. Ethical, existential, philosophical and nursing theories form the basis for the projects. With a caring science theoretical base the projects are clinical and lead to the development of models and new knowledge for practice and for caring science. The overall goal is to find new, integrative and alternative ways of understanding the lived experience of illness, suffering and health. Current interest is research in which phenomena are explored in the context of the lives of patients with chronic pain and its syndrome.

The project team is led by Maria Arman, associate professor and Johanna Hawk, PhD and Susanne Andermo, PhD as permanent employees. Cooperation with the larger research team led by Torkel Falkenberg and its employees are tight. Current funding from Ekhaga Stiftelsen 2014 and 2015

 The research constellation has been active in international and national research collaborations resulting in several PhD theses, over 100 peer-review scientific papers, contributions to international guidelines, and efforts to inform the EU (CAMbrella) and WHO of strategic CAM research as well as undergraduate education with CAM and integrative care courses for medical and nursing students at Karolinska Institutet. We are also engaged as consultants to health care planners and decision makers, including the WHO where we have strategically participated in the core planning group of the new WHO global strategy for TM/CAM 2014-2023. We participate in extensive international scientific networks including the International Society for Complementary Medicine Research and we are in the organisation committee for the leading international research congresses in the area: Korea 2015, Las Vegas 2016, Berlin 2017. 

Ongoing projects

Existential Genomics

Please read our Swedish page for project description (in Swedish only).

Leader: Torkel Falkenberg 

Project start: 2013

Collaboration with Prog. Björn Gerdle, Lindköping University

Anthroposophic Integrative Care in Sweden – Comparative Effectiveness Research of Ideas-driven Non-Profit Health Care Service

Please read our Swedish page for project description (in Swedish only).

Leader: Tobias Sundberg & Torkel Falkenberg

Project start: 2011

Collaboration with Laith N. Hussain University of Gothenburg

CAMbrella - A pan-European research network for Complementary and Alternative Medicine (CAM)

Leader: Torkel Falkenberg och Johanna Hök

Project start: 2010

Please read our Swedish page for project description (in Swedish only).

Existential caregiving in clinical practice – application research in antroposophical health care

Leader: Maria Arman

Project start: 2010

To deepen the understanding of relational aspects in the art of caring an existential outlook is used in this study. Using an integration of anthroposophic and existential caring science framework aims at a deeper understanding in existential caregiving. An aim is to develop and explain concrete clinical examples of existential caregiving. The context for the study is an anthroposophic clinic and a ward offering care for cancer rehabilitation and palliative care. The findings will be possible to learn from in all forms of health care. The research attempt builds on clinical application research. Scientific researchers work together with clinical colleagues which constitute the research team. In close contact the team through dialogues designs questions, method, data collection, analysis, interpretation, publication and clinical application. 

ENGELSK TITEL Vårdande, botande och helande inom biomedicinsk, komplementär och integrativ vård i Sverige och USA - en tvärkulturell etnografisk studie

Leader: Anette Forss

Project start: 2011

Please read our Swedish page for project description (in Swedish only).

An explorative study of a complementary therapy method - Rosen Method Bodywork. User´s reasons for therapy utilization, experienced benefits and existence of caring in the treatment interaction

Leader: Riitta Hoffrén-Larsson

Project start: 2008

This thesis work analyses users´ experiences of Rosen Method Bodywork (RMB), a relatively unevaluated psychologically orientated CAM therapy method. The theory behind RMB suggests that bodily problems such as muscle tension are partly due to unresolved emotional problems or suppressed traumatic experiences. The treatment includes gentle touching on tense muscles with the purpose to detect and make the client aware of the tenseness. The study design is qualitative, exploratory and descriptive. The overall aim is to contribute to the understanding of possible health promoting aspects of RMB. The specific aims are to describe why clients consult RMB and what kind of benefits they perceive (study I), and to explore if caring is a part of the interpersonal interaction in the treatments by analysing RMB clients´ experiences from a nursing theoretical framework (study II). The data was collected from a survey of 53 conveniently sampled Swedish RMB clients (study I) and through semi-structured interviews with 11 clients with both positive and negative experiences from RMB (study II). Based on the results a theoretical model of the components that might contribute to treatment satisfaction and experienced benefits has been presented. However, it is important to note the study limitations and that these qualitative studies were not designed to inform any conclusions about the efficacy of RMB.

ENGELSK TITEL Vårdande beröring - Studier inom akutsjukvård

Leader: Fanny Airosa 

Project start: 2011

Please read our Swedish page for project description (in Swedish only).

The use of placebos in Swedish and British primary care and its ethical perspectives among both patients and primary care physicians

Leader: Kristofer Bjerså 

Project start: 2014

There is extensive worldwide use of placebos in clinical care. Placebo use may be unethical. This area of practice is under-investigated both ethically and in terms of the effectiveness of this intervention in primary care. This postdoctoral program proposes to address these issues with respect to Swedish and UK primary care. The current situation with respect to placebo usage in Swedish health care in primary care is unknown and there are no current national research focusing on this common and significant ethical and clinical issue. This project will combine quantitative and qualitative research. The project is a collaboration with University of Southampton.

For further information, please see the group's external web site.

Targeting patients’ experiences of care; the development of an instrument in a holistic caring environment.

Project leader: Maria Arman

Co- workers: Susanne Andermo and Tobias Sundberg

Collaboration with international researcher Cheryl Rittenbaugh 

Collaboration with Vidarkliniken

Narratives about suffering from chronic pain

Project leader: Maria Arman

Co- workers: Johanna Hök and Susanne Andermo.

Collaboration with Vidarkliniken, Pain rehabilitation at Danderyd hospital and the pain clinic in Linköping 

Exploring Caregiving Aspects of Anthroposophic Integrative Care for Persons with Chronic Widespread Pain 

Project Leader: Johanna Hök

Co- workers: Maria Arman and Susanne Andermo

Collaboration with Vidarkliniken

Group members

Name Position Email
Torkel Falkenberg Associate professor, Group leader
Maria Arman  Associate professor, Deputy group leader
Anette Forss University lecturer
Johanna Hök University lecturer
Riitta Hoffrén-Larsson University lecturer
Kristofer Bjerså University lecturer
Fanny Airosa PhD
Susanne Andermo Doctoral student
Astrid Grensman Doctoral student, reg. at division of family medicine
Bikash Dev Acharya Doctoral student, reg. at division of family medicine
Tobias Sundberg Senior researcher
Astrid Grensman Doctoral student, reg. at division of family medicine
Anita Berlin University lecturer


List of publications