I. INTRODUCTION
Guiding Principles:
Article II, Section 15 of the Philippine Constitution ensures that the “State shall protect and promote the right to health of the people and instill health consciousness among them.” Section 16 of the same article mentions that the State shall likewise protect and advance “the right of the people to a balanced and healthful ecology in accord with the rhythm and harmony of nature.”
Article XIII of the constitution also establishes a particular mode by which the State shall uphold the right to health, through the adoption of an “integrated and comprehensive approach to health development.” While “integration” refers to a unified health delivery system with both public and private sector participation as well as utilization of western and indigenous health care systems, “comprehensiveness” implies delivery of services and the undertaking of activities relating to health promotion, disease prevention, education and planning.
Article XIII furthermore emphasizes that health services shall be made available at “affordable” cost, and that free medical care must be given to impoverished and the disadvantaged. It is clear from all this, therefore, that although the State’s obligation to uphold the right to health of all, a clear bias is established in favor of the vulnerable sectors – the poor and underprivileged, elderly, disabled, women and children.
A law that introduces a fresh and innovative approach to improving access to health care and medical treatment is the Traditional and Alternative Medicine Act of 1997 which promotes research into and utilization of “traditional and alternative health care systems”[1]. The clear intent of this law is to improve the quality and delivery of health services through the development of traditional and alternative medicine, and its gradual integration into the national health care delivery system.
PITAHC, the institution created under Republic Act 8423, is created and tasked to conduct research and study of traditional and alternative medicine, train nurses, physicians and health workers in the use of such techniques, educate the public, and formulate rules and guidelines for the regulation of the practice and usage of traditional and alternative medicine[2].
Considering these principles and the state of affairs in Naturopathyas part of pluralistic practice of medicine or integrated medicine in the Philippine setting, the Competency Standard for Naturopathy for health care professional and workers is directed towards the enhancement of naturopaths who are not only scientifically and technologically competent on Naturopathy but who are committed to comprehensive community health development consistent with the holisticphilosophy and paradigm of traditional andintegrative medicine. This is also consistent with primary health care principles, the core components of the right to health.
PURPOSE:
This Competency Standard defines the MINIMUM required stock of knowledge, skills, attitude for medical and non-medical health care professionals and workers in the area of Naturopathy The competency also defines the proper roles and orientation needed for practice relevant and appropriate to the Philippine setting.. National Certificates are issued by PITAHC when the prescribed units of competencies have been achieved.
This Competency Standard is herein formulated and developed to ensure that Naturopathy practice meets the minimum levels of adequate knowledge, skills and awareness of indications and contraindications. Specifically, the purpose of this benchmark document are as follows:
- To upgrade the level of professional education and training of Naturopathsin Traditional/ Complementary and Alternative Health Care (T/CAHC) with the end view of quality patient care, setting and maintaining standards of competence and integrity, and providing quality life-enhancing and well-being services and products;
- To serve as basis in the establishment of a competency assessment and certification system, which can be used for setting up a classified/ qualified pool of naturopaths ready to serve domestic needs primarily (medical, and community clinics, hospitals, etc.) and overseas requirements secondarily;
- To serve as guide / basis for the Professional Regulation Commission and the various Philippine Health Professional Associations in the accreditation of the practice of Naturopathy;
- To serve as basis for Philippine Health Insurance Corporation’s future guidelines for reimbursement of practitioner/ patient Naturopathy services;
- To serve as guide/ basis for the development of training programs in Naturopathy for community health workers and other health workers.
- To serve as a basis for the development of training programs over the full range of training modalities including those of technical institutions, apprenticeships, and community-based programs;
- To pursue the Philippine Institute for Traditional and Alternative Health Care (PITAHC’s) goal of formulating policies, standards, guidelines, and practices towards improving the quality and delivery of health services through the comprehensive (preventive, curative, rehabilitative, and promotive) development of traditional, complementary and alternative medicine, and its eventual integration into the national health care delivery system.
- To contribute to bringing about paradigm shift towards value formation, ethical and social transformation using the holistic philosophy of traditional, complementary and alternative systems of medicine through integrated multi-disciplinary and developmental approaches to TCAHC trainings.
UNITS OF COMPETENCIES
UNIT I Perform Naturopathic Health Assessment
Unit Descriptor
This unit covers the skills required to observe the condition of the client/patient and gather information relevant to the case, according to a naturopathic framework.
ELEMENTS |
PERFORMANCE CRITERIA |
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ELEMENTS |
PERFORMANCE CRITERIA |
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RANGE OF VARIABLES
Factors likely to have a negative impact on assessment may include: |
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Other health care professional may include: |
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Client history may include: |
- Physical - Emotional - Allergies - Dietary picture - Sleep pattern - Exercise - Leisure activities
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Potential sensitivities may include: |
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Signs of health condition may refer to: |
All procedures must be conducted according to legislative and regulatory requirements. |
Other appropriate assessment techniques may include: |
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EVIDENCE GUIDE
Critical aspects of assessment: |
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Concurrent assessment and relationship with other units: |
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Underpinning knowledge and skills: |
- Musculo-skeletal including muscles, bones, cartilage, joints, head, upper trunk, upper limb, pelvis, and lower limb - Nervous system, including peripheral, autonomic and central nervous systems - Cardiovascular (including haemopoetic) including vascular system, spleen, heart and pericardium, systemic arteries, systemic veins, portal veins, and foetal circulation - Lymphatic including thoracic viscera, abdominal and pelvic viscera, alimentary tract, urinary and genital systems, trunk and limbs, deep and superficial lymph nodes - Gastrointestinal including mouth, salivary glands, tongue, pharynx, esophagus, abdomen and peritoneum, stomach, small intestine, large intestine, liver, biliary system, and pancreas - Respiratory including larynx, trachea, lungs and mediastinum, and pleura - Urogenital (reproductive and urinary) and endocrine incuding kidneys, ureter and bladder, male genital organs, female genital organs, thyroid, parathyroid glands, pituitary gland, adrenal gland, and thymus gland - ENT and special senses including hearing and equilibration, vision, smell, and taste
- General physiology including cell structure and function, metabolism, and levels of organization in the body - Basic physiology including physiology of musculoskeletal system – muscles, posture and movement - Nervous system including central, peripheral and automatic nervous systems - ENT and other senses including hearing and equilibration, vision, smell, and taste - Respiratory system including pulmonary function - Cardiovascular system including heart, and circulation - Lymphatic system including lymph, immunity and allergy - Gastrointestinal including motility, secretions, movement of food, digestion and absorption - Urogenital and endocrine including renal function, micturition, extracellular fluid, metabolism, thyroid gland, hormones, and reproduction
- Central and peripheral nervous tissue, brain, spinal cord and associated nerves, sensory, motor and integrative systems, and autonomic nervous system - Endocrine system including thyroid, parathyroid and adrenal glands, pancreas, calcium and bone metabolism, pituitary gland, and pineal gland - ENT and special senses including vision, hearing, smell, and taste - Respiratory system including pulmonary function, gas transport, regulation of respiration, and respiratory adjustments - Cardiovascular system including blood, clotting, erythropoitin, and cardiac cycle - Lymphatic system including immunity, and allergy - Urogenital system including renal function, fluid balance, male and female reproductive systems
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Resource implications Resource requirements include all the relevant resources commonly used by specific discipline. Specific tools may include: |
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Method of assessment Assessment may include: |
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Context of assessment: |
This unit is most apropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may be on more than one occasion to cover a variety of circumstances |
UNIT II Manage Work Within the Naturopathic Framework
Unit Descriptor
This unit describes the skills required to manage the effective work practices of self and others within a naturopathic framework: Maintain an effective work environment.
ELEMENT |
PERFORMANCE CRITERIA |
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RANGE OF VARIABLES
The major and minor forms of assessment may include: |
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Therapeutic intervention practices may include: |
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Definition of naturopathy is: |
Naturopathy is a distinct method of wholistic healing, underpinned by a philosophical perspective which recognizes that all living forms possess a self-regulatory, inherent ability for self-healing. This inherent ability, or vital force, operates in an intelligent, orderly fashion. Naturopathic approaches to health care are aimed at supporting and enhancing the body’s own ability to heal itself. |
Central philosophies include: |
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Measures implemented could refer to: |
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Effective communication and interpersonal skills may include: |
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Opportunities for formal and informal development of skills and knowledge may include: |
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EVIDENCE GUIDE
Critical aspects of assessment: |
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Underpinning knowledge and skills: |
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Resource implications Resource requirements may include: |
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Method of assessment Assessment may include: |
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Context of assessment: |
This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering wide range of clinical situations. |
UNIT III Apply Naturopathic Assessment Framework
Unit Descriptor
This unit covers the skills required to interpret information gathered in the health assessment and make and review accurate assessment over the course of therapeutic intervention, according to the naturopathic framework.
ELEMENTS |
PERFORMANCE CRITERIA |
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RANGE OF VARIABLES
Signs and symptoms of conditions may include: |
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Patterns may refer to: |
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EVIDENCE GUIDE
Critical aspects of assessment include: |
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Concurrent assessment and relationship with other units: |
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Underpinning knowledge and skills: |
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Resource implications Resource requirements may include: |
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Method of assessment Assessment may include: |
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Context of assessment: |
This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work condition. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations. |
UNIT IV Work Within a Naturopathic Framework
Unit Descriptor
This unit describes the skills required to work effectively within a naturopathic framework.
ELEMENT |
PERFORMANCE CRITERIA |
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are discussed with the client/patient |
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RANGE OF VARIABLES
Definition of Naturopathy is: |
Naturopathy is a distinct method of healing, underpinned by a philosophical perspective which recognizes that all living forms possess a self-regulatory, inherent ability for self-healing. This inherent ability, or vital force, operates in an intelligent, orderly fashion. Naturopathic approaches to health care are aimed at supporting and enhancing the body’s own ability to heal itself. |
Central philosophies of naturopathy are: |
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Major methods of therapeutic intervention include: |
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Other complementary therapies may include: |
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Traditionally used methods of healing include: |
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Appropriate assessment techniques may include: |
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Other healing systems may include: |
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Information on other complementary therapies may include: |
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Relationship between therapies may include: |
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Inquiries may require explanation of: |
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Appropriate information may include: |
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Clinic’s guidelines may include: |
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Legal and regulatory guidelines may include: |
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Relevant documentation may include: |
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EVIDENCE GUIDE
Critical aspects of assessment: |
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Concurrent assessment and relationship with other units: |
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Underpinning knowledge and skills: |
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Resource implications Resource requirements may include: |
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Method of assessment Assessment may include: |
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Context of assessment: |
This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples of a range of clinical situations. |
UNIT V Plan the Naturopathic therapeutic intervention strategy
Unit Descriptor
This unit describes the skills required to prepare for therapeutic intervention of clients/patients and negotiate a therapeutic intervention management plan with them using a naturopathic framework.
ELEMENTS |
PERFORMANCE CRITERIA |
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RANGE OF VARIABLES
Contra-indications to therapeutic intervention and possible complicating factors may include: |
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Therapeutic interventions may include: |
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Client/patient compliance refers to: |
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Discrepancies may include: |
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Practitioner responsibilities may include: |
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Therapeutic intervention evaluation strategies may include: |
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EVIDENCE GUIDE
Critical aspects of assessment: |
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Concurrent assessment and relationship with other units: |
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Underpinning knowledge and skills: |
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Resource implications Resource requirements may include: |
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Method of assessment Assessment may include: |
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Context of assessment: |
This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations. |
UNIT VI. Provide the Naturopathic therapeutic intervention
Unit Descriptor
This unit describes the skills required to administer client/patient according to a naturopathic framework.
ELEMENT |
PERFORMANCE CRITERIA |
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RANGE OF VARIABLES
Factors which interfere with the effectiveness of therapeutic intervention may include: |
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Mode of administration may be: |
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Responses to reactions may include: |
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Consent for therapeutic intervention refers to: |
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Regulations may include: |
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Advise the client/patient refers to: |
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Practical techniques that promote and maintain optimal health may include: |
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EVIDENCE GUIDE
Critical aspects of assessment: Therapeutic intervention plans are implemented to achieve optimal health and rehabilitation, or to improve quality of life. These involve: |
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Concurrent assessment and relationship with other units: |
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Underpinning knowledge and skills: |
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Resource implications Resource requirements may include: |
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Method of assessment Assessment may include: |
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Context of assessment: |
This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations. |
UNIT VII Provide the Herbal Medicine therapeutic intervention
Unit Descriptor
This unit describes the skills required to administer client/patient therapeutic intervention according to a naturopathic framework.
ELEMENT |
PERFORMANCE CRITERIA |
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RANGE OF VARIABLES |
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Factors which interfere with the effectiveness of therapeutic intervention may include: |
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Mode of administration may be: |
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Responses to reactions may include: |
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Consent for therapeutic intervention refers to: |
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Regulations may include: |
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Advise the client/patient refers to: |
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Practical techniques that promote and maintain optimal health may include: |
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EVIDENCE GUIDE |
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Critical aspects of evidence Therapeutic intervention plans are implemented to achieve optimal health, rehabilitation, or to improve quality of life. These involve: |
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Concurrrent assessment and relationship with other units: |
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Underpinning knowledge and skills: |
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Resource implications Resource requirements may include: |
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Method of assessment Assessment may include: |
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Context of assessment: |
This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations |
UNIT VIII Provide Naturopathic nutritional therapeutic intervention
Unit Descriptor
This unit describes the skills required to provide naturopathic advice on dietary modification and nutritional supplements according to a naturopathic framework
ELEMENT |
PERFORMANCE CRITERIA |
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RANGE OF VARIABLES
Factors which interfere with the effectiveness of therapeutic intervention may include: |
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Dietary modification may include |
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Consent for therapeutic intervention refers to: |
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Contra-indications to therapeutic intervention may include: |
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Responses to reactions may include: |
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Nutritional and supplementation may include: |
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Environmental factors may include: |
-intentional -non-intentional
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Other factors may include: |
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Cultural barriers may include: |
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Regulations may include: |
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Advise the client/patient refers to: |
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Relevant and practical techniques that promote and maintain optimal health may include: |
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Lifestyle modification may involve: |
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EVIDENCE GUIDE
Critical aspects of assessment: |
-Demonstrated ability to assess nutritional needs according to naturopathic principles -Appropriate preparation of the client /patient for therapeutic intervention -Therapeutic intervention of a range of health conditions -Incorporation of the philosophies and beliefs of the practice of naturopathy -Demonstration of the application of commonly used therapeutic intervention practices -Provision of therapeutic intervention in accordance with the individual, the condition and the presence of complicating factors -Provision of the safest, most efficacious and cost effective therapeutic intervention method -The use of counselling within the nutritional consultation as an aid to therapeutic intervention -Provision of therapeutic intervention in accordance with the therapeutic intervention plan -Complete documentation of all recommendations and client/patient responses -Review of therapeutic intervention plan
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Concurrent assessment and relationship with other units: |
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Underpinning knowledge and skills: |
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Resource implications Resource requirements may include: |
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Method of assessment Assessment may include: |
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Context of assessment: |
This unit can be assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain theoretical and practical components and examples covering a range of clinical situations. |
UNIT VIII-A Apply literature research findings to clinical nutritional practice
Unit Descriptor
This unit describes the skills required to source and evaluate relevant information and apply findings to clinical nutritional practice. This unit requires high level knowledge of nutrition and its effect on a wide range of complex health conditions.
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PERFORMANCE CRITERIA |
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RANGE OF VARIABLES
Clinical information needs: |
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Primary information sources: |
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Secondary information sources: |
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Established information sources: |
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Evaluate refers to: |
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Implement refers to: |
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EVIDENCE GUIDE
Critical aspects of evidence |
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Concurrent assessment and relationship with other units: |
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Underpinning knowledge and skills: |
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Resource implications Resource requirements may include: |
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Method of assessment Assessment may include: |
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Context of assessment |
This unit is can be assessed in the workplace, in a classroom setting or in a distance learning context. Assessment will mostly contain theoretical components and examples covering a range of clinical situations |
UNIT VIII-B Provide specialized Naturopathic nutritional care
Unit Descriptor
This unit describes the skills required to provide specialized nutritional supplements and/or foods for the therapeutic and prophylactic management of specific health outcomes. This unit requires high level knowledge of nutrition and its effect on a wide range of complex health conditions.
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PERFORMANCE CRITERIA |
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RANGE OF VARIABLES
Nutritional needs refers to: |
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Specific health outcome may include: |
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Specialized Nutritional therapeutic intervention: |
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Various life stage may include: |
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Consent for therapeutic intervention includes: |
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Factors which interfere with the effectiveness of therapeutic intervention may include: |
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EVIDENCE GUIDE
Critical aspects of evidence: |
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Concurrent assessment and relationship with other units: |
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Underpinning knowledge and skills: |
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Resource implications Resource requirements may include: |
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Method of assessment Assessment may include: |
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Context of assessment: |
This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations. |
UNIT HLTNAT IX Provide acute Homeopathic therapeutic intervention
Descriptor
This unit describes the skills required to administer a limited range of homeopathic remedies for acute conditions within naturopathic framework
ELEMENT |
PERFORMANCE CRITERIA |
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RANGE OF VARIABLES
Factors which interfere with the effectiveness of therapeutic intervention may include: |
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Mode of administration may include: |
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Consent for therapeutic intervention refers to: |
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Homeopathic remedies refers to: |
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Providing a homeopathic remedy within a naturopathic framework refers to: |
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Homeopathic diagnostic techniques refers to: |
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Responses may include: |
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Attendance to responses may include: |
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Advise the client/patient refers to: |
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Relevant and practical techniques that promote and maintain optimal health may include: |
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Homeopathic questioning includes: |
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Effects of previous therapeutic intervention may include: |
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On-going and/or additional therapeutic intervention may include: |
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A chronic condition may include: |
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EVIDENCE GUIDE
Critical aspects of assessment: |
-Therapeutic intervention of a range of acute conditions -Use of homeopathic questioning -Incorporation of the philosophies of homeopathy into naturopathic practice -Demonstration of the application of commonly used therapeutic intervention practices -Therapeutic intervention according to the individual, the condition and the presence of complicating factors. It must be the safest, most efficacious method that is also cost effective to the patient -Provision of acute homeopathic therapeutic intervention -Use of advice/ counselling as a therapeutic intervention method, where competence exists -A case requiring referral to a homeopath, or other health care professional -Preparation of the client/patient for therapeutic intervention according to naturopathic practice -Complete documentation of all recommendations and client/patient responses -Review of therapeutic intervention plan
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Concurrent assessment and relationship with other units: |
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Underpinning knowledge and skills: |
-Totality of characteristic symptoms -Keynote characteristic symptom -Central theme of a remedy -Constitutional basis -Miasmatic indications -Etiology -Use of organopathics -Prophylactic use -Ladder-like prescribing -Tautopathy -Isopathy
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Resource implications Resource requirements may include: |
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Method of assessment Assessment may include: |
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Context of assessment: |
This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations. |
UNIT X Prepare and dispense Herbal and Traditional Medicine and Health
Supplements
Unit descriptor
This unit describes the skills required to prepare and dispense herbal and traditional medicine and health supplements. The preparation and dispensing of said herbal and health supplements should be done by a pharmacist. (Note: Refer to Pharmacy Law)
ELEMENT |
PERFORMANCE CRITERIA |
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RANGE OF VARIABLES
Common herbs mean at least 100 herbs which must include but are not limited to:
(See attached list of common Philippine herbs) |
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Common herbs must include a minimum of 3 herbs from each specific action category ie |
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Nutritional ingredients may include: |
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Pharmaceutical ingredients and equipment may include but are not limited to: |
-Water -Vinegar -Wine -Alcohol -Ether -Glycerol -Oil
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Guidelines and methodology refers to: |
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Dispensing ingredients and equipment may include but is not limited to: |
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The form of the medicine may include but is not limited to: |
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Care is done to prevent contamination means: |
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Clinic practice guidelines may include: |
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Instructions for taking the medicine refer to: |
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Acceptable sources includes: |
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Labelled correctly means: |
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Factors which may have an effect on the storage may include: |
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Workplace information may include: |
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EVIDENCE GUIDE
Critical aspects of assessment: |
- Labelling - Stock flow/quantity - Measuring devices - Materials faults - Service faults
- Clean and sanitise equipment - Carry out routine maintenance |
Concurrent assessment and relationship with other units: |
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Underpinning knowledge and skills: |
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Resource implications Resource requirements may include: |
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Method of assessment Assessment may include: |
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Context of assessment: |
This unit is most appropriately assessed in the workplace or in a simulated workplace and under the normal range of work conditions. Assessment may contain both theoretical and practical components and examples covering a range of clinical situations. |
[1] Republic Act 8423, Section 3
[2] Ibid, Section 5-6