How Is It Possible to Treat Diseases Without Medicine?: A Qualitative Study on the Attitude and Perceived Benefits of Yoga and Naturopathy Among Patients Admitted at an Inpatient Hospital

Abstract

Background:

Yoga and naturopathy (Y&N) is a system of medicine primarily focusing on restoration of health and well-being. Objective of this study is to understand the knowledge, attitude, and perception about Y&N among the inpatients of a government Y&N institution in south India.

Methods:

Focus group discussion was conducted in eight adult patients aged between 30 and 60 years who took Y&N treatments for a period of 10 days or more. Purposive sampling method was adopted. Oral informed consent was obtained.

Results:

Knowledge about the Y&N system of medicine was primarily through referral or “word of mouth.” Perceived benefits were both physical and psychological. Uniqueness of the hospital as mentioned by participants includes individual attention, tailor-made treatment protocols, and one-to-one care to the needy patients.

Conclusion:

An integrated approach is very much essential that might bring about better treatment outcomes in patients.

Background

Yoga and Naturopathy (Y&N) is a traditional, complementary, and integrated medicine (TCIM) system of medicine widely practiced across the world, especially in the management of noncommunicable diseases.¹ Public health principles are very much comparable with the principle of Y&N that basically involve health promotion, disease prevention, and patient education.² Previous qualitative studies on Y&N were primarily disease-specific, focusing on disease conditions such as diabetes and COVID-19, and the responses primarily were related to the improvements in “disease-specific symptoms.”^3,4

However, there are no available studies documenting the overall experience of patients undergoing Y&N treatments in an inpatient facility. Objective of this study is to understand the knowledge, attitude, and perception of the inpatients of a government Y&N institution in south India.

Methodology

An in-depth focus group discussion (FGD) for a duration of 120 minutes was conducted to address the aforementioned research questions. FGD was audio recorded and also written as notes by the note takers during the discussion. An institutional review board (IRB) clearance was obtained before the study (RES/IEC-GYNMC/2023/171).

Sample and data collection

Participants were recruited from the inpatient facility of the Government Yoga and Naturopathy Medical College and Hospital. Adults 30 years of age or above, ability to speak conversational English or Tamil, and having undergone a minimum of 10 days treatment in the inpatient facility were included for the study. Purposive sampling was used to recruit the participants. The age range was maintained between 30 and 60 years to avoid heterogeneity. Eight participants fulfilling the criteria were included after getting informed consent. Saturation was established when iterative data extraction revealed that a few or new substantially new concepts relevant to the research topic and sufficient depth and repetition of themes/concepts had been achieved.

Data analysis

Entire FGD session was first transcribed verbatim in Tamil and then translated to English. The authors identified recurrent code, themes, and developed a thematic framework to organize the results of the FGD using Microsoft Excel software. Discrepancies, if any, between the three authors were resolved through discussion and in presence of the fourth author.

Results

The major themes identified include knowledge, attitude, and perceived benefits. Specific notable quotations were also extracted to highlight the themes identified (Table 1).

Table 1.

Details of the Themes and Subthemes

Theme	Sub theme	Quotes
Knowledge	Sources of referrals	“My friend told that…. The quality of the care and attention provided here was very good, I didn't get such attention and care even in private hospital, so she referred me here”
Attitude	Attitude toward doctors	1. “None of the doctors treated us with anger or frowned-face. All had a pleasant smile and addressed all our doubts with kindness. I feel very proud about the doctors. They made the hospital environment friendly and comfortable”
	Attitude toward doctors	2. “This hospital is a temple. I see this hospital as the opportunity that God gave me to heal from my disease.”
	Attitude toward natural diet	1. “Diet was more annoying to me than my physical pain. Raw vegetables were very difficult for me to eat. I asked for discharge because of my natural raw diet but the doctor told me to see for next 2 to 3 days. I slowly adopted to the diet after 2 days of admission”
		2. “Diet did not suit me for the first four days, because I mostly eat non-vegetarian food.”
		3. “When I eat cooked food, I will feel lazy and tired. After eating raw fruits and vegetables, I am feeling very light, energetic and good. Moreover I can carry out my daily routine without tiredness”
	Attitude toward yoga session	1. “I have learnt basics of yoga before. But, I haven't felt any changes during those practices. But here, when they say “close your eyes and feel the stretch.”
		2. “For me shoulders were so painful that I couldn't move it even a little. I can't even comb my hair. Now, I can move my shoulders freely without any discomfort. I understood that yoga can give immense benefits. So if we practice yoga regularly we can lead our life very healthily without taking conventional medicines and also without diseases”
		3. “Before coming here I thought yoga is only for person who are lean. But, after coming here I understood that yoga can be also done by obese person and it will make them flexible. Yoga is not only for body but also for mind”
Perceived benefits	Physical	1. “In my life, there were no hard times like the past five months. I was crying in agony most of the times as I cannot tolerate the pain. Took treatments in different hospitals around Chennai. I cannot even hold my pen or pencil on the day of admission. This is my 15th day of treatment here. Now I can move my hand freely without any discomfort. Treatments provided here was amazing”
		2. “I had fibroid uterus. If I walk, I will feel like stone is hanging from my lower abdomen. But after taking a mud pack and yoga the feeling of heaviness got much reduced. I'm feeling very light now, Doctor(s) gave me much strength because of which I recovered well”
		3. “I came here with many doubts, How is it possible to treat diseases without medicine?” How would the treatments work? “Will it cure my disease? But now, I am seeing results by myself within a week, as (my) sugar levels has started reducing from 396 mg/dl to 198 mg/dl”
	Psychological	1. “I was very dull and mentally down (at the time of admission). I even hesitate to talk to others because of pain, but after admission when my pain gradually reduced, I was able to talk and interact with others freely and much more comfortably”
		2. “I felt like I had come for a picnic. I am no longer a patient. My mind is very relaxed here”
		“I am feeling very light like flying in the sky”

Knowledge

Sources of referrals

Most participants came to know about the hospital and the Y&N system of medicine through word-of-mouth and direct referrals through friends or relatives who successfully got treated at the hospital previously. Participants even from different districts and states of the country were referred to the hospital through the patients' who underwent treatment earlier. And some participants who visited the outpatient department were advised by the doctors to get admitted in the inpatient department for better clinical outcomes.

Attitude

Attitude toward doctors

Attitude experienced by the participants in the hospital was welcoming and appreciable. Participants were very satisfied with the personalized treatment approach provided by the doctors. It involved formulation of unique treatment protocol for each patient, with special individual attention provided by the assigned intern doctor. Friendly environment of the hospital and improvement in health developed constructive outlook toward the Y&N system. Most importantly, participants appreciated the care provided by doctors with no grimace or anger.

Attitude toward natural diet

The hospital provides meal plan that is a raw, natural, and plant-based diet to all the patients. The diet primarily includes fresh juices, fruits, raw vegetable salads, and sprouts. Patients are abstained from eating any other cooked food and beverages throughout their stay in the hospital. Initially after taking natural diet, most participants experienced headache for at least 2 to 4 days. One participant said that the diet is “more annoying” than her physical pain (Table 1). Self-adaptation to the raw natural diet took place within 4 days of admission. However, all patients unanimously agreed that from day 4 of admission they were able to feel the improvement in their health status and were more welcoming to the raw natural diet. They expressed that they feel very light and energetic.

Attitude toward yoga sessions

The hospital provides therapeutic yoga sessions for 1 hour in the morning (5.30 am–6.30 am) and 1 hour in the evening (5.30 pm–6.30 pm), which includes loosening exercises, various asanas, pranayama, meditation, relaxation technique, and short theory sessions. Though most patients had experience with yoga, they felt the yoga sessions to be very lively and energetic, when combined with the natural diet. In addition, yoga benefits and contraindications of each asana are expressed in detail by the doctors who conduct the yoga sessions. Most participants told that yoga sessions decreased their pain, stress, stiffness, and improved their flexibility.

Perceived benefits

Physical

Most participants experienced positive changes in their physical health that includes reduction in pain, stiffness, heaviness in body, reduction in blood glucose levels, and increased mobility without discomfort. Few participants who were obese mentioned reduction in body weight as the most important physical change they experienced.

Psychological

Reduction in stress, anxiety, and improvement in sleep was reported by the patients. Most of them felt very refreshing after taking treatments. Noticeably, one participant told that she is “not feeling like a patient anymore,” and her admission period feels like a “picnic.” One participant said that the lightness she feels after treatment is like “flying in the sky.”

Discussion

The current qualitative study highlights the insights into the knowledge, attitude, and perceived benefits of the participants who underwent Y&N treatments at a Government Yoga and Naturopathy Hospital in the south Indian state of Tamilnadu. Knowledge or awareness about the system of medicine seems to be primarily through “word of mouth.” None of the participants in this study were directly referred by a conventional medicine practitioner.

Musculoskeletal disorder is the major complaint in the current group of participants, followed by metabolic and gynecologic disorders. Due to lack of awareness, most participants were initially hesitant during the time of admission, but after initial consultation provided by the doctors about the treatments and how they work made them to understand the innate healing capacity of the body addressed by the Y&N system of medicine.⁵

The participants stated a general positive attitude toward all the interventions during their hospital stay. Interestingly, almost all participants mentioned that, initially, they were not comfortable with the healthy natural diet provided to them due to Westernization, and Western diet consumption is predominant in their everyday life.⁶ The introduction of natural diet had resulted in initial psychological distress and inertia at mental level that was expressed by the participants as “fear” and “regretful” for getting admitted in the hospital.

Similarly, physical symptoms such as headache were also reported in most patients that could be attributed to the initial ketone bodies formation during a calorie-restricted diet regimen, which subsided ∼3–4 days.⁷ This could be explained through the self-determination theory, which states that switching to a healthy diet requires motivated behavior, and healthy eating habits in turn mold an individual's behavior.⁸

The perceived benefits were both physical and psychological. The participants experienced a sense of well-being and exclaimed that the hospital was more like a “temple” and they did not feel as if they are patients anymore. The service provided by the doctors was much appreciated who themselves are regular yoga practitioners. The uniqueness of the hospital that includes individual attention, tailor-made treatment protocols, and one-to-one care provided to the needy patients by the intern doctors was highlighted by the participants during the FGD. On the whole, the participants perceived that the current government hospital facility is better that even private hospitals, or other conventional medicine government hospitals where they have been previously admitted.

The referral from conventional medical practitioners or hospitals, however, seems to be very limited. The active integration of evidence-based TCIM systems of medicine with conventional medicine holds the potential to provide greater value and benefits to patients. Moving beyond the treatment of isolated disease conditions, adopting a holistic approach to health care can significantly enhance overall individual well-being. This shift from a passive role of “receiving treatment for a specific ailment” to becoming “active decision makers” in lifestyle modifications brings about considerable advantages. Achieving this transformation requires the proactive blending of conventional and complementary medicine systems.

Conclusion

The holistic treatment provided at the Y&N treatment facility provides beneficial effects at physical, psychological, and emotional levels to the patients. An integrated approach between conventional medicine and Y&N would help in better management of many physical and mental disorders.

Footnotes

Acknowledgments

The authors are thankful to all patients for sharing their time and experience

Authors' Contributions

S.S. and S.P. designed and planned the study. S.P. conducted FGD. R.P., S.Pa., P.R.S., and S.P. collected the data. V.V. analyzed the data and interpreted the results. R.P., S.Pa., V.V., and K.M. wrote the article. All authors reviewed the final article.

Author Disclosure Statement

No competing financial interests exist.

Funding Information

No funding was received for this article.

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