This is an integrative literature review of the utilisation of reflexology as complementary and alternative treatment modality in adults with chronic disease. Anecdotal evidence has claimed potential health benefits of reflexology for patients with various chronic diseases. In this study, selected databases that were accessible were searched using keywords such as reflexology therapy, zone therapy and combinations thereof. Databases such as SA Nexus, SAePublications, ProQuest, Web of Knowledge, EBSCOhost Platform, ScienceDirect, Cochrane Library and Google Advanced Scholar were searched for primary studies and reviews of primary studies from 2000 until the end of 2008 (N = 1171). Primary experimental and non-experimental studies in any language with an abstract in English were identified. Only studies that complied with the inclusion criteria were reviewed and appraised (n = 35) for study quality with appropriate tools from the Critical Appraisal Skills Programme (CASP) and the American Dietetic Association's (ADA) Evidence analysis manual. Evidence extraction, analysis and synthesis were done to review available evidence by means of the evidence class rating and evidence grading of strength prescribed in the ADA's manual. Study findings represent a statistical significant reduction in the frequency of seizures of patients with intractable epilepsy, an improvement of sensory and urinary symptoms associated with multiple sclerosis and a clinical significant reduction of pain and anxiety in patients with cancer and fibromyalgia syndrome to increase overall well-being and quality of life. No statistical significant evidence was reported on benefits of reflexology for irritable bowel syndrome, menopausal symptoms, chronic low back pain and asthma. Thus there appears to be fair evidence of the effectiveness of reflexology, in addition clinical evidence supports the utilisation of reflexology to promote well-being and quality of life in adults with chronic disease. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2010

This is an integrative literature review of the utilisation of reflexology as complementary and alternative treatment modality in adults with chronic disease. Anecdotal evidence has claimed potential health benefits of reflexology for patients with various chronic diseases. In this study, selected databases that were accessible were searched using keywords such as reflexology therapy, zone therapy and combinations thereof. Databases such as SA Nexus, SAePublications, ProQuest, Web of Knowledge, EBSCOhost Platform, ScienceDirect, Cochrane Library and Google Advanced Scholar were searched for primary studies and reviews of primary studies from 2000 until the end of 2008 (N = 1171). Primary experimental and non-experimental studies in any language with an abstract in English were identified. Only studies that complied with the inclusion criteria were reviewed and appraised (n = 35) for study quality with appropriate tools from the Critical Appraisal Skills Programme (CASP) and the American Dietetic Association's (ADA) Evidence analysis manual. Evidence extraction, analysis and synthesis were done to review available evidence by means of the evidence class rating and evidence grading of strength prescribed in the ADA's manual. Study findings represent a statistical significant reduction in the frequency of seizures of patients with intractable epilepsy, an improvement of sensory and urinary symptoms associated with multiple sclerosis and a clinical significant reduction of pain and anxiety in patients with cancer and fibromyalgia syndrome to increase overall well-being and quality of life. No statistical significant evidence was reported on benefits of reflexology for irritable bowel syndrome, menopausal symptoms, chronic low back pain and asthma. Thus there appears to be fair evidence of the effectiveness of reflexology, in addition clinical evidence supports the utilisation of reflexology to promote well-being and quality of life in adults with chronic disease. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2010

As a prerequisite for all adult learners in life-long learning, self-directed learning has been constantly discussed since the early 1960s. However, in what manner research operationalizes the concepts and what similarities occur across the empirical studies and theoretical studies are still ambiguous. The purpose of this study is to employ an integrative literature review to investigate and disentangle various interpretations of self-directed learning by identifying how the topic is defined and what competencies and strategies are needed for a highly self-directed learner. This is a six-phase study, including: 1) problem formulation; 2) data collection; 3) problem re-formulation; 4) data evaluation; 5) data collection; and 6) presentation of the findings. This study provided a comprehensive perspective of self-directed learning in a dynamically expanding process to include multifaceted interpretations of the topic and advanced research in self-directed learning in an updated, enriched learning environment. Specifically, the researcher updated the evidence for self-directed learning to date, identified all of the potential dimensions of self-directed learning that distinguish a highly-directed self-directed learner and the related instructional strategies, and made suggestions for the future direction of research on the topic. / Ph. D.

CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior / O comportamento antissocial à um conceito polissÃmico que se encontra presente na prÃtica e no corpus teÃrico de Ãreas como o Direito, a Psicologia, a Psiquiatria e a Sociologia, assumindo uma multiplicidade conceitual anÃloga aos seus vÃrios campos de abordagem. NÃo hà consenso sobre a natureza e dimensionalidade do comportamento antissocial, fazendo com que, nesse contexto plural, despontem uma sÃrie de modelos explicativos do fenÃmeno. Nesse sentido, o presente estudo tem por objetivo analisar a organizaÃÃo epistemolÃgica das teorias explicativas do comportamento antissocial. Para tanto, apresenta-se delineado como revisÃo integrativa de literatura, buscando alÃm de apresentar e descrever o fenÃmeno, conhecÃ-lo e analisÃ-lo dentro de seu contexto sÃcio-histÃrico. Para construÃÃo dessa revisÃo, foram selecionadas as bases de dados APA-PsycArticles, Lilacs e Redalyc. Da mesma forma, adotou-se os seguintes filtros: descritor Ãnico Antisocial Behavior; produÃÃes do tipo artigo de periÃdico; nos idiomas PortuguÃs, InglÃs e Espanhol; no intervalo temporal de 2006 a 2016; e nas Ãreas das CiÃncias Humanas, Sociais e da SaÃde. Como suporte ao processo de organizaÃÃo dos dados, foi feito uso do software Atlas.ti (versÃo 5). Selecionou-se um total de 95 artigos, detalhados da seguinte forma: em termos de bases de dados, obteve-se 26 artigos na APA-PsycArticles, 20 na Lilacs e 49 na Redalyc; no que se refere ao idioma, foram 35 em InglÃs, 38 em Espanhol e 22 em PortuguÃs; em relaÃÃo ao mÃtodo, 19 foram de natureza documental/revisional/teÃrico e 76 sÃo estudos de campo/empÃricos/experimental; em termos de amostra, destacou-se as que empregavam crianÃas e adolescentes em suas avaliaÃÃes, com 48,6% do total de estudos de campo/empÃrico/experimental. ApÃs analisados, os artigos foram organizados em funÃÃo de sua fundamentaÃÃo epistemolÃgica, delineando-se em quatro grandes aproximaÃÃes: clÃnicopsiquiÃtrica (27 artigos), comportamental (28 artigos), legal (17 artigos) e sociolÃgica (23 artigos). Cada uma destas apresentou eixos temÃticos prÃprios que foram discutidos, a fim de clarificar as abordagens mais proeminentes acerca do construto. Na parte final do estudo, em contraponto Ãs aproximaÃÃes expostas, apresentou-se os modelos integrativos de compreensÃo do fenÃmeno a partir de uma epistemologia pluralizada. Essa pesquisa construiu um vasto apanhado epistemo-metodolÃgico dos modelos e teorias explicativas do comportamento antissocial, inÃdito em lÃngua portuguesa, que se espera servir de referÃncia aos estudos e trabalhos nas Ãreas multidisciplinares para as quais o tema surge como demanda relevante. / Antisocial behavior is a polysemic concept that is present in the practice and in the theoretical corpus of areas such as Law, Psychology, Psychiatry and Sociology, assuming a conceptual multiplicity analogous to its various fields of approach. There is no consensus on the nature and dimensionality of antisocial behavior, giving rise to a series of explanatory models of the phenomenon. In this sense, the present study aims to analyze the epistemological organization of theories explaining antisocial behavior. Therefore, it is presented as an integrative literature review, seeking to present and describe the phenomenon, as well as to know and analyze it within its socio-historical context. To construct this review, the APA-PsycArticles, Lilacs and Redalyc databases were selected, as well as the following filters: single descriptor Antisocial Behavior; scientific article type productions; in Portuguese, English and Spanish; in the time period from 2006 to 2016; and in the areas of Human, Social and Health Sciences. The Atlas.ti software (version 5) was used to support the data organization process. A total of 95 articles were selected, detailed as follows: in terms of databases, we obtained 26 articles in APAPsycArticles, 20 in Lilacs and 49 in Redalyc; in terms of language, there were 35 in English, 38 in Spanish and 22 in Portuguese; in relation to the method, 19 were of a theoretical nature and 76 are empirical studies; in terms of sample, the ones that used children and adolescents in their evaluations were highlighted, with 48.6% of the total empirical studies. After analyzed, the articles were organized according to their epistemological basis, outlining four major approaches: clinical-psychiatric (27 articles), behavioral (28 articles), legal (17 articles) and sociological (23 articles). Each one presented its own thematic axes that were discussed in order to clarify the most prominent approaches to the construct. In the final part of the study, in contrast to the exposed approaches, we presented the integrative models of understanding the phenomenon from a pluralized epistemology. This research constructed a vast epistemologicalmethodological survey of the models and theories that explain the antisocial behavior, unpublished in Portuguese language, which hopes to serve as reference to studies and works in the multidisciplinary areas for which the theme emerges as a relevant demand.

Blended/hybrid learning, a combination of face to face and online learning to deliver instruction, is growing in popularity at institutions of higher education, and may lead to many benefits for students, faculty, and administrators. However, the implementation of blended learning (BL) is a complex process. Although the move towards BL adoption is generally accepted by faculty, questions still remain when it comes to adopting and implementing standards across institutions. Given this problem, this integrative literature review was conducted to identify possible factors that impact the process of implementing BL smoothly and successfully at higher education institutions. The purpose of this study was to identify related institutional factors from empirical studies published from 2000 to 2020. Findings from this study may offer institutions a guide to effectively create, execute, and assess BL programs and courses. The study provides recommendations that may be impactful for decision-makers at Saudi higher education institutions. / Doctor of Philosophy / Blended/hybrid learning, a combination of face to face and online learning to deliver instruction, has become popular at universities because it provides advantages for students, faculty members, and the university itself. However, the implementation of blended learning (BL) is a challenging process, and in many instances there is not enough guidance available to assist universities through the process. For this reason, this study has been conducted with the goal of identifying possible factors relating to implementing BL smoothly and successfully at universities. Findings from this study may offer institutions a guide to effectively create, execute, and assess BL programs and courses. The study provides recommendations that may be impactful for decision-makers at Saudi universities

Introduktion: I Sverige har vårdrelaterade infektioner blivit en av de vanligaste vårdskadorna och på avdelningar med stora patientflöden, som till exempel på röntgenavdelningar, finns en ökad risk för smittspridning. Patienters olika medicinska tillstånd och skiftande miljöer de kommer från bidrar till en varierad bakterieflora på röntgenavdelningar. Syfte: Syftet med denna integrativa litteraturstudie var att beskriva hur röntgensjuksköterskor tillsammans med övrig hälso- och sjukvårdspersonal kan arbeta för att minska spridningen av vårdrelaterade infektioner med hjälp av basala hygienrutiner. Metod: Utifrån tre frågeställningar angående vårdrelaterade infektioner eftersöktes vetenskapliga artiklar i databaserna PubMed och CINAHL. 17 Artiklar granskades efter inspiration från Willman, Stoltz och Bahtsevani (2006) och analyserades enligt Whittemore och Knafls (2005) fem steg. Resultat: Av artiklarna som hittades tog två kategorier och sex underkategorier form. Kategorierna omfattade kontamineringsrisk och metoder och hjälpmedel för att hindra smittspridning med underkategorier som patienten, omgivning och utrustning. Slutsats: Röntgensjuksköterskor och utrustningen de använder i den dagliga omvårdnaden är en risk för smittspridning. Följsamheten av de basala hygienrutinerna behöver höjas och för att detta ska uppnås kan förbättringsarbeten användas. / Introduction: Healthcare-associated infections has become one of the more frequent injuries related to healthcare in Sweden and in departments with a great flow of patients, as in a radiology department, there is an increased risk for spread of contagion. The different medical conditions of patients and the variation of environments they come from contribute to a varying bacterial flora in a radiology department. Aim: The aim of this integrative literature review was to describe how radiology nurses, along with other healthcare professionals, can work to reduce the spread of healthcare-associated infections by means of basic hygiene routines. Method: Based on three formulated questions regarding healthcare-associated infections scientific articles were scoured in the databases PubMed and Cinahl. 17 articles were reviewed with inspiration from Willman, Stoltz och Bahtsevani (2006) and were analyzed with Whittemore and Knafl’s (2005) five steps. Result: From the articles two categories and six subcategories were formed. The categories contained risks of contamination and methods and aids to prevent contagion with subcategories such as the patient, the surroundings and equipment. Conclusion: Radiography nurses and the equipment used in daily care is a risk of contagion. The adherence to basic hygiene routines needs to be raised and for this to be achieved improvement interventions can be used.

The survival rate and life expectancy of infants with complex health needs have increased overthe last decades, and this increases the number of families who have to care for such infants at home. These families seek support in the community setting, and supporting them has a positive impact on the well-being of both the parents and the infant. In South Africa the needs of these parents are not known, and this fact makes it difficult to adequately support them in the community. The aim of this study was to explore and describe the needs of parents of infants with complex health needs in the community setting. Two objectives were set to reach the aim mentioned above: 1) to critically appraise and synthesise the best available evidence on the support needs of parents of infants with complex health needs and 2) to explore and describe parents’ emic perspective on their support needs as parents of infants with complex health needs in a South African context. A sequential mixed method approach was utilised in two phases, here discussed in five chapters. In an attempt to meet objective one, the support needs of parents of infants with complex health needs were determined by means of an integrative literature review from studies obtained through computerised searches of several electronic databases, supplemented by checking reference lists and consultation with experts. This was followed by individual face-to-face interviews with the stated parents in three different settings. The latter addressed the second objective of the study, namely to provide an emic perspective on the support needs of parents of infants with complex health needs in a South African context. The integrative literature review described five main themes on the support needs of parents of infants with complex health needs: need for information, need for parent-to-parent support, need for professional support, need for self-confidence in the care of the infant and need for social support. All of these themes were confirmed in the South African context through the interviews with parents. However, South African parents added an additional theme: the need for normality. The final chapter offers an evaluation of the study and discusses study limitations and recommendations for nursing practice, education and research. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

The survival rate and life expectancy of infants with complex health needs have increased overthe last decades, and this increases the number of families who have to care for such infants at home. These families seek support in the community setting, and supporting them has a positive impact on the well-being of both the parents and the infant. In South Africa the needs of these parents are not known, and this fact makes it difficult to adequately support them in the community. The aim of this study was to explore and describe the needs of parents of infants with complex health needs in the community setting. Two objectives were set to reach the aim mentioned above: 1) to critically appraise and synthesise the best available evidence on the support needs of parents of infants with complex health needs and 2) to explore and describe parents’ emic perspective on their support needs as parents of infants with complex health needs in a South African context. A sequential mixed method approach was utilised in two phases, here discussed in five chapters. In an attempt to meet objective one, the support needs of parents of infants with complex health needs were determined by means of an integrative literature review from studies obtained through computerised searches of several electronic databases, supplemented by checking reference lists and consultation with experts. This was followed by individual face-to-face interviews with the stated parents in three different settings. The latter addressed the second objective of the study, namely to provide an emic perspective on the support needs of parents of infants with complex health needs in a South African context. The integrative literature review described five main themes on the support needs of parents of infants with complex health needs: need for information, need for parent-to-parent support, need for professional support, need for self-confidence in the care of the infant and need for social support. All of these themes were confirmed in the South African context through the interviews with parents. However, South African parents added an additional theme: the need for normality. The final chapter offers an evaluation of the study and discusses study limitations and recommendations for nursing practice, education and research. / Thesis (MCur)--North-West University, Potchefstroom Campus, 2013.

En akutsjuksköterska möter varje dag patienter som utsatts för våld. Detta skapar osäkerhet och oro hos akutsjuksköterskan eftersom brist på utbildning och verktyg genom-syrar arbetet med den forensiska patienten. Vårdmötet med patienten som utsatts för våld ställer stora krav på akutsjuksköterskans kunnande att både bedriva en säker forensisk omvårdnad samtidigt som vårdmötet ska ske med omsorg och värdighet. Syftet med studien är att utforska tillgänglig litteratur gällande akutsjuksköterskors kunskap gällande forensisk omvårdnad på akutmottagning. Examensarbetet genomfördes som en systematisk och integrativ litteraturstudie där 13 artiklar med både kvalitativ och kvantitativ ansats granskades. Det redovisade resultatet innehåller artiklar från sex kontinenter vilket visar på en geografisk spridning. En tematisk analys genomfördes. Resultatet redovisas i tre teman: Kunnandet om det forensiska arbetet, rutiner och riktlinjer om det forensiska arbetet och mötet med våldsutsatta patienter. Resultatet visade att akutsjuksköterskan upplever stora brister i utbildning och tillgång på verktyg som kan användas i det forensiska arbetet. Dessa brister skapar otrygghet och rädsla hos akutsjuksköterskan i omhändertagandet av den våldsutsatta patienten. Avsaknad av rutiner och policydokument leder till att akutsjuksköterskan inte vill vara en del av den forensiska omvårdnaden. Känslorna som akutsjuksköterskan upplever påverkar vårdmötet med patienten som utsatts för våld. Akutsjuksköterskan behöver fokusera på att skapa ett omtänksamt vårdmöte och vara närvarande för att minska patientens lidande. Genom ett öppet förhållningssätt och förmågan att visa medmänsklighet kan akutsjuksköterskan lindra framtida men för patienten som utsatts för våld. / Every day, an emergency nurse meets patients who have been subjected to violence. That creates uncertainty and anxiety for the emergency nurse as lack of training, education and available praxis affects the work around the forensic patient. To meet with patients who are victims of violence puts high demands on the emergency nurse knowledge to operate forensic nursing and at the same time nurse for the patient vid dignity and care. The aim of this study is to explore all available litterature about the emergency nurse’s knowledge among forensic nursing in the emergency department. This thesis was carried out as a systematic integrative litterature review where 13 articles with both qualitative and quantitative data were analysed. The carrying result includes articles from 6 continents which shows a widespread. A thematic analyse was carried out through the method designed by Braun and Clarke. The result is presented in three themes: the knowledge of the forensic work, routines and guidelines in the forensic and meeting with the patient who are victim of violence. The results show that the emergency nurse experiences major deficiencies in training and access to tools that can be used in forensic work. These shortcomings create insecurity and fear among the emergency nurse in the care of the abused patient. Lack of routines and policy documents leads to the emergency nurse not wanting to be part of the forensic care. The feelings experienced by the emergency nurse affect the care meeting with the patient who has been subjected to violence. The emergency nurse needs to focus on creating a caring meeting and be present to reduce the patient's suffering. Through an open approach and the ability to show compassion, the emergency nurse can alleviate future but for the patient who has been subjected to violence.

Mobila intensivvårdsgrupper (MIG) är inrättade på sjukhus världen över, som en resurs att aktivera när patienter på vårdavdelningar försämras i sitt sjukdomstillstånd. MIG, med sin specialistkompetens, minskar antalet allvarliga händelser på sjukhus och minskar mortaliteten vid korrekt användning. Trots detta föreligger indikationer på att MIG under används och idagsläget finns det behov av översikter över befintligt kunskapsläge. Syftet med studien är därför att beskriva vårdares upplevelser av barriärer till MIG-aktivering. Studien är genomförd som en integrativ litteraturöversikt bestående av 16 artiklar, sju kvantitativa, sex kvalitativa och tre med mixad metod. Litteratursökningen genomfördes i januari 2023 i databaserna Cinahl och Medline och genererade totalt 1835 träffar. En systematisk urvalsprocess och kvalitetsgranskning av litteraturen utfördes och i samband med dataanalysen bildades tre övergripande teman. Dessa teman är benämnda organisationens betydelse för MIG-aktivering, kunskapsnivåns betydelse för MIG-aktivering och attityders betydelse för MIGaktivering. Resultatet visar att MIG-situationer triggar ett spektrum av komplexa utmaningar för involverade vårdare, främst bestående av rutinrelaterade, kunskapsmässiga och sociokulturella orsaker. Avdelningssjuksköterskans roll är att bedöma när en MIG-aktivering behöver göras. Detta kan leda till känslor av otillräcklighet, och ifrågasättande av sin egen kompetens, grundat i bland annat negativa attityder och bristande interprofessionellt samarbete. MIG-sjuksköterskan har en multifacetterad uppgift som bland annat innefattar att ha ett helhetsperspektiv och arbeta strukturerat med att stabilisera patienter, kommunicera samt delegera uppgifter utefter iakttagelser. Dessa uppgifter integreras med att utgöra en mentorsroll för avdelningssjuksköterskan, där det är av vikt att inte negligera oro. Ur ett patientperspektiv ses en sårbar patient med ett stort behov av vård. Vård riskerar att utebli relaterat till barriärer till utebliven MIG-aktivering. Följaktligen motiveras en korrekt användning av MIG för att främja hälsa och förebygga lidande. / Mobile intensive care teams (MIG) are set up in hospitals worldwide, as a resource to activate when patients deteriorate. MIG, with its specialist skills, reduces the number of serious events in hospitals and reduces mortality when used correctly. Despite this, there are indications that MIG is underused and currently there is a need for overviews of the current state of knowledge. The purpose of the study is therefore to describe careers’ experiences of barriers to MIG activation. The study is conducted as an integrative literature review consisting of 16 articles, seven quantitative, six qualitative and three with a mixed method. The literature search was conducted in January 2023 in the databases Cinahl and Medline and generated a total of 1835 search hits. A systematics election process and quality review of the literature was carried out and in connection with the data analysis three overarching themes were formed. These themes are named the importance of the organization for MIG activation, the importance of the level of knowledge for MIG activation and the importance of attitudes for MIG activation. The results show that MIG situations trigger a spectrum of complex challenges for the careers’ involved, mainly consisting of routine, knowledge-related and sociocultural reasons. The ward nurse's role is to assess when a MIG activation needs to be done. This can lead to feelings of inadequacy, and questioning of one's own competence, based on, among other things, negative attitudes and a lack of interprofessional cooperation. The MIG nurse has a multifaceted task which includes, among other things, having a holistic perspective and working in a structured way to stabilize patients, communicate and delegate tasks based on observations. These tasks are integrated with forming a mentoring role for the ward nurse, where it is important not to neglect concerns. From a patient perspective, a vulnerable patient with a great need for care is seen. There is a risk for missed care related to to non-existent MIG activation. Accordingly, proper use of MIG is warranted to promote health and prevent suffering.