Thesis (M. Eng.)--Carleton University, 1992. / Also available in electronic format on the Internet.

Thesis (Ph. D.)--Ohio State University, 2006. / Title from first page of PDF file. Includes bibliographical references (p. 117-121).

Thesis (Ph. D.)--University of Texas at Austin, 2007. / Vita. Includes bibliographical references.

Thesis (MScIng)--University of Stellenbosch, 2006. / Bibliography. Also available via the Internet.

No description available.

Aim: The overall aim of this thesis was to acquire knowledge about whether tactile touch as a complementary method can (i) promote comfort and (ii) reduce stress reactions during care in an intensive care unit (ICU) Method: In Paper I, five nurses with a touch therapist training were interviewed about their experiences of preparation before giving tactile touch in an ICU. To analyse the meaning of preparation as a phenomenon, Giorgi’s descriptive phenomenological approach was used. In Paper II and III a randomised controlled trial was set up to investigate the effects of a five-day tactile touch intervention on patients’ oxytocin levels in arterial blood (II), on patients’ blood pressure, heart rate and blood glucose level, and on patients’ levels of anxiety, sedation and alertness (III). Forty-four patients were randomised to either an intervention group (n = 21) or a control group (n = 23). Data were analysed with non-parametric statistics. In Paper IV, six patients who had received the tactile touch intervention were interviewed to illuminate the experience of receiving tactile touch during intensive care. To gain a deeper understanding of the phenomenon and to illuminate the meaning, Ricoeur’s phenomenological hermeneutical method, developed by Lindseth and Norberg, was used. Findings: The nurses need four constituents (inner balance, unconditional respect for the patients’ integrity, a relationship with the patient characterized by reciprocal trust and a supportive environment) to be prepared and go through the transition from nurse to touch therapist (I). In the intervention study, no significant differences were shown for oxytocin levels between intervention and control group over time or within each day (II). There were significantly lower levels of anxiety for patients in the intervention group. There were no significant differences between the intervention and control groups for blood pressure, heart rate, the use of drugs, levels of sedation or blood glucose levels (III). The significance of receiving tactile touch during intensive care was described as the creation of an imagined room along with the touch therapist. In this imagined room, the patients enjoyed tactile touch and gained hope for the future (IV). Conclusion: Nurses needed internal and external balance to be prepared for providing tactile touch. Patients did not notice the surroundings as much as the nurses did. Patients enjoyed the tactile touch and experienced comfort. The impact on stress parameters were limited, except for levels of anxiety which declined significantly. The results gave some evidence for the benefit of tactile touch given to patients in intensive care. / <p>För avläggande av filosofie doktorsexamen i omvårdnad, som med</p><p>tillstånd av Fakultetsnämnden vid Fakulteten för samhälls- och livsvetenskaper vid</p><p>Karlstads universtitet framläggs till offentlig granskning fredagen den 18 april 2008 kl.10:00</p><p>M204, Högskolan i Borås.</p>

published_or_final_version / Electrical and Electronic Engineering / Doctoral / Doctor of Philosophy

Chronic diseases such as diabetes, cardiovascular disease, cancer, and depression exist in 45% of the U.S. population and are responsible for 70% of the deaths and 75% of the $2 trillion in annual medical expenditures. Healthy eating, being physically active, managing stress, and avoiding tobacco have well-documented relationships to improved health and well-being, and chronic disease prevention.Integrative healthcare, a holistic approach to care that is patient-centered, personalized, and focused on health and well-being, incorporates conventional and complementary and alternative medicine (CAM). Integrative healthcare has the potential to provide high quality care that prevents illness and promotes optimal wellness, resulting in decreased health care costs and a healthier nation. Although integrative healthcare is increasing in popularity, few integrative healthcare programs have been studied and relatively little is known about the processes, outcomes, feasibility, efficacy, effectiveness, or sustainability of these programs.The purpose of this project was to evaluate selected organizational processes and patient outcomes of an integrative health care program. The three specific aims of the project were to analyze the program theory through the development and evaluation of the program logic model, to evaluate selected organizational processes, and to examine selected client outcomes, including satisfaction.This inquiry used the CDC Framework for Program Evaluation as a guide. The study employed a descriptive design with both qualitative and quantitative methods, including key informant interviews with program staff and a client focus group. De-identified data on pre and post measurements of client Wellness Inventory scores, weight, BMI, and advanced cardiac panels, and post program surveys obtained from the program director were analyzed using descriptive statistics and the paired t test or the Wilcoxon signed-rank test.The evaluation of an existing integrative healthcare program provides potentially useful information to the stakeholders of the program and a valuable referral resource for other providers in the community. Dissemination of the information may also be used as a model and an inspiration for other advanced practice nurses to develop innovative practice models that support holistic, wellness-focused care.

Purpose: The objectives of this pilot study for women breast cancer survivors with lymphedema was 1) to evaluate recruitment rates, retention rates, adherence to Bowenwork (a noninvasive complementary therapy involving gentle muscle movements), home exercises, safety and comfort; 2) determine the effect of Bowenwork on quality of life (QOL), functional status, perceived pain, range of motion (ROM), arm/ankle circumference (to assess for localized and systemic changes). Methods: Participants received 4 Bowenwork sessions with home exercises. Initial and post assessments included QOL, functional status, and pain. ROM, arm/ankle circumference and pain measures were recorded before each session. Results: Twenty-one women enrolled in the study; 95% completion; adherence 100%; home exercises 95%; no adverse events. The intervention improved mental health (SF-36-MCS); breast cancer-related functional (FACT-B); increased ROM; reduced arm circumferences. P value set at <0.05. Conclusions: The Bowenwork intervention was safe and acceptable for women breast cancer survivors with lymphedema.

Cancer is a life-changing disease that introduces an abundance of psychosocial stress into patient's lives. Exposure to psychosocial stress over periods of weeks or more has a maladaptive effect on the human immune system. Chronic psychosocial stress means elevated activates the hypothalamic-pituitary-adrenal (HPA) and the sympathetic-adrenomedullary (SAM) axes which over time induce deleterious physiological effects in the form of glucocorticoid resistance, chronic low-level inflammation, and inhibition of leukocyte telomerase activity. Because these down-stream physiologic effects of psychosocial stress have oncogenic implications, the effective management of chronic stress inherent to a cancer diagnosis should positively impact the efficacy of current cancer therapies. Mindfulness is an age-old concept that has recently gained traction in the medical community for its utility as a cognitive therapy in treating patients with mental health disorders. Although the study of mindfulness as a complementary cancer therapy is in its relative infancy, other examples of mind-body medicine have already been documented to help treat many psychological side effects of cancer including anxiety, depression, sleep deprivation, and pain. It has been theorized that mindfulness acts by providing a cognitive strategy to buffer the harmful effects of psychosocial stress. Mindfulness elicits discrete effects on human psychology and physiology that are conducive to the efficacy of current cancer treatments. Mindfulness techniques have shown promise in providing relief for many of the psychological side effects of a cancer diagnosis. In this thesis, we explore the psychological and physiological effects of mindfulness practice that counter-act many of the harmful consequences of chronic stress exposure specifically immunosuppression, chronic inflammation, and telomerase activity.