Reflexology is one of the top six complementary therapies used in the UK. Reflexologists claim that massage to specific points of the feet increases blood supply to referred or 'mapped' organs in the body. Empirical evidence to validate this claim is scarce. This three-phase RCT measured changes in haemodynamic parameters in subjects receiving reflexology treatment applied to specific areas of the foot which are thought to correspond to the heart (intervention) compared with reflexology applied to other areas on the foot which are not (control).

Published Article / According to Wills reflexology entails the division of the body into ten zones, concentrating on the pressure points on the feet, with each foot representing five zones (2006: Online). Colour therapy uses the vibrational frequencies of colour to restore the client's health. Colour zone therapy on the other hand, is a combination of reflexology and colour therapy. Zone refers to the working of key points on the feet, where colour refers to the assessment of the condition and treating it with the correct colour's frequency (Gimbel, 1993: 2-3). Reflexology uses a physical stimulus and colour therapy, emotional stimulus, thus colour zone therapy addresses both. In this study the researcher's objective was to investigate treatments with reflexology compared with treatments of colour zone therapy, by treating chronic sinusitis to explore the influence of colour on the outcome of reflexology treatments. Ten chronic sinusitis-suffering clients were treated with reflexology in a white cubicle. Another ten clients were treated with colour zone therapy (thus colour therapy as well as reflexology). They had indigo coloured paper in their hands. Results were obtained as case studies, with clients reporting how they felt before and after each treatment. Each client received five treatments. The results indicated that the reflexology clients did experience an improvement after the fourth treatment. By the fifth treatment three of the ten clients had discharged some mucus. However, clients treated with colour zone therapy showed results after the second treatment. At the fourth treatment, already seven of the ten colour zone therapy clients had discharged a large amount of mucus. This concludes that treating a condition with colour, in combination with another treatment provides better and quicker results.

Background The incidence of hypertension is increasing in developing countries such as Thailand (Chaiteerapan et al 1997; Ministry of Public Health 2001; National Library of Thailand Cataloguing in Publication Data 2001) as a result of sociological, political and economic changes. These changes are producing enormous alterations in people�s lifestyles, following similar trends in western countries (National Economic and Social Development Board 1997). Negative changes in food consumption, alcohol consumption, level of physical activity, smoking, stress and tension have led to an increase in chronic health problems for Thai people (National Economic and Social Development Board 1997). Age, gender, ethnicity, genetic background, family health history and hyperlipidaemia are likely to influence hypertension (Kaplan, Lieberman & Neal 2002; Mancia et al 2002; Manger & Gifford 2001; National Heart Foundation of Australia 2003). It has been found that health care professionals and patients with chronic disease have increased their use of complementary therapies to help relieve uncomfortable symptoms and suffering (Long, Huntley & Ernst 2001). Foot reflexology is a well known complementary therapy which claims to help the body achieve homeostasis (Byers 2001; Dougans 2002). It is believed that pressing specific areas on the feet related to specific glands or organs of the body can help these glands and organs to function at their peak, allowing the body to heal itself (Byers 2001; Dougans 2002). The principle difference between massage or touch and foot reflexology is that foot reflexology provides not only the relaxation effect obtained from massage or touch is said to also improve body�s immunity contributing to healing process (Byers 2001;Dougans 2002). Foot reflexology has been scientifically researched in many studies to explore the claimed benefits (Bishop 2003; Kohara et al 2004; Oleson & Flocco 1993; Siev-Ner et al 2003; Yang 2005). Some studies have supported its ability to reduce anxiety and pain (Gambles, Crooke & Wilkinson 2002; Launso, Brendstrup & Arnberg 1999; Stephenson, Dalton & Carlson 2003; Stephenson, Weinrich & Tavakoli 2000). However, there has been little scientific evidence to support the claim that foot reflexology can reduce blood pressure and serum lipids, and can improve the quality of life in patients with hypertension (Hodgson 2000; Milligan et al 2002; Park & Cho 2004). The purpose of this study was to begin to fill this gap by investigating the influence of foot reflexology on blood pressure, serum lipids and quality of life. Aim The aim of this study was to investigate the effect of foot reflexology on reducing blood pressure in patients with hypertension. To this end, patients receiving reflexology were compared with patients receiving a light foot massage, thus controlling for any effects contributed by massage or touch alone. Null hypotheses 1. There is no difference in mean blood pressure level between the foot reflexology group and the light foot massage group at the end of four weeks of treatment. 2. There is no difference in mean low density lipoprotein (LDL) cholesterol and triglyceride levels between the foot reflexology group and the light foot massage group at the end of four weeks of treatment.3. There is no difference in mean quality of life scores between the foot reflexology group and the light foot massage group at the end of four weeks of treatment. Sample A sample size of 128 was required to yield a power of 80%, if the difference in mean diastolic blood pressure between the two groups was 5 mmHg. One hundred twenty eight patients with hypertension who attended the hypertensive clinic in the medical outpatients department of Phramongkutklao Hospital, Bangkok, Thailand were enrolled and participated in the study. Methods Data collection This study used a randomized controlled trial design. Participants were randomly allocated into one of two groups � 64 participants in the foot reflexology group (intervention) and 64 in the light foot massage group (control). Data collection took place over 4� months between 26 July and 9 December 2004. Ethics approval was obtained from both the university and hospital ethics committees. Prior to randomization, participants were asked to complete a demographic data questionnaire and the World Health Organization Quality of Life-BREF (WHOQOLBREF) (World Health Organization 1996) questionnaire. Blood was drawn to test LDL cholesterol and triglyceride levels. Using an intervention protocol based on previous literature (Byers 2001), participants in the foot reflexology group received their usual medical treatment and a 50-minute foot reflexology treatment twice a week for four weeks. Participants in the light foot massage group received their usualmedical treatment and a 30-minute light foot massage session without pressure on specific reflexology areas twice a week for four weeks. Blood pressure was recorded before and after each treatment. At the end of the study, participants were asked to complete the WHOQOL-BREF (World Health Organization 1996) again and blood was once more drawn to test LDL cholesterol and triglyceride levels. Data analysis An independent samples t-test followed by analysis of covariance was used to test for difference in mean diastolic blood pressure between treatment groups both unadjusted and adjusted for baseline values respectively. Descriptive statistics were used to present the demographic data. Results Demographic data Control and intervention groups were similar in gender, age, educational background, economic factors, lifestyle characteristics, co-morbidities and medical treatments. Demographic data which were substantially different between groups were marital status, the length of time experiencing hypertension and the length of time having treatment for hypertension. The study showed that fewer participants in the foot reflexology group (57.8%) were married than in the light foot massage group (70.3%). The foot reflexology group also had a higher rate (32.8%) of �divorced/separated/widowed� compared with the light foot massage group (20.3%). Participants in the light foot massage group had almost nine times the number of participants who had had hypertension for more than 15 years, and almost eight times the number of participants who had been having treatment for hypertension for more than 15 years, compared with those in the foot reflexology group. Outcome variables For both the unadjusted and adjusted analyses, there was no statistically significant difference between treatment groups post-intervention. Conclusions The results from this study did not support the claim that foot reflexology can decrease blood pressure, LDL cholesterol and triglyceride levels. Similarly, there was no evidence that it could improve the quality of life in patients with hypertension.

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

M.Tech. / The aim of this study was to determine the effects of the application of therapeutic reflexology as a complementary medicine, in women with cervical cancer who were receiving radiation therapy with curative intent. Therapeutic reflexology is a therapy that involves stimulating specific reflexes in the hands, feet, body and ears by applying pressure to these reflexes with the thumbs and fingers, using specific techniques. All the body’s organs, glands and other parts of the body are reflected in the feet, body, hands and ears can be stimulated by working over the skin surface with the thumbs and fingers for a specific effect. These specific reflexes have been mapped in miniature on the feet, hands, body and ears (Graham, 1998: 5). Therapeutic reflexology promotes homeostasis within the body, by stimulating reflexes pertaining to organs and glands, and achieving normalisation of organs and glands in the receiver of the treatment. The therapy is non - invasive and non - pharmacological, and has no contra-indications (Graham, 1998: 8). Therapeutic reflexology is often used as a complementary or alternative medicine, yet very little information is available on its effects, which requires further research (Milligan, 2002: 489-96). The number of cancer patients using reflexology as a complementary therapy to allopathic medicine is rapidly rising (Apostolides, 1998: 71-95) It is because of this rise in the number of patients seeking complementary therapy that it is of vital importance that more accurate, results-orientated information is made available to both the patient and the medical practitioner. These findings will allow the patient and medical practitioner to make an informed decision regarding the choices available to complement allopathic medicine, to enhance wellbeing, and achieve better results for the allopathic protocol. A sample group of forty-four women were chosen by simple random selection. Twenty three were treated with therapeutic reflexology, and twenty one were given the placebo treatment for six weeks, while undergoing radiation therapy. The patients chosen for the sample group had stage IIIb as well as stage IIb cervical cancer, and were receiving radiation treatment. The result of the study has been determined by evaluating a questionnaire answered by each patient, after each treatment. The control group who received placebo treatment answered the same questionnaire, formulated in accordance with the Likert Scale, for means of comparison.

Este estudo teve como objetivo avaliar o efeito da reflexologia podal sobre a integridade tissular dos pés de pessoas que apresentam o diagnóstico de enfermagem \"Risco de Integridade da Pele Prejudicada\". Tratou-se de um ensaio clínico randomizado, controlado e mascarado, desenvolvido em um ambulatório de especialidades de Ribeirão Preto, Estado de São Paulo. Dada a suscetibilidade para o diagnóstico de enfermagem mencionado, a população deste estudo foi constituída por pessoas com diabetes mellitus. No pré-teste (T0), foram coletadas as variáveis de caracterização, avaliado o resultado de enfermagem \"Integridade Tissular: pele e mucosas\" e seus indicadores relacionados aos pés de pessoas com diabetes mellitus (acompanhados por suas definições), estabelecido o diagnóstico de enfermagem \"Risco de integridade da pele prejudicada\", aplicada a Escala de Acurácia de Diagnóstico de Enfermagem (versão 2) e preenchido o Instrumento de avaliação dos critérios de elegibilidade. Os participantes elegíveis foram alocados em Grupo Intervenção e Grupo Controle. O Grupo intervenção recebeu, além das informações de rotina do serviço, 16 sessões de reflexologia podal, já o Grupo Controle recebeu apenas as informações de rotina do serviço. O pós-teste (T1) e o pós-teste (T2) ocorreram após o alcance da implementação de 12 e de 16 sessões de reflexologia podal, respectivamente, e consistiu na avaliação do resultado de enfermagem \"Integridade Tissular: pele e mucosas\" e de seus indicadores relacionados aos pés de pessoas com diabetes mellitus (acompanhados por suas definições). A amostra final do estudo foi composta por 78 participantes, sendo 40 do Grupo Intervenção e 38 do Grupo Controle. No pós-teste (T1) e no pós-teste (T2), ao se comparar os grupos, houve diferença nos escores do resultado de enfermagem \"Integridade Tissular: pele e mucosas\" (T1 e T2: valor p <0,001) e dos indicadores: Temperatura da pele (T1 e T2: valor p < 0,001), Hidratação (T1 e T2: valor p < 0,001), Textura (T1 e T2: valor p < 0,001), Perfusão tecidual (T1: Valor p = 0,008; T2: Valor p = 0,001), Distribuição de pelos na pele (T1: valor p = 0,039; T2: valor p = 0,031), Descamação da pele (T1 e T2: valor p < 0,001) e Edema (T1 e T2: valor p < 0,001). Ademais, ao se comparar o pós-teste (T1) e o pós-teste (T2) com o pré-teste (T0), o Grupo Intervenção apresentou melhora nos escores desses indicadores, enquanto o Grupo Controle apresentou piora ou manutenção dos mesmos. Nos demais indicadores - Sensibilidade, Elasticidade, Espessura, Integridade da pele, Pigmentação anormal, Lesões de pele, Tecido cicatricial, Crostas na pele, Eritema, Palidez, Necrose, Endurecimento e Varizes - diante da ausência de diferenças entre os grupos no pós-teste (T1) e no pós-teste (T2), não foi evidenciado efeito da terapia. Ao se comparar, contudo, o pós-teste (T1) e o pós-teste (T2) com o pré-teste (T0), nos indicadores \"Sensibilidade\", \"Elasticidade\", \"Endurecimento\" e \"Varizes\", o Grupo Intervenção apresentou melhora nos escores, enquanto o Grupo Controle apresentou piora nos escores do indicador \"Elasticidade\" e manutenção dos escores dos demais indicadores. O tamanho do efeito da intervenção sobre a integridade tissular dos pés dos participantes foi de grande magnitude tanto no pós-teste (T1) (ES = 1,370) quanto no pós-teste (T2) (ES = 1,538), o que sugere a manutenção do efeito de 12 sessões com 16 sessões da terapia. A guisa de conclusão, ao evidenciar os efeitos da reflexologia podal sobre a integridade tissular dos pés de pessoas com \"Risco de Integridade da Pele Prejudica\", esta investigação aprofundou os conhecimentos acerca da terapia e de sua utilização como uma possível estratégia de assistência à saúde. Ao mesmo tempo, a utilização de definições conceituais e definições e magnitudes operacionais no processo de avaliação dos efeitos da intervenção testada contribuíram para maior fidedignidade dos achados, visto que o emprego de tais definições auxiliam na diminuição de interpretações subjetivas acerca dos indicadores do resultado de enfermagem \"Integridade Tissular: pele e mucosas\" / This study aimed to evaluate the effect of foot reflexology on the tissue integrity of the feet of people with the nursing diagnosis \"Risk For Impaired Skin Integrity\". This was a randomized, controlled and masked trial, developed in an outpatient clinic of specialties at Ribeirão Preto, State of Sao Paulo. Given the susceptibility to the nursing diagnosis mentioned, the population of this study consisted of people with diabetes mellitus. In the pre-test (T0) were collected the characterization variables, evaluated the result of nursing \"Tissue Integrity: skin and mucous membranes\" and their indicators related to the feet of people with diabetes mellitus (accompanied by their definitions), established the diagnosis of nursing \"Risk For Impaired Skin Integrity\", applied the Nursing Diagnosis Accuracy Scale (version 2) and completed the evaluation instrument of the eligibility criteria. Eligible participants were divided into Intervention Group and Control Group. The Intervention Group received, in addition to the service routine information, 16 sessions of foot reflexology, since the Control Group received only routine information service. The post-test (T1) and the post-test (T2) occurred after the scope of the implementation of 12 and 16 sessions of foot reflexology, respectively, and consisted of the evaluation of nursing outcome \"Tissue Integrity: skin and mucous membranes\" and their indicators related to the feet of people with diabetes mellitus (accompanied by their definitions). The final sample consisted of 78 participants, 40 of the Intervention Group and 38 of the Control Group. In the post-test (T1) and post-test (T2), when comparing the groups, there were differences in the scores of nursing outcome \"Tissue Integrity: skin and mucous membranes\" (T1 and T2: p < 0.001) and indicators: Skin temperature (T1 and T2: p < 0.001) Hydratation (T1 and T2: p < 0.001), Texture (T1 and T2: p < 0.001), Tissue Perfusion (T1: p value = 0.008; T2: p value = 0.001), Hair growth on skin (T1: p = 0.039; T2: p = 0.031), Skin scaling (T1 and T2: p <0.001) and Edema (T1 and T2: value p < 0.001). In addition, when comparing the post-test (T1) and the post-test (T2) with pretest (T0), the Intervention Group showed improvement in the scores of these indicators, while the Control Group worsened or maintenance. In the other indicators - Sensation, Elasticity, Thickness, Skin integrity, Abnormal pigmentation, Skin lesions, Scar tissue, Skin flaking, Erythema, Blanching, Necrosis, Induration and Varicose veins - in the absence of differences between the groups in the post- test (T1) and post-test (T2) was not observed effect of therapy. By comparison, however, the post-test (T1) and the post-test (T2) with pretest (T0), the indicators \"Sensation\", \"Elasticity\", \"Induration\" and \"Varicose veins\", the Intervention Group showed improvement in scores, while the Control Group showed worse in score of \"Elasticity\" and maintenance of the others. The effect size of the intervention on the tissue integrity of the feet of the participants was of great magnitude in both the post-test (T1) (ES = 1,370) and the post-test (T2) (ES = 1.538), suggesting maintenance of therapy effect of 12 sessions with 16 sessions. Concludes that, by highlight the effects of foot reflexology on the tissue integrity of the feet of people with \"Risk For Impaired Skin Integrity\", this research deepened knowledge about the therapy and its use as a possible health care strategy. At the same time, the use of conceptual definitions and definitions and operational magnitudes in the evaluation of the effects of the tested intervention contributed to greater reliability of the findings, since the use of such definitions help in the reduction of subjective interpretations of the nursing outcome indicators \"Tissue Integrity: skin and mucous membranes\"

Este estudo teve como objetivo avaliar o efeito da reflexologia podal sobre a integridade tissular dos pés de pessoas que apresentam o diagnóstico de enfermagem \"Risco de Integridade da Pele Prejudicada\". Tratou-se de um ensaio clínico randomizado, controlado e mascarado, desenvolvido em um ambulatório de especialidades de Ribeirão Preto, Estado de São Paulo. Dada a suscetibilidade para o diagnóstico de enfermagem mencionado, a população deste estudo foi constituída por pessoas com diabetes mellitus. No pré-teste (T0), foram coletadas as variáveis de caracterização, avaliado o resultado de enfermagem \"Integridade Tissular: pele e mucosas\" e seus indicadores relacionados aos pés de pessoas com diabetes mellitus (acompanhados por suas definições), estabelecido o diagnóstico de enfermagem \"Risco de integridade da pele prejudicada\", aplicada a Escala de Acurácia de Diagnóstico de Enfermagem (versão 2) e preenchido o Instrumento de avaliação dos critérios de elegibilidade. Os participantes elegíveis foram alocados em Grupo Intervenção e Grupo Controle. O Grupo intervenção recebeu, além das informações de rotina do serviço, 16 sessões de reflexologia podal, já o Grupo Controle recebeu apenas as informações de rotina do serviço. O pós-teste (T1) e o pós-teste (T2) ocorreram após o alcance da implementação de 12 e de 16 sessões de reflexologia podal, respectivamente, e consistiu na avaliação do resultado de enfermagem \"Integridade Tissular: pele e mucosas\" e de seus indicadores relacionados aos pés de pessoas com diabetes mellitus (acompanhados por suas definições). A amostra final do estudo foi composta por 78 participantes, sendo 40 do Grupo Intervenção e 38 do Grupo Controle. No pós-teste (T1) e no pós-teste (T2), ao se comparar os grupos, houve diferença nos escores do resultado de enfermagem \"Integridade Tissular: pele e mucosas\" (T1 e T2: valor p <0,001) e dos indicadores: Temperatura da pele (T1 e T2: valor p < 0,001), Hidratação (T1 e T2: valor p < 0,001), Textura (T1 e T2: valor p < 0,001), Perfusão tecidual (T1: Valor p = 0,008; T2: Valor p = 0,001), Distribuição de pelos na pele (T1: valor p = 0,039; T2: valor p = 0,031), Descamação da pele (T1 e T2: valor p < 0,001) e Edema (T1 e T2: valor p < 0,001). Ademais, ao se comparar o pós-teste (T1) e o pós-teste (T2) com o pré-teste (T0), o Grupo Intervenção apresentou melhora nos escores desses indicadores, enquanto o Grupo Controle apresentou piora ou manutenção dos mesmos. Nos demais indicadores - Sensibilidade, Elasticidade, Espessura, Integridade da pele, Pigmentação anormal, Lesões de pele, Tecido cicatricial, Crostas na pele, Eritema, Palidez, Necrose, Endurecimento e Varizes - diante da ausência de diferenças entre os grupos no pós-teste (T1) e no pós-teste (T2), não foi evidenciado efeito da terapia. Ao se comparar, contudo, o pós-teste (T1) e o pós-teste (T2) com o pré-teste (T0), nos indicadores \"Sensibilidade\", \"Elasticidade\", \"Endurecimento\" e \"Varizes\", o Grupo Intervenção apresentou melhora nos escores, enquanto o Grupo Controle apresentou piora nos escores do indicador \"Elasticidade\" e manutenção dos escores dos demais indicadores. O tamanho do efeito da intervenção sobre a integridade tissular dos pés dos participantes foi de grande magnitude tanto no pós-teste (T1) (ES = 1,370) quanto no pós-teste (T2) (ES = 1,538), o que sugere a manutenção do efeito de 12 sessões com 16 sessões da terapia. A guisa de conclusão, ao evidenciar os efeitos da reflexologia podal sobre a integridade tissular dos pés de pessoas com \"Risco de Integridade da Pele Prejudica\", esta investigação aprofundou os conhecimentos acerca da terapia e de sua utilização como uma possível estratégia de assistência à saúde. Ao mesmo tempo, a utilização de definições conceituais e definições e magnitudes operacionais no processo de avaliação dos efeitos da intervenção testada contribuíram para maior fidedignidade dos achados, visto que o emprego de tais definições auxiliam na diminuição de interpretações subjetivas acerca dos indicadores do resultado de enfermagem \"Integridade Tissular: pele e mucosas\" / This study aimed to evaluate the effect of foot reflexology on the tissue integrity of the feet of people with the nursing diagnosis \"Risk For Impaired Skin Integrity\". This was a randomized, controlled and masked trial, developed in an outpatient clinic of specialties at Ribeirão Preto, State of Sao Paulo. Given the susceptibility to the nursing diagnosis mentioned, the population of this study consisted of people with diabetes mellitus. In the pre-test (T0) were collected the characterization variables, evaluated the result of nursing \"Tissue Integrity: skin and mucous membranes\" and their indicators related to the feet of people with diabetes mellitus (accompanied by their definitions), established the diagnosis of nursing \"Risk For Impaired Skin Integrity\", applied the Nursing Diagnosis Accuracy Scale (version 2) and completed the evaluation instrument of the eligibility criteria. Eligible participants were divided into Intervention Group and Control Group. The Intervention Group received, in addition to the service routine information, 16 sessions of foot reflexology, since the Control Group received only routine information service. The post-test (T1) and the post-test (T2) occurred after the scope of the implementation of 12 and 16 sessions of foot reflexology, respectively, and consisted of the evaluation of nursing outcome \"Tissue Integrity: skin and mucous membranes\" and their indicators related to the feet of people with diabetes mellitus (accompanied by their definitions). The final sample consisted of 78 participants, 40 of the Intervention Group and 38 of the Control Group. In the post-test (T1) and post-test (T2), when comparing the groups, there were differences in the scores of nursing outcome \"Tissue Integrity: skin and mucous membranes\" (T1 and T2: p < 0.001) and indicators: Skin temperature (T1 and T2: p < 0.001) Hydratation (T1 and T2: p < 0.001), Texture (T1 and T2: p < 0.001), Tissue Perfusion (T1: p value = 0.008; T2: p value = 0.001), Hair growth on skin (T1: p = 0.039; T2: p = 0.031), Skin scaling (T1 and T2: p <0.001) and Edema (T1 and T2: value p < 0.001). In addition, when comparing the post-test (T1) and the post-test (T2) with pretest (T0), the Intervention Group showed improvement in the scores of these indicators, while the Control Group worsened or maintenance. In the other indicators - Sensation, Elasticity, Thickness, Skin integrity, Abnormal pigmentation, Skin lesions, Scar tissue, Skin flaking, Erythema, Blanching, Necrosis, Induration and Varicose veins - in the absence of differences between the groups in the post- test (T1) and post-test (T2) was not observed effect of therapy. By comparison, however, the post-test (T1) and the post-test (T2) with pretest (T0), the indicators \"Sensation\", \"Elasticity\", \"Induration\" and \"Varicose veins\", the Intervention Group showed improvement in scores, while the Control Group showed worse in score of \"Elasticity\" and maintenance of the others. The effect size of the intervention on the tissue integrity of the feet of the participants was of great magnitude in both the post-test (T1) (ES = 1,370) and the post-test (T2) (ES = 1.538), suggesting maintenance of therapy effect of 12 sessions with 16 sessions. Concludes that, by highlight the effects of foot reflexology on the tissue integrity of the feet of people with \"Risk For Impaired Skin Integrity\", this research deepened knowledge about the therapy and its use as a possible health care strategy. At the same time, the use of conceptual definitions and definitions and operational magnitudes in the evaluation of the effects of the tested intervention contributed to greater reliability of the findings, since the use of such definitions help in the reduction of subjective interpretations of the nursing outcome indicators \"Tissue Integrity: skin and mucous membranes\"

This study examines the unique cultural practices related to disease prevention and health maintenance within a Holmes County, Ohio Amish community. This research focuses on the many options for healthcare within this community and the decisions behind their use. By engaging with these Amish community members to discuss their methods of managing health, the non-Amish medical professionals who treat Amish patients can learn cultural understandings of health within the community. As we learn that there are useful techniques to health beyond the dominant biomedical model, it is valuable to incorporate more traditional methods into our existing healthcare in to boost compliance and comfort for those seeking medical help.

This study examined Neuro-Reflex Therapy, a type of reflexology, and effleurage massage for the treatment of diabetic neuropathy in men and women 40-73 years old with Type II diabetes. Participants were physician-referred to an alternative medicine clinic and were randomly assigned to Neuro-Reflex Therapy, effleurage massage, or a wait-list control group. The treatment groups received 12 individual 30 min sessions scheduled once a week for 12 weeks, and the control group received treatment after the study was completed. Scores on the Neuropathic Pain Scale, Section III of the Multidimensional Pain Inventory, the Profile of Mood States, the Short-Form McGill Pain Questionnaire, changes in foot temperature, and changes in scores on a Visual Analogue Scale (VAS) were analyzed. As hypothesized, pain for both treatment groups significantly decreased from the control group; however, mood states, participation in daily activities, and temperature for the treatment groups did not significantly increase, compared to the control group, as expected.