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Page 1: Good Practice Guidline On Reflexology
Page 2: Good Practice Guidline On Reflexology
Page 3: Good Practice Guidline On Reflexology

Publication of Traditional and Complementary Medicine Division, Ministry of Health Malaysia.

Good Practice Guideline on Reflexology

For reflexologists

practicing in Malaysia

Page 4: Good Practice Guidline On Reflexology

First edition 2011

Copyright 2011, Ministry of Health Malaysia.

All rights reserved. No part of this book may be reproduced,

stored, or transmitted in any form or by any means, electronic

or otherwise, including photocopying, recording, internet

or any storage and retrieval system without prior written

permission from the publisher.

Published by:

Traditional and Complementary Medicine Division

Ministry of Health Malaysia

ISBN 978-983-44754-9-9

Cover design by :

Siti Noraisyah Bt. Adam

Cover artwork by:

Dr Syahrir Sukarno Mohd Fadzil

Ministry of Health Malaysia

Page 5: Good Practice Guidline On Reflexology

Preface vi

Part I – IntroductIon and general Issues 1

1. Introduction 2 1.1. Definition 2 1.2. Treatment concept 2 1.3. Objectives of treatment 2

2. General considerations 2 2.1. Record keeping 2 2.2. Ethical issues 3 2.3. Cleanliness and sterility 4

3. Practice facilities 4

Part II – clIent care decIsIon-makIng model 5

4. Section I - Evaluative Phase 6 4.1. History taking 6 4.2. Examination 6 4.3. To treat or not to treat? 6 4.4. Indications 7 4.5. Precautions in client handling 7 4.6. Contraindications 8

5. Section II - Treatment Planning Phase 9

6. Section III - Treatment Phase 10

7. Section IV - Discharge Phase 11

Part III – conclusIon 12

8. Conclusion 13

9. References 13

Contents

Good Practice Guideline for Reflexology

Page 6: Good Practice Guidline On Reflexology

10. Appendices

Appendix 1 - Glossary of terms 15

Appendix 2 - Process of care: Evaluative 16

Appendix 3 - Process of care: Treatment Planning Phase 17

Appendix 4 - Process of care: Treatment Phase 18

Appendix 5 - Process of care: Discharge Phase 19

Appendix 6 – Client Screening Form 20

Appendix 7 – Consultation Form 21

Appendix 8 – Consent Form 23

Appendix 9 – List of Potential Client Reactions to Treatment 24

Appendix 10 – Different Types of Hand Hygiene 25

Good Practice Guideline for Reflexology

Page 7: Good Practice Guidline On Reflexology

Acknowledgements

Special thanks to every individual and organizations who have in one way or another contributed comments and advices during the preparation of this Good Practice Guideline on Reflexology.

Good Practice Guideline for Reflexology

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vi • T&CMD

Good Practice Guideline for Reflexology

Preface

The Good Practice Guideline on Reflexology has

been prepared by a team of officers from Traditional

and Complementary Division, Ministry of Health, and

Reflexology practitioners, with reviewers from various

disciplines and institutions. It is intended for reflexologists

involved in administering the therapy especially for

therapeutic purposes.

In preparing the guideline, we discovered that information

on benefits of reflexology is difficult to obtain. There are

many aspects of reflexology that has not been proven by

good clinical trials. Therefore, it is impossible to give a

completely evidence based facts. Where good evidence

is not available, we have used other reference sources

that are recognized worldwide.

Realizing the fact that the decision to administer

reflexology rests solely on the attending practitioner; we

hope that this guideline will be able to assist them to

wisely prescribe the therapy after careful assessment of

risk and benefit.

This guideline is not meant to be regulatory, but rather to

act as a guidance that will benefit reflexologists practicing

in Malaysia.

Maintaining Medical & Health Professionalism

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T&CMD • 1

Good Practice Guideline for Reflexology

Part I

Introduction and general issues

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Good Practice Guideline for Reflexology

1. Introduction

1.1. Definition

Reflexologyisthestudyandpracticeoftreatingreflexpointsandareasin

thefeet,handsandearsthatrelatetocorrespondingpartsofthebody,using

precisehandandfingertechniquestoimprovebloodandenergycirculation,

inducerelaxationandenablehomeostasis.

1.2. Treatment concept

Reflexologyisofferedasacomplementarytherapytoapatient’sexisting/

current allopathic treatment. It is not, and should not be an alternative

therapy.

1.3. Objectives of treatment

To achieve therapeutic effect by improving blood and energy circulation,

induce relaxation and enable homeostasis. These three outcomes can

activatethebody’sownhealingsystemtohealandpreventillhealth.

2. General considerations

2.1. Record keeping

2.1.1. General

• All recordsshouldbeentered inchronologicalorderand

enteredascontemporaneouslyaspossible.

• Recordsshouldnotbebackdatedoraltered.

• Correctionsoradditionsshouldbeinitialled&dated.

• Files should include all relevant, objective information,

extraneousinformationshouldnotbeincluded.

• Recordsmustbecompletetoprovidethepractitionerwith

informationrequiredforsubsequentclientcareorreporting

tooutsideparties.

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Good Practice Guideline for Reflexology

2.1.2 Legibility & clarity

• All records should be neat, organized and complete to

provideadequateinformationrequestedbyasubsequent

healthcareprovider, insurancecompany,and/orattorney.

A dated record of what occurred on each visit and any

significantchangesintheclinicalpictureorassessmentor

careplanneedtobenoted.

• Allentriesshouldbewrittenininkortypewritten.

• Entries should not be erased or altered with correction

fluid/tape/adhesivelabels.

• Ifthecontentsarechanged,thepractitionershouldinitial

anddatesuchchangesinthecorrespondingmargin.

• All recordsmust be in a language that hasbeen agreed

upon, i.e. Malay or English, typewritten or in a legible

handwriting.

• The client’s records are confidential and should be kept

properly.

2.2. Ethical issues

2.2.1. At all times during the provision of treatment to clients, practitioners

should;

• Adhere to guideline for ethical conduct (refer to Code

of Ethics and Code of Practice for Traditional and

ComplementaryMedicinePractitioners).

• Maintainsclinicalboundariesduringthetreatmentthrough

appropriateconductandcommunicationwiththeclient.

• Demonstrates responsible and caring concern for the

client.

• Respondsappropriately to theclient’semotional reaction

totreatment.

• Elicit client’s ongoing feedback on progresswith clinical

outcomes and provides the client with appropriate

educationonongoingcare.

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Good Practice Guideline for Reflexology

• Maintain an updated documentation on the treatment

providedandtheclient’sresponsetoit.

• Maintaincommunicationwiththereferringclinicianorother

healthcareprofessionalasappropriate.

2.3. Cleanliness and sterility

2.3.1. Practitionersmustalwaysmaintainagoodpersonalhygiene.

2.3.2. Practitionersshouldwashhisorherhandspriortotheexamination

ofclientsandstartingtreatment.

2.3.3. Thepremiseandallequipmentsusedshouldbecleanedregularly

andaftereachtreatmentsession.

2.3.4. Practitioners are required to take appropriate measures for

prevention of infection (e.g. the use of personal protective

equipments-PPE1)andobserveproperhandhygiene2.

2.3.5. Allinstrumentsusedshouldbedisinfectedandsterilizedaccording

totherecommendedmethodsofsterilizationanddisinfection.

3. Practice Facilities

3.1. Eachpracticefacilityshouldhaveadedicatedroomfortreatmentwhichis

equippedwithaheight-adjustable/recliningcouch,equipmenttrayortrolley,

andproperwastebins.

3.2. Treatmentroomsshouldbewelllightedandventilated.

3.3. Thereshouldbearegularcleaningschedulewhichisdiligentlyadheredto

keeptheenvironmentcleanandsafe.

3.4. Thereshouldbepropermanagementofspillage,soiled/contaminatedlinen,

anddisposalofsharpsandclinicalwaste.

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Good Practice Guideline for Reflexology

Part II

Client care decision-making model

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Good Practice Guideline for Reflexology

4. Section I - Evaluative Phase

Thissectionisconcernedwithadequatepractitioner’spreparationandappropriate

engagement of the client’s information into the clinical process. It provides the

foundation of the practitioner’s treatment process. The steps revolve around the

formulationandconfirmationofthehypothesisabouttheclient’sproblem.Itbegins

withdatagatheringthroughclientexaminationandalsoinvolvestheconfirmationof

theclient’sproblem,thecreationofasummaryofclinicalfindings,andthedecision

of whether to pursue treatment. Below are the steps involved in this process of

informationgathering(Appendix2);

4.1. History taking

4.1.1. Priortotakingtheclient’shistory,determinewhethertheclienthas

aspecificdiagnosisonarrival.Ifthereisaspecificdiagnosis,then

thehistorytakingwillincludequestionsrelatingtothatcondition

andwillfocusonelicitinginformationtoassesstheclient’scurrent

condition.

4.1.2. If it is a walk-in client, without a specific diagnosis, begin by

elicitinggeneralinformationthatwillclarifytheclient’spresenting

problemandsuggestadiagnosis.

4.2. Examination

4.2.1. Thepractitionerthenproceedstoclientexamination,inwhichthe

focusofexaminationshouldbeatthehands,feetandears(the

areastobeworkedon).

4.2.2. Practitionersarerequiredtodocumentallfindingsintheclerking

form.

4.3. To treat or not to treat?

4.3.1. Notallclientswhopresentedtothereflexologycentrearesuitable

for reflexology therapy. Therefore, determinewhether the client

wouldbenefitfromtreatmentornot.

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Good Practice Guideline for Reflexology

4.3.2. Oncethepractitionerhasconfirmedthattreatmentisappropriate,

andbeforehe/shebeginstreatmentplanning,thepractitionerhas

todeterminethepresenceorabsenceofanycontraindications.

The client should be referred to the appropriate healthcare

professionalshouldtheneedarise.

4.4. Indications

4.4.1. Reflexologymaybeusedformostmedicalconditions.

4.4.2. However,itshouldnotbeusedtotreatacuteconditions3andany

conditionswherereflexology iscontraindicated,as listedbelow

(para4.6).

4.5. Precautions in client handling

Care should be taking when applying treatment to clients with these

conditions;

4.5.1. Pregnancy

4.5.2. Cardiovasculardisorders

4.5.3. Oedema

4.5.4. Osteoporosisoranyconditionswherethebonesareweakened

4.5.5. Arthritis

4.5.6. Epilepsyanddisordersaffectingthecentralnervoussystem(e.g.

multiplesclerosis,Parkinson’sdisease)

4.5.7. Psychiatricconditions

4.5.8. Recentsurgery

4.5.9. Diabetesmellitus

4.5.10. Asthma

4.5.11. Any disorders of the peripheral nervous system (e.g. sciatica,

peripheralneuropathy)

4.5.12. HIVinfection

4.5.13. Bleedingdisordersoronanticoagulanttherapy,wherethereisa

tendencyforeasybruising/bleeding

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Good Practice Guideline for Reflexology

4.6. Contraindications

Listedbelowaretheconditionsinwhichreflexologyshouldnotbeperformed

totheclient.

4.6.1. Fever and any infectious diseases (systemic4 or localized5)

Givingtreatmentwhilsttheclientissufferingfrominfectionmay

over-stimulatethealreadystressedsystemsofthebody,whichis

tryingtofighttheinfection.

4.6.2. Diarrhoea and vomiting

Asinanyinfection,reflexologymayover-stimulatethebody,and

furtheraggravatethecondition.

4.6.3. Pregnancy(firsttrimesteronly)

In the unfortunate event of amiscarriage, the practitionermay

beimplicatedtohavecausedtheevent.Thus,itisbesttoavoid

givingtreatmentduringthefirsttrimester.

4.6.4. Localized skin diseases of the hands, feet, and ears

Ifthereareskindiseasesoverthehands,feetorears,application

of reflexology can be painful andmay aggravate the condition

further.

4.6.5. Localizedinflammationorswellingofthefeet,handsandears

As in skin diseases,movement of the practitioner’s hands and

fingersduringtreatmentmayaggravatethesituation.

4.6.6. Thrombosis and thrombophlebitis

This condition may be harmful due to the risk of blood clots

lodginginorneartheheart.

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Good Practice Guideline for Reflexology

4.6.7. Varicoseveinsofthelowerlimbs

4.6.8. Cancers

Care should be taken when working with cancer patients.

Practitioners should avoid giving treatment for sufferers of

localized cancers (or tumours) of the hands, feet and ears as

cancercellsmayspread.

4.6.9. Continuingextremenegativereactiontoreflexology

Where the client feels consistently worse after treatment, it is

advisabletoreconsiderthesuitabilityofreflexologyfortheclient.

5. Section II - Treatment Planning Phase

5.1. This section begins with the summary of assessment findings from the

evaluativephase.Thepractitionerhas todistinguishbetween theclient’s

areaoffunctionanddysfunction,andareasthatwillbenefitfromreflexology

fromthosethatwillnot(Appendix3).

5.2. Once these areas has been identified, the practitioner should select the

appropriatemethodortechniquetobeappliedtotherelevantreflexzones

on the feet, hands or ears, and to apply the technique with maximum

efficiencyandeffect.Thereareafewmethodsortechniquesofreflexology.

Belowaretwomethodsthatareacceptedinternationally.

5.2.1. Ingham method –

It is themethodpioneeredanddevelopedbyEunice Inghamin

theearly1930’s.Itisamethodthatdoesnotuseanytoolinits

practice.

5.2.2. RwoShurmethod–

It is themethodthatwaspopularizedbyaSwisspriest,Father

Josef Eugster.Hismethod ismore popular amongst theAsian

countriesanditutilizestheuseoftoolssuchaswoodensticks.

However,overtime,themethodnowismostlydonewithknuckles

insteadofwoodensticks.

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Good Practice Guideline for Reflexology

5.3. The client should be explained regarding the treatment that has been

decidedupon.Ifthereissignificantharmfromtheproposedtreatment,the

riskshouldbedisclosed,understoodandacceptedbytheclient.

5.4. Obtaintheclient’sconsentpriortotheprovisionoftreatment.Clientsmust

becompetenttogiveconsentofcare.Incaseofminors(lessthan18years

old)andmentally impairedadults,practitioners requires theconsentofa

legalguardian.

5.5. Information about any cream, powder, lotion or oil to be applied to the

client’shands,feetorearsshouldbemadeavailabletotheclient.Purpose

ofcream,powder, lotionoroilapplicationandsafety informationsuchas

thecontentoringredientsofthesesubstancesareexplainedtotheclients.

Thesecream,powder,lotionoroilareusedas;

5.5.1. An aid during therapy, to ease movement of the practitioner’s

handsorfingersduringthetreatment.

5.5.2. Toprovideaddedbenefittotheclient(e.g.relaxationorsoothing

propertiesofthecream).

5.6. Beawareof anyallergies that theclientmight haveprior to startingany

therapy.Avoidusingoils/creams/lotionsthatcontainsingredientstheclient

isallergicto.

5.7. Eachtreatmentsessionlastsfrom30to45minutes.Thenumberoffollowup

orfrequencyofvisitsplannediscateredtotheindividualclient,dependingon

theclient’spresentingcondition,ageandoverallstateofhealth.Acomplete

fourstepprogramwill;

5.7.1. Stopfurtherdeterioration

5.7.2. Persuadethebodytobiologicallycorrectitself

5.7.3. Strengthenandreinforceallsystemsofthebody

5.7.4. Maintainsthebody’sbalance(goodhealth)

6. Section III - Treatment Phase

This phase involves an ongoing cycle of treatment, re-examination and treatment

progressionthatbeginsafterthepractitionercompletestheplanofcare(Appendix

4).

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Good Practice Guideline for Reflexology

6.1. Inthefirststageoftreatment,thepractitionerevaluatestheappropriateness

oftheplanofcareandgaugestheclient’streatmenttolerance.Becautious

nottointroducetoomanytreatmentmethodsatonce,lestitbedifficultto

identifywhichmethodtowhichtheclienthasapositiveoradverseresponse

to.

6.2. At any time during the intervention, the practitioner can perform client

assessment to elicit any changes. The re-examination is focused on the

identificationandmeasurementofchangesintheclient’s impairmentand

functionallevelfromthebaseline.Itisalsotoidentifywhethertheclienthas

apositiveoradverseresponsetothetreatmentgiven.

6.3. Thepractitionershouldreassesstheclientatsuitableintervalsasdeemed

appropriate.

6.4. Ideally,duringeachtreatmentsession,thepractitionerincorporatesclient’s

examination and progression or modification of either the treatment

techniquesorclienteducation.

7. Section IV - Discharge Phase

Thedischargephaseinvolvesthetransitionoftheclientfromthecareofthepractitioner

tothecareofanotherclinicianortoself-care.Thestepsinvolvedare(Appendix5);

7.1. Thepractitionerelicitstheclient’sperceiveddischargeneeds.

7.2. Theclientistheninformedofpost-dischargetreatmentrequirements.

7.3. Anappropriateinitialdischargeplanbasedonclinicalfindingsisprepared.

7.4. Dischargegoalsandarrangementsarediscussedwiththeclient,andthe

practitionerdocumentsthefinaldischargeplan.

7.5. Theclientispreparedforpre-dischargeeducationandpreparation.

7.6. The practitioner completes and documents pre-discharge examination

and determineswhether the client has achieved the identified functional

outcomes.Theclientmaybereferredtoanotherpractitionerorhealthcare

providerforfollowupcareasappropriate.

7.7. Adviceshouldbegivenonself-care,maintenanceofhealthandprevention

ofrecurrenceoftheclient’sproblem(s).

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Good Practice Guideline for Reflexology

Part III

Conclusion

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Good Practice Guideline for Reflexology

8. Conclusion

Thisguidelinewiththeclinicaldecisionmakingprocessproposed is forTraditional

& Complementary Medicine Practitioners of reflexology, through the evaluative,

treatment planning, treatment and discharge phases of a client care. It enhances

the appropriateness and adequacy of examinations performed, the plans of care,

andtheinterventionsplannedandprovidedbythepractitioners.Thisguidelinealso

encourages the T&CM practitioners to adhere to the code of ethics and code of

practice,andmaintainsahighlevelofmedicalprofessionalism.

9. References

9.1. CoreCurriculumforReflexology.CliveS.O’Hara.DouglasBarryPublication,

2006.

9.2. National Policy on Traditional/Complementary Medicine Malaysia. The

Division of Traditional and Complementary Medicine, Ministry of health

Malaysia,2001.

9.3. FeetFirst(AGuidetoFootReflexology).LauraNorman.Simon&Schuster,

1988.

9.4. TheReflexologyWorkshop.JennyHope-Spencer.TheCrowoodPressLtd,

1999.

9.5. StoriestheFeetCanTellThrureflexology&StoriesthefeetHaveToldThru

Reflexology.EuniceD.Ingham.InghamPublisher,1984.

9.6. Reflexology A Practical Introduction. Denise Whichello Brown. Universal

International,1999.

9.7. HealingYourselfwithFootReflexology.MildredCarterandTammyWeber,

RewardBooks,1996.

9.8. ReflexologyanIllustratedguide.BerylCrane.ElementBooks,1998.

9.9. Clinical reflexology, A guide for Health Professional. Edited by Peter A

MackerethandDeniseTiran.ChurchillLivingstone,2002.

9.10. BetterHealthWithFootReflexology,theOriginalIngamMethod.DwightC.

Byers,IngamPublishingInc,1983.

9.11. TheRwoShurHealthMethod. TranslatedbyGeraldineTay andEuHooi

Khan.ArtPrintingWorks,1988.

9.12. Reflexology Association of Australia. http://www.reflexology.au.org,

accessedon24January2011.

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Good Practice Guideline for Reflexology

9.13. Reflexology Association of Canada. http://www.reflexologycanada.ca,

accessedon25January2011.

9.14. Reflexology Association of America. http://reflexology-usa.org, accessed

on24January2011.

9.15. EdzardErnst.Isreflexologyaneffectiveintervention?Asystematicreviewof

randomizedcontroltrials.MJA191:5,2009.

9.16. MYWang,PSTsaietal.Theefficacyofreflexology:systematicreview.JAN

62:5,p:512-520,2008.

9.17. HPoole,SGlenn,etal.Arandomisedcontrolledstudyofreflexologyforthe

managementofchroniclowbackpain.EuropeanJournalofPain,2007.

9.18. CA Brown, C Lido. Reflexology treatment for patients with lower limb

amputations and phantom limb pain – An exploratory pilot study.

ComplementaryTherapiesinClinicalPractice,2008.

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Good Practice Guideline for Reflexology

APPEnDIx 1 : GlOSSARy OF TERmS

1Personal protective equipments (PPE) - refers toprotective clothing, helmets, goggles,

orothergarmentorequipmentdesignedandworntominimizeexposuretoavarietyof

hazardsforjob-relatedoccupationalsafetyandhealthpurposes.ExamplesofPPEinclude

suchitemsasgloves,footandeyeprotection,protectivehearingdevices(earplugs,muffs),

hardhats,respiratorsandfullbodysuits.

2 Handhygiene- isageneral termthatappliestoroutinehandwashing,antiseptichand

wash,antiseptichandrub,orsurgicalhandantisepsis.Itsubstantiallyreducespotential

pathogenson thehandsand is consideredaprimarymeasure for reducing the riskof

transmitting organisms to patients and health care personnel. Indications for hand

hygiene include the following:beforeandafter treatingeachpatient (e.g.,beforeglove

placementandaftergloveremoval);afterbarehandedtouchingofinanimateobjectslikely

tobecontaminatedbyblood,saliva,orrespiratorysecretions;beforeleavingthedental

operatory;whenhandsarevisiblysoiled;andbeforeregloving,afterremovingglovesthat

aretorn,cut,orpunctured.

3 Acuteconditions/diseases–diseasesthathasasuddenonset,sharprise,severesymptoms

andshortcourse(lastingforashorttime).

4 Systemic–relatingtothewholebodyratherthanonlypartofthebody.

5 Localised–relatingtoaspecificpartorareaofthebodyonly.

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APPEnDIx 2 : PROCESS OF CARE: EVAluATIVE PHASE

Presenting client

History &examination

Within scopeof treatment

Contraindications

Treatment planningphase

Refer toappropriatehealthcare

professional

No

No

Yes

Yes

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Good Practice Guideline for Reflexology

APPEnDIx 3 : PROCESS OF CARE: TREATmEnT PlAnnInG PHASE

Treatment planningphase

Areas ofdysfunction

Establish client’sproblem list and

appropriateoutcomes list

Consider referral toanother appropriate

healthcareprofessional

Identifyappropriatetechniques

Suitable forreflexology

Not Suitable for reflexology

Preparation fortreatment

Treatment sessions

Plan of care

Areas of functioncompensating for

deficit

Identifycompensation

strategies

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Good Practice Guideline for Reflexology

APPEnDIx 4 : PROCESS OF CARE: TREATmEnT PHASE

Plan of care

Initiate treatment

Monitoringof client’s

response totreatment

-veresponse

Continue treatmentprogramme,

reassessment andafter care advise

Outcomesmet

Continue treatmentplan

Revise plan of care

Re�ne applicationtechnique

Reassess client’ssuitability to treatment

+veresponse

Yes

No

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Good Practice Guideline for Reflexology

APPEnDIx 5 : PROCESS OF CARE: DISCHARGE PHASE

Assess progressionand re-examination

Continuetreatment plan

Healthoutcomes

met

Initiate dischargeassessment &

education

Document findingsand plans on

discharge

Discharge

No

Yes

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APPEnDIx 6 : ClIEnT SCREEnInG FORm

S A M P L E

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Good Practice Guideline for Reflexology

APPEnDIx 7 : COnSulTATIOn FORm

S A M P L E

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APPEnDIx 7 (Continue)

S A M P L E

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Good Practice Guideline for Reflexology

APPEnDIx 8 : COnSEnT FORm

S A M P L E

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List of potential reactions clients may experience during or after treatment.

* AdaptedfromTheReflexologyWorkshop,JennyHope-Spencer,

TheCrowoodPress,1999.

1. Positive effects

a. Relaxedfeeling

b. Increasedenergy

c. Improvedsleeppattern

d. Feelingelatedor‘onahigh’

e. Feelingasthoughtheyare‘floatingonair’

f. Feelingmoreincontroloftheirlives

g. Relieffrompain

h. Feelingofbalanceinbody,mindandspirit

2. negative effects

a. Painfromreflexpoints

b. Temporaryworseningofpresentingand/ortheunderlyingcondition

c. Afeelingofbeinggenerallyunwell

d. Headaches

e. Needingtosleepalot

f. Feelingtiredandlistless

g. Feelingemotionallyupset,irritableorrestless

h. Feelingdepressed

i. Feelingcoldorhot

3. Eliminatory effects

a. Increasedurinationand/ordefaecation

b. Slightconstipationordiarrhoea

c. Increasedsweating,especiallyfromthehandsandfeet

d. Nauseaordizziness

e. Runnynose

APPEnDIx 9 : lIST OF POTEnTIAl ClIEnT REACTIOnS TO TREATmEnT

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Good Practice Guideline for Reflexology

methods

RoutineHandwash

Antiseptichandwash

Antiseptichandrub

SurgicalAntisepsis

Agent

Waterandnon-antimicrobialsoap(i.e.plainsoap)

Waterandantimicrobialsoap(e.g.chlorhexidine,iodineandiodophors,chloroxylenol,triclosan)

Alcohol-basedhandrub

Waterandantimicrobialsoap(e.g.chlorhexidine,iodineandiodophors,chloroxylenol,triclosan)

Waterandnon-antimicrobialsoap(i.e.plainsoap)followedbyanalcohol-basedsurgicalhandscrubproductwithpersistentactivity

Purpose

Removesoilandtransientmicroorganisms

Removeordestroytransientmicroorganismsandreduceresidentflora(persistentactivity)

Removeordestroytransientmicroorganismsandreduceresidentflora(persistentactivity)

Removeordestroytransientmicroorganismsandreduceresidentflora(persistentactivity)

Area

Allsurfacesofthehandsandfingers

Allsurfacesofthehandsandfingers

Allsurfacesofthehandsandfingers

Handsandforearms

Duration(minimum)

15seconds

15seconds

Untilthehandsaredry

2–6minutes

Followmanufacturerinstructionsforsurgicalhandscrubproductwithpersistentactivity

Adapted from Centres for Disease Control and Prevention website.

Accessedonline:http://www.cdc.gov/oralhealth/infectioncontrol/faq/hand.htm,on25April2011.

APPEnDIx 10 : DIFFEREnT TyPES OF HAnD HyGIEnE

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Good Practice Guideline for Reflexology

Dr. Ramli Abd. GhaniDirector

TraditionalandComplementaryDivision,MinistryofHealth

Jaafar lassaDeputyDirector

TraditionalandComplementaryDivision,MinistryofHealth

Dr. Shamsaini ShamsuddinSeniorPrincipalAssistantDirector

TraditionalandComplementaryDivision,MinistryofHealth

Dr. Zalilah AbdullahSeniorPrincipalAssistantDirector

TraditionalandComplementaryDivision,MinistryofHealth

Dr. nur Hidayati Abdul HalimPrincipleassistantDirector

TraditionalandComplementaryDivision,MinistryofHealth

Committe members

Ministry of Health

MohdZulkifliAbdulLatifDr.AidatulAzuraBt.AbdulRaniDr.RadzuanBinMatIbrahim

Dr.RimahMelatiBintiAbd.GhaniNorlailiBt.Ahmad

AsmirahBt.Md.RedzuanNurHazirahBt.Kamarudin

Traditional and Complementary Medicine Practitioners

Abd.AzisBinIshakMohd.FaridA.Rahman

ChewYangHuaDorotheaJustinModuying

GeraldineTay

Editorial Board

Page 35: Good Practice Guidline On Reflexology
Page 36: Good Practice Guidline On Reflexology