A concept analysis: the effect of reflexology on homeostasis to establish and maintain lactation.

The focus of this paper is to consider whether reflexology can have an effect on homeostasis to establish and maintain lactation. This complementary therapy encompasses the theory of holism to nurture the whole body, mind and spirit (Crane 1997). Parents experience many stressful emotions when their baby is admitted to a neonatal intensive care unit (NICU), which in turn can affect the body, mind and spirit, often contributing to the reduction of lactation for the mother. This paper will utilize a concept analysis approach (Chinn & Jacobs 1987) to provide a focus and sense of direction to the discussion and exploration of the topic.

'Just the ticket': case studies, reflections and clinical supervision (Part III).

An earlier paper in this series of three has detailed the background development and organization of a pilot complementary therapy service. The setting was a neuroscience ward with existing staff carrying out the treatments. Outcome measures including physiological indices and patient feedback were reported on in Part II (Dryden et al. 1999). This paper will now focus on both the records of the practitioner's reflections and the recurring themes of their monthly clinical supervision sessions. Subgroups of four patients with Guillain-Barre Syndrome (GBS) are discussed in detail, as they received the most number of treatments between them.

'Just the ticket': the findings of a pilot complementary therapy service (Part II).

In part I of this series of articles (Dryden et al. 1998) the authors detailed the background to a project offering hand and foot massage incorporating reflexology techniques. The following paper reports back on the findings and evaluation. Over a 4-month period a total of 61 recorded treatments were given to 18 in-patients. Each session was to last approximately 30 minutes and included recordings of physiological data as well as pre- and post comments from the patient. The six practitioners, who were already working within the ward setting in various capacities, were asked to record reflective comments after each treatment. This paper will conclude by discussing future recommendations. Part III of this series (CTNM 5: 2, 1999) will focus on a subgroup of patients within the study highlighting the experiences of both practitioners and patients.

An introduction to catharsis and the healing crisis in reflexology.

This paper explores the concept of healing through catharsis in relation to the practice of reflexology. The literature will be reviewed to inform a critical analysis of the role of the reflexologist and specifically the therapeutic relationship. This area was chosen as I have had experiences of reflexology clients reporting feeling 'emotional', 'being tearful', and 'thinking more about their lives' past and present'. These observations have been illuminated by a recent study that suggests reflexology can be helpful for people with emotional needs (Trousdall 1997). Emotional and physical responses to reflexology are traditionally attributed to 'detoxification' and the signs of it occurring known as a 'healing crisis' (Sahai 1993, Griffiths 1995). Consideration will be given to the practitioner's skills and support, issues of boundaries to practice, and the effective management of patient's emotional and physical responses. The safety and potency of the therapeutic work will be key elements to the discussions.

'Just the ticket': integrating massage and reflexology in practice (Part I).

The purpose of these papers is to describe and discuss the piloting and evaluation of an inpatient complementary therapy service. This was a single site case study without a control group and involving practitioners themselves collecting data, recording reflections on their own practice and engaging in monthly clinical supervision sessions. The service was aimed at providing treatments of hand and foot massage incorporating reflexology techniques for a total of 18 patients. In part 2 of this paper, an evaluation of the project will be presented including the findings of this pilot service from the perspective of both the patients and practitioners, and the analysis of some of the physiological data collected. Part 3 will focus on a subgroup of the patient cohort to illuminate the experience from both patient and practitioner perspective.

HIV and homophobia: nurses as advocates.

Nurses are frequently encouraged in colleges of nursing and professional journals to consider themselves as ideally placed to act as advocates for vulnerable patients. This paper sets out to challenge this assumption in the light of the stigma and discrimination experienced by people affected by HIV and AIDS. Sexuality and in particular homophobia--the fear and aversion of gay and lesbian behaviour--need to be addressed by the nursing profession. The paper considers concerns about and evidence of discrimination in the light of nurses' claim to be best placed to adopt the role of advocate in representing any patient's health care needs. It is argued that such an assumption is problematical in the face of homophobia and fears around contagion.