Good Practice Guidline On Reflexology
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Transcript of 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
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
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
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
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
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
T&CMD • 1
Good Practice Guideline for Reflexology
Part I
Introduction and general issues
2 • T&CMD
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.
T&CMD • 3
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.
4 • T&CMD
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.
T&CMD • 5
Good Practice Guideline for Reflexology
Part II
Client care decision-making model
6 • T&CMD
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.
T&CMD • 7
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
8 • T&CMD
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.
T&CMD • 9
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.
10 • T&CMD
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).
T&CMD • 11
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).
12 • T&CMD
Good Practice Guideline for Reflexology
Part III
Conclusion
T&CMD • 13
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.
14 • T&CMD
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.
T&CMD • 15
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.
16 • T&CMD
Good Practice Guideline for Reflexology
APPEnDIx 2 : PROCESS OF CARE: EVAluATIVE PHASE
Presenting client
History &examination
Within scopeof treatment
Contraindications
Treatment planningphase
Refer toappropriatehealthcare
professional
No
No
Yes
Yes
T&CMD • 17
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
18 • T&CMD
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
T&CMD • 19
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
20 • T&CMD
Good Practice Guideline for Reflexology
APPEnDIx 6 : ClIEnT SCREEnInG FORm
S A M P L E
T&CMD • 21
Good Practice Guideline for Reflexology
APPEnDIx 7 : COnSulTATIOn FORm
S A M P L E
22 • T&CMD
Good Practice Guideline for Reflexology
APPEnDIx 7 (Continue)
S A M P L E
T&CMD • 23
Good Practice Guideline for Reflexology
APPEnDIx 8 : COnSEnT FORm
S A M P L E
24 • T&CMD
Good Practice Guideline for Reflexology
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
T&CMD • 25
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
26 • T&CMD
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