PURPOSE/OBJECTIVES: To compare the effects of partner-delivered foot reflexology and usual care plus attention on patients' perceived pain and anxiety. DESIGN: The experimental pretest/ post-test design included patient-partner dyads randomly assigned to an experimental or control group. SETTING: Four hospitals in the southeastern United States. SAMPLE: 42 experimental and 44 control subjects comprised 86 dyads of patients with metastatic cancer and their partners, representing 16 different types of cancer; 23% of patients had lung cancer, followed by breast, colorectal, and head and neck cancer and lymphoma. The subjects had a mean age of 58.3 years, 51% were female, 66% had a high school education or less, and 58% were Caucasian, 40% were African American, and 1% were Filipino. METHODS: The intervention included a 15- to 30- minute teaching session on foot reflexology to the partner by a certified reflexologist, an optional 15- to 30-minute foot reflexology session for the partner, and a 30-minute, partner-delivered foot reflexology intervention for the patient. The control group received a 30-minute reading session from their partners. MAIN RESEARCH VARIABLES: Pain and anxiety. FINDINGS: Following the initial partner-delivered foot reflexology, patients experienced a significant decrease in pain intensity and anxiety. CONCLUSIONS: A nurse reflexologist taught partners how to perform reflexology on patients with metastatic cancer pain in the hospital, resulting in an immediate decrease in pain intensity and anxiety; minimal changes were seen in the control group, who received usual care plus attention. IMPLICATIONS FOR NURSING: Hospitals could have quali- fied professionals offer reflexology as a complementary therapy and teach interested partners the modality. Stephenson NL, Swanson M, Dalton J, Keefe FJ, Engelke M. Oncology Nursing Forum. 2007 Jan;34(1):127-32. School of Nursing, East Carolina University, Greenville, NC, USA. stephensonn@mail.ecu.edu PMID: 17562639
"Ten minute reflexology treatments can provide relief from pain, nausea and anxiety according to a report from the School of Nursing, Division of Science and Design, University of Canberra, Australia. Nurses at the school conducted an empirical study on the use of foot massage as a nursing intervention in patients hospitalised with cancer. The study was developed from the earlier work of Ferrell-Torry and Glick (1992) "87 patients participated in the study and each received a 10-minute reflexology foot massage (5 minutes per foot). The results revealed that the treatments produced a significant and immediate effect on the patients' perceptions of pain, nausea and relaxation when measured with a visual analog scale. The use of reflexology foot massage as a complementary method is recommended as a relatively simpler nursing intervention for patients experiencing nausea or pain related to the cancer experience. The results were so positive that the researchers recommend that further research using larger numbers of patients in controlled clinical trials into its effectiveness of reflexology in alleviating pain, nausea and anxiety in the management of these symptoms by the family at home is warranted." ("Reflexology Used for Cancer Patients," Internet Health Library, October 11, 2000; Review of "Foot Massage: A nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalized with cancer," Grealish, L. Lomasney, A., Whiteman, B., Cancer Nurse 2000, June;23(3):237-43)
The use of reflexology improved the quality of life for twelve British hospitalized cancer patients. Six patients with different types of tumors were randomly assigned to a reflexology group and six to a placebo reflexology group during research conducted for the Master's dissertation of nurse H. Hodgson.
The placebo group was given "gentle foot massage that does not stimulate reflexology points." Patients completed a visual analogue scale (VAS) 24 hours before commencement of the intervention and within 24 hours of completion. Placebo and reflexology groups received three 40 minute sessions, every other day over a five-day period. The VAS measured quality of life components: appearance, appetite, breathing, communication (doctors), communication (family), communication (nurses), concentration, constipation, diarrhoea, fear of future, isolation, micturition, mobility, mood, nausea, pain, sleep and tiredness.
"From the results it was concluded that all participants received some comfort from the intervention, be it reflexology or placebo reflexology. However, only 33% of the placebo group benefited from an improvement in quality of life compared to 100% of the reflexology group. Within the reflexology group, the participants reported an improvement in all components of the quality of life scale compared to 67 5 in the placebo group. However, despite there being an improvement reported in 67% of the components, the frequency of improvement was greater in the reflexology group compared to the placebo group."
"Should reflexology be available for palliative care patients within a general hospital setting? The researcher recognized that this was indeed a small-scale study with limitations. Nevertheless, this study would suggest that the provision of reflexology for palliative patients within the general setting could be beneficial. Not only did the patients in this study enjoy the intervention, they were also 'relaxed,' 'comforted' and achieved relief from some of their symptoms. Furthermore they demonstrated an improvement in their quality of life." (Hodgson, H., "Does reflexology impact on cancer patients' quality of life?" Nursing Standard (England). 14, 31, 33-38)
Researchers at the School of Nursing, East Carolina University, Greenville, North Carolina found that foot reflexology alleviates anxiety and pain for twenty-three patients with breast and lung cancer. Researchers noted a significant decrease in anxiety for patients diagnosed with breast or lung cancer and a significant decrease in pain for patients with breast cancer. "This has important implications for nursing practice as both professionals and lay people can be taught reflexology. Reflexology is a simple technique for human touch which can be performed anywhere, requires no special equipment, is non-invasive and does not interfere with patients' privacy. The patients were given a 30 minute session by a certified reflexologist. (Stephenson, NL, Weinrich, SP and Tavakoli, AS, "The effects of foot reflexology on anxiety and pain in patients with breast and lung cancer," Oncol Nurs Forum 2000 , Jan-Feb;27(1):67-72)
"Thirty-six oncology inpatients participated in this third pilot study investigating the effects of foot reflexology in which equianalgesic dosing was calculated. Foot reflexology was found to have a positive immediate effect for patients with metastatic cancer who report pain, although there was no statistically significant effect at 3 hours after intervention or at 24 hours after intervention. Further study is suggested for foot reflexology delivered by family in the homes for management of cancer pain." (Stephenson N, Dalton JA, Carlson J, "The effect of foot reflexology on pain in patients with metastatic cancer," Appl Nurs Res . 2003 Nov;16(4):284-6 PMID: 14608562)
"Ross et al. (2002) studied 26 patients with advanced cancer; 14 patients received foot reflexology interventions, and 12 patients received foot massage interventions by trained reflexologists. Patients attended therapy sessions once weekly for six weeks. The Hospital Anxiety and Depression Scale and a 10-point rating scale for the severity of 10 common symptoms were used. The study did not show a greater effect of reflexology over simple foot massage and did not demonstrate a cumulative effect. Measurements were made prior to the first treatment and within 24 hours of the last treatment. Immediate postmeasurement was not recorded; the delay may have been the reason the study did not show immediate benefits for decreasing symptoms such as pain and nausea. Patients made positive comments and were relaxed." (Stepehnson, Nancy, "Partner delivered reflexology Š"
Ross, C S., Hamilton, J, Macrae, G, Docherty, C, Gould, A, Cornbleet, M A (2002). A pilot study to evaluate the effect of reflexology on mood and symptom rating of advanced cancer patients. Palliat Med 16: 544-545 PMID: 12465705
"Purpose: The purpose of this study was to identify the effects of foot reflexology on nausea, vomiting and fatigue in breast cancer patients undergoing chemotherapy. "Method: The research was a quasi-experimental study using a non-equivalent pre-post design and was conducted from Jan. 26, to Mar. 20, 2004. The subjects consisted of 34 patients with 18 in the experimental group and 16 in control group. A pretest and 2 post tests were conducted to measure nausea, vomiting and fatigue. For the experimental group, foot reflexology, which was consisted of 4 phases for 40 minutes, was given by a researcher and 4 research assistants. Š. "Results: There was a statistically significant decrease in nausea, and vomiting in the experimental group compared to the control group over two different times. In addition, there was a statistically significant decrease in fatigue in the experimental group compared to the control group over two different times.
"Conclusion: Foot reflexology was effective on nausea, vomiting and fatigue in breast cancer patients receiving chemotherapy in this study. Therefore, foot reflexology can be usefully utilized as a nursing intervention in the field of cancer nursing for breast cancer patients receiving chemotherapy."
Yang JH., "The effects of foot reflexology on nausea, vomiting and fatigue of breast cancer patients undergoing chemotherapy" (Korean), Taehan Kanho Hakhoe Chi. 2005 Feb;35(1):177-85
"PURPOSE: This study was done to investigate the effect of foot reflexology on vital signs, general fatigue, mood and foot fatigue in cancer patients receiving chemotherapy. METHOD: Data were collected from a convenience sample of 11 patients who were admitted at S and E University Hospital. Changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate(PR), general fatigue, mood status, and foot fatigue between pre and post foot reflexology were analyzed using Wilcoxon signed rank test and Friedman test at 0.05 level of significance. RESULTS: There were significant differences in the SBP(p=.009), DBP(p=.014), PR(p=.015), general fatigue (p=.015), mood status(p=.007), and foot fatigue(p=.007) between pre and post foot reflexology. CONCLUSION: Foot reflexology can improve vital signs, general/foot fatigue, and mood status, therefore we recommend to use foot reflexology as an effective nursing intervention in cancer patients receiving chemotherapy."
Won JS, Jeong IS, Kim JS, Kim KS, "Effect of Foot Reflexology on Vital Signs, Fatigue and Mood in Cancer Patients Receiving Chemotherapy," Journal of Korean Acad Fundam Nursing 2002 Apr;9(1):16-26. Korean; Department of Nursing, Seoul Health College, Korea; Department of Nursing, College of Medicine, Pusan National University, Korea; Head Nurs of GS Dept, Dondaemoon Hospital of Ewha Woman's University, Korea; College of Nursing, Seoul National University, Korea. kimks@snu.ac.kr
"AIM: To examine the effectiveness of reflexology foot massage in hospitalized cancer patients undergoing second or third chemotherapy cycles. BACKGROUND: Since the late-1970s, studies have been conducted to assess the efficacy of behavioural and relaxation approaches in controlling nausea/vomiting, anxiety and other side-effects associated with chemotherapy. METHODS: The study consisted of 30 patients being admitted to the oncology unit at a Scientific Research Hospital in Italy. Only 15 of the 30 participants received (reflexology foot) therapeutic massage. The subjects' self-reports of anxiety (measured by the Spielberger State-Trait Anxiety Inventory) were recorded before, after and 24 hours after the intervention. RESULTS: There was an average decrease of 7.9 points on the state-anxiety scale in the treatment group and of 0.8 points in the control group (P < 0.0001). CONCLUSIONS: Reflexology foot massage can be considered a support treatment used in combination with traditional medical treatments and executed by an expert, qualified person to help cancer patients receiving chemotherapy feel better and also cope better with their disease. "'Use of reflexology foot massage to reduce anxiety in hospitalized cancer patients in chemotherapy treatment: methodology and outcomes.'" Quattrin, R, Zanini A, Buchini S, Turello D, Annunziata D, Vidotti, C, Colobatti A, Brusagerro Chair of Hygiene, DPMSC School of Medicine, University of Udine, Udine, Italy. J Nurs Manag. 2006 Mar;14(2):96-105 (r.quattrin@med.uniud.it) PMID: 16487421
"BACKGROUND: Fatigue is one of the most distressful symptoms experienced by patients with advanced cancer. Aromatherapy, footsoak, and reflexology are popular health care modality treatments in Japan, however, the effectiveness of each treatment for cancer-related fatigue has not been fully established. DESIGN AND SUBJECTS: To investigate the effectiveness of combined modality treatment consisting of aromatherapy, footsoak, and reflexology against fatigue, an open study was performed in 20 terminally ill patients with cancer. After a patch test was performed, patients received aromatherapy that was accompanied with footsoak in warm water containing lavender essential oil for 3 minutes, followed by reflexology treatment with jojoba oil containing lavender for 10 min. Fatigue was evaluated using the Cancer Fatigue Scale (CFS) before, 1 hour after, and 4 hours after treatment. RESULTS: Total CFS scores improved significantly after this treatment (from 25.6 +/- 11.0 to 18.1 +/- 10.0, p < 0.001). Among three CFS subscales, physical and cognitive subscale scores were reduced significantly (11.3 +/- 6.1 to 6.7 +/- 6.1, p < 0.001; 4.5 +/- 3.2 to 2.4 +/- 2.4, p < 0.001). No adverse effects were experienced. Because all patients desired to continue this treatment, they received treatment eight times on average. CONCLUSIONS: Combined modality treatment consisting of aromatherapy, footsoak, and reflexology appears to be effective for alleviating fatigue in terminally ill cancer patients. To confirm safety and effectiveness of this combined modality treatment, further investigation including randomized treatment assignment is warranted." Kohara H, Miyauchi T, Suehiro Y, Ueoka H, Takeyama H, Morita T., "Combined modality treatment of aromatherapy, footsoak, and reflexology relieves fatigue in patients with cancer," Journal Palliative Medicine , 2004 Dec;7(6):791-6. (Department of Internal Medicine, Palliative Care Unit, National Sanyo Hospital, Yamaguchi, Japan. hkohara@ bk4.so-net.ne.jp) PMID: 15684846
Cancer (Nausea and vomiting) Cobblestone Objective To investigate the bamboo Reflexology Massage for cancer chemotherapy-induced nausea and vomiting effect. Methods 240 cases of cancer chemotherapy patients were randomly divided into massage group (120 cases) and the control group (120 cases). Massage group bamboo Reflexology massage system for treatment of cancer patients undergoing chemotherapy nurses guidance biped barefoot stampede bamboo rolling massage, each 20 to 30 min until Juxin fever, three times daily to observe nausea, vomiting improve the situation and assess. The physical state of the control group did not undergo massage. Results massage group effectual 75 cases (62.50%), effective 34 cases (28.33%) and the overall efficiency of 90.83%, the ?2 test, P "0.05, Massage efficacy superior to the control group group. Conclusion bamboo massage for Reflexology treatment of cancer chemotherapy-induced nausea and vomiting significant effect. Bamboo massage for economic, simple, chemotherapy for cancer patients to accept. Wang Cui Cheng Rui Dan, Cai Rong-hua, Chin Chu, "Reflexology bamboo massage for the treatment of cancer chemotherapy-induced nausea and vomiting effect of Š," Modern Nursing in 2007 , 33
"In Switzerland, many new nurses are taught this approach. When applied skillfully, a reflexology massage is pleasantly relaxing and able to diminish painful sensations in the body. Given the number of uncontollable variables involved in the decrease of pain and the establishment of a feeling of relaxation, our small study has no scientific value. It was only intended to motivate nurses to look for ways to integrate aspects of alternative care in the management of terminal patients. Š "Our purpose for using reflexology with these patients was to decrease their pain but we soon realized the beneficial effect of reflexology on the morale of patients and families. Something was being done for them. Patients expressed feelings of being less abandoned and the families expressed satisfaction at seeing that something painless existed that could aid their relative. In three situations we taught a relative how to use reflexology and the benefit seemed to have been as important for the relative as for the patient. Š "Patients' comments about reflexology seem to show that it could be one way for them to feel this support and to have a helping presence near them in their last days."(Dobbs, Barbara Zeller, "Alternative health approaches," Nursing Mirror (England), Vol. 160, No. 9, Feb. 27, 1985) XIII.
Cancer (Fatigue and Emotional State in Cancer Patients receiving Radiotherapy) Purpose: The purpose of this study was to identify the effect of hand reflexology on fatigue and emotional state in cancer patients receiving radiotherapy. Method: This study was designed with non-equivalent control group pre and post test. Subjects were 29 patients who receiving radiotherapy in one hospital. Fifteen patients were assigned to the experimental group, and fourteen to the control group. The hand reflexology was applied to both hands for ten minutes each time, five times during five days. For data collection, questionnaires for fatigue, anxiety, mood, blood pressure, and pulse rate were measured before and after the program. For data collection, questionnaires for fatigue, anxiety, mood, blood pressure, and pulse rate were measured before and after the program. The degree of fatigue, anxiety, and mood state in the experimental group were significantly lower than that of the control group. The systolic blood pressure and pulse rate in the experimental group were lower than that of the control group, but diastolic blood pressure in the experimental group were not significantly lower than that of the control group. Conclusion: Hand Reflexology could be an effective nursing intervention for cancer patients suffering from fatigue, emotional states from radiotherapy. And it can help cancer patients to receive radiotherapy with lower degrees of side effects.
Kim Myung Ae,Kim Su Jung, Kim Su Jin, Kim Yang Ji, "Effects of Hand Reflexology on Fatigue and Emotional State in Cancer Patients Receiving Radiotherapy," Article 8 issue of Science nursing commandment No. 1, 2004. pp. 39-47
(9 pages) Receiving radiation therapy to treat cancer hand reflective of the impact of fatigue and emotional state http://translate.google.com/translate?hl=en&langpair=ko|en&u=http://dbpia.co.kr/view/ ar_view.asp%3Fpid%3D625%26isid%3D25164%26arid%3D544180%26topMenu%3D%26top Menu1%3D&prev=/ translate_s%3Fhl%3Den%26q%3Dresearch%2B%252Breflexology%26tq%3D%25EC%2597% 25B0%25EA%25B5%25AC%2Breflexology%26sl%3Den%26tl%3Dko%26start%3D30
"Even after receiving analgesia, patients with gastric and liver cancer still report moderate levels of postoperative pain. The purpose of the study was to investigate the efficacy of foot reflexotherapy as adjuvant therapy in relieving pain and anxiety in postoperative patients with gastric cancer and hepatocellular cancer.
"The study design was a randomized controlled trial. Data were collected from 4 surgical wards of a medical center in 2005 in Taipei, Taiwan. Sixty-one patients who had received surgery for gastric cancer or hepatocellular carcinoma were randomly allocated to an intervention (n = 30) or control (n = 31) group. Patients in the intervention group received the usual pain management plus 20 minutes of foot reflexotherapy during postoperative days 2, 3, and 4. Patients in the control group received usual pain management.
"Outcome measures included the short-form McGill Pain Questionnaire, visual analog scale for pain, summary of the pain medications consumed, and the Hospital Anxiety and Depression Scale. Results demonstrated that studied patients reported moderately high levels of pain and anxiety postoperatively while patients were managed with patient-controlled analgesia. Using generalized estimation equations and controlling for confounding variables, less pain (P < .05) and anxiety (P < .05) over time were reported by the intervention group compared with the control group. In addition, patients in the intervention group received significantly less opioid analgesics than the control group (P < .05). Findings from this study provide nurses with an additional treatment to offer postoperative digestive cancer patients."
Tsay, Shiow-Luan PhD, RN; Chen, Hsiao-Ling MS, RN; Chen, Su-Chiu MS, RN; Lin, Hung-Ru PhD, RN; Lin, Kuan-Chia PhD, "Effects of Reflexotherapy on Acute Postoperative Pain and Anxiety Among Patients With Digestive Cancer," Cancer Nursing , 31(2):109-115, March/April 2008.
PURPOSE: A pragmatic randomised controlled trial was carried out to evaluate the effects of reflexology on QofL in women with early breast cancer. METHODS: 183 women with early breast cancer were randomised six weeks post-surgery to self-initiated support (SIS) (comparator intervention), SIS plus reflexology, or SIS plus scalp massage (control for physical and social contact). Patients randomised to reflexology and massage had eight sessions at weekly intervals. The primary endpoint was 18 weeks post surgery, and the primary outcome was the Trial Outcome Index (TOI) of the Functional Assessment of Cancer Therapy}breast cancer version. The secondary endpoint was 24 weeks post surgery, and secondary outcomes included the Hospital Anxiety and Depression Scale (HADS) and the Mood Rating Scale (MRS). RESULTS: After adjusting for age and baseline scores, at the primary endpoint (week 18), massage, but not reflexology, was significantly better than SIS in terms of the Trial Outcome Index (TOI). Reflexology and massage were both better than SIS for MRS relaxation, and massage was better than reflexology and SIS for MRS easygoingness. At the secondary endpoint (week 24), reflexology, but not massage, was better than SIS in terms of the TOI and MRS relaxation. The difference between reflexology and massage was not significant. The three groups were similar in terms of HADS anxiety and depression at both endpoints. CONCLUSIONS: When compared to SIS, reflexology and massage have statistically significant, but modest, effects on QofL following lowest score surgery for early breast carcinoma.
"Does Reflexology Improve Quality of Life in Women Who Have Undergone Surgery for Early Breast Carcinoma?" Walker LGa,c, Sharp DMa, Walker MBb, Green- bman Ja Institute of Rehabilitation, University of Hull, Kingston upon Hull, UK; bOncology Health Cen-tres Hull and East Yorkshire Hospitals, NHS Trust Kingston upon Hull, UK; cPostgraduate Medical Institute, University of Hull, Kingston upon Hull, UK, Psycho-Oncology 15: S1 S478 (2006) ACKNOWLEDGEMENT: Funding from the NHS R&D
"PURPOSE: A pragmatic randomised controlled trial was carried out to evaluate the psychoneuro immunological effects of reflexology in early breast cancer. METHODS: 183 women with early breast cancer were randomised six weeks post-surgery to self-initiated support (SIS) (comparator intervention), SIS plus reflexology, or SIS plus scalp massage (control for physical and social contact). Patients randomised to reflexology and massage had eight sessions at weekly intervals. The primary and secondary endpoints were 18 and 24 weeks post-surgery, respectively. Pre-randomisation, and at the two endpoints, blood was taken to enumerate lymphocyte subsets (CD profiles), cytokine production (Th1, Th2), and hormones (prolactin, cortisol, growth hormone). Mood, coping and quality of life were assessed at the same time points using standardised tests. RESULTS: At week 18, massage, but not reflexology, was significantly better than SIS in terms of the primary outcome measure, namely the Trial Outcome Index (TOI) of FACT-B. At the secondary endpoint (week 24), reflexology, but not massage, was better than SIS in terms of TOI. Analysis of neuroendocrinological factors for the first 120 women found that women randomised to reflexology, but not to massage, had fewer B lympho-cytes than those receiving SIS alone. However, neither reflexology nor massage affected any of the T lymphocyte subsets, cytokine production, or hormones. CONCLUSIONS: Reflexology and massage have modestly beneficial effects on quality of life. However, neither reflexology nor massage had statistically significant effects on any endocrinological and immunological parameters thought to be relevant to an anti-tumour response.
"The Psychoneuroimmunological Effects of Reflexology in Women with Early Breast Carcinoma," Sharpe D, Walker AA, Walker V, Green V, Alexandropoulos A, Institute of Rehabilitation Oncology Health,Centres, University of Hull, Hull,UK Psycho-Oncology 15: S1 S478 (2006) DOI: 10.1002/pon ABSTRACTS OF THE 8TH WORLD CONGRESS OF PSYCHO-ONCOLOGY 16TH21ST OCTOBER 2006 Ferrara}Venice, Italy
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