A review of thirteen studies conducted in six countries (US, Korea, UK, Italy, Japan, Switzerland) showed that cancer patients experienced significant improvements and changes in each category researched. Common complaints (pain, anxiety, nausea, vomiting, and fatigue) for those undergoing chemotherapy were ameliorated. In addition, improvements were seen in vital signs, mood, and foot fatigue. Results were immediate following a ten-minute session in one study and a thirtyminute session in another.
Those undergoing palliative care reported results from reflexology work: feeling "relaxed," "comforted" and achieving relief from some of their symptoms. All of those in the study recounted improvements in quality of life: appearance, appetite, breathing, communication (doctors), communication (family), communication (nurses), concentration, constipation, diarrhoea, fear of future, isolation, micturition, mobility, mood, nausea, pain, sleep and tiredness.
To compare the effects of partner-delivered foot reflexology and usual care plus attention on patients' perceived pain and anxiety.
The experimental pretest/post-test design included patient-partner dyads randomly assigned to an experimental or control group.
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.
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.
Following the initial partner-delivered foot reflexology, patients experienced a significant decrease in pain intensity and anxiety.
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.
Hospitals could have qualified 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
Reflexology modifies the distressing symptoms of pain and nausea in patients hospitalized with cancer. "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."
Grealish, L. Lomasney, A., Whiteman, B., "Foot Massage: A nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalized with cancer,"
Cancer Nurse 2000, June;23(3):237-43
Results of study: 100% of the reflexology group benefited from an improvement in quality of life: appearance, appetite, breathing, communication (doctors), communication (family), communication (nurses), concentration, constipation, diarrhoea, fear of future, isolation, micturition, mobility, mood, nausea, pain, sleep and tiredness. 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. 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.
Hodgson, H. "Does reflexology impact on cancer patients' quality of life?," Apr. 2000, Nursing Standard , 14, 31, pp. 33-38
Foot reflexology alleviated 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." Stephenson, N. L., Weinrich, S. P. and Tavakoli, A. S., "The effects of foot reflexology on anxiety and pain in patients with breast and lung cancer,"
Oncology Nursing 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
"The purpose of study was to determine the effects of hand massage on nausea, vomiting and anxiety in acute lymphocytic leukemia children with high dose chemotherapy. The subjects of this study consist of 15 in experimental group and 15 in control group. All subjects were diagnosed as acute lymphocytic leukemia and admitted for high dose chemotherapy at the C University Medical Center in Seoul, Korea. The hand massage was performed for 10 minutes twice a day through three days in the experimental group, not in the control group. To evaluate the effects of hand massage, the Index of Nausea, Vomiting by Rhodes et al and State-Trait Anxiety Inventory for children by Spielberger were measured before and after the experiment in both groups. Also, the level of anxiety as measured by blood pressure, pulse rate were measured before and after hand massage therapy.
"Result of the study were as follows; (1) The score of nausea, vomiting decreased in the experimental group, not in the control group. There was a significant difference of nausea, vomiting between the two groups. (2) The score of state anxiety decreased in the experimental group and increased in the control group. After hand massage, the state anxiety of the experimental group was significantly more positive than the control group at the 2nd measurement (3) There was no significant difference of pulse rate between the two groups. (4) systolic blood pressure decreased in the experimental group and some increased in the control group. There was a significant difference of systolic blood pressure between the two groups. (5) The level of diastolic blood pressure in the two groups was significantly decreased over time."In conclusion, hand massage could be effective in decreasing nausea, vomiting, state anxiety, pulse rate and blood pressure of acute leukemia children receiving high dose chemotherapy."
Ji-Eun Han, Master, RN, Young-Im Moon, PhD, and Ho-Ran Park, PhD. College of Nursing, Catholic University of Korea, Seoul, none, South Korea, "Effect of Hand Massage on Nausea, Vomiting and Anxiety of Childhood Acute Lymphocytic Leukemia with High Dose Chemotherapy," Presented at Back to Evidence-Based Nursing: Strategies for Improving Practice, Sigma Theta Tau International, July 21, 2004
The purpose of this study was to identify the effects of foot reflexology on nausea, vomiting and fatigue in breast cancer patients undergoing chemotherapy.
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 posttests 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. The collected data were analyzed by repeated measures ANOVA using the SPSS WIN 10.0 program.
ResultsThere 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.
ConclusionFoot 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
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.
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.
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.
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," J Korean Acad Fundam Nurs. 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
To examine the effectiveness of reflexology foot massage in hospitalized cancer patients undergoing second or third chemotherapy cycles.
Since the late-1970s, studies have been conducted to assess the efficacy of behavioral and relaxation approaches in controlling nausea/vomiting, anxiety and other side-effects associated with chemotherapy.
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 therapeutic massage. The subjects' selfreports of anxiety (measured by the Spielberger State-Trait Anxiety Inventory) were recorded before, after and 24 hours after the intervention.
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).
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.
Quattrin, R, Zanini A, Buchini S, Turello D, Annunziata D, Vidotti, C, Colobatti A, Brusagerro S, "Use of reflexology foot massage to reduce anxiety in hospitalized cancer patients in chemotherapy treatment: methodology and outcomes" Journal of Nursing Management 2006 Mar;14(2):96- 105 PMID: 16487421 Chair of Hygiene, DPMSC School of Medicine, University of Udine, Udine, Italy. r.quattrin@ med.uniud.it
Fatigue is one of the most distressful symptoms experienced by patients with advanced cancer. Aroma therapy, 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.
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 signifi- cantly (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.
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
"Complementary therapies are being accessed increasingly by cancer patients. The aims of this audit were to investigate the impact of reflexology on the quality of life of 20 cancer patients, to determine their satisfaction with the service provided and to investigate the availability of thistherapy within Scottish hospices. The audit findings suggest that the clients were satisfied with the service received. Respondents noted that their quality of life was improved through a reduction in physical and emotional symptoms. It was found that the provision of reflexology within Scottish hospices varied, with less than half providing this service. The results of this audit suggest that reflexology may be a worthwhile treatment for other cancer patients and requires further research to evaluate the benefits."
Milligan M, Fanning M, Hunter S, Tadjali M, Stevens E, Int J Oalliat Nurs 2002 Oct;8(10):489-96 (PMID: 12419988)
"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 uncontrollable 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.... "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.... "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
Complementary and alternative medicine (CAM) is used by one in ten of the UK population yearly and 47% during their lifetime. One-third of cancer patients seek some form of CAM treatment during their illness. AIM: To evaluate the use of and attitudes to CAM among patients and all health care staff in the Southampton Cancer Care Directorate (UK).
The Royal South Hants Hospital, Countess Mountbatten and Oakhaven Hospices.
A questionnaire-based survey performed between January 2001 and March 2001.
Two hundred and seventy questionnaires were distributed to patients and 162 responses received. The distribution of cancers within this population was generally typical of those in the community. Thirty-two percent (n = 52) were receiving some form of CAM, half of those receiving CAM were in hospice care. Forty-nine percent of those not receiving CAM would like to, and 76% of all patients would be prepared to pay for this treatment. The five most popular treatments were massage, nutrition, aromatherapy, relaxation and reflexology. While most patients expected CAM to palliate their symptoms (n = 149, 92%), some had unrealistic expectations that CAM would cure their cancer (n = 13, 8%). Four hundred and forty-eight staff questionnaires were distributed and 196 responses were received: 148 (75.5%) from nurses. Twenty-one percent of staff responding had CAM training and two-thirds would like to receive training. The most popular therapies used by staff were the same as those identified by the patients. Ninety-nine percent of staff and 98.5% of patients wished to see CAM treatments introduced into service provision within the CancerCare Directorate.
The use of CAM for cancer care in Southampton is widespread and consistent with its use nationally. There is a clearly expressed need for CAM treatments by patients and a willingness to pay. Two-thirds of the cancer care staff responding wished to receive training in and provide these therapies. There are some misconceptions among patients about the role of CAM in cancer care which need to be discussed and resolved. We believe that all cancer care units should have clear policies on the use of CAM for cancer patients."
Lewith GT, Broomfield J, Prescott P. "Complementary cancer care in Southampton: a survey of staff and patients," Complement Ther Med. 2002 Jun;10(2):100-6. (University of Southampton, GL3@soton.ac.uk) PMID: 12481958
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