Comparing the Effect of Foot and Hand Reflexology on Pain Severity after Appendectomy: A Randomized Clinical Trial

Effect of Combining Dhikr and Prayer Therapy on Pain and Vital Signs in Appendectomy Patients: A Quasi-Experimental Study

Purpose: Dhikr and prayer reduce pain and improve a patient's vital signs. However, the interactions among these require further clarification in patients undergoing appendectomy. This study aimed to assess the effects of the combination of dhikr and prayer on pain, pulse rate, respiratory rate, and oxygen saturation. Study design: Quasi-experimental design. Method: Pain, pulse, respiratory rate, and oxygen saturation were measured via clinical examination immediately after leaving the recovery room at 1 and 2 hr after surgery in both the experimental and control groups. In total, 88 eligible participants were allocated to two groups: participants who received both dhikr and prayer (n  =  44), and those who received routine care without analgesic therapy (n  =  44). The chi-square test, independent t test, and general equation model were employed. Results: Respondents showed a significant interaction between group and time to decrease in pain, pulse, respiratory rate, and improved oxygen saturation, except for pain within 1 hr. The differences in all outcome scores between the groups after 1 and 2 hr were statistically significant, except for oxygen saturation after 1 hr. Conclusion: The combination of dhikr and prayer effectively decreased pain and improved vital signs. This helped nurses implement this procedure by promoting an essential culture of spiritual care for appendectomy patients.

Effect of Foot Reflexology and Benson Relaxation on Pain, Breastfeeding and Weight of Neonates of Women Undergoing a Cesarean Section

BACKGROUND

Given the negative effect of postoperative pharmacological pain control on breastfeeding, the present study aimed to compare the effects of reflexology and Benson relaxation methods on pain, breastfeeding, and infant weight gain in women undergoing a cesarean section (C/S).

METHODS

This randomized clinical trial was conducted on 135 women undergoing a C/S in the Gynecology Ward of Bushehr Persian Gulf Martyrs Hospital in Bushehr, Iran, in 2020. The participants were selected using convenience sampling, and randomly divided into three groups of foot reflexology, Benson relaxation, and control. The interventions were performed two hours post-operation and six hours after the first intervention. The pain score was measured and recorded immediately, and 30 and 60 minutes after each intervention. Breastfeeding frequency and duration were also assessed in the first 18 hours of birth. The infants' weight was assessed at birth and 10 days later. Data analysis was performed using inferential statistics, chi-square or Fisher's exact test, Kruskal-Wallis test, Mann-Whitney U or one-way ANOVA, Wilcoxon test and logistic regression analysis.

RESULTS

There was a larger decrease in the pain score of the reflexology and Benson relaxation (P<0.01) groups after the first and second interventions, compared to the control group. The breastfeeding frequency was higher in the two intervention groups, compared to the control group (P<0.001). Furthermore, the rate of return to the birth weight in ten days of birth was higher in the reflexology (P<0.01) and Benson groups (P<0.05) than the control group.

CONCLUSION

Both the reflexology and the Benson relaxation methods effectively decreased pain and increased breastfeeding frequency and the infant's weight gain.

Effect of Reflexology on Decreasing Postoperative Pain and Anxiety After Total Abdominal Hysterectomy

Surgical patients experience both postoperative pain and anxiety, as they try to cope with pain. Despite technological advances, pharmacological methods are inadequate for decreasing postoperative pain and anxiety. Reflexology has been implemented and considered effective in these areas in many countries. The aim of this study was to determine the effect of reflexology on decreasing postoperative pain and anxiety after a hysterectomy. The study was an intervention randomized study. The population of the investigation is all patients who had a hysterectomy between February 2012 and December 2014 in the Istanbul University Obstetrics and Gynecology service. The sample was 100 women chosen after a power analysis (minimum: 74) (experimental: 54, control: 46) within the population of the investigation who agreed to participate in the study. Using a table of random numbers, patients in the sample were divided into groups. Data was collected using the patient information and vital signs form, State-Trait Anxiety Inventory (STAI-I), Visual Analog Scale (VAS) Pain and Anxiety Scales, and BRIEF pain inventory. All women in the groups had similar sociodemographic, obstetric, and pain characteristics, past experience of illness, and characteristics related to their hysterectomy. All of the patients in the reflexology group stated that reflexology helped them feel better. The reflexology group compared with the control group had lower than the average VAS pain and VAS and STAI anxiety at all assessment times. Reflexology is effective in reducing anxiety and pain.

Effectiveness of Breathing Exercises, Foot Reflexology and Massage (BRM) on Maternal and Newborn Outcomes Among Primigravidae in Saudi Arabia: A Randomized Controlled Trial

BACKGROUND

Labor pain and anxiety are important concerns during labor, especially among the primigravidae. It may increase the duration of labor, increase stress hormones, and affect maternal and new-born related outcomes. This study examined the effectiveness of combined breathing exercises, foot reflexology, and massage (BRM) interventions on labor pain, anxiety, labor duration, stress hormone levels, maternal satisfaction, maternal vital signs, and the new-born's APGAR scores.

PARTICIPANTS AND METHODS

This single-blind-parallel randomized controlled trial (RCT) was conducted at the Maternity and Children Hospital (MCH), Makkah, Saudi Arabia, by recruiting primigravidae aged 20 to 35 years, without any medical complications, and who were block-randomized at six-centimeter cervical dilation and stratified by intramuscular pethidine. The intervention is BRM compared to standard care. The labor pain was measured via present behavioral intensity (PBI) and visual analogue scale (VAS), and the anxiety was measured via Anxiety Assessment Scale for Pregnant Women in Labor (AASPWL). The secondary outcomes were duration of labor, maternal stress hormone levels, maternal vital signs, maternal satisfaction, fetal heart rate, and APGAR scores. All outcomes were measured at multiple time-points during and after contraction at baseline, during BRM intervention, at 60, 120, and 180 minutes post-intervention. Generalized linear mixed models were used to estimate the intervention effects over time.

RESULTS

A total of 225 participants were randomized for the control (n = 112) and intervention group (113). BRM lowered the labor pain intensity at 60 minutes after intervention during (1.3 vs 3.5, F = 102.5, p < 0.001) and after contraction (0.4 vs 2.4, F = 63.6, p < 0.001) and also lowered anxiety (2.9 vs 4.2, F = 80.4, p < 0.001). BRM correspondingly lowered adrenocorticotropic (ACTH) (133 vs 209 pg/mL, p < 0.001), cortisol (1231 vs 1360 nmol/mL, p = 0.003), and oxytocin (159 vs 121 pg/mL, p < 0.001). It also shortened the labor duration (165 vs 333 minutes, p < 0.001), improved vital signs, which resulted in higher APGAR scores, and increased maternal satisfaction.

CONCLUSION

The labor unit management could consider adopting BRM as one of the non-pharmacological analgesia for healthy women in labor.

TRIAL REGISTRATION

ISRCTN87414969, registered 3 May 2019.

The effects of foot reflexology on pain and physiological indicators in children with leukemia under chemotherapy: a clinical trial study

BACKGROUND

Foot reflexology is a popular complementary medicine method; however, previous studies have shown conflicting results. This study aimed to investigate the impact of foot reflexology on pain and physiological responses caused by intrathecal injection of chemotherapy drugs in children with leukemia.

MATERIALS AND METHODS

This clinical trial included 80 children with leukemia. The participants received 20 min foot reflexology (10 min each foot). The primary measured outcomes included pain and physiological indicators (blood pressure and heart rate).

RESULTS

The results showed that foot reflexology had a significant effect on reducing pain (p = 0.002) and improving physiological indicators [blood pressure (p = 0.002) and heart rate (p = 0.003)].

CONCLUSION

Based on the results of the present study, which shows the positive effect of foot reflexology on the improvement of pain and physiological indicators, foot reflexology can be used as a complementary treatment along with conventional therapies.

Comparison of the effect of foot reflexology and body massage on physiological indicators and bilirubin levels in neonates under phototherapy

BACKGROUND

Hyperbilirubinemia is one of the most common problems in infancy in the world. The aim of this study was to compare the effect of foot therapy and body massage on physiological indicators and bilirubin levels in infants under phototherapy.

METHODS

This study was a randomized clinical trial that conducted on 51 infants with jaundice at Imam Hussein Pediatrics' Medical Center, Goldis Hospital in Isfahan (Iran). The samples randomly assigned to first intervention (reflexology), second intervention (body massage) and control groups using the block randomization. In the reflexology group, the relevant area on each foot was massaged for 15 min in a relaxed position. In the massage body group, the limbs were massaged with circular motion. The massage was performed once a day for 15 min and the control group did not receive any intervention. Physiological indicators were monitored using vital sign monitoring tools, and blood bilirubin levels were measured photo metrically (intravenous blood samples from the wrist). Finally, the data were analyzed using descriptive and inferential statistics and SPSS software version 18.

RESULTS

The results showed that before the intervention there was no significant difference in the mean of physiological indicators and bilirubin level between the three groups (p > 0.05), but after the intervention the average percentage of arterial oxygen saturation and bilirubin levels were significantly improved in the intervention groups compared to the control group (p < 0.05), while the mean of heart rate and respiration rate between the three groups were not significant (p > 0.05).

CONCLUSION

The results showed that reflexology and massage therapy can be effective in improving the condition of physiological indicators and blood bilirubin levels.

Effectiveness of breathing exercises, foot reflexology and back massage (BRM) on labour pain, anxiety, duration, satisfaction, stress hormones and newborn outcomes among primigravidae during the first stage of labour in Saudi Arabia: a study protocol for a randomised controlled trial

INTRODUCTION

Labour pain is among the severest pains primigravidae may experience during pregnancy. Failure to address labour pain and anxiety may lead to abnormal labour. Despite the many complementary non-pharmacological approaches to coping with labour pain, the quality of evidence is low and best approaches are not established. This study protocol describes a proposed investigation of the effects of a combination of breathing exercises, foot reflexology and back massage (BRM) on the labour experiences of primigravidae.

METHODS AND ANALYSIS

This randomised controlled trial will involve an intervention group receiving BRM and standard labour care, and a control group receiving only standard labour care. Primigravidae of 26-34 weeks of gestation without chronic diseases or pregnancy-related complications will be recruited from antenatal clinics. Eligible and consenting patients will be randomly allocated to the intervention or the control group stratified by intramuscular pethidine use. The BRM intervention will be delivered by a trained massage therapist. The primary outcomes of labour pain and anxiety will be measured during and after uterine contractions at baseline (cervical dilatation 6 cm) and post BRM hourly for 2 hours. The secondary outcomes include maternal stress hormone (adrenocorticotropic hormone, cortisol and oxytocin) levels, maternal vital signs (V/S), fetal heart rate, labour duration, Apgar scores and maternal satisfaction. The sample size is estimated based on the between-group difference of 0.6 in anxiety scores, 95% power and 5% α error, which yields a required sample size of 154 (77 in each group) accounting for a 20% attrition rate. The between-group and within-group outcome measures will be examined with mixed-effect regression models, time series analyses and paired t-test or equivalent non-parametric tests, respectively.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the Ethical Committee for Research Involving Human Subjects of the Ministry of Health in the Saudi Arabia (H-02-K-076-0319-109) on 14 April 2019, and from the Ethics Committee for Research Involving Human Subjects (JKEUPM) Universiti Putra Malaysia on 23 October 2019, reference number: JKEUPM-2019-169. Written informed consent will be obtained from all participants. Results from this trial will be presented at regional, national and international conferences and published in indexed journals.

TRIAL REGISTRATION NUMBER

ISRCTN87414969, registered 3 May 2019.