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The Effect of Foot Reflexology Massage on Sleep Quality in Women With Type 2 Diabetes; a Clinical Study

Authors:
Original Article | Sci J Hamadan Nurs Midwifery Fac. 2018; 26 (5)
Scientific Journal of Hamadan Nursing & Midwifery Faculty - ISSN 2008-2819
1. Instructor, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University
of Medical Sciences, Tehran, Iran
2. Associate Professor, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran
University of Medical Sciences, Tehran, Iran
3. Professor of Biostatistics, Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares
University, Tehran, Iran
4. MSc Of Nursing, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran
University of Medical Sciences, Tehran, Iran
Shadan Pedram Razi 1, Shokoh Varaei 2, Anoushirvan Kazemnejad 3, Fatemeh Bagheri*4
Introduction: Sleep disorders are one of the most important problems in patients
with diabetes. The most commonly used method for treating sleep disorders is med-
ication therapy. Therefore, it is important to perform an uncomplicated intervention
to relieve sleep disorders in these patients. The aim of this study was to investigate
the effect of foot reflexology massage on the quality of sleep in women with type 2
diabetes mellitus in Arak city in 2017.
Methods: This study was a simple randomized clinical trial performed on 54
women with type 2 diabetes mellitus. Patients were randomly divided into control
and intervention groups. Before the intervention, Pittsburgh sleep quality question-
naire was completed for both groups. In the intervention group, foot reflexology
massage was performed for 8 sessions. After the intervention, sleep quality ques-
tionnaire was completed for both patients. Data was analyzed using SPSS version
24 by Mann-Whitney, Chi-square and T-test.
Results: Foot reflexology massage improved sleep quality in the intervention
group (P<0.001). There was no significant difference in the quality of sleep in the
control group (P>0.05).
Conclusion: Foot reflexology massage improved the sleep quality of women
with type 2 diabetes mellitus. Foot reflexology massage can be used as an effective
intervention to improve the quality of sleep in these women.
Keywords: Massage, Sleep quality, Type 2 Diabetes Mellitus
Fatemeh Bagheri, MSc Of Nursing, Department of Medical Surgical Nursing, School of Nursing and Mid-
wifery, Tehran University of Medical Sciences, Tehran, Iran. Email: Fatemehbagheri817@yahoo.com
Copyright © 2018, Sci J Hamadan Nurs Midwifery Fac. This is an open-access article distributed under the terms of the Creative Commons Attribution-noncommer-
cial 4.0 International License which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
Pedram Razi S, Varaei S, Kazemnejad A, Bagheri F. The Effect of Foot Reflexology Massage on Sleep
Quality in Women With Type 2 Diabetes; a Clinical Study. Sci J Hamadan Nurs Midwifery Fac. 2018; 26
(5): 283 - 289
Abstract
DOI:
Original Article
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Published Online:
2017/10/20
2017/11/18
2017/12/2
The Effect of Foot Reflexology Massage on Sleep Quality in Women With Type 2
Diabetes; a Clinical Study
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Original Article | Sci J Hamadan Nurs Midwifery Fac. 2018; 26 (5): 283 - 289
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      


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
         

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
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

      

 
   
 




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
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1397 ید و رذآ - 5 ۀرامش 26 ۀرود





      

      
     
 

Cho 

Luyster 




Chaput 



       


   
        
    




       


 
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CastroSánchez
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
 Hosseinabadi
 
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        
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

  

       
      
       
      

 
       

     

        
 





       
 

1

 







1. Random Allocation
 
 
  






Kheyri




     

        

         

     
Hosseinabadi

       
  
 


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
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       

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        
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 
       
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      
 
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         
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1397 ید و رذآ - 5 ۀرامش 26 ۀرود



<
<







        





       


       
Seyyedrasooli

Asltoghiri


Mordasi

 
Lee 
       



    Seyyedrasooli  
      


 Asltoghiri 

Mordasi 



Lee


 





Bahraini 

  




      Lee



       
 
 
Yeung      



KimSong
    
Field






     






 
 

         


 
       




      

 






         
 IR.TUMS.FNM.REC.1395.1654
 IRCT2017091236148N1



 
       




References
1. Wild S, Ruglie G, Grcon A. Global prevalence of
diabetes estimates for the year 2000 and prgec-
tion for Diabetes Care 2004; 27: 1047-53.
2. Khaledi S, Moridi G, Gharibi F.Quality of life for
patien with diabetes type II referred to Sanandaj
Diabetes Center. Journal of Fasa Universily of
Medical Sciences 2011; l: 29-37.
3. Joshi SK, Shrestha S. Diabetes mellitus: a review
of its associations with different environmental
factors. Kathmandu Univ Med J (KUMJ) 2010; 8:
109-15. https://doi.org/10.3126/kumj.v8i1.3233
4. Mensink M, Blaak EE, Corpeleijn E, Saris WH,
de Bruin TW, Feskens EJ. Lifestyle interven-
tion according to general recommendations im-
proves glucose tolerance.Obes Res 2003; 11:
1588-96. https://doi.org/10.1038/oby.2003.211
PMID:14694225
5. Lena M, Jan B, Jerkir A. High incidence of dia-
betes in men with sleep complaints or short sleep
duration American Diabetes Association 2005;
28:2762-67
6. Nakajima H, Kaneita Y, Yokoyama E, Harano S,
Tamaki T, Ibuka E, Kaneko A, Takahashi I, Ume-
da T, Nakaji S, Ohida T. Association between
sleep duration and hemoglobin A1c level. Sleep
medicine. 2008 Oct 1;9(7):745-52.
7. Khealani BA. Neurobiology of Sleep. Pakistan
Journal of Neurological Sciences. Neurobiology
of Sleep. 2006; 3:155-58.
8. Ghorbani A, Farahani MA, Mohammadi N.Rela-
tionship between sleepiness, physical activity,and
functional outcomes in iranian patients with type
II diabetes.Jundishapur J Chronic Dis Care2014;
3(1): 54-60.
9. Cho EH, Lee H, Ryu OH, Choi MG, Kim
SW.Sleep Disturbances and Glucoregulation
in Patientswith Type 2 Diabetes.J Korean Med
Sci2014;29(2): 243-7. https://doi.org/10.3346/
jkms.2014.29.2.243 PMID:24550652
10. Luyster FS, Dunbar-Jacob J. Sleep quali-
ty andquality of life in adults with type 2 di-
abetes.Diabetes Educ 2011; 37(3): 347-55.
https://doi.org/10.1177/0145721711400663
PMID:21467248 PMCID:PMC3220408
11. Gottlieb DJ, Punjabi NM, Newman AB, Resnick
HE, Redline S, Baldwin CM, et al. Association
of sleep time with diabetes mellitus and impaired
glucose tolerance. Archives of Internal Medi-
cine 2005; 165:836-68. https://doi.org/10.1001/
archinte.165.8.863 PMID:15851636
12. Nilsson PM, Rööst M, Engström G, Hedblad
B, Berglund G. Incidence of diabetes in mid-
dle-aged men is related to sleep disturbanc-
es. Diabetes care. 2004 Oct 1;27(10):2464-9.
https://doi.org/10.2337/diacare.27.10.2464
PMID:15451917
13. Chaput JP, Després JP, Bouchard C, Tremblay
A. Association of sleep duration with type 2
diabetes and impaired glucose tolerance. Di-
abetologia. 2007 Nov 1;50(11):2298-304.
https://doi.org/10.1007/s00125-007-0786-x
PMID:17717644
14. Montgomery P, Dennis J. Physical exercise for
sleep problems in adults aged 60. The Cochrane
Database of systematic reviews.2002; 4CD
003404.



1397 ید و رذآ - 5 ۀرامش 26 ۀرود
15. Snyder L, editor. Complementary and Alterna-
tive Medicine: Ethics, the Patient, and the Physi-
cian. Springer Science & Business Media; 2007
Nov 17. https://doi.org/10.1007/978-1-59745-
381-3
16. Speroff L, Fritz MA, editors. Clinical gynecolog-
ic endocrinology and infertility. lippincott Wil-
liams & wilkins; 2005.
17. Phuyorit P. Effect of foot reflexology on numb-
ness and foot pressure in persons with type 2 dia-
betes. (ThesisMaster of Nursing Science). Mahi-
dol University; 2009.
18. Dalal K, Maran VB, Pandey RM, Tripathi M.
Determination of efficacy of reflexology in man-
aging patients with diabetic neuropathy: A ran-
domized controlled clinical trial. Evidence-Based
Complementary and Alternative Medicine.
2014;2014.
19. Castro-Sánchez AM, Moreno-Lorenzo C,
Matarán- Pe-arrocha GA, et al. Connective tis-
sue reflex massage for type 2 diabetic patients
with peripheral arterial disease: randomized con-
trolled trial. Evid Based Complement Alternat
Med 2011. https://doi.org/10.1093/ecam/nep171
20. Hosseinabadi R, Norozi K, Pourismail Z, Karim-
lo M, Madah SB. Effect of Massage pressure
points on sleep quality of elderly. Quarterly Jour-
nal of Rehabilitation. 2008;9(2):8-14.
21. Sadat Izedi Avanji F, Adib Hajibagheri M, Afzal
MR. Sleep quality and related factors in elderly
patients in Faze hospital.Kashan Univ Med Sci J
2009(12)4:52-59.
22. Kiejna A, Rymaszewska J, Wojtyniak B, Stok-
wiszewski J.Characteristics of sleep distur-
bances in Poland: results of the National Health
Interview Survey. Acta Neuropsychiatrica
2004,16:124-129. https://doi.org/10.1111/j.0924-
2708.2004.00063.x PMID:26984163
23. Gunter H. The effect of reflexology on blood
glucose levels and quality of life in adults with
diabetes mellitus type 2 (Doctoral dissertation,
Cardiff Metropolitan University).
24. Kheyri AZ, Bastani FA, Haghani HA. Effects of
reflexology on sleep quality of elderly women
undergoing abdominal surgery’. Journal of Cli-
ent-Centered Nursing Care. 2016;2(1):11-8.
25. Goosmann L, Astrid I. Reflexology foot mas-
sage points. Tehran: Nil Publication; 2010.
PMCID:PMC3125121
26. Valizadeh L, Seyyedrasooli A, Zamanazadeh V,
Nasiri K. Comparing the effects of reflexolo-
gy and footbath on sleep quality in the elderly:
a controlled clinical trial. Iranian Red Crescent
Medical Journal. 2015 Nov;17(11). https://doi.
org/10.5812/ircmj.20111
27. Jasvir K, Sukhpal K, Neerja B. Effect of foot
massage and reflexology on physiological pa-
rameters of critically ill patients. Nurs Midwif
Res. 2012;8(3):223-33
28. Arab Z, Shariati A, Bahrami H, Asayesh H, Va-
kili M. The Effect of Acupressure on Quality of
Sleep in Hemodialysis Patients. J Nurs Midwife-
ry Urmia Univ Med Sci. 2012;10(2):237-45.
29. Asltoghiri M, Ghodsi Z. The effects of Reflex-
ology on sleep disorder in menopausal women.
Procedia Soc Behav Sci. 2012;31:242-6. https://
doi.org/10.1016/j.sbspro.2011.12.049
30. Seyyedrasooli A, Valizadeh L, Zamanzadeh V,
Gasemi O, Nasiri J. The effect of reflexology on
sleep quality of elderly: A single–blind clinical-
trial. Med Surg Nurs J. 2013;2(1):18-1.
31. Song RH, Kim DH.The effects of foot reflexion
massage on sleep disturbance, depression dis-
order, and the physiological index of the elder-
ly. Taehan Kanho Hakhoe Chi. 2006; 36(1):15-
24. https://doi.org/10.4040/jkan.2006.36.1.15
PMID:16520560
32. Mordasi F, Taddaion M, Najja S, Haghighizadeh
M. The Effect of Foot Massage on Sleep Disor-
ders among Mothers in Postpartum Period. Ira-
nian J Obstet Gynecol Infert. 2013;16(73):19-28
33. Lee CY, Chen SF, Li CF, Gau MF, Huang CM.
Randomised controlled trial of the effectiveness
of using foot reflexology to improve quality of
sleep amongst Taiwanese postpartum women. El-
sevier. 2011;27(2):181-6. PMID:19577829
34. Bahraini S, Naji A, Mannani R, Bekhradi R. The
effect of massage therapy on the quality of sleep
in women with multiple sclerosis being admited
by Isfahan M.S. Association. Journal of Nursing
and Midwifery Urmia University of Medical Sci-
ences. 2010;8(4)
35. Yeung WF, Chung KF, Poon MM, Ho FY, Zhang
SP, Zhang ZJ, et al. Acupressure, reflexology, and
auricular acupressure for insomnia: a systemat-
ic review of randomized controlled trials. Sleep
Med. 2012;13(8):971-84. PMID: 22841034
36. Song RH, Kim DH. The effects of reflexion mas-
sage on sleep disturbance depression disorder
and the physiological index of the elderly. Taehan
Kanho Hakhoe Chi. 2006;36(1):15-24.https://doi.
org/10.4040/jkan.2006.36.1.15 PMID:16520560
37. Field T, Hernandez-reif M, Diego M, Fraser M.
Lower back pain and sleep disturbance are reduced
following massage therapy. Journal of Bodywork
and Movement Therapies. 2007;11:141-145
https://doi.org/10.1016/j.jbmt.2006.03.001
... The validity of the PSQI was confirmed by Boyce et al. and its internal consistency was also confirmed with a Cronbach's alpha of 0.83 [25]. The validity of the Persian translation of the PSQI questionnaires was confirmed by Pedram et al. [26]. In Iran, the reliability of the PSQI was confirmed by Mohammadzadeh et al. with a Cronbach's alpha of 0.73 [27]. ...
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Full-text available
Purpose The present study aimed to assess the effects of Viola odorata syrup on the sleep quality of postmenopausal women. Methods This triple-blinded randomized clinical trial was conducted on menopausal women presenting to the healthcare centers in Mashhad, Iran, in 2019. The participants were selected using simple random sampling. Participants received 5 ml syrup V. odorata or placebo twice a day for 1 month. Data were collected using the Pittsburgh Sleep Quality Index. The data were analyzed using SPSS version 25. Results The 118 eligible women enrolled in the study were divided into two groups of V. odorata syrup and placebo (n = 59 each). The analysis was conducted on only 84 menopausal women (42 in each group) due to exclusions. Exclusions consisted of 12 participants who withdrew from the study due to unwillingness to cooperate, 8 who had irregular consumption of the therapeutic syrup, 6 with inaccurate completion of the questionnaire, and 8 due to lack of accessibility. The two study groups were homogenous in terms of demographic characteristics. Before the intervention, no significant difference was observed in the mean PSQI score between the two groups (9.2 ± 2.9 vs. 8.4 ± 2.5) (P = 0.18). However, a significant difference was seen in the mean PSQI score between the two groups (4.9 ± 1.9 vs. 8.1 ± 2.1, P < 0.001) after the intervention. Conclusions The findings of this study suggest that V. odorata syrup may be a useful therapeutic agent to improve the sleep quality of menopausal women. Registration code IRCT20180514039660N1.
... In addition, it has been observed in other studies in the literature that reflexology or foot massage applied in different samples has favorable effects on sleep disorders. 47,54 In this study, according to the comparison of the posttest Pretest. ...
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Objective: This study aims to determine the impact of foot massage given to postmenopausal women on anxiety, fatigue, and sleep. Methods: This randomized-controlled study was conducted with 70 women (35 experimental, 35 control) who resided in a village located in Northern Turkey. In the study, the women in the experimental group were given foot massage once every day for 7 days. No intervention was applied to the women in the control group. The data were collected using a Personal Information Form, the Fatigue Severity Scale (FSS), and the Beck Anxiety Inventory (BAI) Descriptive statistics (frequency, percentage distribution, median, and Q1-Q3), χ2 test, Mann-Whitney U test, and Wilcoxon test were used in the analysis of the data. Results: It was found that the women in the control group had lower pretest BAI scores than those in the experimental group (P < 0.05), whereas before the foot massage intervention, the women in the experimental and control groups had similar FSS scores and sleep hours (P > 0.05). After the foot massage, the FSS scores were 2.3 (1.6-3.4) in the experimental group and 5.5 (4.6-6.2) in the control group, the BAI scores were 26.0 (23.0-29.0) in the experimental group and 36.0 (31.0-43.0) in the control group, the daily sleep hours were 8.0 (8.0-10.0) in the experimental group and 7.0 (6.0-8.0) in the control group, and the differences between the groups were statistically significant (P < 0.001). Conclusions: It was determined that foot massage applied during menopause increases the average daily sleep duration (hours) and reduces women's fatigue and anxiety levels.
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Introduction: Hemodialysis is one of the chronic diseases that has negative effects on all aspects of the patient’s life. The quality of life of patients with hemodialysis is impaired due to the many problems and chronic nature of the disease. Also, fatigue is one of the common problems of these patients. The aim of this study was to evaluate the effect of sleep health education on the severity of fatigue and quality of sleep in hemodialysis patients in Hamadan. Methods: In this quasi-experimental study, 60 hemodialysis patients were selected by available sampling from Besat (Intervention) and Beheshti (Control) hospitals. All samples completed the demographic checklist, Piper Fatigue scale and Pittsburgh Sleep Quality Index (PSQI). The control group received routine care and the intervention group, received sleep hygiene education face to face and by providing educational booklet in 3 consecutive dialysis sessions. After two months of training, sleep quality and fatigue intensity of the samples were checked. To analyze the data, SPSS software, descriptive and inferential tests were used. Results: There were no significant differences between the intervention and control groups in terms of underlying variables. There was a significant difference between the control and intervention groups regarding quality of sleep and fatigue after sleep hygiene education (P
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Background: Sleep disorder is one of most prevalent complaints in elderly people. Tension reduction can be effective in improving sleep quality. In this regard, reflexology can be effective in reducing anxiety and tension. This study aimed to determine reflexology effects on sleep disorders of elderly women undergoing abdominal surgery. Methods: This study was a non-randomized clinical trial (quasi-experimental). A total of 80 elderly women undergoing abdominal surgery were selected by continuous sampling method and simple random selection of two hospitals (Hazrat-e-Rasool [PBUH] and Firouzgar). Then, they were assigned in experimental and control groups. The study instrument was sleep quality questionnaire (PSQI). Descriptive statistics included calculating mean and standard deviation and inferential statistics were performed through the independent t-test and paired t-test. Results: There was no significant difference in terms of quality of sleep (P=0.504) between control and experimental groups, before the intervention. Also, There was no significant difference between means of quality of sleep scores (P=0.606) before and after the intervention in the control group. However, there was a significant difference between the means of quality of sleep scores (P=0.048) before and after the intervention in the experimental group. Finally, the means of quality of sleep scores of two groups after the intervention was significantly different (P
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Background: Sleep disorders are common mental disorders reported among the elderly in all countries, and with nonpharmacological interventions, they could be helped to improve their sleep quality. Objectives: The aim of this study was to compare the effects of two interventions, foot reflexology and foot bath, on sleep quality in elderly people. Patients and methods: This three-group randomized clinical trial (two experimental groups and a control group) was conducted on 69 elderly men. The two experimental groups had reflexology (n = 23) and foot bath (n = 23) interventions for 6 weeks. The reflexology intervention was done in the mornings, once a week for ten minutes on each foot. The participants in the foot bath group were asked to soak their feet in 41°C to 42°C water one hour before sleeping. The pittsburgh sleep quality index (PSQI) was completed before and after the intervention through an interview process. Results: The results showed that the PSQI scores after intervention compared to before it in the reflexology and foot bath groups were statistically significant (P = 0.01 , P = 0.001); however, in the control group did not show a statistically significant difference (P = 0.14). In addition, the total score changes among the three groups were statistically significant (P = 0.01). Comparing the score changes of quality of sleep between the reflexology and foot bath groups showed that there was no significant difference in none of the components and the total score (P = 0.09). The two interventions had the same impact on the quality of sleep. Conclusions: It is suggested that the training of nonpharmacological methods to improve sleep quality such as reflexology and foot bath be included in the elderly health programs. In addition, it is recommended that the impact of these interventions on subjective sleep quality using polysomnographic recordings be explored in future research.
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Complementary and Alternative Medicine examines the real-life implications of patient issues and the healthcare system in which care is delivered. Because complementary and alternative medicine (CAM) are not presently considered to be a part of conventional medicine, this book discusses the effect that CAM has on patients, physicians, healthcare, and policymakers. Also included are the implications that CAM has on traditional patient-physician relationships as well as the physician's ethical obligations on this subject.
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Introduction: Postpartum period is transition to a critical stage and the rapid changes that are experienced during postpartum expose mothers to unpleasant experiences such as changes in sleep pattern. Massage as one of the complementary therapies lead mothers to accelerate recovery in sleep disorders. The aim of this study was to determine the effect of foot massage to improve sleep disorders in post partum mothers. Methods: This randomized clinical trial was conducted on 60 primiparous women who referred to health care centers in Khoramshahr, Iran in 2011. Samples were divided randomly into two groups (30 women in intervention group and 30 women in control group).Data were collected by a questionnaire included demographic characteristics and Pittsburgh Sleep Quality Index. The intervention group received a single 30-minute foot massage session each evening at the same time for five consecutive days and the control group has not received any intervention. Research information were collected on enrollment (13th day after delivery), immediately after intervention and one week after the intervention were collected. Data were analyzed by SPSS software version 17, repeated measure, chi-square and paired t-tests. P value less than 0.05 was considered significant. Results: Mean of Pittsburgh sleep quality index in before, immediately after and a week after intervention showed significance differences (p<0.001) at the end of study. Conclusion: Foot massage was effective on improvement sleep disorders in mothers. Therefore foot massage is recommended to enhance the quality of postpartum care.
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