Article

Partner-Delivered Reflexology: Effects on Cancer Pain and Anxiety

February 2007
Oncology Nursing Forum 34(1):127-32

DOI:10.1188/07.ONF.127-132

Source
PubMed

Authors:

Nancy Stephenson

East Carolina University

Melvin Swanson

East Carolina University

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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. 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. 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.

The effects of reflexology on anxiety, depression and quality of life in patients with gynecological cancers with reference to Watson's theory of human caring

Article

Jun 2021
Compl Ther Clin Pract

Objectives This study aimed to examine the effects of reflexology based on Watson’s theory of human caring on anxiety, depression, and quality of life in gynecological cancer patients. Material and Methods The study was a prospective, single-blind, randomized controlled trial with a pretest-posttest and a control group. The clinical trial was conducted at a university hospital in the Aegean region between October 2016 and June 2018. It was completed with 62 women, of whom 31 were in the intervention group and 31 were in the control group. Data were collected by using a personal information form, the Beck Anxiety Inventory, the Beck Depression Inventory, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-version 3.0. Results Anxiety and depression levels were lower in the intervention group than in the control group. Besides, the quality of life was higher in the intervention group than in the control group. Reflexology significantly reduced symptoms due to chemotherapy, such as fatigue, pain, insomnia, and loss of appetite. Although there was a decrease in symptoms, such as nausea, vomiting, diarrhea and constipation immediately after reflexology, an increase in symptoms was observed in the intervention group two weeks later. Conclusion These results showed that reflexology based on Watson’s theory of human caring is effective in reduction of anxiety and depression and improves the quality of life in gynecological cancer patients during chemotherapy. It can be suggested that offering reflexology at certain intervals during chemotherapy will increase the duration of its effect.

Complementary therapy in palliative care: A synthesis of qualitative and quantitative systematic reviews

Article

Full-text available

Jul 2020

Background Interventions delivered in palliative care are complex and their evaluation through qualitative and quantitative research can lead to contrasting results. In a systematic review of trials, the effectiveness results of complementary therapies in palliative care were inconclusive; however, our qualitative synthesis showed participants perceived them to be beneficial. Aim Use a novel methodology to synthesise evidence from qualitative and quantitative systematic reviews on complementary therapy in palliative care to explore the following: (1) If interventions delivered in trials reflect how participants in qualitative studies report they are delivered in real-life settings and (2) whether quality of life measures used in trials capture perceived benefits that are reported in qualitative studies. Methods Two matrix tables were formulated. In one, key components in delivery of the complementary therapy from the qualitative synthesis which are as follows: (1) relationship with therapist, (2) comfortable environment, (3) choices (e.g. area of massage) and (4) frequent sessions, were plotted against intervention description, to explore matches and mismatches. In the other, items included in quality of life scales were compared with perceived benefits of complementary therapy. Results None of the trials included all four key delivery components. The five quality of life scales used in the trials failed to capture the range of perceived benefits from the complementary therapies and many included inappropriate or redundant items. Conclusions By integrating qualitative and quantitative review data, we determined the reasons trials may be inconclusive. This methodological exemplar provides a framework for understanding complexity in outcomes across trials and a direction for future research.

The effectiveness of aromatherapy, massage and reflexology in people with palliative care needs: A systematic review

Article

Full-text available

Oct 2019

Background Aromatherapy, massage and reflexology are widely used in palliative care. Despite this, there are questions about their suitability for inclusion in clinical guidelines. The need to understand their benefits is a public priority, especially in light of funding pressures. Aim To synthesise current evidence on the effectiveness of aromatherapy, massage and reflexology in people with palliative care needs. Design A systematic review of randomised controlled trials (PROSPERO CRD42017081409) was undertaken following international standards including Cochrane guidelines. The quality of trials and their pooled evidence were appraised. Primary outcomes on effect were anxiety, pain and quality-of-life. Data sources Eight citation databases and three trial registries were searched to June 2018. Results Twenty-two trials, involving 1956 participants were identified. Compared with a control, four evaluated aromatherapy, eight massage and six reflexology. A further four evaluated massage compared with aromatherapy. Trials were at an unclear risk of bias. Many had small samples. Heterogeneity prevented meta-analysis. In comparison with usual care, another therapy or an active control, evidence on the effectiveness of massage and aromatherapy in reducing anxiety, pain and improving quality-of-life was inconclusive. There was some evidence (low quality) that compared to an active control, reflexology reduced pain. Conclusions This review identified a relatively large number of trials, but with poor and heterogeneous evidence. New clinical recommendations cannot be made based on current evidence. To help provide more definitive trial findings, it may be useful first to understand more about the best way to measure the effectiveness of these therapies in palliative care.

Caregiver-Delivered Foot Reflexology: Effects on Patients and Caregivers

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Full-text available

Nov 2019

The aim of this study was to evaluate the effects of caregiver-delivered foot reflexology on patients with cancer and their caregivers. A 2-group pre- and posttest design was used in this study, and the study was conducted in an oncology hospital between January 2016 and February 2018. The study included 60 patients and 60 caregivers. Caregivers performed interventions once a day for 15 days. Patients in the experimental group received reflexology, and patients in the control group were included in the reading session. Mean pain, anxiety, and fatigue levels significantly decreased for the patients who received foot reflexology from their caregivers for 15 days compared with patients in the control group. The mean care burden score of the caregivers in both groups decreased. Clinicians should teach caregiving practices such as foot reflexology and know that these practices are a positive influence on both patients and caregivers.

Comparison of the Effects of Hand Reflexology versus Acupressure on Anxiety and Vital Signs in Female Patients with Coronary Artery Diseases

Article

Full-text available

Jan 2019

Hospitalization in the cardiac care unit can increase anxiety in patients. This study aimed to compare hand reflexology versus acupressure on anxiety and vital signs in female patients with coronary artery diseases. This double-blinded randomized placebo-controlled trial with a pre- and post-intervention design was conducted on 135 female patients with coronary artery diseases. Female patients hospitalized in a cardiac care unit were randomly divided into three groups of hand reflexology, acupressure and placebo (n = 45 patients in each group) using blocking and a table of random numbers. Data was collected using the Spielberger anxiety inventory. Also, their vital signs were measured before, immediately after and half an hour after the intervention. Data analysis was performed using descriptive and analytical statistics. Before the intervention, there was no statistically significant difference in anxiety levels between the groups (p > 0.05). Also, the effects of hand reflexology and acupressure immediately and half an hour later on the reduction of anxiety and vital signs were equal (p < 0.05). Implementation of hand reflexology and acupressure can have positive effects on anxiety and vital signs in patients with coronary artery diseases. They can reduce patients’ anxiety with an equal effectiveness.

INVESTIGATING THE EFFECT OF REFLEXOLOGY IN INTENSITY OF PAIN AND ANXIETY AMONG PATIENTS SUFFERING FROM METASTATIC CANCER IN ADULTS’ HEMATOLOGY WARD

Article

Full-text available

Jun 2018

Objective: Findings suggest dissatisfaction of half of the cancer patients regarding pain and anxiety management. This study aimed to determine the effect of reflexology on the intensity of pain and anxiety among patients with metastatic cancer hospitalized inadulthematology ward. Methods: In this study, the samples were selected from adult hematology ward in Baghaei 2 hospital in Ahwaz, Iran, according to the inclusion criteria. They were then assigned into treatment and control groups. In the treatment group, reflexology protocol was performed following manual reflexology method by Fr Josef Eugster based on Ingham method on the patient’s bed. In the control group, sole touching was used as the placebo. Reflexology was performed for three days, 30 min per day. Spielberger questionnaire were provided to the samples and completed in the first and third days, and Spielberger questionnaire was provided to the samples and completed. The data obtained from this study were then analyzed by SPSS 20.Results: The two groups did not show a significant difference in terms of demographic characteristics (p>0.05). Based on the obtained results, it was found that in the test group, there was a significant difference between the mean intensity of pain before and after the treatment across all 3 days as well as the mean anxiety of the 1st and 3rd days (p<0.05). However, in the control group, there was no significant difference in terms of mean pain intensity before and after the treatment across 3 days (p>0.05). No significant difference was observed between the mean anxiety of the 1st and 3rd days either (p>0.05).Conclusion: Considering the findings of this research, it can be concluded that reflexology has a positive effect on mitigating the intensity of pain and anxiety in metastatic cancer patients. Therefore, it is recommended that nurses employed in cancer centers benefit from the findings of this research to further help patients with cancer. It is also suggested that further research be conducted on the effect of reflexology on the pain and anxiety of other patients.

Onkoloji Hemşireliğinde Kanıta Dayalı Bakım Konsensus 2010

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Jan 2010

Gulbeyaz Can

Effect of Reflexology in Treating Cancer Pain: A Meta-Analysis

Article

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Jul 2020

Effect of Reflexology in Treating Cancer Pain: A Meta-Analysis

Article

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Jul 2020

Context: Pain is a common symptom associated with cancer and its treatment. The conventional treatment does not often relieve cancer pain optimally. The complementary therapies are increasingly used as adjunct therapy alongside pharmacological and conventional treatments in patients. Objectives: The aim of this systematic review was to investigate the existing evidence for reflexology effect on cancer pain through a meta-analysis. Data Sources: In this systematic review, electronic databases including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and PubMed were searched to find relevant studies until December 2018. Study Selection: We included before-after studies and trials of interventions that focused on pain management using reflexology modality as an intervention in patients with cancer regardless of cancer type. The effect of reflexology for patients with cancer pain was investigated as the main outcome. Data Extraction: The extracted information included name of authors, year of publication, study location, type of study, sample size, and outcome indicator. Consensus was reached by discussion in case of disagreement during each stage of selection, qualitative assessment, and extraction of data. We assessed heterogeneity using the I2 statistics. The publication bias was explored using the Egger’s and the funnel plot. We meta-analyzed the data and reported the standardized mean difference (SMD) with 95% confidence intervals (CI) using the random-effects model. Meta-analysis was done using the Revman software. Results: Eight studies with 948 participants were analyzed using a random- effects model meta-analysis. Included studies consisted of five randomized clinical trials, one quasi-experimental, and two pre-post design. We observed a positive effect for reflexology in patients with cancer pain compared with usual care (SMD- 0.55 [95% CI-0.82 to 0.21] P < 0.001). Conclusions: This systematic review provides sufficient evidence for the effectiveness of reflexology as an effective treatment in cancer pain. But we recommend conducting studies with larger sample size, well-designed trials with sufficient duration and longer follow-up periods with clear details about reflex practitioners, duration of intervention, instrument for pain assessment, and outcome. Meanwhile, patients should be adequately monitored and adverse effects should be reported. All of the aforementioned issues might affect the impact of reflexology adjuvant treatment.

Body-Centered Interventions for Psychopathological Conditions: A Review

Article

Full-text available

Jan 2020

World-wide, billions of dollars are spent each year on body-centered interventions to alleviate both physical and psychological pathologies. Given the high demand and increasing popularity of body-centered interventions, there is need for a systematic organization of empirical evidence associated with body-centered therapies. This article reviews the psychological effects of body-centered interventions on emotional well-being, including both self and other-administered (receptive) therapies. Theory behind body-centered interventions rely upon the bidirectional communication pathway between the brain and body. We investigated the bidirectional communication pathway between the brain and body by evaluating evidence across multiple body-centered therapies. The research reviewed includes studies that investigate effects of massage therapy, reflexology, acupuncture, functional relaxation, emotional freedom technique, Rolfing, yoga, tai-chi, and dance/movement therapy on psychological conditions across the lifespan. Results demonstrated that overall, massage therapy, tai-chi, dance/movement therapy, functional relaxation, reflexology, acupuncture and emotional freedom technique seem to alleviate stress, depression, anxiety, bipolar disorder and facilitate pain reduction. Of these, the most robust evidence available was for massage therapy, indicating it is an effective intervention for numerous age groups and populations. Rolfing and reflexology had the least amount of support, with few studies available that had small sample sizes. Although these conclusions are limited by scarcity of high-quality empirical data and contradictory findings, available evidence indicates that body-centered interventions can be effective in reducing psychopathology and supports the proposed mechanism of the bidirectional pathway between the brain and body: the body holds the potential to influence the mind. Integrating body-centered therapies in both clinical settings and as self-care could lead to better outcomes. Lastly, we propose the first taxonomy of body-centered interventions and empirical evidence of their effectiveness for clinicians and researchers.

Symptom response analysis of a randomized controlled trial of reflexology for symptom management among women with advanced breast cancer

Article

Full-text available

Mar 2020
SUPPORT CARE CANCER

Purpose To examine symptom responses resulting from a home-based reflexology intervention delivered by a friend/family caregivers to women with advanced breast cancer undergoing chemotherapy, targeted, and/or hormonal therapy. Methods Patient-caregiver dyads (N = 256) were randomized to 4 weekly reflexology sessions or attention control. Caregivers in the intervention group were trained by a reflexology practitioner in a 30-min protocol. During the 4 weeks, both groups completed telephone symptom assessments using the M. D. Anderson Symptom Inventory. Those who completed at least one weekly call were included in this secondary analysis (N = 209). Each symptom was categorized as mild, moderate, or severe using established interference-based cut-points. Symptom response meant an improvement by at least one category or remaining mild. Symptom responses were treated as multiple events within patients and analyzed using generalized estimating equations technique. Results Reflexology was more successful than attention control in producing responses for pain (OR = 1.84, 95% CI (1.05, 3.23), p = 0.03), with no significant differences for other symptoms. In the reflexology group, greater probability of response across all symptoms was associated with lower number of comorbid condition and lower depressive symptomatology at baseline. Compared to odds of responses on pain (chosen as a referent symptom), greater odds of symptom response were found for disturbed sleep and difficulty remembering with older aged participants. Conclusions Home-based caregiver-delivered reflexology was helpful in decreasing patient-reported pain. Age, comorbid conditions, and depression are potentially important tailoring factors for future research and can be used to identify patients who may benefit from reflexology. Trial registration ClinicalTrials.gov Identifier: NCT01582971

Reflexology and cancer

Article

Full-text available

Apr 2018

Reflexology is a complementary alternative medicine procedure carried out by applying pressure to specific points located mostly in the feet (sometimes in the hands), with intent to provide relief from certain symptoms. In reflexology thought to have a history of approximately 5000 years, it is believed that specific points in the feet are linked to certain organs and systems in the body, through energy channels, and that applying pressure to these points provides relief in the relevant organ and system, as well. However, no evidence has yet to be found that proves the alleged connections and mechanisms of reflexology. Indeed, studies carried out up to date were focused on the symptomatic effects of reflexology, rather than such links and mechanisms. In some studies, certain positive results have been obtained especially in terms of pain and anxiety. However, these studies were methodologically incomplete, as well, due to challenges such as the difficulty in creating blinding and placebo effect. As a result, currently we have no reliable evidence about the use of reflexology in any clinical situation. Nevertheless, when it is considered to be a safe procedure in terms of unwanted effects, it can be provided to patients as a supportive care service.

Effect of Reflexology Training for Family Caregivers on Health Status of Elderly Patients with Colorectal Cancer

Article

Full-text available

Jan 2017

Patients with colorectal cancer experience physical, psychological and social challenges and family caregivers are usually not prepared for these new challenges.Foot reflexology is one of the most frequently used complementary therapies and has been shown to be effective for cancer patients.The aim: Determine the effect of reflexology training for family caregivers on health status of elderly patients with colorectal cancer. Design: Quasi-experimental design was used in this study. Setting:This study was carried out at Mansoura University hospital (Oncology Center).Subjects:A purposive sample of 50 elderly patients diagnosed with colorectal cancer and their family caregivers attending in the above mentioned settings within a period of six months.Tools:Six tools was utilized in this study;socio demographic and clinical data structured interview schedule,the short form (36) health survey, hospital anxiety&depression scale, memorial symptom assessment scale,foot reflexology knowledge structured interview schedule and foot reflexology training observational checklist.Results:Family caregivers' reflexology training has a significant positive effect on their knowledge and practices and on elderly patients' health status, anxiety & depression and symptoms management.Conclusion:This study concluded that,the implementation of foot reflexology training for family caregivers was successful in improving their knowledge and practice regarding foot reflexology and in improving the health status of elderly patients with colorectal cancer.

Evaluation des soins de support en cancérologie : bénéfice de la réflexologie plantaire au niveau des nausées/vomissements chimio-induits

Thesis

Mar 2021

Audrey Ringot

« En Février 2016, le troisième rapport sur la « Survie des personnes atteintes de cancer en France métropolitaine 1989-2013 » révèle une amélioration de la survie à 5 ans pour la plupart des cancers. Cette augmentation réside à la fois dans des diagnostics de plus en plus précoces et des thérapeutiques de plus en plus performantes. Ces avancées ont modifié le paradigme du cancer, soit guéri par la chirurgie soit mortel, qui est devenu dépassé car le cancer est devenue une maladie chronique qui nécessite un accompagnement pluriprofessionnel et pluridisciplinaire. Parallèlement, les patients atteints d’un cancer ont de plus en plus recours aux médecines alternatives et complémentaires MAC pour traiter leur cancer, pour prévenir voire diminuer les effets secondaires de la maladie et des traitements et arriver en soutien à leur bien-être physique et psychologique. À partir de 2004 le premier Plan Cancer a établi l’accès aux soins de support définis comme « l’ensemble des soins et soutiens nécessaires aux personnes malades atteintes de maladies graves potentiellement mortelles, tout au long de la maladie, conjointement aux traitements spécifiques, lorsqu’il y en a ». Toutefois, pour la majorité des MAC peu voire aucune preuve scientifique n’est disponible à ce jour, sans oublier le fait qu’elles puissent être plus néfastes que bénéfiques aux patients. Au Centre de Coordination en Cancérologie de l’Hôpital Lyon Sud (Hospices Civils de Lyon), pour répondre aux attentes des patients, des séances de réflexologie plantaire leur sont désormais proposées conjointement à leurs traitements conventionnels. Ce travail de thèse avait trois objectifs : i) faire un état de l’art des preuves scientifiques apportées par des essais cliniques randomisés (ECR) des MAC dans le cadre du cancer, ii) s’assurer que la réflexologie plantaire n’interfère pas avec les pratiques professionnelles, iii) évaluer les bénéfices de la réflexologie plantaire auprès de patients sous chimiothérapie en particulier les nausées/vomissements chimio-induits. Tout d’abord, la revue de la littérature montre que l’évaluation des MAC à l’aide d’ECR au niveau mondial est rare et est essentiellement menés par les États-Unis et la Chine. Ces études concernent principalement l’acupuncture, le yoga et les herbes chinoises avec des bénéfices significatifs au niveau de la qualité de vie globale, fatigue, douleur et anxiété. Enfin, l’évaluation de leur innocuité fait souvent défaut dans ces études. Ensuite, l’enquête réalisée auprès des professionnels de santé de l’hôpital suggère que la réflexologie plantaire délivrée lors des soins conventionnels n’interfère pas avec leur pratique et que ces derniers perçoivent de réels bénéfices pour leurs patients. Enfin les résultats de notre étude prospective contrôlée randomisée montrent une diminution significative des nausées aiguës. Nous observons également une tendance à une diminution des nausées retardées, conjointement à une diminution significative de la consommation des médicaments antiémétiques entre chaque cure de chimiothérapie. Aucun événement indésirable n’a été constaté dans cet ECR. En conclusion, les résultats de ce travail de thèse ont montré que la réflexologie plantaire, accueillie très favorablement par les professionnels de santé, semble être un complément prometteur aux médicaments antiémétiques. Cette thèse ouvre des perspectives de recherches des MAC avec des enjeux de santé publics majeurs : fournir aux professionnels de santé des données scientifiques rigoureuses, évaluer l’innocuité des MAC et améliorer la communication entre les professionnels de santé et les patients à propos des MAC.

Effects of Reflexology on the Pain Intensity among Patients with Depression after Receiving Electroconvulsive Therapy: A Randomized Clinical Trial

Article

Full-text available

Mar 2021

Introduction: High prevalence of psychiatric disorders and the high effectiveness of electroconvulsive therapy (ECT) have made this treatment a useful intervention. Memory impairment, headache, and muscle pain are the most important complications after ECT. This research aimed to determine the effect of reflexology on the headache and muscle pain intensity of patients after receiving ECT. Methods: This randomized controlled trial was conducted in Razi teaching hospital of Urmia, Iran. A total of 56 patients with depression receiving ECT were randomly assigned into two equal groups of control (n=28) and intervention (n=28). In the intervention group, reflexology was performed for 20 minutes at reflex points and, in the control group, only the conventional measures were taken. Pain intensity was measured with visual analogue scale (VAS) before and 1, 6, and 24 hours after the intervention. Data were analyzed using the SPSS software version 13. Furthermore, chi-square, Mann-Whitney, Wilcoxon, and repeated-measures tests were performed. Results: The mean difference in the severity of headache and muscle pain in the intervention group was significantly reduced compared to the control group. Moreover, the results demonstrated a significant difference between the mean headache and muscle pain in the two groups after the intervention. Conclusion: The results of this study showed the positive effect of reflexology on reducing the intensity of pain in patients receiving ECT. Thus, it is recommended that nurses, health care providers, and caregivers use reflexology to reduce pain in patients with depression receiving ECT.

Reflexology in Childbirth Pain Management

Article

Full-text available

Aug 2021

Aim: this study was conducted to review the related articles and draw a final conclusion regarding the application of reflexology for delivery (labor and cesarean section) pain management in woman all over the world. Methodology: In this systematic review, relevant articles were searched in Google Scholar, PubMed, Cochrane Library, Science Direct, and Scopus databases from the year 2000 to 2018. All the human clinical trials that examined the effects of reflexology methods on delivery pain (labor or Cesarean section) were included and others excluded from the study. Results: All the 18 included original articles (with 1391 patients) reported that reflexology significantly reduces the pain of delivery, confirming its decreasing effect on labor, Cesarean section, and post-delivery pain. Results of all articles showed that, if true reflexology is performed on the right location of the body and at the appropriate time, the pain of delivery can be significantly decreased Conclusion: Reflexology is an appropriate pain relief and prophylaxis for any kind of pain, especially delivery and post-delivery pain. It is a safe remedy with no adverse effects reported so far.

Foot reflexology in painful conditions: systematic review

Article

Full-text available

Jan 2021

BACKGROUND AND OBJECTIVES: Because foot reflexology is commonly associated with other interventions, its benefits are difficult to establish. In addition, systematic reviews have been carried out many years ago, analyzing unspecific parameters and with controversial results. Thus, the objectives of this study were: to analyze the results of randomized controlled trials with a control group in painful conditions, using foot reflexology as a single intervention; describe the proposed application and methodological quality of the studies (PEDro scale). CONTENTS: The PEDro, Pubmed, Scielo and LILACS data bases were consulted, searching for clinical trials with the following keywords and Boolean index: Foot Reflexology AND pain; reflexology foot massage AND pain (English, Portuguese and Spanish). These keywords should have been present in the title or summary of the article for inclusion, directing to pain and moving away from other variables. 95 studies were found, 17 were selected and most of the results were favorable. The usual application varies from 2-30 minutes of stimulation on each foot, varying between massaging in general or using the somatotopic map stimulating the solar plexus, pain correspondence zone and accessory points related to the diagnosis. In short, the studies showed moderate to good methodological quality according to the PEDro scale. CONCLUSION: Foot reflexology has shown promise for pain relief as an isolated therapy in neuromusculoskeletal cases in hospital and outpatient settings. The hope is that studies of excellent methodological quality can support this statement in the near future.

Scalp Massage Therapy According to Symptoms Based on Vietnamese Traditional Medicine

Chapter

Full-text available

Mar 2021

A massive growth in the modernize population, because of disabled people, patients after surgery those whom cannot have ability to move and even wash themselves. Tied on their own bed, has created many problems including the need for massage service and convenient healthcare to help patients body relax and shampoo themselves which reduce medical care staff, otherwise, most of them feel inferior when someone touches their head when they are sick or having dermatological problem. In this paper, on-going projects related to essential technology for reducing work force and overcrowding in Vietnamese hospital are discussed. We propose robotic autonomous scalp massage and shampoo combine with traditional Vietnamese’s acupuncture massage to aid in resolving problems that people suffering from bed sick are experiencing, reports on design, service personalization and deployment of an assistive robot to support elderly people, disabled and patients with scalp care. Levenberg-Marquardt algorithm in artificial neural network are applied to train from collected acupuncture points to give the best trajectories following patient’s symptoms, analyzed for diagnosing and evaluating hairy scalp issues for the neural network input variables associated with body values such as height, weight, age or race which plays an important role in the composition of the multi-layer perceptron. The experimented and analyzed from multi-modal data collection of the first ever longitudinal field trials from patients throughout each experiment, indoor environments demonstrate by people with unmovable needs care. From the experiments, it indicates the ability of combining the mechanical system with 2-DOFs, human scalp massages by water jets with trajectories predicted by machine learning based on physical factors to meet the desired position on human scalp, providing enhanced resilience to being treated patients.

The effects of foot reflexology on chemotherapy-induced nausea and vomiting in digestive or lung cancer patients: protocol for randomized controlled trial (Preprint)

Article

Full-text available

Nov 2019

Background: Side effects of chemotherapy are feared by patients, specifically chemotherapy-induced nausea and vomiting. To relieve them, it is recommended to prescribe antiemetic drugs. However, some patients report that they are not sufficiently effective. Moreover, patients with chronic disease, including cancer, are increasingly interested in alternative and complementary medicines and express the desire that non-pharmacological treatments be used in hospitals. Foot reflexology is a holistic approach that is reported to decrease significant reduction in the severity of chemotherapy-induced nausea and vomiting in breast cancer patients. Some chemotherapy for lung and digestive cancer patients is moderately or highly emitting. Objective: The primary objective of the present study is to assess the benefits of foot reflexology as a complement to conventional treatments on severity and frequency of chemotherapy-induced nausea and vomiting in digestive or lung cancer patients. The secondary objectives assessed are quality of life, anxiety, and self-esteem. Methods: This study is an open label randomized controlled trial conducted over 22 months (18 months intervention and 4 months follow-up). Eligible participants are patients with a lung or digestive cancer with indication for platinum-based chemotherapy. Participants are randomized into two groups: conventional care with foot reflexology and conventional care without foot reflexology. Foot reflexology sessions (30 minutes) are performed on an outpatient or inpatient. It was estimated that 40 participants per group will be required. The benefits of foot reflexology will be assessed by comparing the relative change in the severity of nausea and vomiting, as assessed by a visual analogic scale, and the frequency of this between the two groups. The secondary objectives will be assessed with European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 30 items, Hospital and Anxiety Depression Scale and Body Image Questionnaire. Results: The present study was approved by the regional ethics committee (Île de France X CPP) on 3 April 2018 (n°ID RCB 2018-A00571-54). The enrollment started in Jun 2018 and as of November 2019, we enrolled 70 patients. The results are expected for the first quarter of 2020. Conclusions: The lack of knowledge regarding the efficacy and safety of foot reflexology limits oncologists to recommend this use. The present study will provide evidence on the benefits of foot reflexology. If efficacy is confirmed, foot reflexology may be a promising complement to conventional antiemetic drugs. Clinicaltrial: The present study registered with clinicaltrials.gov: NCT03508180 (28/06/2018) https://www.clinicaltrials.gov/ct2/show/NCT03508180?term=NCT03508180&draw=2&rank=1.

The Effectiveness of Foot Reflexology in the Severity of Restless Legs Syndrome in Female Patients Undergoing Dialysis: A Randomized Controlled Trial

Article

Full-text available

May 2018

Background: Restless leg syndrome is an ordinary complaint among patients undergoing hemodialysis. Reflexology is a nursing intervention that can reduce the restless leg syndrome. This study aimed at investigating the effect of foot reflexology on the severity of restless leg syndrome in patients undergoing hemodialysis. Methods: A randomized controlled trial with a before-and-after design was conducted in hemodialysis patients attending a hospital in an urban area of Iran in 2016. Using a random sampling method, 72 female patients were divided into the experimental and placebo groups (n = 36 in each group). The patients in the experimental group received foot reflexology. In the placebo group, simple foot reflexology without pressing certain parts of the foot was conducted. The restless leg syndrome questionnaire was used to measure the severity of restless leg syndrome before and after the intervention. Statistical analysis was performed using SPSS v. 21 software. Results: After the intervention, the score of restless leg syndrome in the experimental group reduced compared to the placebo group (P = 0.02), while the group score of restless leg syndrome showed no statistically significant difference between the experimental and placebo groups (P = 0.84). Conclusions: Foot reflexology can be used as a safe and non-pharmacologic nursing intervention in reducing the restless leg syndrome among female patients undergoing hemodialysis.

A systematic review of complementary and alternative medicine in oncology: Psychological and physical effects of manipulative and body-based practices

Article

Full-text available

Oct 2019
PLOS ONE

Background: Complementary and Alternative Medicines (CAM) are widely used by cancer patients, despite limited evidence of efficacy. Manipulative and body-based practices are some of the most commonly used CAM. This systematic review evaluates their benefits in oncology. Method: A systematic literature review was carried out with no restriction of language, time, cancer location or type. PubMed, CENTRAL, PsycArticle, PsychInfo, Psychology and Behavioral Sciences Collection and SOCindex were queried. Inclusion criteria were adult cancer patients and randomized controlled trials (RCT) assessing manipulative and body-based complementary practices on psychological and symptom outcomes. Effect size was calculated when applicable. Results: Of 1624 articles retrieved, 41 articles were included: massage (24), reflexology (11), acupressure (6). Overall, 25 studies showed positive and significant effects on symptom outcomes (versus 9 that did not), especially pain and fatigue. Mixed outcomes were found for quality of life (8 papers finding a significant effect vs. 10 which did not) and mood (14 papers vs. 13). In most studies, there was a high risk of bias with a mean Jadad score of 2, making interpretation of results difficult. Conclusion: These results seem to indicate that manipulative CAM may be effective on symptom management in cancer. However, more robust methodologies are needed. The methodological requirements of randomized controlled trials are challenging, and more informative results may be provided by more pragmatic study design.

The Effects of Reflexology on Fatigue Severity of Patients with Cancer

Article

Full-text available

Feb 2019

Introduction: Breast cancer is a major threat to women’s health and a common factor that can reduce their life expectancy. Complementary medicine such as reflexology is known to reduce fatigue severity in cancer patients. The present study aimed to cultivate the effect of reflexology on fatigue severity of patients with breast cancer. Methods: The present pre-post clinical trial recruited 57 patients with breast cancer and involved an experimental and a control group. All patients were livening in Ilam, Iran. Patients were randomly assigned to two groups of experimental (N=27) and control (N=30). The experimental group received reflexology for 4 sessions. Data were collected using Fatigue severity scale (FSS) and demographic information questionnaire. FSS was completed by the patients twice; before the intervention and 2 months after the intervention. Data were analyzed using SPSS and running t-test and ANOVA. Results: Results showed no significant difference in fatigue severity between experimental (45.44±5.30) and control (43.66±7.68) groups prior to the intervention (p>0.05). However, after conducting the intervention, a significant difference in fatigue severity was seen between the experimental (20.66±4.54) and control (40.36±9.58) groups (p=0.000). Conclusion: The present study showed that reflexology decrease fatigue severity in patients with breast cancer and community health nursing can to use of these complementary medicine to increase patients health conditions.

Comparison the Effect of Golghand and Foot Reflexology on Constipation in Elderlies

Article

Feb 2019

Objective: Constipation is one of the most common problems of the elderly, causing many complications and high costs for these individuals and affecting their quality of life. This study aimed to compare the effect of Golghand (a pharmaceutical composition of roses and honey) and foot reflexology on constipation in the elderly. Methods: This clinical trial was conducted on 60 elderly people with constipation in 2017. Subjects were selected through simple and purposive sampling and were randomly allocated to Golghand and foot reflexology groups by permuted block method. The foot reflexology was carried out in the specific area of constipation twice a day and each time for 15 minutes for two weeks. Golghand group received Golghand half an hour before lunch (one teaspoon of Golghand in one cup of cooled boiled water). Constipation assessment scale was filled for the subjects before and at the end of the intervention by an evaluator, who was unaware of the intervention approaches of the groups. Data analysis was performed in SPSS version 20 using statistical tests of Chi-square, Fisher’s exact test, Mann-Whitney U, and Friedman test at the significance level of <0.05. Results: In this research, mean age of the participants was 66±8.66 years. According to the results of Mann-Whitney U, no significant difference was observed between the groups in terms of the frequency of bowel movements on the first day after intervention (P=0.246). However, on days 2-14 after the intervention, a significant difference was observed between the study groups in this regard (P<0.05). Similarly, results of the Friedman test were indicative of a significant difference between the two groups regarding the frequency of bowel movements (P<0.001), in a way, that after the passing of the mean period, the number of bowel movements increased in both groups. However, this increase was higher in the Golghand group, compared to the foot reflexology group (P<0.001). Moreover, independent t-test demonstrated a statistically significant difference between the groups regarding mean intensity of constipation (P=0.01). Conclusion: Consumption of Golghand increased the frequency of bowel movements and reduced the intensity of constipation in elderly individuals. This method had greater impacts on constipation, compared to the foot reflexology technique.

The Benefits of Reflexology for the Chronic Pain Patient in a Military Pain Clinic

Article

Full-text available

Dec 2018

Background: Chronic pain is a major cause of disability across the military, especially for the combat Soldier. More than twothirds of Americans with chronic pain are now using complementary medicine. Methods: Patients with chronic pain opting for reflexology as part of their treatment plan received bilateral therapy. Alternating pressure was applied to the individual patient's reflex points corresponding to their pain sites. Following a single treatment session, patients were asked to complete a short survey. Discussion: There is evidence that reflexology is therapeutic for many conditions, to include sleep and anxiety, both of which can be comorbidity in the patient with chronic pain. There is a lack of evidence on the use of reflexology with chronic pain patients receiving multidisciplinary pain care. Results: A total of 311 participants completed the survey. Posttreatment pain scored decreased by a median of 2 points (interquartile range [IQR] 1-3) on a 10-point pain scale. This represents a median 43% (IQR 25%-60%) reduction in pain for males and a 41% (IQR 30%-60%) reduction in pain for females. Conclusion: Currently research is limited on effects of reflexology in treating chronic pain, yet, like acupuncture, this is an inexpensive, reliable, teachable, and simple noninvasive treatment. Further studies are warranted.

A prospective cohort study on the impact of reflexology in breast cancer patients using the MYCaW scale

Article

Dec 2018

Introduction: Breast cancer treatment and recovery remain physically and psychologically challenging for patients. Reflexology has been studied as a complementary therapy to help relieve patients of the physical and psychological stresses involved with breast cancer. As a result of recent positive evidence, we studied its effects quantitatively from 2015 to 2016. Patients and methods: Fifty-two patients completed pre- and post-reflexology intervention 'Measure Yourself Concerns and Wellbeing' (MYCaW) questionnaires. Patients were subdivided into breast cancer (BC) and non-breast cancer (NBC) groups. Concerns raised were subdivided in subcategory groups as per MYCaW guidelines and analyzed for improvements in each domain. Results: Thirty (57.7%) patients in the BC group and 22 (42.3%) patients in the NBC group were analyzed. In the BC group, there was a 46.2% improvement in patients' concerns, and in the NBC group, a 41.4% improvement in concerns were noted. Overall, the symptoms improved by 44.2% (P < .0001). There was an improvement of 43.4% in patient well-being in the BC group, and a 37.8% change in the NBC group, signifying a total improvement in well-being of 41.2%. There was an improvement of 46.4% in the MYCaW scores; 46.4% in the BC group and 42.6% in the NBC group, signifying a combined average improvement of 42.4%. Patients with poor energy level, sleep problems, stress and tension, and hot flushes and sweats experienced the most improvement in their concerns. Conclusions: Our findings show that reflexology has significantly improved patient-reported outcomes using the MYCaW scale. These findings are encouraging and reflect that increased attention to strategies focusing on improving psychological well-being can help patients in managing their symptoms.

Healthcare service utilization and work-related productivity in reflexology intervention for advanced breast cancer women

Article

Full-text available

Aug 2019
SUPPORT CARE CANCER

Purpose This project’s purpose was to determine the effects of a home-based reflexology intervention on symptom-related use of health services and work-related productivity during the 11-week study. Methods A total of 256 patients were randomized to four weekly reflexology sessions (each lasting 30 min, delivered by lay caregivers who received two training sessions by a professional reflexologist) or attention control. The Conventional Health Service and Productivity Costs Form was used to collect information on health service utilization and out-of-pocket expenditure of symptom management. The Health and Work Performance Questionnaire was used to measure workplace performance for patients during the study period. We used weighted and unweighted logistic and linear regression analyses. Results Patients in the reflexology group were less likely to have hospital visits compared to the control group in the weighted unadjusted (odds ratio [OR] = 0.49; 95% confidence interval [CI] = [0.25, 0.97]), unweighted adjusted (OR = 0.35; 95% CI = [0.16, 0.75]), and weighted adjusted (OR = 0.30, 95% CI = [0.13, 0.66]) logistic regressions. Compared to attention control, patients in the reflexology group had lower relative absenteeism in the unweighted adjusted (− 0.32; 95% CI = [− 0.60, − 0.03]) linear regressions and less absolute presenteeism (15.42, 95% CI = [0.87, 29.98]) in the weighted unadjusted analysis. Conclusion The reflexology intervention delivered by lay caregivers reduced hospital visits and increased workplace productivity in a short-term period, which has potential for cost saving for health care systems and employers. Trial registration NCT01582971

The Effectiveness of Foot Reflexology in the Severity of Restless Legs Syndrome in Female Patients Undergoing Dialysis: A Randomized Controlled Trial

Article

May 2018

Can reflexology help in managing physical and psychological symptoms in breast cancer patients?

Article

Jun 2018
EJSO-EUR J SURG ONC

Healing Art of Hand: Reflexology

Article

Dec 2014

H. Dilek Doğan

The effectiveness of reflexology on mental health in cancer patients: A systematic review and meta-analysis of randomised controlled trials

Article

Nov 2022
Compl Ther Clin Pract

Background and purpose: The current body of research examining the effectiveness of reflexology in patients with cancer have predominantly focused on managing physical symptoms and treatment side effects. This review aimed to synthesise evidence from randomised controlled trials (RCTs) examining the effectiveness of reflexology on mental health outcomes in people with cancer. Methods RCTs published in English and measuring stress, anxiety, depression or quality of life (QoL) were included. Eligible RCTs were identified through search of MEDLINE, Embase, Emcare, PsycINFO, Scopus, the Cochrane Library, OTseeker, PEDro (18 June 2021) and Google and Google Scholar (21 June 2021). The Critical Appraisal Skills Programme Randomised Controlled Trials Checklist was used to assess risk of bias. Meta-analysis and narrative synthesis were undertaken. The certainty of evidence was assessed by using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. Results Fifteen RCTs (1356 adult participants) were included. Evidence for stress and anxiety (primary outcomes), as well as depression and QoL (secondary outcomes), were mixed and conflicting. The certainty of the evidence was low to very low. Conclusion An unequivocal recommendation supporting reflexology cannot be made. Greater utilisation of well-established reporting guidelines, together with increased investment in well-designed, high-quality clinical research are required.

Integrative Medicine for Pain Management in Oncology: Society for Integrative Oncology-ASCO Guideline

Article

Sep 2022
J CLIN ONCOL

Purpose: The aim of this joint guideline is to provide evidence-based recommendations to practicing physicians and other health care providers on integrative approaches to managing pain in patients with cancer. Methods: The Society for Integrative Oncology and ASCO convened an expert panel of integrative oncology, medical oncology, radiation oncology, surgical oncology, palliative oncology, social sciences, mind-body medicine, nursing, and patient advocacy representatives. The literature search included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2021. Outcomes of interest included pain intensity, symptom relief, and adverse events. Expert panel members used this evidence and informal consensus to develop evidence-based guideline recommendations. Results: The literature search identified 227 relevant studies to inform the evidence base for this guideline. Recommendations: Among adult patients, acupuncture should be recommended for aromatase inhibitor-related joint pain. Acupuncture or reflexology or acupressure may be recommended for general cancer pain or musculoskeletal pain. Hypnosis may be recommended to patients who experience procedural pain. Massage may be recommended to patients experiencing pain during palliative or hospice care. These recommendations are based on an intermediate level of evidence, benefit outweighing risk, and with moderate strength of recommendation. The quality of evidence for other mind-body interventions or natural products for pain is either low or inconclusive. There is insufficient or inconclusive evidence to make recommendations for pediatric patients. More research is needed to better characterize the role of integrative medicine interventions in the care of patients with cancer.Additional information is available at https://integrativeonc.org/practice-guidelines/guidelines and www.asco.org/survivorship-guidelines.

L’évaluation des prises en charge non-médicamenteuses dans le cadre d’affections chroniques. Etudes interventionnelles basées sur des Protocoles Expérimentaux à Cas Unique.

Thesis

Dec 2020

Nicolas Calcagni

Les Interventions Non-Médicamenteuses (INM), et autres procédures qui peuvent leur être associées (Médecine Traditionnelle, Médecines Complémentaires et Alternatives), sont aujourd’hui d’une prépondérance à ne pas sous-estimer dans l’optique d’une santé intégrative. Une évaluation scientifique robuste est nécessaire afin de trier les pratiques néfastes ou inefficaces, de celles attestant de réels bénéfices. Dans ce domaine, les essais randomisés contrôlés (ERC) font loi, à un titre discutable du fait de leurs limites intrinsèques. Par le biais d’une revue systématique de littérature centrée sur les pratiques de manipulation corporelles comme soins de support proposés en oncologie, nous confirmons la difficulté qu’ont les ERCs de tirer des conclusions fermes et bien appuyées. Nous présentons alors une méthode interventionnelle différente et peu enseignée, les protocoles expérimentaux à cas unique, et proposons leur illustration à travers quatre études. Celles-ci portent sur l’évaluation de différentes interventions dans des contextes de maladies chroniques ou de problèmes de santé variables : 1) Jeu vidéo thérapeutique dans le cadre de la réadaptation physique de la maladie de Parkinson, 2) Intervention musicale en Soins Palliatifs, 3) Hypnose face aux restrictions hydriques de patients sous hémodialyse et 4) Séances de shiatsu face à la dysménorrhée primaire. Ces études rendent compte de résultats intéressants, et permettent de discuter des forces et faiblesses de cette méthode. Nous plaidons alors en sa faveur du fait de ses principes expérimentaux légitimes ainsi que son adéquation avec la pratique fondée sur la preuve. Nous profitons enfin de la faible qualité des études que nous avons menées pour dresser une liste de recommandations et d’écueils à considérer afin de les employer de façon optimale.

Determining the Effect of Reflexology on Nausea, Vomiting and Anxiety in Patients with Breast Cancer Receiving Chemotherapy: A Randomized Controlled Study

Article

May 2022

Abstract Aim: This study was conducted in a randomized controlled manner to evaluate the effect of reflexology on nausea, vomiting and anxiety due to taxane group chemotherapeutics in patients with breast cancer. Method: The study was conducted in the Daytime Chemotherapy Unit of Gülhane Training and Research Hospital and Ankara Training and Research Hospital from June 28 to December 20, 2019, with intervention (n=29) and control (n=29) groups. Data were collected using the Patient Description Form, the Rhodes Nausea, Vomiting, and Retching Index, and the Spielberg State/Trait Anxiety Scale. Patients in the intervention group received reflexology for a total of six weeks, once a week. The patients in the control group did not receive any treatment other than the routine maintenance of the chemotherapy unit. Result: As a result, it was determined that 40% of all patients were 55 years or older. While nausea was observed in all patients in the intervention and control groups, vomiting was not noted in the vast majority of patients. Regarding the effect of reflexology on nausea and vomiting; although the mean scores of nausea, vomiting and retching experience, occurrence and distress in both groups were lower than the initial measurement, there was no difference between the groups. Based on the research findings, the state and trait anxiety mean scores in the intervention group decreased significantly while they increased in the control group. Conclusion: The research showed that while reflexology did not affect nausea and vomiting in breast cancer patients receiving chemotherapy, it was helpful in reducing anxiety.

Méthodologie d’évaluation des interventions non médicamenteuses et approche bio-psycho-sociale : le cas de la réflexologie plantaire et ses perspectives de recherche

Article

Nov 2021

The effect of foot reflexology on chemotherapy-induced nausea and vomiting in digestive or lung cancer patients: a randomized controlled trial (Preprint)

Article

Nov 2020

Background Cancer is a chronic disease with an incidence of 24.5 million and 9.6 million deaths worldwide in 2017. Lung and colorectal cancer are the most common cancers for both sexes and, according to national and international recommendations, platinum-based chemotherapy is the reference adjuvant treatment. This chemotherapy can be moderately to highly emetogenic. Despite antiemetic therapy, chemotherapy-induced nausea and vomiting (CINV) may persist. Moreover, cancer patients are increasingly interested in alternative and complementary medicines and have expressed the desire that nonpharmacological treatments be used in hospitals. Among alternative and complementary medicines, foot reflexology significantly decreases the severity of CINV in patients with breast cancer. Objective The primary aim of this study was to assess the benefits of foot reflexology as a complement therapy to conventional treatments regarding the severity of acute CINV in patients with digestive or lung cancer. The secondary objectives assessed were the frequency and severity of delayed CINV, quality of life, anxiety, and self-esteem. Methods This study was conducted between April 2018 and April 2020 in the Hospices Civils de Lyon, France. This was an open-label randomized controlled trial. Participants were randomized into two groups: the intervention group (ie, conventional care with foot reflexology; n=40) and the control group (ie, conventional care without foot reflexology; n=40). Foot reflexology sessions (30 minutes each) were performed on outpatients or inpatients. Eligible participants were patients with lung or digestive cancer with an indication for platinum-based chemotherapy. Results The severity of acute nausea and vomiting was assessed with a visual analog scale during the second cycle of chemotherapy. A significant increase of at least 2 points was observed for the control group (7/34, 21%; P=.001). Across all cycles, the foot reflexology group showed a trend toward less frequent delayed nausea (P=.28), a significantly less frequent consumption of antiemetic drugs (P=.04), and no significant difference for vomiting (P=.99); there was a trend toward a perception of stronger severity for delayed nausea in the control group (P=.39). Regarding quality of life and anxiety, there was no significant difference between the intervention group and the control group (P=.32 and P=.53, respectively). Conclusions This study’s results indicate that foot reflexology provides significantly better management of acute nausea severity and decreased consumption of antiemetic drugs in patients with lung or digestive cancer. In order to fulfill patients’ desires to use nonpharmacological treatments and complementary and alternative medicines in hospitals, foot reflexology could be provided as a complementary intervention to conventional antiemetic drugs. Foot reflexology did not result in adverse effects. To assess the benefits of foot reflexology in routine practice, a larger study with several health care centers would be needed with a cluster randomized controlled trial. Trial Registration ClinicalTrials.gov NCT03508180; https://clinicaltrials.gov/ct2/show/NCT03508180 International Registered Report Identifier (IRRID) RR2-10.2196/17232

Reflexology and meditative practices for symptom management among people with cancer: Results from a sequential multiple assignment randomized trial

Article

Jul 2021

Optimal sequencing of complementary therapies can help improve symptom management through nonpharmacological approaches. A 12‐week sequential multiple assignment randomized trial comparing home‐based reflexology and meditative practices on severity of fatigue and other symptoms was conducted among patients with cancer and their informal caregivers. Dyads were initially randomized to reflexology (N = 150), meditative practices (N = 150), or control (N = 47). If patient's fatigue did not improve (nonresponse) after 4 weeks of reflexology or meditative practices, the dyad was rerandomized to either add the other therapy or continue with the original therapy for weeks 5–8. Four decision rules (DRs) were compared: (1) Initiating reflexology, and if nonresponse on fatigue after 4 weeks, continue with reflexology for another 4 weeks, thus providing a higher dose; (2) Initiating reflexology, and if nonresponse on fatigue after 4 weeks, add meditative practices for the next 4 weeks; (3) Initiating meditative practices, and if nonresponse on fatigue after 4 weeks, continue meditative practices for another 4 weeks, thus providing a higher dose; and (4) Initiating meditative practices, and if nonresponse on fatigue after 4 weeks, add reflexology for the next 4 weeks. Symptoms were evaluated weekly using the M.D. Anderson Symptom Inventory (MDASI). Clinically, nurses can recommend either therapy since no differences were found among the 4 DRs, with the exception of lower severity for summed MDASI symptoms at week 8 for the use of reflexology only (DR‐1) versus DR‐2 (sequencing reflexology to meditative practices). Adding the other therapy for nonresponders after 4 weeks may not be warranted.

How Long Can they Stand it? Examining the Effectiveness of Reflexology and a Passive Relaxation Intervention in Improving Health Outcomes in Workers Who Stand

Article

Full-text available

Mar 2021

Many jobs require workers to stand for prolonged periods of time while performing their job duties. Prolonged standing at work has been linked to negative health outcomes, particularly musculoskeletal symptoms (MSS) and fatigue. Reflexology is a complementary and alternative medicine technique that may be well-suited to reduce musculoskeletal symptoms, fatigue, stress, and anxiety in workers who stand for prolonged amounts of time because it involves stimulating reflex points on the feet purported to correspond to different bodily parts, increases relaxation, and reduces stress. Additionally, general relaxation techniques applied to the feet and lower leg, combined with passive relaxation time, may also provide some relief. In the current longitudinal, mixed-method intervention study, participants are randomized to either a reflexology condition or a passive relaxation condition, and their self-reported levels of MSS, fatigue, stress, and anxiety are assessed for two weeks at pre-test, two weeks during the intervention stage, and two-weeks post-intervention along with qualitative responses about their experiences. Multilevel analyses reveal participants in both groups reported significant reductions in scores across all measures from pre-test through intervention, but the decreases did not vary significantly by condition for any outcomes except anxiety. In addition, results from qualitative thematic analysis substantiate findings regarding the prevalence of negative health outcomes in standing workers and provide support for the use of reflexology or relaxation in helping to alleviate those outcomes.

The Effect of Reflexology on Low Back Pain in Operating Room Nurses

Article

Dec 2020

Operating room nurses often face acute or chronic back and low back pains, shoulder and neck injuries. In recent years, the use of complementary and alternative treatment methods has been increasing due to the fact that pharmacological treatment cannot control the pain in general, and its various side effects and cost. The aim of this study was to investigate the effect of foot reflexology on low back pain of operating room nurses. This quasiexperimental study was conducted with 38 operating room nurses. The nurses in the experimental group were given a 30-minute reflexology protocol once a week for 4 weeks and their pain levels were assessed again at week 5. The control group nurses did not receive any intervention. Data were collected using a demographic information form and a visual analog scale (VAS). The low back pain of the nurses in the reflexology group decreased significantly at week 5 compared with week 1, whereas the severity of low back pain of the nurses in the control group did not change between weeks 1 and 5. There were no statistically significant differences between the groups in terms of the mean VAS pain score at week 1. However, the nurses in the reflexology group had significantly lower VAS pain mean scores at week 5 than the control group. In this study, reflexology significantly reduced the pain of nurses who had low back pain. Therefore, reflexology might be useful in controlling low back pain of operating room nurses.

Management of Cancer Pain in Primary, Secondary, and Palliative Care

Chapter

Jan 2021

Section 26.1: Pain is the most frequent complication of cancer. Treatment needs to be holistic, involving carers and/or family. It needs to include physical, emotional, psychological, and spiritual aspects and should be reviewed regularly. Good records need to be kept in order to facilitate cooperation with medical colleagues. Pharmacological titration should follow the WHO pain ladder. Opioids and opiates should be administered in the most appropriate form. Physiotherapy and alternative forms of medicine may play an important role in the management of cancer pain. In Sect. 26.2, the approach to assessment and management of cancer pain is discussed, with a focus on care delivered in hospital and in specialist palliative care settings. Opioids are central to cancer pain management and should be individualised to the patient based on the pain history and side effects of the drugs. Opioid switching may be considered in selected patients who do not respond to morphine first line. The impact of renal and hepatic impairment should be considered in the safe prescribing of opioids. A range of adjuvant treatments including drugs for neuropathic pain may complement opioid analgesia in cancer pain.

The Effect of Caregiver-Facilitated Pain Management Interventions in Hospitalized Patients on Patient, Caregiver, Provider, and Health System Outcomes: A Systematic Review

Article

Full-text available

Jun 2020
J PAIN SYMPTOM MANAG

Context Alternative pain management interventions involving caregivers may be valuable adjuncts to conventional pain management interventions. Objective Use systematic review methodology to examine caregiver-facilitated pain management interventions in a hospital setting and whether they improve patient, caregiver, provider or health system outcomes. Methods We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Scopus databases from inception to April 2020. Original research on caregiver-facilitated pain management interventions in hospitalized settings (i.e., any age) were included and categorized into three caregiver engagement strategies: inform (e.g., pain education), activate (e.g., prompt caregiver action), and collaborate (encourage caregiver’s interaction with providers). Results Of 61 included studies, most investigated premature (n=27/61, 44.3%) and full-term neonates (n=19/61, 31.1%). Interventions were classified as: activate (n=46/61, 75.4%), inform-activate-collaborate (n=6/61, 9.8%), inform-activate (n=5/61, 8.2%), activate-collaborate (n=3/61, 4.9%), or inform (n=1/61, 1.6%) caregiver engagement strategies. Interventions that included an activate engagement strategy improved pain outcomes in adults (18-64 years)(e.g., self-reported pain, n=4/5, 80%) and neonates (e.g., crying, n=32/41, 73.0%), but not children or older adults (≥65 years). Caregiver outcomes (e.g., pain knowledge) were improved by inform-activate engagement strategies (n=3/3). Interventions did not improve provider (e.g., satisfaction) or health system (e.g., hospital length of stay) outcomes. Most studies were of low (n=36/61, 59.0%) risk of bias. Conclusions Caregiver-facilitated pain management interventions using an activate engagement strategy may be effective in reducing pain of hospitalized neonates. Caregiver-facilitated pain management interventions improved pain outcomes in the majority of adult studies, however the number of studies of adults is small warranting caution pending further studies.

Effects of aroma self-foot reflexology on peripheral neuropathy, peripheral skin temperature, anxiety, and depression in gynaecologic cancer patients undergoing chemotherapy: A randomised controlled trial

Article

Aug 2019
EUR J ONCOL NURS

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) can interfere with activities of daily living and can negatively affect symptoms. Thus, this study aimed to develop and implement an aroma self-foot reflexology regimen based on Cox's Interaction Model of Client Health Behaviour (IMCHB) as an intervention that can be self-performed at home and at any time. The effects of aroma self-foot reflexology on peripheral neuropathy, peripheral skin temperature, anxiety, and depression were examined in patients with gynaecologic cancer who were undergoing chemotherapy. Methods: This randomized controlled trial included 32 experimental and 31 control patients with CIPN. Data were collected using self-reported questionnaires (CIPN assessment tool, HADS). In the experimental group, peripheral neuropathy, peripheral skin temperature, anxiety, and depression were measured before and after aroma self-foot reflexology therapy for 6 weeks. The control group was provided with identical aroma self-foot reflexology training 6 weeks later and underwent the intervention at that time. Results: The intervention resulted in lower levels of symptoms of peripheral neuropathy, less interference with activities (p < .001), and higher peripheral skin temperature level (p < .001). Anxiety and depression decreased in the experimental group (p < .001). The ratio of borderline and definite cases of anxiety and depression did not differ between groups. Conclusions: An aroma self-foot reflexology intervention can reduce CIPN, anxiety, and depression in gynaecologic cancer patients. Further research is required to assess the effects of differences in the content of the intervention and the effects of various numbers of applications and durations of applications based on each individual patient's condition.

Couple Interventions for Chronic Pain: A Systematic Review

Article

Aug 2019
CLIN J PAIN

Objective: Couple interventions for chronic pain have been shown to more effectively reduce pain intensity for individuals with chronic pain (ICPs) than individual behavioral interventions or usual care. This systematic review identifies randomized controlled trials (RCTs) of couple interventions to highlight strategies that could be incorporated into psychotherapy with ICPs and their romantic partners. Methods: We identified articles reporting RCTs of couple interventions for chronic pain. Three databases were searched (i.e., PubMed, Embase, and PsycInfo), resulting in 18 studies and 22 articles. Results: Couple interventions resulted in statistically significant improvements in pain intensity compared to other conditions in 8-40% of the studies, as well as in statistically significant improvements on a pain-related outcome compared to other conditions in 31-50% of the studies. Educating couples about pain was the most common strategy (83%). Jointly administered relaxation or meditation skills were included in nearly half of the interventions (48%). Many interventions taught cognitive behavioral skills jointly to couples (39%) or to the ICP with partner encouragement (30%). Teaching couples how to request and provide assistance (30%), as well as encouraging partners to avoid reinforcing pain behaviors (39%), occurred frequently. ICPs and their partners were often asked to set goals (30%). Discussion: This review outlines strategies included in couple interventions for chronic pain which are derived from the cognitive behavioral therapy, acceptance and commitment therapy, and operant-behavioral traditions, but delivered relationally. Therapists working with ICPs and their partners may integrate these strategies into their practice to help couples who are managing chronic pain.

Psychosocial interventions for informal caregivers of people living with cancer

Article

Jun 2019

Background: Increasingly, cancer is recognised as a chronic condition with a growing population of informal caregivers providing care for cancer patients. Informal caregiving can negatively affect the health and well-being of caregivers. We need a synthesised account of best evidence to aid decision-making about effective ways to support caregivers for individuals 'living with cancer'. Objectives: To assess the effectiveness of psychosocial interventions designed to improve the quality of life (QoL), physical health and well-being of informal caregivers of people living with cancer compared with usual care. Search methods: We searched CENTRAL, MEDLINE, Embase, PsycINFO, ProQuest, Open SIGLE, Web of Science from inception up to January 2018, trial registries and citation lists of included studies. Selection criteria: We included randomised and quasi-randomised controlled trials comparing psychosocial interventions delivered to adult informal caregivers of adults affected by cancer on a group or individual basis with usual care. Psychosocial interventions included non-pharmacological interventions that involved an interpersonal relationship between caregivers and healthcare professionals. We included interventions delivered also to caregiver-patient dyads. Interventions delivered to caregivers of individuals receiving palliative or inpatient care were excluded. Our primary outcome was caregiver QoL. Secondary outcomes included patient QoL, caregiver and patient depression, anxiety, psychological distress, physical health status and intervention satisfaction and adverse effects. Data collection and analysis: Pairs of review authors independently screened studies for eligibility, extracted data and conducted 'Risk of bias' assessments. We synthesised findings using meta-analysis, where possible, and reported remaining results in a narrative synthesis. Main results: Nineteen trials (n = 3, 725) were included in the review. All trials were reported in English and were undertaken in high-income countries. Trials targeted caregivers of patients affected by a number of cancers spanning newly diagnosed patients, patients awaiting treatment, patients who were being treated currently and individuals post-treatment. Most trials delivered interventions to caregiver-patient dyads (predominantly spousal dyads) and there was variation in intervention delivery to groups or individual participants. There was much heterogeneity across interventions though the majority were defined as psycho-educational. All trials were rated as being at 'high risk of bias'.Compared to usual care, psychosocial interventions may improve slightly caregiver QoL immediately post intervention (standardised mean difference (SMD) 0.29, 95% confidence interval (CI) 0.04 to 0.53; studies = 2, 265 participants) and may have little to no effect on caregiver QoL at 12 months (SMD 0.14, 95% CI - 0.11 to 0.40; studies = 2, 239 participants) post-intervention (both low-quality evidence).Psychosocial interventions probably have little to no effect on caregiver depression immediately to one-month post-intervention (SMD 0.01, 95% CI -0.14 to 0.15; studies = 9, 702 participants) (moderate-quality evidence). Psychosocial interventions may have little to no effect on caregiver anxiety immediately post-intervention (SMD -0.12, 95 % CI -0.33 to 0.10; studies = 5, 329 participants), depression three-to-six months (SMD 0.03, 95% CI -0.33 to 0.38; studies = 5. 379 participants) post-intervention and patient QoL six to 12 months (SMD -0.05, 95% CI -0.37 to 0.26; studies = 3, 294 participants) post-intervention (all low-quality evidence). There was uncertainty whether psychosocial interventions improve patient QoL immediately (SMD -0.03, 95 %CI -0.50 to 0.44; studies = 2, 292 participants) or caregiver anxiety three-to-six months (SMD-0.25, 95% CI -0.64 to 0.13; studies = 4, 272 participants) post-intervention (both very low-quality evidence). Two studies which could not be pooled in a meta-analysis for caregiver physical health status found little to no effect immediately post-intervention and a small intervention effect 12 months post-intervention. Caregiver or patient satisfaction or cost-effectiveness of interventions were not assessed in any studies. Interventions demonstrated good feasibility and acceptability.Psychosocial interventions probably have little to no effect on patient physical health status immediately post-intervention (SMD 0.17, 95 % CI -0.07 to 0.41; studies = 4, 461 participants) and patient depression three to six months post-intervention (SMD-0.11, 95% CI -0.33 to 0.12; studies = 6, 534 participants) (both moderate-quality evidence).Psychosocial interventions may have little to no effect on caregiver psychological distress immediately to one-month (SMD -0.08, 95% CI -0.42 to 0.26; studies = 3, 134 participants), and seven to 12 months (SMD 0.08, 95% CI -0.42 to 0.58; studies = 2, 62 participants) post-intervention; patient depression immediately (SMD -0.12, 95% CI -0.31 to 0.07; studies = 9, 852 participants); anxiety immediately (SMD -0.13, 95% CI -0.41 to 0.15;studies = 4, 422 participants), and three to six months (SMD -0.22, 95% CI -0.45 to 0.02; studies = 4, 370 participants); psychological distress immediately (SMD -0.02, 95% CI -0.47 to 0.44; studies = 2, 74 participants) and seven to 12 months (SMD -0.27, 95% CI -0.78 to 0.24; studies = 2, 61 participants); and physical health status six to 12 months (SMD 0.06, 95% CI -0.18 to 0.30; studies = 2, 275 participants) post-intervention (all low-quality evidence).Three trials reported adverse effects associated with the interventions, compared with usual care, including higher distress, sexual function-related distress and lower relationship satisfaction levels for caregivers, higher distress levels for patients, and that some content was perceived as insensitive to some participants.Trials not able to be pooled in a meta-analysis did not tend to report effect size and it was difficult to discern intervention effectiveness. Variable intervention effects were reported for patient and caregiver outcomes. Authors' conclusions: Heterogeneity across studies makes it difficult to draw firm conclusions regarding the effectiveness of psychosocial interventions for this population. There is an immediate need for rigorous trials with process evaluations and clearer, detailed intervention descriptions. Cost-effectiveness studies should be conducted alongside future trials.

La réflexologie plantaire comme traitement complémentaire des douleurs chez une patiente atteinte d’un cancer du sein

Article

Jan 2019

Chemotherapy for patients with breast cancer causes numerous side effects, including muscle pain. Foot reflexology is a complementary treatment whose efficacy with regard to other side effects has been demonstrated. We observed a decrease in pain in our study as well as improvements to patients’ quality of life. However, few changes to their physical abilities were noted.

How Effective Is Reflexology on Physiological Parameters and Weaning Time from Mechanical Ventilation in Patients Undergoing Cardiovascular Surgery?

Article

Feb 2019

Didem Kandemir

Introduction Cardiovascular disease is one of the leading causes of morbidity and mortality in both developed and developing countries. The present research was designed to determine the effects of reflexology on physiological parameters and mechanical weaning (MV) weaning time. Methods In this non-randomized controlled clinical trial, 85 patients who underwent open heart surgery were allocated into either an experimental group (n = 42) or aut control group (n = 43) using convenience sampling. The participants were informed about the study and a written and oral informed consent was obtained from each patient. Along with the study, a twenty-thirty-minute foot reflexology and routine care treatments were applied to the patients in the experimental group and control group, respectively in the post-operative period. In this context, physiological parameters and mechanical ventilation weaning time of the patients were examined at certain intervals. Results According to the values obtained before reflexology for experimental and control group, the pulse rate (p = 0.013) and diastolic blood pressure (p = 0.021) of the patients in the experimental group at 5 min before reflexology were significantly higher. Moreover, oxygen saturation values of the patients in the experimental group at 5 min after extubation were lower (p = 0.012). However, reflexology did not exhibit any significant changes in other physiological parameters but the mechanical ventilation weaning time after reflexology was shorter in the experimental group (p = 0.023). Conclusion Reflexology did not have a significant effect on physiological parameters in patients receiving mechanical ventilation support. Shortening the weaning time from mechanical ventilation suggests that it might be applied effectively in patients receiving mechanical ventilation support in intensive care unit.

Integrative Therapies for Pain Modulation

Chapter

Jan 2019

Since the 1970s, there has been an increase in both the development and use of integrative therapies, and from the mid-1990s until 2014, there have been hundreds of research studies regarding the efficacy and/or validity of these therapies. Most of these studies concur that integrative therapies reduce pain, anxiety, and fear and promote general well-being. For the most part, no formal education in any of these therapies occurs within educational institutions other than a lecture or guest speaker conferences. This chapter is an account of some of the uses and benefits of these treatments. It is not the intent to be all inclusive, but rather to assist in opening colleagues to pursue personal learning and/or referring patients to receive such treatments.

DİSPNE

Chapter

Jan 2017

Vildan Kocatepe

DİSPNE

Chapter

Jan 2017

Vildan Kocatepe

Kanser Hastasında Kanıta Dayalı Palyatif Bakım - Konsensus 2017

Book

Full-text available

Jun 2018

Gulbeyaz Can

“Kanser Hastalarında Kanıta Dayalı Palyatif Bakım” konulu 4. konsensüs toplantısı, Florence Nigh- tingale Hemşire Mektepleri ve Hastahaneleri Vakfının desteği ile İstanbul Üniversitesi Florence Nightingale Hemşirelik Fakültesi tarafından 06-07 Şubat 2017 tarihleri arasında İstanbul Cevahir Kongre ve Toplantı Merkezinde gerçekleştirildi. Toplantıya Orta Doğu Kanser Konsorsiyuma (MECC) bağlı ülkelerden, Avrupa Palyatif Bakım Derneğinden (EAPC), Avrupa Onkoloji Hemşireleri Derneğinden (EONS) ve Amerika Onkoloji Hemşireleri Derneğinden (ONS) ve ülkemizden palyatif bakıma gönül vermiş pek çok meslektaşımız davet edildi. Orta Doğu Kanser Konsorsiyuma (MECC) bağlı 12 ülkeden (Mısır, İran, Irak, İsrail, Ürdün, Kenya, Pakistan, Sudan, Umman, Tanzanya, Arap Emirlikleri, Uganda) 20 kişi, Avrupa’dan (İspanya) 1 kişi, Amerika’dan On- line bağlantı kurarak 1 kişi ve ülkemizin pek çok ilinden 364 kişi katıldı. İki günlük toplantı sırasında, palyatif bakım hastasında sık görülen semptomların yönetiminde kul- lanılabilecek girişimler, bakım veren aile üyelerinin ve sağlık çalışanlarının güçlendirilmesinde etkili yakla- şımlar tartışıldı ve kanser hastasının palyatif bakımında benimsenmesi gereken stratejiler oluşturuldu. Toplantı sırasında elde edilen sonuçlar konsensus çalışma grupları tarafından incelenerek, bu kita- bın içinde yer alan bölümlerde sunuldu. Palyatif hasta bakımının planlanmasında önemli literatür bilgilerini ve 2017 konsensus kararları içeren bu kitabın hazırlanmasında ve toplantının gerçekleşmesinde emeği geçen tüm hocalarıma ve meslektaşlarıma teşekkür ederim.

Dyspnea

Chapter

Full-text available

Feb 2018

The effects of foot reflexology on anxiety and pain in patients with breast and lung cancer

Article

Full-text available

Nov 1999
ONCOL NURS FORUM

To test the effects of foot reflexology on anxiety and pain in patients with breast and lung cancer. Quasi-experimental, pre/post, crossover. A medical/oncology unit in a 314-bed hospital in the southeastern United States. Twenty-three inpatients with breast or lung cancer. The majority of the sample were female, Caucasian, and 65 years or older; had 12 or fewer years of education and an annual income of $20,000 or more; and were receiving regularly scheduled opioids and adjuvant medications on the control and intervention day. Procedures included an intervention condition (foot reflexology to both feet for 30 minutes total by a certified reflexologist) and a control condition for each patient (with at least a two-day break). No changes were made in patients' regular schedule or medications. Anxiety and pain. Following the foot reflexology intervention, patients with breast and lung cancer experienced a significant decrease in anxiety. One of three pain measures showed that patients with breast cancer experienced a significant decrease in pain. The significant decrease in anxiety observed in this sample of patients with breast and lung cancer following foot reflexology suggests that this may be a self-care approach to decrease anxiety in this patient population. Professionals and lay people can be taught reflexology. Foot reflexology is an avenue for human touch, can be performed anywhere, requires no special equipment, is noninvasive, and does not interfere with patients' privacy.

Safety and Efficacy of Massage Therapy for Patients with Cancer

Article

Full-text available

Aug 2005

Lisa Corbin

As the popularity of complementary/alternative medicine (CAM) grows, patients are incorporating more CAM therapies into their conventional cancer care. Massage therapy, a CAM therapy known primarily for its use in relaxation, may also benefit patients with cancer in other ways. Massage can also be associated with risks in the oncology population. Risks can be minimized and benefits maximized when the clinician feels comfortable discussing CAM with his or her patients. This article reviews and summarizes the literature on massage and cancer to help provide the clinician with information to help facilitate discussions with patients. MEDLINE and CINAHL databases were searched to identify relevant articles. These were reviewed for content and other pertinent references. Significant information was extracted from these resources to provide this overview of the use of massage for patients with cancer. Conventional care for patients with cancer can safely incorporate massage therapy, although cancer patients may be at higher risk of rare adverse events. The strongest evidence for benefits of massage is for stress and anxiety reduction, although research for pain control and management of other symptoms common to patients with cancer, including pain, is promising. The oncologist should feel comfortable discussing massage therapy with patients and be able to refer patients to a qualified massage therapist as appropriate.

Prevalence of complementary and alternative medicine use in cancer patients

Article

Oct 2001
ONCOLOGY-NY

Interest in complementary and alternative medicine (CAM) has grown dramatically over the past several years. Cancer patients are always looking for new hope, and many have turned to nontraditional means. This study was conducted to determine the prevalence of complementary and alternative medicine use in cancer patients and what if any agents are being used. Approximately, 100 adult cancer patients in a private nonprofit South Florida hospital completed a descriptive cross-sectional survey questionnaire. The mean age of participants was 59 years; 42 patients were male and 58, female. According to survey results, 80% of patients reported using some type of CAM; 81 % took vitamins, 54% took herbal products, 30% used relaxation techniques, 20% received massages, and 10% used home remedies. Among patients who took vitamins, 65% said they took a multivitamin, 39% took vitamin C, and 31%, vitamin E. The most common herbal remedies used were green tea, echinacea, shark cartilage, grape seed extract, and milk thistle. Meditation and deep breathing were the two most common relaxation techniques practiced. A large majority of cancer patients are using CAM. In light of the growing interest in CAM, health-care professionals need to be educated about the most common therapies used.

Multidimensional reflexology

Article

Jan 1993

Raz Ashkenazi

The effect of reflexology on baroreceptor reflex sensitivity, blood pressure and sinus arrhythmia

Article

Jun 1997
COMPLEMENT THER MED

B.S.M. Frankel

The objective of this pilot study is to identify if reflexology and foot massage (FM) affect the physiology of the body by measuring baroreceptor reflex sensitivity (BRS) using phase IV of the Valsalva manoeuvre, blood pressure (BP) and sinus arrhythmia (SA). The reflexology (n = 10) and FM groups (n = 10) showed significantly greater reductions in BRS compared to the control group (n = 4). Analysis of the mean differences between groups showed a greater difference in BRS between reflexology or FM and the control group than between reflexology and FM. This study found no significant difference in resting BP after intervention. The frequency of SA after reflexology and FM increased by 43.9% and 34.1% respectively. Further thoughts from the results of this study suggest a ‘neuro theory’ whereby reflexology and FM alter the BRS by stimulating the sensory nervous system in the feet.

Pain and stress: A new perspective

Article

Jan 1999

Ronald Melzack

The neuromatrix theory of pain (R. Melzack, 1995) proposes that pain is a multidimensional experience produced by characteristic "neurosignature" patterns of nerve impulses in the brain. These neurosignature patterns may be triggered by sensory inputs or independently of them. This theory of pain proposes that the output patterns of the neuromatrix activate perceptual, homeostatic, and behavioral programs after injury or pathology or as a result of multiple other inputs that act on the neuromatrix. Pain, then, is produced by the output of a widely distributed neural network in the brain rather than directly by sensory input evoked by injury, inflammation, or other pathology. The neuromatrix, which is genetically determined and modified by sensory experience, is the primary mechanism that generates the neural pattern that produces pain. Its output pattern is determined by multiple influences, of which the somatic sensory input is only a part. We are so used to considering pain as a purely perceptual phenomenon that we have ignored the fact that injury also disrupts the body's homeostatic regulation systems, thereby producing stress and initiating complex programs to restore homeostasis. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

The McGill Pain Questionnaire: Major Properties and Scoring Methods

Article

Oct 1975

Ronald Melzack

The McGill Pain Questionnaire consists primarily of 3 major classes of word descriptors--sensory, affective and evaluative--that are used by patients to specify subjective pain experience. It also contains an intensity scale and other items to determine the properties of pain experience. The questionnaire was designed to provide quantitative measures of clinical pain that can be treated statistically. This paper describes the procedures for administration of the questionnaire and the various measures that can be derived from it. The 3 major measures are: (1) the pain rating index, based on two types of numerical values that can be assigned to each word descriptor, (2) the number of words chosen; and (3) the present pain intensity based on a 1-5 intensity scale. Correlation coefficients among these measures, based on data obtained with 297 patients suffering several kinds of pain, are presented. In addition, an experimental study which utilized the questionnaire is analyzed in order to describe the nature of the information that is obtained. The data, taken together, indicate that the McGill Pain Questionnaire provides quantitative information that can be treated statistically, and is sufficiently sensitive to detect differences among different methods to relieve pain.

Standardization of the Visual Analog Scale

Article

Nov 1992
NURS RES

Complementary therapy in practice

Article

Feb 1991

D Crowther

Dorothy Crowther describes the evolution of the Wirral Holistic Care Services, a company dedicated to helping people cope with cancer. Based on a recognition that such patients want more than the standard NHS fare, initial evaluations suggest that the company is going some way to meeting the extra needs of this group. Available therapies include aromatherapy, kinesiology, reflexology and meditation, incorporating a model of care which endorses putting the patient first.

The Short-form McGill Pain Questionnaire

Article

Sep 1987

Ronald Melzack

A short form of the McGill Pain Questionnaire (SF-MPQ) has been developed. The main component of the SF-MPQ consists of 15 descriptors (11 sensory; 4 affective) which are rated on an intensity scale as 0 = none, 1 = mild, 2 = moderate or 3 = severe. Three pain scores are derived from the sum of the intensity rank values of the words chosen for sensory, affective and total descriptors. The SF-MPQ also includes the Present Pain Intensity (PPI) index of the standard MPQ and a visual analogue scale (VAS). The SF-MPQ scores obtained from patients in post-surgical and obstetrical wards and physiotherapy and dental departments were compared to the scores obtained with the standard MPQ. The correlations were consistently high and significant. The SF-MPQ was also shown to be sufficiently sensitive to demonstrate differences due to treatment at statistical levels comparable to those obtained with the standard form. The SF-MPQ shows promise as a useful tool in situations in which the standard MPQ takes too long to administer, yet qualitative information is desired and the PPI and VAS are inadequate.

Oncology nursing. 6. Alternative health approaches

Article

Mar 1985

B Z Dobbs

Development of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases

Article

Nov 1983

This paper reports the development of a self-report instrument designed to assess pain in cancer and other diseases. It is argued that issues of reliability and validity should be considered for every pain questionnaire. Most research on measures of pain examine reliability to the relative neglect of validity concerns. The Wisconsin Brief Pain Questionnaire (BPQ) is evaluated with regard to both reliability and validity. Data from patients with cancer at 4 primary sites and from patients with rheumatoid arthritis suggest that the BPQ is sufficiently reliable and valid for research purposes. Additional methodological and theoretical issues related to validity are discussed, and the need for continuing evaluation of the BPQ and other measures of clinical pain is stressed.

The Short-Form McGill Pain Questionnaire in chronic cancer pain

Article

Jun 1993
J PAIN SYMPTOM MANAG

A short form of the McGill Pain Questionnaire (SF-MPQ) was previously developed. It was found to correlate highly with and demonstrate differences due to treatment in a manner similar to the long form of the McGill Pain Questionnaire (LF-MPQ). The LF-MPQ was previously found to be a valid measurement of pain in the cancer population. The present study demonstrated that the sensory, affective, and total scores of the SF-MPQ correlated highly with the LF-MPQ on three administrations, each 3-4 wk apart in 24 patients with chronic pain due to cancer. Both the long and short total scores correlated highly with the visual analogue scale (VAS) and present pain intensity (PPI) scale. The SF-MPQ demonstrated changes over time in a manner similar to the LF-MPQ in this patient group. These observations support the value of the SF-MPQ as a tool for studying interventions in patients with chronic pain due to cancer.

Cleeland CS, Ryan KMPain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore 23: 129-138

Article

Apr 1994
ANN ACAD MED SINGAP

Poorly controlled cancer pain is a significant public health problem throughout the world. There are many barriers that lead to undertreatment of cancer pain. One important barrier is inadequate measurement and assessment of pain. To address this problem, the Pain Research Group of the WHO Collaborating Centre for Symptom Evaluation in Cancer Care has developed the Brief Pain Inventory (BPI), a pain assessment tool for use with cancer patients. The BPI measures both the intensity of pain (sensory dimension) and interference of pain in the patient's life (reactive dimension). It also queries the patient about pain relief, pain quality, and patient perception of the cause of pain. This paper describes the development of the Brief Pain Inventory and the various applications to which the BPI is suited. The BPI is a powerful tool and, having demonstrated both reliability and validity across cultures and languages, is being adopted in many countries for clinical pain assessment, epidemiological studies, and in studies of the effectiveness of pain treatment.

Reflexology.

Article

Jan 1994
Nurs Times

B Booth

Spouse-assisted coping skills training in the management of osteoarthritic knee pain

Article

Sep 1996
Arthritis Care Res

To evaluate the effects of a spouse-assisted pain-coping skills training intervention on pain, psychological disability, physical disability, pain-coping, and pain behavior in patients with osteoarthritis (OA) of the knees. Eighty-eight OA patients with persistent knee pain were randomly assigned to 1 of 3 conditions: 1) spouse-assisted pain-coping skills training, (spouse-assisted CST), 2) a conventional CST intervention with no spouse involvement (CST), or 3) an arthritis education-spousal support (AE-SS) control condition. All treatment was carried out in 10 weekly, 2-hour group sessions. Data analysis revealed that at the completion of treatment, patients in the spouse-assisted CST condition had significantly lower levels of pain, psychological disability, and pain behavior, and higher scores on measures of coping attempts, marital adjustment, and self-efficacy than patients in the AE-SS control condition. Compared to patients in the AE-SS control condition, patients who received CST without spouse involvement had significantly higher post-treatment levels of self-efficacy and marital adjustment and showed a tendency toward lower levels of pain and psychological disability and higher scores on measures of coping attempts and ratings of the perceived effectiveness of pain-coping strategies. These findings suggest that spouse-assisted CST has potential as a method for reducing pain and disability in OA patients.

Validity of a verbally administered numeric rating scale to measure cancer pain intensity

Article

May 1997
CANCER NURS

The ability to quantify pain intensity is essential when caring for individuals in pain in order to monitor patient progress and analgesic effectiveness. Three scales are commonly employed: the simple descriptor scale (SDS), the visual analog scale (VAS), and the numeric (pain intensity) rating scale (NRS). Patients with English as a second language may not be able to complete the SDS without translation, and visually, cognitively, or physically impaired patients may have difficulty using the VAS. The NRS has been found to be a simple and valid alternative in some disease states; however, the validity of this scale administered verbally, without visual cues, to oncology patients has not yet been established. The present study examined validity of a verbally administered 0-10 NRS using convergence methods. The correlation between the VAS and the NRS was strong and statistically significant (r = 0.847, p < 0.001), supporting the validity of the verbally administered NRS. Although all subjects were able to complete the NRS and SDS without apparent difficulty, 11 subjects (20%) were unable to complete the VAS. The mean opioid intake was significantly higher for the group that was unable to complete the VAS (mean 170.8 mg, median 120.0 mg, SD = 135.8) compared to the group that had no difficulty with the scale (mean 65.6 mg, 33.0 mg, SD = 99.7) (Mann-Whitney test, p = 0.0065). The verbally administered 0-10 NRS provides a useful alternative to the VAS, particularly as more contact with patients is established via telephone and patients within the hospital are more acutely ill.

The use of complementary therapies in midwifery practice: a focus on reflexology

Article

May 1996
Compl Ther Nurs Midwifery

Denise Tiran

This paper introduces the use of complementary therapies within midwifery practice, and particularly focuses on reflexology. Case reports illustrate instances in which reflexology has been successful for childbearing women. Some of the issues pertinent to midwives are explored.

A call for standardizing the clinical rating of pain intensity using a 0 to 10 rating scale

Article

Mar 1998
CANCER NURS

Pain is difficult to measure, regardless of etiology. Furthermore, the measurement of pain is complicated by variation in the use of visual analogue scales as well as other pain assessment measures. This brief article reviews situations contributing to confusion regarding pain intensity measures and argues for consistency in its measurements with adults not experiencing cognitive disorders in the clinical setting.

Pain: An overview

Article

Jun 1999

Until the 1960s, pain was considered an inevitable sensory response to tissue damage. There was little room for the affective dimension of this ubiquitous experience, and none whatsoever for the effects of genetic differences, past experience, anxiety, or expectation. In recent years, great advances have been made in our understanding of the mechanisms that underlie pain and in the treatment of people who complain of pain. The roles of factors outside the patient's body have also been clarified. Pain is probably the most common symptomatic reason to seek medical consultation. All of us have headaches, burns, cuts, and other pains at some time during childhood and adult life. Individuals who undergo surgery are almost certain to have postoperative pain. Ageing is also associated with an increased likelihood of chronic pain. Health-care expenditures for chronic pain are enormous, rivalled only by the costs of wage replacement and welfare programmes for those who do not work because of pain. Despite improved knowledge of underlying mechanisms and better treatments, many people who have chronic pain receive inadequate care.

Foot massage: A nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalized with cancer

Article

Jul 2000
CANCER NURS

This article describes the findings of an empirical study on the use of foot massage as a nursing intervention in patients hospitalized with cancer. The study was developed from the earlier work of Ferrell-Torry and Glick (1992). In a sample of 87 subjects, a 10-minute foot massage (5 minutes per foot) was found to have a significant immediate effect on the perceptions of pain, nausea, and relaxation when measured with a visual analog scale. The use of foot massage as a complementary method is recommended as a relatively simple nursing intervention for patients experiencing nausea or pain related to the cancer experience. Further research into its effectiveness in the management of these symptoms by the family at home is warranted.

Does reflexology impact on cancer patients' quality of life?

Article

Apr 2000

Heather Hodgson

The objective of this study was to determine whether reflexology has an impact on the quality of life of patients in the palliative stage of cancer. Twelve patients in the palliative stage of cancer with various tumour types were randomised into two groups. They were randomly assigned to receive either reflexology or placebo reflexology. All participants completed a linear analogue self-assessment scale relating to quality of life. All participants then received three sessions of either reflexology or placebo reflexology. The same person, a qualified reflexologist, provided the interventions for both groups. The participants were not aware of which intervention they were receiving. All participants then completed a second linear analogue self-assessment scale relating to quality of life. All participants felt that their quality of life had improved, even those who had received the placebo treatment. The reflexology group, however, reported more benefit than the placebo group. There was a significant difference (p = 0.004) between the reflexology group and the placebo group. This study showed that reflexology does have an impact on the quality of life of patients in the palliative stage of cancer.

Perceptions of patients' self-efficacy for managing pain and lung cancer symptoms: Correspondence between patients and family caregivers

Article

Aug 2002

This study examined the degree of correspondence between lung cancer patients and their family caregivers in their perceptions of the patients' self-efficacy for managing pain and other symptoms of lung cancer, and the association of this correspondence to demographic, disease, and psychosocial variables. Thirty patients who were newly diagnosed with lung cancer and their primary family caregivers completed telephone interviews assessing the patient's symptoms, the patient's self-efficacy for managing symptoms, the quality of the relationship between the patient and caregiver, patient and caregiver psychological distress, and caregiver strain. Although patients and their caregivers showed a moderate degree of agreement in their perceptions of the patient's self-efficacy for managing pain and other symptoms, there was considerable variability in the degree of congruence. Factors that contributed to lower levels of congruence included low patient-rated self-efficacy, female gender of the patient, high patient psychological distress, and high caregiver strain. Caregivers were about evenly split in their tendency to overestimate versus underestimate the patient's self-efficacy. A poorer quality of relationship between the caregiver and the patient (as rated by the patient), high levels of patient-rated symptoms, and high levels of caregiver strain were associated with caregivers overestimating patient self-efficacy.

Outcomes of Therapeutic Massage for Hospitalized Cancer Patients

Article

Feb 2002

To examine the effects of therapeutic massage on perception of pain, subjective sleep quality, symptom distress, and anxiety in patients hospitalized for treatment of cancer. Rogers' Science of Unitary Human Beings and Watson's theory of human caring. Quasiexperimental. The sample consisted of 41 patients admitted to the oncology unit at a large urban medical center in the United States for chemotherapy or radiation therapy. Twenty participants received therapeutic massage and 21 received the control therapy, nurse interaction. The outcome variables were measured on admission and at the end of 1 week via the following instruments: a Numerical Rating Scale for pain intensity and Likert-type scale for distress from pain; The Verran Snyder-Halpern Sleep Scale, McCorkle and Young's Symptom Distress Scale, and the Speilberger State Anxiety Inventory. ANOVA and t tests were used to analyze between and within group differences in mean scores and main effects on outcome variables. Mean scores for pain, sleep quality, symptom distress, and anxiety improved from baseline for the subjects who received therapeutic massage; only anxiety improved from baseline for participants in the comparison group. Statistically significant interactions were found for pain, symptom distress, and sleep. Sleep improved only slightly for the participants receiving massage, but it deteriorated significantly for those in the control group. The findings support the potential for massage as a nursing therapeutic for cancer patients receiving chemotherapy or radiation therapy.

Reflexology audit: patient satisfaction, impact on quality of life and availability in Scottish hospices

Article

Nov 2002
Int J Palliat Nurs

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 this therapy 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.

A pilot study to evaluate the effect of reflexology on mood and symptom rating of advanced cancer patients

Article

Dec 2002

In summary, patients in both groups generally enjoyed their therapy and there were few possible adverse effects.

Using Reflexology for Pain Management: A Review

Article

Jul 2003

More than two thirds of Americans with chronic pain are now using complementary and alternative therapies. One complementary and alternative therapy, reflexology, has a long history and has been found useful on a case-by-case basis. This article provides a review of the literature on the use of reflexology as a therapy in pain management. Although reflexology is widely used, systematic research is needed to examine its effectiveness. To date, however, only a few studies have focused on reflexology's use in pain management. Because reflexology is a noninvasive, nonpharmacological therapy, nurses are in a position to do research on and make decisions about its clinical effectiveness.

The effect of foot reflexology on pain in patients with metastatic cancer

Article

Dec 2003
APPL NURS RES

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.

Oncology outpatients with cancer-related pain require more than around-the-clock dosing of analgesics to achieve adequate pain control

Article

Mar 2002
J PAIN

Around-the-clock (ATC) dosing of opioid analgesics is the established approach for the management of chronic cancer pain. The purposes of this study were to determine whether there were differences in pain intensity scores and pain duration between oncology outpatients who were taking opioid analgesics on an around-the-clock (ATC) compared with an as needed (PRN) basis and to determine differences in opioid prescription and consumption between the 2 groups during a period of 5 weeks. Oncology patients (n = 137) with pain from bone metastasis were recruited from 7 outpatient settings. Patients completed a demographic questionnaire and on a daily basis recorded pain intensity scores and medication intake in a diary. No significant differences in average, least, or worst pain intensity scores or number of hours per day in pain were found between the 2 groups. However, the average total opioid dose, prescribed and taken, was significantly greater for the ATC group than for the PRN group. These findings suggest the need for further investigations in the following areas: the appropriate treatments for pain related to bone metastasis, the use of various pain measures to evaluate the effectiveness of analgesic medications, and the need to evaluate how analgesics are prescribed and titrated for patients with cancer-related pain.

Complementary therapies for cancer-related symptoms

Article

Nov 2003
J Support Oncol

Relief of cancer-related symptoms is essential in the supportive and palliative care of cancer patients. Complementary therapies such as acupuncture, mind-body techniques, and massage therapy can help when conventional treatment does not bring satisfactory relief or causes undesirable side effects. Controlled clinical trials show that acupuncture and hypnotherapy can reduce pain and nausea. Meditation, relaxation therapy, music therapy, and massage mitigate anxiety and distress. Pilot studies suggest that complementary therapies may treat xerostomia, hot flashes, and fatigue. Botanicals or dietary supplements are popular but often problematic. Concurrent use of herbal products with mainstream medical treatment should be discouraged.

Combined Modality Treatment of Aromatherapy, Footsoak, and Reflexology Relieves Fatigue in Patients with Cancer

Article

Jan 2005

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. 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. 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. 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.

Prevalence of complementary and alternative medicine use in cancer patients during treatment

Article

Nov 2005

To assess complementary and alternative medicine (CAM) therapies being utilized by cancer patients during treatment and communication about CAM usage between the patient and physician. Newly diagnosed cancer patients receiving chemotherapy or radiation therapy were recruited to complete a CAM survey within 2 weeks after the termination of treatment. Patients were queried on which CAM modalities they utilized and whether or not they were discussed with either their oncologist or primary care physician. Of the patients surveyed, 91% reported using at least one form of CAM. The most widely used forms of CAM were prayer, relaxation and exercise. CAM users tended to be women chemotherapy patients with at least a high school education. Of the patients using CAM, 57% discussed the use of at least one of these therapies with their oncologist or primary care physician. The most frequent CAM modalities discussed with at least one physician were diets, massage, and herbal medicine. An overwhelming proportion of cancer patients are using CAM, particularly prayer, relaxation, and exercise. However, patients may not discuss the use of CAMs at all or fully with their physician; if they do, it is most likely to be their oncologist, but not about the most frequently used CAMs. Future research needs to assess effective ways for oncologists to gather information about CAM usage by patients during allopathic treatment and discern ways these therapies may enhance or interfere with traditional cancer treatments.

Integrative Oncology: Complementary Therapies for Pain, Anxiety, and Mood Disturbance

Article

Mar 2005

Many people with cancer experience pain, anxiety, and mood disturbance. Conventional treatments do not always satisfactorily relieve these symptoms, and some patients may not be able to tolerate their side effects. Complementary therapies such as acupuncture, mind-body techniques, massage, and other methods can help relieve symptoms and improve physical and mental well-being. Self-hypnosis and relaxation techniques help reduce procedural pain. Acupuncture is well documented to relieve chronic cancer pain. Massage and meditation improve anxiety and other symptoms of distress. Many dietary supplements contain biologically active constituents with effects on mood. However, not all complementary therapies are appropriate or useful, and even helpful complementary modalities may not be optimal under some circumstances. Situations when precaution is indicated include acute onset of symptoms and severe symptoms, which require immediate mainstream intervention. Dietary supplements are associated with serious negative consequences under some circumstances. The authors summarize the research on these modalities and discuss the rationale, expectation, and necessary precautions involved with combining complementary therapies and mainstream care. Practical clinical issues are addressed.

Partner-Guided Cancer Pain Management at the End of Life: A Preliminary Study

Article

Apr 2005
J PAIN SYMPTOM MANAG

This preliminary study tested the efficacy of a partner-guided cancer pain management protocol for patients who are at the end of life. Seventy-eight advanced cancer patients meeting criteria for hospice eligibility and their partners were randomly assigned to a partner-guided pain management training intervention, or usual care control condition. The partner-guided pain management training protocol was a three-session intervention conducted in patients' homes that integrated educational information about cancer pain with systematic training of patients and partners in cognitive and behavioral pain coping skills. Data analyses revealed that the partner-guided pain management protocol produced significant increases in partners' ratings of their self-efficacy for helping the patient control pain and self-efficacy for controlling other symptoms. Partners receiving this training also showed a trend to report improvements in their levels of caregiver strain. Overall, the results of this preliminary study suggest that a partner-guided pain management protocol may have benefits in the context of cancer pain at the end of life. Given the significance of pain at the end of life, future research in this area appears warranted.

Measuring health-related quality of life in References chronic pain patients. Paper presented at the 19th Annual American Pain Society Meeting Pain: An overview

Jan 1999
1607-1609

A G Lipman
D B Carr
W H Rogers
M A Ashburn
H Wittink
G M Oderda

Lipman, A.G., Carr, D.B., Rogers, W.H., Ashburn, M.A., Wittink, H., Oderda, G.M., et al. (2000, November). Measuring health-related quality of life in References chronic pain patients. Paper presented at the 19th Annual American Pain Society Meeting, Atlanta, GA. Loeser, J.D., & Melzack, R. (1999). Pain: An overview. Lancet, 353, 1607–1609.

The challenge of pain

Jan 1982

R Melzack
P D Wall

Melzack, R., & Wall, P.D. (1982). The challenge of pain. New York: Basic Books.

Pain measurement in persons in pain

Jan 1994

R Melzack
J Katz

Melzack, R., & Katz, J. (1994). Pain measurement in persons in pain. In P.D.

Central TV teaching program

Jan 1991

X W Hang

Hang, X.W. (1991). Central TV teaching program. Beijing, China: People's Republic of China.

Refl exotherapy of the feet

Jan 2000

H Marquardt

Marquardt, H. (2000). Refl exotherapy of the feet. New York: Thieme.

Better health with foot refl exology: The Ingham method of refl exology. Saint Petersburg Better health with foot refl exology: The Ingham method of refl exology (Rev Saint

Jan 1983

D C Byers

Byers, D.C. (1983). Better health with foot refl exology: The Ingham method of refl exology. Saint Petersburg, FL: Ingham. Byers, D.C. (2001). Better health with foot refl exology: The Ingham method of refl exology (Rev. ed.). Saint Petersburg, FL: Ingham.

An exploration of the clinical indicators of foot refl exol-ogy: A retrospective of its clinical application to 8,096 cases

Jan 1996
140-143

W Liang

Liang, W. (1996). An exploration of the clinical indicators of foot refl exol-ogy: A retrospective of its clinical application to 8,096 cases. In 1996 China refl exology symposium report (pp. 140–143). Beijing, China: China Refl exology Association.

The clout behind a cancer maverick The Washington Post Validity of a verbally administered nu-meric rating scale to measure cancer pain intensity

Jan 1997
88-93

S Okie

Okie, S. (2000, January 18). The clout behind a cancer maverick. The Washington Post. Retrieved February 21, 2000, from http://www.msnbc.com/news/359023.asp Paice, J.A., & Cohen, F.L. (1997). Validity of a verbally administered nu-meric rating scale to measure cancer pain intensity. Cancer Nursing, 20, 88–93.

Medical applications of refl exology: Find-ings in research about safety, effi cacy, mechanism of action and cost-effectiveness of refl exology

Jan 1999

K Kunz
B Kunz

Kunz, K., & Kunz, B. (1999). Medical applications of refl exology: Find-ings in research about safety, effi cacy, mechanism of action and cost-effectiveness of refl exology. Albuquerque, NM: Refl exology Research Project Press.

Partner-Delivered Reflexology: Effects on Cancer Pain and Anxiety

Abstract

No full-text available

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