The effect of reflexology on pain, anxiety, fatigue, and sleep in patients undergoing coronary artery bypass graft surgery: A randomized controlled trial

Abstract

IntroductionReflexology is a non-pharmacological method that helps normalization of bodily functions by applying pressure to the reflex points on the hands, feet and ears, which correspond to all the organs and glands in the body. This study aimed to evaluate the effect of reflexology on pain, anxiety, fatigue, and sleep in patients undergoing cardiovascular surgery. MethodsThis open-label, randomized parallel-group controlled trial was conducted between September 2020 to May 2021 in a university hospital in Turkey. Seventy eligible patients who underwent cardiovascular surgery were randomized into reflexology group (n = 35) or control group (n = 35). While foot reflexology was applied to the reflexology group for 40 min in the first three days after surgery, no intervention was applied to control group. The primary outcome was pain severity, assessed using the Visual Analog Scale, in the first three postoperative days. The other outcomes were anxiety level assessed using the State-Trait Anxiety Inventory, fatigue level assessed using the Visual Analog Scale in the first three postoperative days, and sleep quality assessed using the Richards-Campbell Sleep Questionnaire in the first four postoperative days. ResultsAfter applying reflexology on the first, second, and third postoperative days, pain scores (d=-2.736, 95% Cl=-3.388 to -2.084) (d=-7.954, 95% Cl=-9.352 to -6.555) (d=-7.528, 95% Cl=-8.860 to -6.196), anxiety scores (d=-3.462, 95% Cl=-4.202 to -1.721) (d=-6.077, 95% Cl=-7.187 to -4.967) (d=-6.537, 95% Cl=-7.717 to -5.357), and fatigue scores (d=-2.490, 95% Cl=-3.115 to -1.866) (d=-6.245, 95% Cl=-7.380 to -5.109) (d=-8.223, 95% Cl=-9.675 to -6.791, respectively) were statistically significantly lower in reflexology group compared to control group. On the second, third, and fourth postoperative days, sleep scores in reflexology group were statistically significantly higher than control group (d = 3.230, 95% Cl=2.519 to 3.941) (d = 4.280, 95% Cl=3.431 to 5.130) (d = 6.106, 95% Cl=4.992 to 7.221, respectively). During the study period, no adverse events were noted in either groups. ConclusionThis study showed that applying foot reflexology to patients undergoing cardiovascular surgery reduced pain, anxiety, and fatigue and improved sleep quality. Further studies on reflexology practice are recommended to be conducted with larger sample sizes and different groups. Trial registration ClinicalTrials.gov NCT04473287.