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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

Sinem Göral Türkcü 1Sevgi Özkan 2

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  • PMID: 34157494



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.


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.


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.

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The effects of foot reflexology on back pain after coronary angiography: A randomized controlled trial

Mojgan Kardan 1Bahare Zarei 2Hamidreza BahramiTaghanaki 3Seyyed Abolfazl Vagharseyyedin 4Nahid Azdaki 5

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  • PMID: 31739213


Back pain is among the most common complaints of patients during the first hours after coronary angiography (CA), i.e. when they are restricted to complete bed rest. This study aimed to evaluate the effects of foot reflexology on back pain after CA.

METHODS: This randomized controlled trial was conducted in 2018-2019 on patients hospitalized in the post-angiography unit of Razi hospital, Birjand, Iran. Through convenience sampling, 120 patients were recruited and their demographic characteristics and baseline back pain intensity were assessed immediately after angiography using a demographic questionnaire and a visual analogue scale, respectively. Then, patients were randomly allocated to a control (n = 60) and a reflexology (n = 60) group through block randomization. Patients in the reflexology group received 8-min foot reflexology for each foot (16 min for both feet) while their counterparts in the control group solely received routine post-angiography care services. Back pain assessment was repeated for all participants immediately, two, four, and 6 h after the intervention. 


Back pain intensity significantly increased after angiography in both groups (P < 0.05). Yet, pain intensity in the reflexology group at all post-intervention measurement time points was significantly less than the control group (P < 0.001).


Foot reflexology is effective in significantly reducing back pain after CA.


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


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


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

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


Use of reflexology in managing secondary lymphoedema for patients affected by treatments for breast cancer: A feasibility study.

Whatley J, Street R, Kay S, Harris PE.


A significant reduction in the volume of the affected arm was identified at follow-up compared to baseline. This reduction in volume appeared to be maintained for more than six months. Participant concerns were significantly reduced and their wellbeing significantly increased. No serious adverse effects were reported.

Please note the above study was using the specific sequence RLD technique which our therapist Andrea is trained in.


Experiences of breast cancer related lymphoedema and the use of reflexology for managing swelling:

A qualitative study.

Whatley J1, Street R2, Kay S3.


Four main themes emerged which comprised physical and psycho-social impacts of lymphoedema, experiences of physical change, and the return of optimism. RLD treatment was considered pleasant and non invasive, and the reduction in swelling helped with pain and mobility.

Please note this study was using the specific RLD technique which our therapist Andrea is trained in.

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The effect of massage on immune function and stress in women with breast cancer--a randomised controlled trial.

Billhult A1, Lindholm CGunnarsson RStener-Victorin E.


Light pressure effleurage massage decreased the deterioration of NK cell activity occurring during radiation therapy. Furthermore it lowered heart rate and systolic blood pressure.

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Natural killer cells and lymphocytes increase in women with breast cancer following massage therapy.

Hernandez-Reif M1, Field TIronson GBeutler JVera YHurley JFletcher MASchanberg SKuhn CFraser M.


Women diagnosed with breast cancer received massage therapy or practiced progressive muscle relaxation (PMR) for 30-min sessions 3 times a week for 5 weeks or received standard treatment. The massage therapy and relaxation groups reported less depressed mood, anxiety, and pain immediately after their first and last sessions. By the end of the study, however, only the massage therapy group reported being less depressed and less angry and having more vigor. Dopamine levels, Natural Killer cells, and lymphocytes also increased from the first to the last day of the study for the massage therapy group. These findings highlight the benefit of these complementary therapies, most particularly massage therapy, for women with breast cancer.


Massage therapy for symptom control: outcome study at a major cancer center.

Cassileth BR1, Vickers AJ.

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Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.


Massage is increasingly applied to relieve symptoms in patients with cancer. This practice is supported by evidence from small randomized trials. No study has examined massage therapy outcome in a large group of patients. At Memorial Sloan-Kettering Cancer Center, patients report symptom severity pre- and post-massage therapy using 0-10 rating scales of pain, fatigue, stress/anxiety, nausea, depression and "other." Changes in symptom scores and the modifying effects of patient status (in- or outpatient) and type of massage were analyzed. Over a three-year period, 1,290 patients were treated. Symptom scores were reduced by approximately 50%, even for patients reporting high baseline scores. Outpatients improved about 10% more than inpatients. Benefits persisted, with outpatients experiencing no return toward baseline scores throughout the duration of 48-hour follow-up. These data indicate that massage therapy is associated with substantive improvement in cancer patients' symptom scores.

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The clinical efficacy of reflexology in nursing home residents with dementia. Clinical efficacy of reflexology in nursing home residents with dementia.

Hodgson NA1, Andersen S.

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This experimental, repeated-measures, crossover design study with nursing home residents examined the efficacy of reflexology in individuals with mild-to-moderate stage dementia. Specifically, the study tested whether a weekly reflexology intervention contributed to the resident outcomes of reduced physiologic distress, reduced pain, and improved affect.


The first group received 4 weeks of weekly reflexology treatments followed by 4 weeks of a control condition of friendly visits. The second group received 4 weeks of friendly visits followed by 4 weeks of weekly reflexology.


The findings demonstrate that when receiving the reflexology treatment condition, as compared to the control condition, the residents demonstrated significant reduction in observed pain and salivary alpha-amylase. No adverse events were recorded during the study period.


This study provides preliminary support for the efficacy of reflexology as a treatment of stress in nursing home residents with mild-to-moderate stage dementia.