Meta-Analysis of the Effectiveness on Foot-Reflexo-Massage for Cancer Patients

Assessment of non-pharmacological nursing strategies for pain management in tumor patients: a systematic review and meta-analysis

Summary background

Cancer is a multifactorial disease associated with intense pain and fatigue. Pain is the main discomfort experienced during cancer treatment, particularly as a major side effect of chemotherapy.

Objective

This study has aimed to investigate the effectiveness of non-pharmacological nursing strategies, including reflexology, aromatherapy, acupressure, massage therapy and acupuncture, in the management of cancer-associated pain. Moreover, it provides evidence-based recommendations for integrating these interventions into standard pain management protocols.

Search methodology

We gathered data from three major online databases; PubMed, the Cochrane Library and Embase. For the analysis, we exclusively targeted randomized controlled trials (RCTs) assessing the effectiveness of non-pharmacological interventions in managing cancer-related pain. No language restrictions were applied, and pain was considered the primary outcome measure.

Results

Seventeen RCTs (n = 1,070) were included in this meta-analysis from 166 eligible studies. The pooled effect size demonstrated that all evaluated non-pharmacological nursing strategies, including aromatherapy, massage, reflexology, acupressure and acupuncture significantly reduced cancer-related pain compared to usual care (p < 0.001). Moreover, the reflexology and massage showed negligible heterogeneity among other interventions.

Conclusion

This meta-analysis found the significant effectiveness of non-pharmacological nursing strategies, particularly reflexology and massage in reducing cancer-related pain. The findings support their integration into clinical practice, providing evidence-based recommendations for enhancing standard pain management protocols.

Effects of foot-massage in pregnant women with hyperemesis gravidarum on severity of nausea-vomiting and anxiety

OBJECTIVE

This study was conducted to determine the effects of foot massage performed on pregnant women with hyperemesis gravidarum on the severity of nausea and vomiting and pregnancy-related anxiety.

MATERIAL AND METHOD

This randomised controlled study was conducted between February and November 2020 with 104 pregnant women hospitalised in the pregnant women follow-up service ward of a public hospital in eastern Turkey with the diagnosis of hyperemesis gravidarum. Data were obtained from the pregnant women who were given a 'Personal Information Form' and before and after each application by using the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) Test and the Pregnancy-Related Anxiety Scale-Revision 2 (PRAQ-R2).

RESULTS

Before foot massage, the pre-test mean PUQE total, PRAQR-2 total, and PRAQR2 fear of childbirth and concerns about physical appearance dimension scores of the participants in the experimental and control groups were similar (p > 0.05), It was determined that the PRAQR2 fear of having a disabled child control group had significantly higher pre-test scores compared to the massage group (p < 0.05). After foot massage, the severity of nausea and vomiting was significantly lower in the participants in the experimental group compared to those in the control group (p < 0.001). Additionally, the mean PRAQR2 total and dimension scores of the participants in the experimental group were significantly lower than those in the control group (p < 0.05).

CONCLUSION

These findings support the use of the foot massage is an effective intervention in reducing the severity of nausea and vomiting and pregnancy-related anxiety.

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

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.

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

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.

Effects of Reflexology and Progressive Muscle Relaxation on Pain, Fatigue, and Quality of Life during Chemotherapy in Gynecologic Cancer Patients

PURPOSE

Our aim was to investigate the effect of reflexology and progressive muscle relaxation (PMR) exercises on pain, fatigue, and quality of life (QoL) of gynecologic cancer patients during chemotherapy.

METHODS

Eighty participants were randomly assigned to one of four groups: reflexology, progressive muscle relaxation (PMR) exercises, both (reflexology + PMR), or a control group. Data were collected with a general data collection form, Brief Pain and Fatigue inventories, and Multidimensional Quality-of-Life Scale-Cancer.

RESULTS

In reflexology and reflexology + PMR groups, a significant decrease in pain severity and fatigue and an increase in QoL were found (p < .05). In the PMR alone group, pain severity and fatigue decreased significantly (p < .05), but there was no significant change identified in QOL (p > .05).

CONCLUSIONS

Reflexology and PMR exercises given to gynecologic cancer patients during chemotherapy were found to decrease pain and fatigue and increase QoL.

[Meta-analysis of spiritual intervention studies on biological, psychological, and spiritual outcomes]

PURPOSE

The purpose of this study was to evaluate the effectiveness of spiritual intervention studies by examining biological, psychological, and spiritual outcomes.

METHODS

From electronic databases 2522 studies were retrieved, of which 21 studies met the inclusion criteria. These studies had 1411 participants. Two authors independently extracted data from the selected studies and assessed the methodological quality. The data were analyzed using the RevMan 5.1 program of the Cochrane library.

RESULTS

Overall effect size of spiritual intervention on spiritual and psychological (depression and anxiety) outcomes were moderate (d=-0.65 to d=-0.76, p<.001). The effects on biological outcomes (pain and functional status) ranged from -0.51 to -0.39, respectively. No publication bias was detected as evaluated by a funnel plot. Spiritual intervention had a moderate effect on psychological and spiritual outcomes and a smaller effect on biological outcomes.

CONCLUSION

The results of this study suggest that spiritual intervention can relieve depression and anxiety. Further randomized controlled trials studies are needed to evaluate the effects of spiritual intervention on biological outcomes.