Multiple studies show reflexology helps in the treatment of patients placed on mechanical ventilators. Five of six studies, all but one noting its use as “an effective nursing intervention,” recommended nurses’ training in and use of foot reflexology for patients on mechanical ventilators. (1, 2, 3, 5, 6)
Results of the studies noted patients experienced: improved physiological parameters (e.g. heart rate, oxygen saturation) (2, 5); lessened anxiety and agitation as well as better sleep and patient-ventilator synchrony; (5) less use of drugs for sedation (2, 5) and pain (2); shorter length of time on the ventilator (weaning time) (1, 2, 3) and increased level of consciousness for those in a coma (6).
Ventilator use creates problems for patients
Problems result for patients placed on a ventilator. As noted by researchers Abbas Ebadi et al: “Studies have shown that prolonged mechanical ventilation increases healthcare costs and also negatively affects patients’ cardiovascular, respiratory, digestive, and musculoskeletal systems, fluid and electrolyte balance and psychological state. … MV (Mechanical Ventilator) associated with physical and psychological problems cause considerable stress to patients …. This stress, in turn, stimulates sympathetic and neuroendocrine responses, disturbs patients' sleep, increases cardiac muscle oxygen demand, and causes tachypnea, and hypertension …. Accordingly, patients who receive MV usually are treated with sedatives, hypnotic, and tranquilizers to alleviate their pain, stress, and anxiety and also to prevent from patient-ventilatory asynchrony …. However, these agents can slow the process of weaning from MV ….” (1)
Why the therapeutic application of reflexology is important for patients using ventilators
Reflexology provides a therapeutic application with advantages over other methods utilized to address physical and psychological problems experienced by patients on ventilators. (1)
As noted by researchers Abbas Ebadi et al: “Complementary therapies and non-pharmacological interventions are noninvasive, simple and less expensive, and have less or no adverse effects compared with pharmacological remedies. Shortening the length of mechanical ventilation (MV) and lowering dose of sedatives among critically ill patients can decrease complications, intensive care length of stay and mortality rate. Therefore, introducing non-pharmacologic interventions such as reflexology became an issue of concern for critical care nurses.” (1)
Researchers Elsayed et al note: “Some studies revealed that foot reflexology has immediate effects on reducing heart rate (HR), systolic and diastolic blood pressure (SBP & DBP), and increasing arterial oxygen saturation (SaO2) …. These findings are worthy of getting the attention of critical care nurses as the improvement of vital signs without medications is a significant goal of care. Additionally, foot reflexology can be used to improve physiological indicators in unconscious patients in ICUs.” (2)
Researchers Elsayed et al further note: “It had been proven that foot reflexology massage is an efficient technique in decreasing postoperative pain and the use of analgesics, as well as lowering anxiety levels 19. Additionally, it has been reported that foot reflexology is a useful method for managing incision pain after coronary artery bypass graft surgery …. Reflexology is an effective method for improving muscle comfort by enhancing blood flow which stimulates the parasympathetic nervous system ….” (2)
Among results noted by researchers:
“Conclusion: Study findings indicate that foot reflexology is an effective nursing intervention for facilitating MV (Mechanical Ventilator) weaning after OHS (Open Heart Surgery). Given the simplicity, safety, and cost-effectiveness of foot reflexology, we recommend the development and implementation of reflexology training programs for both nursing and practicing nurses.” (1)
“Conclusion: Foot reflexology is an effective method for stabilizing physiological indicators and decreasing ventilator dependence among patients undergoing OHS (Open Heart Surgery). Therefore, it can be introduced as an adjunct to daily care of OHS patients in ICU.” (2)
“… 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.” (3)
“Conclusion: Foot reflexology massage in reflection points of the heart and lung in patients after surgery did not reduce anxiety and agitation in patients.” (4)
“Reflexology can serve as an effective method of decreasing the physiological signs of anxiety and the required level of sedation in patients receiving mechanically ventilated support. Nurses who have appropriate training and certification may include reflexology in routine care to reduce the physiological signs of anxiety of patients receiving mechanical ventilation.” (5)
“There was significant increase in (conscious level as measured by) GCS (Glasgow Coma Scale). So, because of the positive results of the intervention, the nurse practitioners may be trained about the technique of foot massage and reflexology.” (6)
References
Mechanical ventilator: Physiological parameters (Pulse rate, respiratory rate, systolic and diastolic blood pressures, mean arterial pressure, percutaneous oxygen saturation); Weaning time
1 Abbas Ebadi, Parastoo Kavei, Seyyed Tayyeb Moradian, Yaser Saeid “The Effect of Foot Reflexology on Physiologic Parameters and Mechanical Ventilation Weaning Time in Patients Undergoing Open-Heart Surgery: A Clinical Trial Study” Complement Ther Clin Pract 2015 Aug;21(3):188-92. PMID: 26256138 DOI: 10.1016/j.ctcp.2015.07.001
Mechanical ventilator: Physiological parameters (Heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, oxygen saturation); Weaning time; Sedation and analgesic drug use
2 Elsayed, Amira, Kandeel, Nahed, El-Aziz, Wafaa, “The Effect of Foot Reflexology on Physiological Indicators and Mechanical Ventilation Weaning Time among Open-Heart Surgery Patients” American Journal of Nursing Research. 2019, 7(4), 412-419 DOI: 10.12691/ajnr-7-4-2
(Full study available: http://pubs.sciepub.com/ajnr/7/4/2/index.html)
Mechanical ventilator: Heart rate, Oxygen saturation
3 Didem Kandemir, “How Effective Is Reflexology on Physiological Parameters and Weaning Time from Mechanical Ventilation in Patients Undergoing Cardiovascular Surgery?,” European Journal of Integrative Medicine 26 · February 2019 DOI: 10.1016/j.eujim.2019.01.008
Mechanical ventilator: Anxiety, Agitation
4 Kavei, P, Ebadi, A, Saeed Y, Moradian S. T., Sedigh Rahimabadi M, “.Effect of Reflexology on Anxiety and Agitation in patients Under Mechanical Ventilation after Open Heart Surgery: A Randomized Clinical Trial Study, Journal of Clinical Nursing and Midwifery, Spring 2015, Volume 4, Number 1; Pages 16-26
Mechanical ventilator: Physiological anxiety signs (Heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate); Sedation
5 Akin Korhan, Esra PhD; Khorshid, Leyla PhD; Uyar, Mehmet MD, “Reflexology: Its Effects on Physiological Anxiety Signs and Sedation Needs (in patients receiving mechanically ventilated support/ICU),” Holistic Nursing Practice: January/February 2014 - Volume 28 - Issue 1 - p 6–23 doi: 10.1097/HNP.0000000000000007
Mechanical ventilator: Consciousness (Glasgow Coma Scoring)
6 Maha Salah Abdullah Ismail, Manal S. Ismail, Amir M. Saleh “Effect of Foot Reflexology Treatment on Glasgow Coma Scoring Among Mechanically Ventilated Patients,”IJBPAS International Journal of Biology, Pharmacy and Allied Science), July, 2017, 6(7): 1384-1394, ISSN: 2277–4998; (Full Study available: https://ijbpas.com/pdf/2017/July/1498792891MS%20IJBPAS%202017%204209.pdf)
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