Some of the challenges of caring for ventilator-dependent Covid19 patients are cited in recent news articles. Included is the time consuming task of monitoring and adjusting oxygen levels (1) as well as the increased use of painkillers and sedatives leading to potential shortages of the drugs (2).
In one example of reflexology research, ventilator dependent ICU patients showed statistically significant differences in sedation and patient-ventilator syncrony following 30 minutes of targeted reflexology work for each of five days. Also improved were other signs of sedation assessment agitation, anxiety, and sleep. In addition physiological parameters of anxiety improved: significantly lower heart rate, systolic blood pressure, diastolic blood pressure and respiratory rate. (3)
Reflexology was seen by multiple researchers as a non-pharmacological treatment option for nursing care to address physiological and psychological problems presented by ventilator dependent patients: reducing anxiety, preventing physiological reactions caused by anxiety, stabilizing vital signs and managing pain. (4) Such goals are of interest in the management of the sickest of all Covid19 patients, those on a ventilator. While less urgent these goals are also important to those hospitalized with Covid19.
A single round of reflexology work applied to specific reflex areas of the feet was found to create significant differences from control group patients for ventilator-dependent patients recovering from open-heart surgery. (5) In addition significant differences were found when a single bout of reflexology work was applied to hospitalized patients. (9-18) Significant differences were reported in physiologic parameters as well as anxiety and pain.
Two (5) (6) of four studies of ventilator-dependent patients found significantly improved physiology parameters. Noted in parentheses is the number of studies finding differences from the control group in: oxygen saturation [2], heart rate [1], respiratory rate [2], mean arterial pressure [2], systolic and diastolic blood pressure [2]. One study found anxiety and agitation was significantly reduced following 30 minutes of reflexology work (6) while another found anxiety was not reduced following 20 minutes of reflexology work (7). Three of three studies found reduced time spent weaning patients from the ventilator, important following recovery from open heart surgery, by 39 minutes (4), 100 minutes (8) and 165 minutes (5).
Significant differences in physiologic parameters were found for hospitalized patients in nine ((9) through (18) in References) of ten ((19) in References) studies. Noted in parentheses is the number of studies finding differences from the control group in: heart rate [3], pulse rate [3], respiratory rate [6], breathing [1], mean arterial pressure [2], temperature [1], blood pressure [4], systolic [3] and diastolic [2] blood pressure. Significant differences in level of anxiety were found in two of the three studies that looked at the issue.
References
- Bernstein, Lenny, “Ventilator use is helping save lives,” Albuquerque Journal, July 14, 2020, p. B-3
- Hopkins, Jared S., “Hospital Stockpiling Sparks Drug Shortage,” Wall Street Journal, p. A-1
(3) Akin Korhan, Esra PhD; Khorshid, Leyla PhD; Uyar, Mehmet MD, “Reflexology: Its Effects on Physiological Anxiety Signs and Sedation Needs,” Holistic Nursing Practice: January/February 2014 - Volume 28 - Issue 1 - p 6–23 doi: 10.1097/HNP.0000000000000007
(4) Abbas Ebadi, Parasoo 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
(5) 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
(6)Yaser Abbaszadeh, Atefeh Allahbakhshian, Alehe Seyyedrasooli, Parvin Sarbakhsh, Sakineh Goljarian, Naser Safaei, Yaser Abbaszadeh , Atefeh Allahbakhshian, Alehe Seyyedrasooli, Parvin Sarbakhsh, “Effects of Foot Reflexology on Anxiety and Physiological Parameters in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Clinical Trial,” Complement Ther Clin Pract. 2018 May;31:220-228. PMID: 29705459
(7) 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
(8)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
(9) Arash Khalili, Negin Masoudi Alavi, Davoud Mardani, Nastoor Bekhradiani Pour, Akvan Paymard, Mehdi Daraei, Shapour Yaripoor, Saba Bashiri and Mehdi Molavi Vardanjani, “The effect of foot reflexology on physiological parameters,” International Journal of Medical Research & Health Sciences, 2016/09/01
(10) Mahin Moeini, Leila Sadat Kahangi, Mahboobeh Valiani, Reza Heshmat, “The Effect of Reflexotherapy on Patients’ Vital Signs Before Bypass Graft Surgery,” Iran J Nurs Midwifery Res, Winter 2011;16(1):8-12 PMID: 22039373 PMCID: PMC3203304
(11) Khosrow Hashemzadeh, Marjan Dehdilani, Mehdi Khanbabayi Gol, “Effects of Foot Reflexology on Post-sternotomy Hemodynamic Status and Pain in Patients Undergoing Coronary Artery Bypass Graft: A Randomized Clinical Trial” Published 2019, Corpus ID: 211201347
(12) Fatemeh Rigi, Aram Feiz, Zainab American, Mohsen Naseri, Shahyad Salehi, “The Effect of foot reflexology massage on physiological parameters in patients undergoing coronary artery bypass,” Complementary Medicine Journal of (Arak University) Faculty of Nursing and Midwifery, 2014; 4 (3) :865-875 Corpus ID: 110819484
(13) Vinaya Anjaly Thomas, Shweta Pattnaik, “Effect of Foot Reflexology on Vital Parameters of Hypertensive Patients” Published 2017 Corpus ID: 195746695
(14) Quattrin R., Zanini A., Buchini S., Turello D., Annunziata M. A., Vidotti C., Colmbatti A. & Brusaferro S. “Use of reflexology foot massage to reduce anxiety in hospitalized cancer patients in chemotherapy treatment: methodology and outcomes,” (2006) Journal of Nursing Management 14, 96–105
(15) Fatemeh Heidari, Nahid Rejeh, Majideh Heravi-Karimooi, Kamran Ghodes, Mehrdad Karimi, Davood Tadrissi, “The effect of stress on foot reflex zone therapy on anxiety, hemodynamic parameters of patients waiting for cardiac catheterization,”Avicenna Journal of Nursing and Midwifery Care Summer 2015 Volume 23 Number 2 (49) #G00167; Pages 63 to 73
(16) M. Torabi, M. Salavati, A. Ghahri Sarabi, "Effect of Foot Reflexology Massage and Benson Relaxation Techniques on Anxiety and Physiological Indexes of Patients Undergoing Coronary Heart Angiography," Iran Avicenna Journal of Nursing and Midwifery Care Volume 20, Issue 1 (5-2012)
(17) Khosrow Hashemzadeh, Marjan Dehdilani, Mehdi Khanbabayi Gol, “Effects of Foot Reflexology on Post-sternotomy Hemodynamic Status and Pain in Patients Undergoing Coronary Artery Bypass Graft: A Randomized Clinical Trial,” Crescent Journal of Medical and Biological Sciences, Vol. 6, No. 4, October 2019, 517–522 eISSN 2148-9696
(18) Hassani, S., & Hassani, K. (2015). “The Effect of Foot Reflexology on Physiologic Indices and Pain Severity Following Cesarean Delivery.” Research Journal of Medical Sciences, 9(3), 114-117
(19) Mehrnoosh Khoshtarash, Atefeh Ghanbari Mohammad Reza Yegane, Ehsan Kazemnejhad, Parvine Rezasoltani, “Effects of foot reflexology on pain and physiological parameters after cesarean section,” Iran Koomesh Autumn 2012, 14 (1): 109 - 116
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