New title: Reflexology and Mechanical Ventilation

Why write a book about reflexology research and mechanical ventilation? I couldn’t help myself. The search for information was so fascinating. The results showing what reflexology could do were so dramatic.

It started when we were working with neuroscientist Dr. Stefan Posse of the University of New Mexico School of Medicine preparing for research, finding out what happens as foot reflexology is applied during brain scans, fMRI imaging. Stefan had asked about reflexology research of medical topics. I started looking.

I discovered 75 to 80 studies of reflexology applied to hospital patients from the maternity ward, the cardiac care unit and beyond. It was, however, the height of the Covid pandemic and the sight of patients on mechanical ventilation filled the news and evoked all sorts of emotions from empathy to dread. I zeroed in on the studies I had found about ICU patients on mechanical ventilation following surgery or hospitalized for various causes.

There in the research was a surprise: reflexology got people off ventilators sooner. Amazing. How? Why? 

I kept going. I would discover a lot. How surgery, mechanical ventilation and hospitalization present life-threatening problems. The anxieties faced by patients. The challenges facing critical care nurses. What is important to help patients survive. 

I found out more, more about reflexology itself. All those things we reflexologists know are right and were reaffirmed. Yes, reflex areas do matter. Yes, selecting the right reflex areas does matter. That, yes, dosing, the appropriate amount of reflexology does matter. 

Then there was, why would this be? How and why would reflexology help in such a critical situation? It all went back to: how does reflexology work? There are answers to those questions, fun to explore.

And, finally, it occurred to me: these studies had more to say. More to say about how reflexology provides the opportunity for us to help: help our clients, ourselves and virtually anyone with a health concern.

 

Yes, this is a book about reflexology research of patients supported by mechanical ventilation. But sometimes, when you least expect it, you get more than you could have ever imagined. 

Barbara Kunz

 Get your copy now https://a.co/d/6awLMQZ or https://books2read.com/u/bx6VLl

 Reflexology and weaning time from ventilator and return to consciousness after brain surgery

The results showed that the time interval between the admission to ICU and weaning or withdrawal from mechanical ventilation support was 92.03 ± 34.22 h in the intervention/reflexology group and 209.73 ± 65.87 h in the control group. Furthermore, the time interval between the admission to ICU and full consciousness in the intervention group was 92.56 ± 36.05 h and in the control group was 215.06 ± 65.28 h. The independent t-test showed a significant difference between the two groups in terms of the time of weaning or withdrawal from mechanical ventilation support (p<0.001). The groups’ difference related to the time of full consciousness was also significant (p<0.001) (Table 2). 

Izadinezhad M, Rahemi Z, Ghasembandi M, Sadat Z, Mirbagher Ajorpaz N. The Effect of Foot Reflexology on the Time of Full Consciousness Recovery and Weaning from Mechanical Ventilation in Patients with Brain Tumor after Craniotomy. Clin Surg. 2022; 7: 3562

Reflexology research for hospitalized patients

 Reflexology research for hospitalized patients supported by mechanical ventilation:

Potential General Impact of a Single Reflexology Session on Physiologic Parameters

Research shows that reflexology effects a variety of physical and psychological concerns. Research also demonstrates what a single reflexology session reflexology can do for the reflexology client:

• creates relaxation
• reduces anxiety
• diminishes pain
• improves blood flow to the kidneys, intestines, and feet
• improves blood flow to parts of the brain related to the reflex area
• decreases heart rate and blood pressure
• increases oxygen saturation and lowers respiratory rate (functions of the lungs)

Can a single reflexology session make a difference for hospitalized patients, especially for those in the most serious of circumstances, supported by mechanical ventilation?  Findings in research show possibilities. 

Further, what can such findings mean for the providing of reflexology services for the benefit of reflexology clients? 

While multiple variables can influence the results of a reflexology session, three studies of patients supported by mechanical ventilation demonstrate key issues. In the studies, the length of time reflexology is applied and reflex areas to which technique is applied potentially made a difference in positive results.

At issue for the reflexologist and client: can applying technique to a limited number of reflex areas for the duration of a session provide specific benefits?

The three studies investigated physiologic parameters of patients following open heart surgery as well as length time for weaning from mechanical ventilator support. Stabilization of physiologic parameters and length of time on mechanical ventilation are both important to a successful outcome for patients.

The best results among the three studies were achieved in a study where 30 to 40 minutes of reflexology work was applied to solar plexus, heart and lung reflex areas of study participants. Following reflexology work, statistically significant differences were found in physiologic parameters (heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and oxygen saturation) for intervention participants compared to those in the control group. (17a/29)

No significant differences were found for physiologic parameters in a study where 20 minutes of foot reflexology was applied to the heart and lung reflex areas  of study participants.

No significant differences were found for physiologic parameters in a study where 20-30 minutes of foot reflexology was applied to the solar plexus, respiratory, circulatory, urinary, lymphatic reflex areas of study participants.

All three studies demonstrated shorter weaning times from mechanical ventilators: 165 minutes for the first noted above; 39 minutes less for the second and 100 minutes less for the third. 

As noted by the first study:

“Statistically significant differences from patients in the control groups were found in heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and oxygen saturation. As noted by researchers: “The findings of this study support the hypothesis that foot reflexology positively affects the stabilization of physiological indicators of critically ill patients and decreases ventilation dependence as compared with patients who did not receive foot massage.” 

Length of time and reflex areas were deliberately chosen. Length of time for technique application was chosen from three previous studies. “Based on the claim of reflexologists (three studies as well as Kunz and Kunz, Complete Reflexology for Life), the points on the plantar surface of the foot which may be responsible for stabilization of physiological indicators and reduction of ventilation dependence were chosen. … “The steps of foot reflexology technique were adopted from Kunz and Kunz (Complete Reflexology for Life)”

Additional research demonstrated positive results in two studies of physiologic parameters following coronary artery bypass surgery.

30 minutes of foot reflexology applied to solar plexus, hypothalamus, pituitary, lung, adrenal gland, heart (left foot only) reflex areas  of study participants resulted in greater improvement than the control group to physiologic parameters (respiratory rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, oxygen saturation, heart rate)

Also improved to a level greater than other the control group was patients’ anxiety. Patients’ agitation showed significantly higher reduction. Extubation time was significantly shorter.

30 minutes of foot reflexology applied to solar plexus, hypothalamus, pituitary, lung, adrenal gland, heart (left foot only) reflex areas  of study participants was shown to result in a significant difference in physiologic parameters (respiratory rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, oxygen saturation). No significant difference was shown for heart rate. A significant difference was seen in patients’ anxiety levels.

Books by Kunz and Kunz

Research Books

Medical Applications of Reflexology: Findings in Research About Post-operative care, Maternity Care and Cancer Care
Evidenced Based Reflexology Research: For Health Professionals and Researchers
Medical applications of Reflexology:: Findings in Research about Cancer Care

Bestselling Books

 Reflexology: Hands-on Treatment for Vitality and Well-being
Complete Reflexology for Life: Your Definitive Photographic Reference to the Best Techniques and Treatments  
 

Intermittent Moving Books

Intermittent Moving: How I Lost My Pants and Mastered My Weight
Un-Sit Your Life: The Reflex "Diet" Solution

Reflexology Research with Ventilator-Dependent Patients: Methods for Positive Results

Brian Hall / Public domain

How to get results. This is always a topic of interest to reflexologists. The discussion centers around where to apply technique, how frequently and for how long a period of time to apply technique. 

The same issue is important for researchers working with patients in a hospital setting. Setting such parameters is a part of establishing Method for a study. Defining Method in a study is critical to ascertain a potential future protocol that will create results. This is a part of evidence-based medicine. Here we consider the reflex areas and amount of time utilized in research with ventilator-dependent patients.

Following are synopses of research with ventilator-dependent patients. Some studies found positive results, others did not. As common with research, researchers cite and consider methods in similar studies seeking to understand reported results. Study (1), for example was criticized for using different reflexologists. As you look through the synopsis, consider the Method and positive or negative results.

Multiple studies show that reflexology helps in the treatment of patients on mechanical ventilators. Patients experience: Improved physiological parameters (positive results in (2) and (5), negative results in (1) and (3)); Lessened anxiety and agitation (positive results as well as better sleep and patient-ventilator synchrony (5), negative results (4); less use of drugs for sedation (5); shorter length of time on the ventilator (weaning time) (Positive results for all three studies1, 2, 3) and increased level of consciousness for those in a coma (6). Five of the six studies, noted  use of reflexology as “an effective nursing intervention,” recommended training in and use of foot reflexology for patients on mechanical ventilators. (1, 2, 3, 5, 6,7)

(1) Researched: Physiological parameters (Pulse rate, respiratory rate, systolic and diastolic blood pressures, mean arterial pressure, percutaneous oxygen saturation); Weaning time

Researchers Abbas Ebadi et al noted the method implemented in their research: Following open heart surgery (OHS), transfer to an OHS-ICU and placement on a mechanical ventilator (MV), 31 patients who had been randomly assigned to the study’s reflexology group received on each foot 7 to 10 minutes of reflexology work applied to the lung and heart reflex areas. Work was applied by same-gender nurses. Measured were pulse rate, systolic and diastolic blood pressure, mean arterial pressure and oxygen saturation. 

Results were reported as: “Study findings also showed that although reflexology had no significant effect on physiological parameters, it significantly reduced the length of MV weaning time. The mean of weaning time in the reflexology group was 39.11 min shorter than the control group.…

“Conclusion: Study findings indicate that foot reflexology is an effective nursing intervention for facilitating MV weaning after OHS. 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) 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 DOI: 10.1016/j.ctcp.2015.07.001

(2) Researched: Physiological parameters (Heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, oxygen saturation), Weaning time, Sedation and analgesic drug use

Researchers Amira Elsayed et al noted the method implemented in their research. Monitored six times were: (a) heart rate, (b) respiratory rate, (c) systolic and (d) diastolic blood pressure, (e) mean arterial pressure and (f) oxygen saturation. Following open heart surgery and within 60 minutes of being admitted to the cardio-thoracic ICU, 40 patients who had been randomly assigned to the study’s reflexology group received on each foot 15 to 30 minutes of reflexology work applied to the lung and heart reflex areas. 

Results demonstrated reflexology work positively affects stabilization of physiological parameters. were reported. Compared to the patients in the control group patients in the reflexology group experienced a: (a) statistically significant decrease in heart rate,  (b) significantly lower respiratory rate, (c) statistical significant reduction in the systolic blood pressure, (d) statistically significant lower diastolic blood pressure, (e) statistically significant drop in mean arterial pressure and (f) statistical significant elevation in the oxygen saturation level. Weaning time from the mechanical ventilator for those in the reflexology group was 270 minutes while in the control group it was 435 minutes. 

“Based on the results of our study, we conclude that foot reflexology massage can significantly enhance the physiological indicators, and shorten MV weaning time in patients undergone OHS (Open Heart Surgery). Therefore, foot reflexology massage can be incorporated into daily patient care in cardiothoracic ICU. Training programs on applying foot reflexology for critical care nurses are needed. Future large scale studies on different patient population are also required in order to obtain a strong evidence to support this approach and enrich the body of knowledge in this area. … 

“Conclusion: Foot reflexology is an effective method for stabilizing physiological indicators and decreasing ventilator dependence among patients undergoing OHS. Therefore, it can be introduced as an adjunct to daily care of OHS patients in ICU.” 

(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 http://pubs.sciepub.com/ajnr/7/4/2/index.html)

(3) Researched: Heart rate, oxygen saturation; Weaning time

Researcher Kandmire noted the method of the study: a twenty-thirty-minute foot reflexology session was applied post operatively to 42 non-randomly selected open heart surgery patients.

Results: “(As compared to those in the control group) 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) 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

(4) Researched: Anxiety, Agitation

Researchers Kavei et al describe a double blind three group randomized study. Following open heart surgery: “Foot reflexology massage for 20 minutes was provided to patients in the experimental group on the reflection points in the heart and lungs. The rate of anxiety and agitation based on Faces of Anxiety Scale (FAS) and the Richmond Agitation Scale (RSAS) were recorded in 6 stages.”

“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) 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

(5) Physiological anxiety signs (Heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate) and Sedation Needs

Researchers Akin Korhan et al note their method: “… a single blinded, randomized controlled design with repeated measures was used in the intensive care unit of a university hospital in Turkey. Patients (n = 60) aged between 18 and 70 years and were hospitalized in the intensive care unit and receiving mechanically ventilated support. Participants were randomized to a control group or an intervention group. The latter received 30 minutes of reflexology therapy on their feet, hands, and ears for 5 days. …”

Results: “The reflexology therapy group had a significantly lower heart rate, systolic blood pressure, diastolic blood pressure, and respiratory rate than the control group. A statistically significant difference was found between the averages of the scores that the patients included in the experimental and control groups received from the agitation, anxiety, sleep, and patient-ventilator synchrony subscales of the American Association of Critical-Care Nurses Sedation Assessment Scale. … “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) 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

(6) Researched: Conscious level

“Methodology: The study group constituted (50) patient (adult mechanically ventilated patients hospitalized in ICU), who was received two reflexology session on feet and the control group constituted (50) patient who was received the routine care, GCS (Glasgow Coma Scale) measured before session, immediate after, post 2 hours and post 4 hours.” A 30-45 minute session was applied including “a mild massage will be done to the all feet and then pressure will be applied once to specified reflex points related to brain, heart, renal and respiratory systems.”

Result: No statistical difference was found in time on mechanical ventilator or days in ICU.  “The findings of the study revealed that there was effect of foot reflexology on the conscious level after the second session … “There was significant increase in 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.”

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)

(7) Researched: Systolic and diastolic blood pressure, mean arterial pressure, heart rate, respiratory rate, percutaneous oxygen saturation, and anxiety

“Results showed a statistically significant difference between intervention and control groups in terms of the level of anxiety (p < 0.05). Also, results showed a statistically significant effect on all physiological parameters except heart rate (p < 0.05).”

“Today,  it  seems  that  non-pharmaceutical therapies such as complementary and alternative medicine (CAM) may be used to reduce anxiety [21,37e 40], prevent physiological reactions caused by anxiety [37, 40, 41], stabilize vital signs [42], and manage pain [43]. Since nurses play a key role in predicting psychological and physiological needs of patients and reducing their level of anxiety and stress [25], it seems that nurses can practice some CAMs to reduce stress, pain, and improve the health conditions of patients [44]. As a result, in addition to helping patients relax, nurses can lower the chance of complications by actively reducing the anxiety levels of their patients.””

Kavei, P, Ebadi, A, Saeed Y, Moradian S. T., Sedigh Rahimabadi M,, “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 DOI: 10.1016/j.ctcp.2018.02.018.

Books by Kunz and Kunz

Research Books

Medical Applications of Reflexology: Findings in Research About Post-operative care, Maternity Care and Cancer Care
Evidenced Based Reflexology Research: For Health Professionals and Researchers
Medical applications of Reflexology:: Findings in Research about Cancer Care

Bestselling Books

 Reflexology: Hands-on Treatment for Vitality and Well-being
Complete Reflexology for Life: Your Definitive Photographic Reference to the Best Techniques and Treatments  
 

Intermittent Moving Books

Intermittent Moving: How I Lost My Pants and Mastered My Weight
Un-Sit Your Life: The Reflex "Diet" Solution

Ventilators, Reflexology and Research

Brian Hall / Public domain

Ventilators, Reflexology and Research: Reflexology Use an Effective Treatment Application to Address Patients’ Physical and Psychological Problems

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)

Copyright 2020 Kunz and Kunz