Pain and Spirituality Outcomes Among Women With Advanced Breast Cancer Participating in a Foot Reflexology Trial

Authors: Miller Megan, Xu Ding, Lehto Rebecca, Moser Jason, Wu Horng-Shiuann, Wyatt GwenJournal: Oncology nursing forumPublished: January 4, 2021DOI: 10.1188/21.ONF.31-43

Q1 JournalSJR: 0.9h-index: 97SCImago

Strong EvidenceRandomized Controlled Trialn=256 participants

Cancer Pain Management

In Plain Language: reflexology for cancer pain, explained

To examine pain and spirituality, demographic and clinical factors associated with pain and spirituality, the contribution of spirituality to experiences of pain over time, and how pain and spirituality relate to engagement with a caregiver-delivered intervention. Women with advanced breast cancer (N = 256) enrolled in a home-based randomized controlled trial of foot reflexology. Secondary analyses were conducted with baseline and postintervention data. Stepwise model building, linear mixed-effects modeling, and negative binomial regression were used. Participants who were younger, not married or partnered, not employed, or receiving hormonal therapy had increased odds of higher pain levels. Those who were older, non-White, or Christian had increased odds of higher spirituality. Spirituality's contribution to pain was not significant over time. Women in this sample experienced moderate pain, on average, at baseline. Women with specific demographic and clinical characteristics may require additional support with pain management and spiritual care.

Key Findings: what this randomised trial found about cancer pain

✓Younger, unmarried, unemployed women with advanced breast cancer receiving hormonal therapy experienced significantly higher pain levels than other demographic groups.
✓Older, non-White, and Christian women in the study reported higher spirituality scores than other demographic groups.
✓Spirituality did not have a statistically significant effect on pain experiences over the course of the foot reflexology intervention.

What This Means for You

While this study shows foot reflexology was tested with women with advanced breast cancer, spirituality alone didn't reduce pain levels; talk with your healthcare team about whether reflexology combined with other pain management strategies might help your specific situation.

What This Means for Practitioners

Consider screening clients for demographic and clinical risk factors (younger age, unmarried status, unemployment, hormonal therapy use) that may indicate they need additional pain management support beyond reflexology alone.

Study Design: how this randomised trial was run

Sample Size

256 participants

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Reflexology for cancer pain: common questions

Does reflexology help with cancer pain?

What did this study find?

Younger, unmarried, unemployed women with advanced breast cancer receiving hormonal therapy experienced significantly higher pain levels than other demographic groups. Older, non-White, and Christian women in the study reported higher spirituality scores than other demographic groups. Spirituality did not have a statistically significant effect on pain experiences over the course of the foot reflexology intervention.

How strong is this evidence?

This is a randomised trial and we rate its evidence strong. It covers 256 participants. It was published in Oncology nursing forum, a Q1 journal. Reflexology is a complementary therapy, not a replacement for medical treatment.