The effect of foot reflexology massage on burn-specific pain anxiety and sleep quality and quantity of patients hospitalized in the burn intensive care unit (ICU)
Strong EvidenceIn Plain Language: reflexology for anxiety, explained
Burn-specific pain anxiety and sleep disorders are common factors in burned patients that affect wound healing process, as well as the severity of burn pain. This study aimed to investigate the effect of foot reflexology massage on burn-specific pain anxiety and sleep condition of patients hospitalized in the burn ICU. In this randomized controlled clinical trial, 52 patients were assigned by permuted block randomization 1:1 to the intervention (n=26) and control (n=26) groups. The intervention group received 20min of foot reflexology massage during 3 days on their third, fourth and fifth days of hospitalization and 15min before changing wound dressings. Patients in the control group merely received routine care. The Burn-Specific Pain Anxiety Scale (BSPAS) was completed for three consecutive days before and after changing wound dressings, and St. Mary's Hospital Sleep Questionnaire (SMHSQ) was filled out for four consecutive days before changing wound dressings for patients in both groups. The data were analyzed by IBM SPSS 16 software, Chicago, independent t, Chi-square, Friedman, Mann-Whitney and Wilcoxon tests. We found no significant difference between pain-anxiety in the two groups before the intervention. The trend of different days in each groups were compared with Friedman test and showed that pain anxiety (p<0.001), sleep latency (p<0.001), duration of the last day's sleep (p<0.001) and satisfaction of the last night sleep (p<0.001) had a significant difference. In addition, Mann-Whitney test results showed that there were significant differences between the two groups at different times in terms of the above variables (p<0.05). The effect size was=0.82 for pain anxiety between group after the intervention. Based on the results, foot reflexology massage can effectively reduce pain anxiety levels and improve sleep quality and quantity of patients with burn injuries; therefore, this non- pharmacological therapeutic method is recommended to be used in the
Key Findings: what this randomised trial found about anxiety
- ✓Foot reflexology massage administered for 20 minutes over 3 days and 15 minutes before wound dressing changes reduced burn-specific pain anxiety in hospitalized ICU patients.
- ✓The reflexology intervention improved sleep quality and quantity in burn patients as measured by the St. Mary's Hospital Sleep Questionnaire.
- ✓Reflexology massage showed potential as a non-pharmacological nursing intervention to address multiple complications (pain anxiety and sleep disorders) that impair wound healing in burn ICU patients.
What This Means for You
This study suggests foot reflexology may meaningfully reduce anxiety and improve sleep in hospitalized burn patients, though you should discuss it with your medical team as part of your overall burn care.
What This Means for Practitioners
Consider offering 20-minute foot reflexology sessions to hospitalized burn patients, particularly around wound dressing changes, as evidence supports its effectiveness for reducing burn-related anxiety and improving sleep quality.
Study Design: how this randomised trial was run
Reflexology for anxiety: common questions
Does reflexology help with anxiety?
This study suggests foot reflexology may meaningfully reduce anxiety and improve sleep in hospitalized burn patients, though you should discuss it with your medical team as part of your overall burn care.
What did this study find?
Foot reflexology massage administered for 20 minutes over 3 days and 15 minutes before wound dressing changes reduced burn-specific pain anxiety in hospitalized ICU patients. The reflexology intervention improved sleep quality and quantity in burn patients as measured by the St. Mary's Hospital Sleep Questionnaire. Reflexology massage showed potential as a non-pharmacological nursing intervention to address multiple complications (pain anxiety and sleep disorders) that impair wound healing in burn ICU patients.
How strong is this evidence?
This is a randomised trial and we rate its evidence strong. It covers 52 participants. It was published in Burns : journal of the International Society for Burn Injuries, a Q1 journal. Reflexology is a complementary therapy, not a replacement for medical treatment.
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