The Effect of Foot Reflexology Massage on Fatigue and Sleep Quality in Hemodialysis Patients

Authors: Rajabi Raheleh, Akhlaghi Fatemeh, Asadi Neda, Zamani Babgohari Fatemeh, Arabpoor FatemehJournal: SAGE open nursingPublished: January 1, 2025DOI: 10.1177/23779608251364099

Moderate EvidenceObservationaln=50 participants

Insomnia

In Plain Language: reflexology for sleep, explained

Hemodialysis patients experience fatigue due to factors such as toxic compounds in the bloodstream, fluid, and electrolyte disorders. Despite resting, they still feel tired and report poor sleep quality. This study aimed to investigate the effect of foot reflexology massage on reducing fatigue and improving sleep quality in hemodialysis patients. This quasi-experimental study was conducted on hemodialysis patients in southeastern Iran. Eligible patients were selected through purposive sampling and allocated to either the intervention group (n = 25) or the control group (n = 25). The intervention group received foot reflexology massage three times weekly for three weeks, while the control group received routine care. Data were collected using the Pittsburgh Sleep Quality Index (PSQI) and Piper Fatigue Scale at three time points: pre-intervention, immediately post-intervention, and two weeks after intervention. The findings showed that the mean score of sleep quality in the intervention group decreased from 16.23 before the intervention to 3.31 two weeks after the intervention (p .001). Furthermore, the mean fatigue score in the intervention group decreased from 8.63 before the intervention to 3.11 two weeks after the intervention (p .001). The results of this study showed that foot reflexology can reduce fatigue and increase sleep quality in hemodialysis patients. As a simple, feasible, and non-invasive method without complications, reflexology can be used by nurses to reduce fatigue and increase sleep quality in HD patients.

Key Findings: what this observational study found about sleep

✓Foot reflexology massage administered three times weekly for three weeks significantly improved sleep quality in hemodialysis patients as measured by the Pittsburgh Sleep Quality Index.
✓Hemodialysis patients who received foot reflexology massage experienced reduced fatigue levels compared to the control group receiving routine care only.
✓The benefits of foot reflexology massage on sleep quality and fatigue in hemodialysis patients were sustained at two weeks following the completion of the three-week intervention.

What This Means for You

This moderate-quality study suggests foot reflexology may help reduce fatigue and improve sleep for dialysis patients, though more rigorous research with larger groups would strengthen this evidence.

What This Means for Practitioners

This study supports reflexology's potential as a non-invasive, complication-free intervention for hemodialysis patients experiencing fatigue and sleep disturbances, with a practical protocol of three sessions weekly.

Study Design: how this observational study was run

Sample Size

50 participants

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Reflexology for sleep: common questions

Does reflexology help with sleep?

This moderate-quality study suggests foot reflexology may help reduce fatigue and improve sleep for dialysis patients, though more rigorous research with larger groups would strengthen this evidence.

What did this study find?

Foot reflexology massage administered three times weekly for three weeks significantly improved sleep quality in hemodialysis patients as measured by the Pittsburgh Sleep Quality Index. Hemodialysis patients who received foot reflexology massage experienced reduced fatigue levels compared to the control group receiving routine care only. The benefits of foot reflexology massage on sleep quality and fatigue in hemodialysis patients were sustained at two weeks following the completion of the three-week intervention.

How strong is this evidence?

This is a observational study and we rate its evidence moderate. It covers 50 participants. It was published in SAGE open nursing. Reflexology is a complementary therapy, not a replacement for medical treatment.