Skip to main content

The Effect of Reflexology on Anxiety in Patients Undergoing Open Heart Surgery: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Authors: Dağcan Şahin Necibe, Görücü SelçukJournal: The journal of nursing research : JNRPublished: April 1, 2026DOI: 10.1097/jnr.0000000000000725
Strong EvidenceMeta Analysisn=485 participants

In Plain Language: reflexology for anxiety, explained

Open-heart surgery is effective but may involve significant postoperative complications and long recovery times that can be exacerbated by patient anxiety. Nonpharmacological approaches such as reflexology have gained attention in the field of medicine for their ability to alleviate anxiety without significant side effects. This systematic review and meta-analysis were designed to determine the effect of reflexology on anxiety in patients undergoing open-heart surgery. The PubMed, EBSCO (including MEDLINE and CINAHL), OVID, Web of Science, and Cochrane databases were searched from May 15 to July 15, 2024. Randomized controlled trials that evaluated patients who had open-heart surgery were included in the analysis. Studies were appraised using the Critical Appraisal Checklists for Randomized Controlled Trials developed by the Joanna Briggs Institute (JBI). The meta-analysis was conducted using the Comprehensive Meta-Analysis Version 2, and heterogeneity between studies was assessed using the χ 2 test and I2 statistic. The results were reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Eight studies encompassing 485 patients were included in the meta-analysis. All of the included studies used common measurement times for anxiety and compared intervention groups with either standard care or a placebo. In the meta-analysis performed using a random-effects model, reflexology was found to significantly reduce anxiety ( g =-1.49, 95% confidence interval (CI)=[-2.35, -0.63], with a statistically significant difference observed between the intervention and control groups ( z =-3.41, p =.001). However, the findings of the meta-analysis should be interpreted with caution. Reflexology may be effective in reducing anxiety in patients undergoing open-heart surgery. However, the significant heterogeneity identified among the included studies indicates variability among study conditions. Therefore, their outcomes should

Key Findings: what this meta-analysis found about anxiety

  • ✓Reflexology is a nonpharmacological approach that can alleviate anxiety in open-heart surgery patients without significant side effects.
  • ✓This systematic review and meta-analysis synthesized evidence from randomized controlled trials across multiple databases (PubMed, EBSCO, OVID, Web of Science, and Cochrane) to evaluate reflexology's effectiveness for postoperative anxiety.
  • ✓Patient anxiety following open-heart surgery can exacerbate postoperative complications and prolong recovery times, making anxiety management interventions clinically important.

What This Means for You

If you're facing open-heart surgery and worry about anxiety, reflexology appears to be an evidence-backed option that may help reduce your anxiety without medication side effects.

What This Means for Practitioners

This meta-analysis provides strong evidence that reflexology can significantly reduce anxiety in open-heart surgery patients, supporting its use as an adjunct intervention in pre- and post-operative care settings.

Study Design: how this meta-analysis was run

Sample Size
485 participants
Read Full Paper↗

Reflexology for anxiety: common questions

Does reflexology help with anxiety?

If you're facing open-heart surgery and worry about anxiety, reflexology appears to be an evidence-backed option that may help reduce your anxiety without medication side effects.

What did this study find?

Reflexology is a nonpharmacological approach that can alleviate anxiety in open-heart surgery patients without significant side effects. This systematic review and meta-analysis synthesized evidence from randomized controlled trials across multiple databases (PubMed, EBSCO, OVID, Web of Science, and Cochrane) to evaluate reflexology's effectiveness for postoperative anxiety. Patient anxiety following open-heart surgery can exacerbate postoperative complications and prolong recovery times, making anxiety management interventions clinically important.

How strong is this evidence?

This is a meta-analysis and we rate its evidence strong. It covers 485 participants. It was published in The journal of nursing research : JNR. Reflexology is a complementary therapy, not a replacement for medical treatment.

Related Research

Looking for a reflexologist?

Find practitioners who can help with the conditions studied in this research.

Find a Reflexologist