Pain management continues to be a priority for patients and their families. Even with prescribed analgesics, many patients continue to report pain; some explore complementary and alternative therapies to control their pain. The complementary and alternative therapy of reflexology is being used for pain relief although empirical evidence of its effectiveness is only beginning to be available. Recent pilot studies with cancer patients who had metastases found an immediate effect from reflexology on pain. While reflexology is Eastern in origin, and there are many Eastern theories explaining its actions, the current use of reflexology for pain relief is based on the Western neuromatrix theory of pain, which is an expansion of the Gate Control Theory. Since most cancer patients are currently being cared for in the home, research is needed to examine the effectiveness of reflexology and the best way to integrate this therapy into traditional care in the home. This experimental repeated-measures study of 100 inpatients with metastatic cancer and their partners, randomized to experimental and control groups at each of 2 sites in the southeastern United States, is designed to test the effectiveness and integration of reflexology as an alternative and complementary therapy in pain management in the home. Pain will be measured using the Brief Pain Inventory and the Short-Form McGill Pain Questionnaire, substituting the 0-10 scale recommended by Joint Commission on the Accreditation of Healthcare Organizations for the Present Pain Intensity. Patient and partner's evaluation of the partner's self-efficacy to manage the patient's cancer pain with partner-delivered reflexology will be measured with visual analogue scaled for self-efficacy of partner-delivered reflexology. Partner-delivered reflexology will be taught during the patient's hospitalization, delivered a minimum of 3 times a week for 4 weeks immediately following hospital discharge, with baseline measurements in the hospital, at Week 1 and at Week 4 at home, and a follow-up descriptive evaluation at Week 8. Equianalgesic dosing will be calculated. Analyses of covariance will be used to compare adjusted pain intensity means between the intervention and control groups, and descriptive analyses will be used to explain follow-up evaluation of patients' experiences with partner-delivered foot reflexology. If reflexology is effective, teaching partners this noninvasive therapy could become part of standard care at no cost other than partner instruction.
| Stephenson, Nancy L N; Swanson, Melvin; Dalton, Joann et al. (2007) Partner-delivered reflexology: effects on cancer pain and anxiety. Oncol Nurs Forum 34:127-32 |
