Two methods of foot reflexology and Benson relaxation on pain and analgesics received by women undergoing caesarean section: a randomized clinical trial

Document Type : Original Article

Authors

1 Associate Professor, Department of Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran.

2 Assistant Professor, Department of Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran.

3 Instructor, Department of Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran.

4 M.Sc. of Nursing, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran.

5 Associate Professor, Department of Midwifery, School of Nursing and Midwifery, Bushehr University of Medical Sciences, Bushehr, Iran.

Abstract

Introduction: Despite the adverse effects of post-caesarean pain relievers, few studies have compared non-pharmacological methods of pain control. The present study was conducted with aim to compare the effects of foot reflexology and Benson's relaxation on pain levels in women candidates for caesarean section.
Methods: This randomized controlled clinical trial study was conducted in 2019-2020 on 135 women candidates for caesarean section in Persian Gulf Martyrs hospital, Bushehr. The participants were selected via convenience sampling and divided into three groups using block randomization: reflexology, Benson's relaxation, and control. In the reflexology and Benson's relaxation groups, the intervention was performed two hours post-operation and six hours after the first time. Pain levels were measured using a visual pain scale immediately, 30 and 60 minutes after the procedure. The amount of pain medication was also recorded. Data were analyzed using SPSS (version 19) and chi-square, Fisher's exact, One-way ANOVA, Kruskal-Wallis, Mann-Whitney, Friedman, and Wilcoxon tests. P<0.05 was considered statistically significant.
Results: Before the intervention, the mean pain ranks were not significantly different among the three groups (P>0.05). Immediately, 30 and 60 min after the intervention, the mean pain ranks were significantly lower in the two intervention groups than the control group (P<0.05). There were no significant differences among the three groups in pethidine intake (P=0.193). However, the control group received significantly higher amounts of ketorolac and diclofenac when compared to the two intervention groups (P<0.05).
Conclusion: Reflexology and Benson's relaxation techniques can reduce post-cesarean pain and analgesics. Therefore, nurses can use these two non- pharmacological pain control methods.

Keywords


  1. Abidi SM, Abbas S, Abidi ST, Hussain N, Haresh S. Application of the Robson Classification in Assessing Cesarean Section Rates: An Audit of a Tertiary Care Hospital's Gynecology Department in Karachi, Pakistan. medRxiv 2023: 2023-04.
  2. Adibi P, Kalani N, Razavi BM, Mehrpour S, Zarei T, Malekshoar M. Pharmacological and nonpharmacological methods of pain control in women undergoing caesarean section: a narrative review. Iran J Obstet Gynecol Infertil 2022; 25(7):91-112.
  3. Dorosti A, Mallah F, Ghafani Z. Effects of Foot Reflexology on Post-Cesarean Pain: A Randomized Clinical Trial. Journal biochemical technology 2019(2):170-4.
  4. Ghana S, Hakimi S, Mirghafourvand M, Abbasalizadeh F, Behnampour N. The effects of abdominal binder on wound healing and consumed pain medications after cesarean section: A randomized control trial. Iran Red Crescent Med j 2017; 19(4):e44119.
  5. Schoenwald A, Windsor C, Gosden E, Douglas C. Nurse practitioner led pain management the day after caesarean section: A randomised controlled trial and follow-up study. International journal of nursing studies 2018; 78:1-9.
  6. Maroufizadeh S, Bagheri-Lankarani N, Almasi-Hashiani A, Amini P, Esmaeilzadeh A, Navid B, et al. Prevalence of cesarean section and its related factors among primiparas in Tehran Province, Iran, in 2015. Journal of isfahan medical school 2017; 35(423):303-9.
  7. Marzouk SS, Eshra DK, Aly IK, Mady MM. Effect of Reflexology and Nursing Management Protocol versus Hospital Routine Care on Pain and anxiety among Post Cesarean Section Primipara. International Journal of Novel Research in Healthcare and Nursing 2019; 6(3):1028-40.
  8. Khloobagheri E, Kazemi M, Loripoor M, Bakhtar B. Effect of foot reflexology with auriculotherapy on pain after elective cesarean section: A Randomized Clinical Trial. Iran J Obstet Gynecol Infertil 2020; 23(5):67-78.
  9. Irani M, Kordi M, Tara F, Bahrami HR, Shariati Nejad K. The effect of hand and foot massage on post-cesarean pain and anxiety. Journal of midwifery and reproductive health 2015; 3(4):465-71.
  10. Solehati T, Rustina Y. Benson relaxation technique in reducing pain intensity in women after cesarean section. Anesthesiology and pain medicine 2015; 5(3).
  11. Windartik E, Yuniarti EV, Akbar A. Effectiveness of Relaxation Handheld Fingertechnique and Benson Relaxation to the Changes Level of Post Operative Pain Sectio Caesarea in Rsi Sakinah Mojokerto. International Journal of Scientific Research and Management 2017; 5(9):7107-11.
  12. Momen R, Roshandel M, Pishgooie SA. The effect of Benson relaxation method on pain severity after laminectomy in admitted patients to AJA hospitals. Military Caring Sciences Journal 2018; 4(3):168-77.
  13. Korhan EA, Uyar M, Eyigör C, Yönt GH, Khorshid L. Effects of reflexology on pain in patients with fibromyalgia. Holistic nursing practice. 2016 Nov 1; 30(6):351-9.
  14. Khorsand A, Tadayonfar MA, Badiee S, Aghaee MA, Azizi H, Baghani S. Evaluation of the effect of reflexology on pain control and analgesic consumption after appendectomy. The Journal of Alternative and Complementary Medicine 2015; 21(12):774-80.
  15. Bakir E, Baglama SS, Gursoy S. The effects of reflexology on pain and sleep deprivation in patients with rheumatoid arthritis: a randomized controlled trial. Complementary therapies in clinical practice 2018; 31:315-9.
  16. Seyyedrasooly A, Kalantarih H. The effects of reflexology on breathing rate and blood pressure of the patients with chronic obstructive pulmonary disease (copd). Complementary Medicine Journal 2014; 3(4):654-65.
  17. Mohammadpour A, Dehnoalian A, Mojtabavi J. Effect of Foot Reflexology on Blood Pressure in Patients with Stroke. Hayat 2013; 19(1):16-28.
  18. McCullough JE, Liddle SD, Sinclair M, Close C, Hughes CM. The physiological and biochemical outcomes associated with a reflexology treatment: a systematic review. Evidence-Based Complementary and Alternative Medicine 2014; 2014.
  19. Abbasi M, Bavazin F, Mansouri L. Effectiveness of benson relaxation method on reduction of stress and increase of the number and motility of sperms among infertile males. Iranian journal of psychiatric nursing 2017; 5(3):22-8.
  20. Seifi L, Najafi Ghezeljeh T, Haghani H. The effects of benson relaxation technique and nature sound’s on anxiety in patients with heart failure. Nursing And Midwifery Journal 2017; 15(2):147-58.
  21. Teimouri F, Pishgooie SA, Malmir M, Rajai N. The effect of Benson relaxation on physiological criteria in patients undergoing coronary artery bypass graft surgery. Complementary Medicine Journal 2019; 9(3):3812-23.
  22. Elsayed EB, Radwan EH, Elashri NI, El-Gilany AH. The effect of Benson's relaxation technique on anxiety, depression and sleep quality of elderly patients undergoing hemodialysis. International journal of nursing didactics 2019; 9(02):23-31.
  23. Aghakhani N, Seyyedakbari V, Khademvatani K, Alinejad V. Study of the effect of benson relaxation method on the anxiety level of patients with myocardial infarction admitted to ccu wards of educational and treatment center of Seyyed Shahada, Urmia, IRAN, 2017. J Urmia Nurs Midwifery 2019; 17(3):239-50.
  24. Mokhtari J, Sirati Nir M, Sadeghi Sherme M, Ghanbari Z, Babatabar Darzi H, Mahmoodi H. Comparison of impact of foot reflexology massage and Bensone relaxation on severity of pain after cesarean section: a randomized trial. Payesh 2010; 9(3):289-298.
  25. Nazari F, Soheili M, Hosseini S, Shaygannejad V. A comparison of the effects of reflexology and relaxation on pain in women with multiple sclerosis. Journal of Complementary and Integrative Medicine 2016; 13(1):65-71.
  26. Bakavoly ME, Sajjadi M, Ghasemi R, Ajamzibad H. Comparison of the Impacts of Benson Relaxation Technique and Foot Reflexology Massage on Sleep Quality of Patients with Systolic Heart Failure: A Randomized Clinical Trial. Iranian Journal of Nursing and Midwifery Research 2023; 28(4):448-54.
  27. Parmar R, Tiwari A. Effect of Benson's Relaxation Therapy on Post Caesarean Section Pain and Stress: A Pilot Study. Journal of Clinical & Diagnostic Research 2021; 15(6).
  28. Mohammadalieha J, Falah A. The effects of foot reflexology massage on incisional pain in abdominal and chest surgery patients admitted to intensive care units. Avicenna Journal of Phytomedicine 2015; 5.
  29. Öztürk R, Sevil Ü, Sargin A, Yücebilgin MS. The effects of reflexology on anxiety and pain in patients after abdominal hysterectomy: A randomised controlled trial. Complementary therapies in medicine 2018; 36:107-12.
  30. Mohammady M, Janani L. Randomization in randomized clinical trials: From theory to practice. Hayat 2016; 22(2):102-14.
  31. Habibabad HZ, Afrasiabifar A, Mansourian A, Mansourian M, Hosseini N. Effect of chamomile aromatherapy with and without oxygen on pain of women in post cesarean section with spinal anesthesia: A randomized clinical trial. Heliyon 2023; 9(4).
  32. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Academic emergency medicine 2001; 8(12):1153-7.
  33. Fadaeizadeh L, Emami H, Samiei K. Comparison of visual analogue scale and faces rating scale in measuring acute postoperative pain. Arch Iran Med 2009; 12(1):73-5.
  34. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual analog scale for pain (vas pain), numeric rating scale for pain (nrs pain), mcgill pain questionnaire (mpq), short‐form mcgill pain questionnaire (sf‐mpq), chronic pain grade scale (cpgs), short form‐36 bodily pain scale (sf‐36 bps), and measure of intermittent and constant osteoarthritis pain (icoap). Arthritis care & research 2011; 63(S11):S240-S252.
  35. Embong NH, Soh YC, Ming LC, Wong TW. Revisiting reflexology: Concept, evidence, current practice, and practitioner training. Journal of traditional and complementary medicine 2015; 5(4):197-206.
  36. Kamel Sadek Abd El Rahman W, A Ahmed A, Mohamed El-Sayed Atwa A. Effect of Benson Relaxation Therapy on Post-Operative Pain and Stress among Nulliparus Women undergoing Cesarean Section. Egyptian Journal of Health Care 2022; 13(3):2053-64.
  37. Saber Mohamed S, Farouk Thabet O, Ahmed Sayed Z, Dahi Mohamed R. Effect of Foot Reflexology Massage versus Benson Relaxation Technique on Physiological Parameters and Pain after Open Heart Surgery. Egyptian Journal of Health Care 2021; 12(3):1737-49.
  38. Babajani S, Babatabar DH, Ebadi A, Mahmoudi H, Nasiri E. The effect of foot reflexology massage on the level of pain during chest tube removal after open heart surgery. Iran Journal Critical Care Nursing 2014; 7(1):15-22.
  39. Nasiri K, Eyvanbagha R, Nazari N, Savadpoor MT, Soleymanifard P, Khalili Z. Physiological and therapeutic effects of reflexology in Iran: a systematic review. Depiction of Health 2016; 7(1):49-61.
  40. Mohamady SH, Abd Elmoniem SO, Araby OA, Elrefaeys SR, Nageeb SM. Effect Of Benson Relaxation Technique On Reducing Pain And Stress Among Post Cesarean Section Mothers. Journal of Positive School Psychology 2022; 6(8):6820-48.
  41. Ahmadi F, Dalvand S, Babaie M, Akbari A, Khazaei S. Impact of white noise and Benson’s relaxation technique on death anxiety in patients undergoing coronary artery bypass graft surgery: a randomized clinical trial. Evidence Based Care 2022; 12(1):40-7.
  42. Ibrahim SS, Ebeid IA, El-Aty A, Mostafa E. Efficacy of benson relaxation technique on physiological parameters, anxiety and sleep quality among gestational hypertensive women. Assiut Scientific Nursing Journal 2022; 10(29):14-25.