The Effect of Foot Reflexology Massage on Patient's Anxiety during Chest Tube Removal after open Heart Surgery: A Randomized Controlled Trial

Chest tube removal is one of the most anxious events in Intensive Care Unit patients. Reflexology foot massage is considered to be one of the non-pharmacological approaches that has been the focus of researchers in patients undergoing open heart surgery due to the reduction of complications and costs. The purpose of this study was to evaluate the effect of foot reflexology massage on patients' anxiety during chest tube removal after open heart surgery.

This double-blind, three-group, randomized, controlled, clinical trial study was conducted in Baqiyatallah and Jamaran hospitals in Tehran, Iran in 2013-2014. Eighty-eight patients were selected by convenience sampling method prior to chest tube removing and were randomly allocated in six-blocks into three groups: intervention (10 minutes center and anterior one-third reflective massage of foot (n=29), placebo (one-third posterior surface contact of patient's left foot (n=30), and control (routine care (n=29). Before intervention, the Spielberger anxiety test was completed in all three groups. This test was again immediately recorded after removing the chest tube. Data were analyzed by SPSS software version 18 and descriptive and inferential statistics.

Based on the results of this study, the mean difference of quantitative variables including age, height, weight and body surface, and qualitative demographic variables including educational status, occupation, and marital status were not significantly different between the three groups before intervention (P>0.05), indicating that the samples were homogeneous before the intervention.  Paired t-test showed a statistically significant difference between the two groups so that the level of situational stress decreased post-removing the tube in the intervention group (P<0.003) but significantly increased in the placebo and control groups (P=0.025, P<0.001), respectively.

According to findings it can be stated that foot reflexology massage significantly reduces anxiety in patients undergoing chest tube removal after open heart surgery and as a result is a useful nursing intervention in patients undergoing chest tube removing procedure after open heart surgery. Actually, with minimum costs and no side effects this technique can improve the level of care for these patients in the critical phase of recovery after open heart surgery.