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Effect of Foot Reflexology on Pain, Anxiety, and Physiological Indices in Leukemia Patients Undergoing Bone Marrow Aspiration: A Randomized Clinical Trial Study Publisher



Mehri M1 ; Golitaleb M2, 3 ; Safdari A4 ; Madadi S5 ; Rafiei F6 ; Shahbazi H5 ; Mokhtari R3 ; Nejat N3
Authors
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Authors Affiliations
  1. 1. Department of Internal Medicine, School of Medicine, Arak University of Medical Sciences, Arak, Iran
  2. 2. Department of Critical Care Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
  4. 4. Department of Nursing, Malayer School of Medical Sciences, Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
  5. 5. Student Research Committee, Arak University of Medical Sciences, Arak, Iran
  6. 6. Department of Biostatistics and Epidemiology, School of Health, Tehran University of Medical Sciences, Tehran, Iran

Source: Contemporary Clinical Trials Communications Published:2025


Abstract

Introduction: Patients with leukemia undergoing bone marrow aspiration (BMA) frequently experience considerable pain and anxiety, which may negatively impact physiological outcomes. Reflexology, a complementary therapeutic approach, has demonstrated effectiveness in reducing pain and anxiety across various medical procedures. This randomized clinical trial aimed to evaluate the impact of foot reflexology on pain, anxiety, and physiological indices in leukemia patients undergoing BMA. Methods: This randomized clinical trial was conducted at Ayatollah Khansari Hospital in Arak between August 2021 and January 2023. Patients were randomly assigned to either a reflexology intervention group or a control group receiving routine care. The intervention group underwent a 30-min foot reflexology session. Pain was assessed using the Numeric Rating Scale (NRS), and anxiety levels were measured via the Spielberger State-Trait Anxiety Inventory (STAI). Physiological indices, including systolic and diastolic blood pressure, heart rate, and arterial oxygen saturation, were measured before and after the intervention. Results: Of the 72 patients, 68 completed the study (intervention: n = 35, control: n = 33). Post-intervention, the intervention group showed a significant reduction in systolic (p = 0.017) and diastolic blood pressure (p = 0.028), while the control group experienced no significant changes. Heart rate significantly increased in the control group (p = 0.030), but no significant change was observed in the intervention group (p = 0.977). Anxiety levels significantly decreased in the intervention group (p < 0.001), with a notable between-group difference (p = 0.006). Pain intensity was also significantly lower in the intervention group compared to the control group (p = 0.034). Conclusion: Foot reflexology is an effective intervention for reducing pain and anxiety in leukemia patients undergoing BMA. Reflexology may be considered a valuable, non-invasive supportive therapy for managing procedural pain and anxiety in oncology settings. © 2025 The Authors
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