Effectiveness of reflexology on anxiety of patients undergoing cardiovascular interventional procedures: A systematic review and meta-analysis of randomized controlled trials

J Adv Nurs. 2019 Jan;75(1):43-53. doi: 10.1111/jan.13822. Epub 2018 Sep 5.


Aim: To appraise the evidence concerning the effect of reflexology on the anxiety in patients undergoing cardiovascular interventional procedures.

Background: Anxiety, fear, and other unpleasant emotional experiences are common among patients before and after cardiovascular interventional procedures. The higher anxiety may affect prognosis and recovery of patients.

Design: A systematic review and meta-analysis.

Data sources: The MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Central Register of Controlled Trials (Cochrane Library), EMBASE, PsycINFO, and Web of Science were searched between 2001-2017.

Review methods: Randomized controlled trials evaluated the effectiveness of reflexology on anxiety among patients undergoing cardiovascular interventional procedures were included. Meta-analysis was done using Revman 5.3.

Results: Ten trials, representing 760 patients with the mean age of 59, fulfilled the inclusion criteria. Reflexology significantly decreased the anxiety of patients undergoing cardiovascular interventional procedures in the treatment group compared with the control group.

Conclusion: Reflexology has some positive effects on anxiety among patients undergoing cardiovascular procedures. It may be a useful complementary therapy and further research is necessary to create reliable evidence.

Keywords: anxiety; cardiac surgical procedures; complementary therapies; coronary angiography; meta-analysis; nursing; percutaneous coronary intervention; reflexology; systematic reviews.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety Disorders / etiology*
  • Anxiety Disorders / therapy*
  • Cardiovascular Surgical Procedures / psychology*
  • Female
  • Humans
  • Male
  • Massage / methods*
  • Middle Aged
  • Music Therapy / methods*
  • Randomized Controlled Trials as Topic
  • Young Adult