Randomized controlled trial of the foot reflexology on pain and anxiety severity during dressing change in burn patients

Burns. 2021 Feb;47(1):215-221. doi: 10.1016/j.burns.2020.06.035. Epub 2020 Jul 12.


Background: One of the most important problems in burn patients was pain, especially in dressing changes. This pain can lead to anxiety in the patient. The aim of this study was to determine the effect of foot reflexology on pain and anxiety severity in burn patients.

Methods: This study was a randomized controlled trial, in which 66 patients with burn injuries referred to Vali-e-asr Hospital, Arak, Iran participated. After obtaining written consent, patients were enrolled to study according to inclusion criteria and then, divided into intervention (n = 33) and control (n = 33) groups using simple random allocation. In the intervention group, in addition to standard care, reflexology was performed for one week on Saturday, Monday and Wednesday (three times in a week). The intervention was done one hour before dressing change in a separate room for 30 min. The control group received only standard care during this time (both intervention and control groups were the same in the type of treatment, and reflexology was considered as an extra care in the intervention group). Severity of pain and anxiety in both groups was measured using visual analog scale twice a day (5-10 min before dressing change and 5-10 min after dressing change) for six days. SPSS software ver. 15 was used for statistical analysis. Mean and standard deviation were used for quantitative variables and qualitative variables were reported as frequency and percentage. Data were analyzed using Chi‑square, Mann-Whitney, Fisher's exact tests, and paired t-test. The Kolmogorov-Smirnov test was used to check the normality of data.

Results: The results showed no significant difference in severity of pain (p = 0.25) and anxiety (p = 0.37) between the two groups on the first day, before the intervention. In the following days, the results showed no significant difference between the two groups in the second and third treatments after intervention . However, the mean pain scores showed a significant difference between the two groups in the forth (p = 0.005), fifth (p = 0.001), and sixth (p = 0.001) days after intervention. Anxiety scores also showed a significant difference between the two groups on the fourth (p = 0.01), fifth (p = 0.001), and sixth (p = 0.001) days.

Conclusions: Our results showed foot reflexology is an appropriate and safe intervention for management of pain and anxiety of burn patients. Therefore, it can be used as a complementary method alongside other methods.

Keywords: Anxiety; Burn; Nursing care; Pain; Reflexology; Visual analog scale.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / psychology
  • Anxiety / therapy*
  • Bandages / adverse effects*
  • Bandages / trends
  • Burns / complications
  • Burns / psychology
  • Burns / therapy*
  • Chi-Square Distribution
  • Female
  • Foot
  • Humans
  • Iran
  • Male
  • Middle Aged
  • Musculoskeletal Manipulations / methods
  • Musculoskeletal Manipulations / psychology
  • Musculoskeletal Manipulations / standards*
  • Pain Management / methods
  • Pain Management / standards*
  • Pain Management / statistics & numerical data
  • Pain Measurement / methods
  • Statistics, Nonparametric
  • Visual Analog Scale