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Reflexology could aid cancer pain

(June 8, 2004)   —   An East Carolina University School of Nursing researcher is studying how cancer patients benefit from reflexology - manual pressure applied to specific points on their feet — to relieve pain.

Dr. Nancy Stephenson is a faculty member in the Department of Adult Health Nursing, a certified reflexologist and principal investigator of a two-year study funded by the National Cancer Institute of the National Institutes of Health. She is trained in the Ingham method of reflexology, named for Eunice Ingham, a pioneer in the field of reflexology who first published a book on the subject in 1938.

Reflexology is a complementary and alternative medicine therapy in which manual pressure is applied to specific points on the hand or feet which are thought to correspond with specific organs or parts of the body.

The origin of reflexology dates back thousands of years and was practiced as early as 2330 B.C. by the Egyptian culture. Reflexology is one of several complementary and alternative medicine therapies seeing increased usage in recent years. An exact number is unknown, but it is estimated up to 83 percent of cancer patients use some form of alternative therapy. In addition to reflexology, therapies include massage therapy, music therapy, biofeedback, acupuncture and yoga, which advocates say address the mind, body and spirit without side affects found with some medications or invasive procedures. An estimated 1.3 million new cancer cases will be diagnosed this year, according to the American Cancer Society. Up to 90 percent of patients with advanced cancer experience pain, and up to 25 percent experience severe pain, research shows. Dr. Stephenson's study is investigating the effect of partner-delivered reflexology on the pain and anxiety of patients with advanced cancer.

In the study, patients are randomly placed in an intervention group and control group. Patients and partners in the intervention group are visited by Dr. Stephenson or one of her graduate nursing research assistants in the hospital and are taught the reflexology technique. Later, they are visited at home to reinforce the teaching and evaluate the pain and anxiety of the patient. Dr. Stephenson's study is also evaluating whether the partners' confidence in doing reflexology affects therapy.

Pain severity and impact is measured with a Brief Pain Inventory Short Form (BPI). The Short-Form McGill Pain Questionnaire measures the sensory, affective and cognitive aspects of pain. A one-page list of descriptive words such as "throbbing," "shooting" or "sharp" is checked on a simple form. Caregivers are asked to note how the patient is functioning at home. Visual Analog Scales are used to measure the patient and partner's perception of the effectiveness of the partner-delivered reflexology on the patient's level of pain and anxiety.

Partners in the control group read a book of their choice to their partner. The control group is offered a free reflexology session after they complete the study.

Both groups administer the therapy at home for 30 minutes three times a week for a minimum of four weeks. Research has been under


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