ARTICLE INFO

Article Type

Original Research

Authors

Khosravan   Sh. (1 )
Shojaei   M. (* )
Basiri Moghadam   M. (2 )
Mojtabavi   S.J. (3 )






(* ) “Student Research Committee” and “Nursing Department, Nursing & Midwifery Faculty”, Gonabad University of Medical Sciences, Gonabad, Iran
(1 ) “Social Determinants of Health Research Center” and “Nursing Department, Nursing & Midwifery Faculty”, Gonabad University of Medical Sciences, Gonabad , Iran
(2 ) “Social Health Research & Development Center” and “Nursing Department, Nursing & Midwifery Faculty”, Gonabad University of Medical Sciences, Gonabad, Iran
(3 ) Clinical Specialist in Chinese Medicine, Specialized Clinic of Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran

Correspondence

Address: Nursing Department, Nursing & Midwifery Faculty, Gonabad University of Medical Sciences, Near Sento Road, Gonabad, Iran. Postal Code: 9691793718
Phone: +985157252915
Fax: +985157223962
mshojaie67@yahoo.com

Article History

Received:  September  9, 2014
Accepted:  November 6, 2014
ePublished:  February 19, 2015

BRIEF TEXT


… [1-5] Urinary retention after surgery is the conscious patient’s incapability to urinate in 4-6 hours after surgery [6]. Catheterization of the bladder, if it causes some injuries, makes the patient capable of infections, stenosis, retraction, and bleeding in the urinary tract [6]. … [7-15] Based on the principles of reflexology, pressure on a foot reflex point can affect all the organs [16-18]. … [19-23]

Feet reflexology massage has been studied as a non-invasive nursing intervention in different conditions. The studies show recoveries in migraine headaches [24], breath problems [25], blood flow [26, 27], and high blood pressure and insomnia [30], and lower pain, anxiety, and stress [28, 29], as well as treating some prevalent pregnancy problems [31] and affecting time and volume of the first urine repulse in women after selective Caesarian surgery without urine catheter [32].

The aim of this study was to study the effects of feet reflexology massage on urinary retention relieving after surgery.

This is a randomized clinical trial with control group.

Patients with urinary retention after surgery were studied at the surgery ward of 15 Khordad Hospital of Bidakht (Iran) in 2014.

Based on the mean comparison formula, the sample size for each group was estimated 70 persons. Sampling was done through random allocation with permutation blocks method.

The samples were divided into two equal groups including experiment and control. The inclusion criteria included the patient’s self-report of urinary retention after non-urgent surgery despite of the need for repulse half an hour after surgery or urinary retention after surgery for 6 hours without feeling the need for repulse. Other inclusion criteria were full consciousness, ability for communication and reporting the symptoms and their severity, 18 years old and beyond, no history of renal failure, urethral catheterization, urinary tract stones, urinary tract infections, urethral stricture and benign grow of prostate, no history of neurological disease, neuropathy due to diabetes or alcohol, cerebral palsy, multiple sclerosis, spinal cord injury and surgery on the nervous system, and no fracture, wound, skin problem and plaster in the location of foot massage. The exclusion criteria were intolerance of the intervention and failure to continue. After routine activities to stimulate the repulse, the volume of the retained urine was measured. To control the retained urine volume in the bladder, to adapt it with the definition of urinary retention, and to control it as an intervening factor, the volumes of the repulsed urine in both groups were measured and compared with each other. Sampling was done in patients with urinary retention after surgery, and they could not repulse after routine nursing interventions without bladder catheterization. Data was collected, using demographic information questionnaire, a checklist for investigating the inclusion criteria to select the study units, and a register form to record the results of the interventions. 1min feet general massage was done. In experiment group, feet reflexology massage was done up to 30min (15min for each foot) on the bladder-point on foot [13]. In control group, feet placebo massage was done up to 30min (15 min for each foot). In both groups, if until 6 hours there was no ability for repulse despite the mentioned activities, the patients were catheterized [13]. Data was recorded on the information record sheet. Data was analyzed, using SPSS 16 software. Independent T test was used to compare the mean ages, weights, blood pressures, pulses, and surgery lengths. Mann-Whitney test was used to compare the volumes of repulse urine, urinary outputs, and lengths of elimination of urinary retention. Chi-square test was used to compare genders, types of anesthesia, types of surgery, elimination of urinary retention, and morphine reception between both groups.

Mean ages of experiment and control groups were 38.05±17.85 and 37.94±13.82 years, respectively. There was no significant difference in demographic and clinical characteristics between the groups (Table 1). In 27 persons (58.7%) of experiment group and 19 persons (41.3%) of control group urinary retention elimination was observed. Length of the urinary retention elimination in experiment group (30.28±47.89min) was significantly lesser than control group (40.28±29.65). There was no significant difference between mean volumes of repulse urine in experiment group (465.14±229.37) and control group (414.28±222.14).

There was a significant difference between the groups in urinary retention elimination and its length without catheterization. 20-minute feet reflexology massage on pituitary, kidneys, and bladder points 2-3 hours after Caesarian surgery leads to a shorter time and lower volume of the first urine repulse without catheter after surgery than control group with feet surface massage [32]. … [33-36] 20-minute reflexology massage on the kidneys, bladder, and urinary tract points in a delivery person with pliers tool, who has been unable to repulse urine after removing urine catheter, leads to feel pressure in the bladder and repulsion of about 1.5lit urine during half an hour [37]. The result is consistent with the present result. The utilization of methods such as water sound, warm air flow, and bladder massage are successful up to 75% [38]. In the present study, opening the water tap and putting warm water sack on the bladder for 20min was successful up to 41.3%. There is removal of urinary retention after putting warm water sack and early leaving the bed in 77% of patient under general surgery [12], which is higher than the present success. 10- to 30-minute urine repulse by reflexology massage compared to 30-minute repulse by water sound, warm air flow, and bladder massage methods is consistent with the present results [38]. Feet reflexology massage in women after selective Caesarian surgery without urinary catheter leads to a significant decrease in the elimination time of urinary retention [32]. The result is consistent with the present results. Mean volumes of urine repulsion in experiment and control groups were 400ml and 300ml, respectively. In addition, there was no significant difference between the groups. 20-minute feet reflexology massage on pituitary, kidneys, and bladder points 2-3 hours after surgery leads to a significant difference in the volume of the first urine repulse after surgery than feet surface massage [32]. Feet reflexology massage can be more effective on blood flow increase and producing more urine [27]. … [39]

Training the reflexology massage to the nurses with its applications in the surgery wards should be noticed.

The patient’s self-report of urinary retention after surgery and no application of sonography methods or bladder scan, no study about the effects of feet reflexology massage before other interventions or simultaneously, and lack of any control on repulse model and other intervention consequences after surgery were of the limitations for the study.

Feet reflexology massage is effective on urinary retention after surgery.

All the participants, staff of Bidakht 15 Khordad Hospital, and Education and Research Deputies of Gonabaad University of Medical Sciences are appreciated.

Non-declared

Ethics Committee of Gonabaad University of Medical Sciences confirmed the study.

Research and Technology Deputy of Gonabaad University of Medical Sciences funded the study.

TABLES and CHARTS

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CITIATION LINKS

[1]Feliciano T, Montero J, McCarthy M, Priester M. A retrospective, descriptive, exploratory study evaluating incidence of postoperative urinary retention after spinal anesthesia and its effect on PACU discharge. J Perianesth Nurs. 2008;23(6):394-400.
[2]Cooper CJ. Effect of trans-radial access on quality life and cost of cardiac catheterization: A randomized comparison. Am Heart J. 1999;138(3 Pt 1):430-6.
[3]O'Riordan JA, Hopkins PM, Ravenscroft A, Stevens JD. Patient-controlled analgesia and urinary retention following lower limb joint replacement: prospective audit and logistic regression analysis. Eur J Anaesthesiol. 2000;17(7):431-5.
[4]Baldini G, Bagry H, Aprikian A, Carli F. Postoperative urinary retention: Anesthetic and perioperative considerations. Anesthesiology. 2009;110(5):1139-57.
[5]Thomas K, Oades G, Taylor-Hay C, Kirby RS. Acute urinary retention: What is the impact on patients, quality of life. BJU Int. 2005;95(1):72-6.
[6]Monahan F, Sands JK, Neighbors M, Marek JF, Green CJ. Medical surgical nursing, health and illness perspectives. 8th ed. St. Louis: Mosby, 2007: 991-995.
[7]Bonow RO, Mann DL, Zipes DP, Libby P. Braunwald's heart disease: A text book of cardiovascular medicine. 9th ed. NewYork: Saunders, 2008;439-62.
[8]Baldini G, Bagry H, Aprikian A, Carli F, Postoperative urinary retention: Anesthetic and perioperative considerations. Anesthesiology. 2009;110(5):1139-57.
[9]Williamson J. Management of postoperative urinary retention. Nurs Times. 2005;101(29):53.
[10]Ribby KJ. Decreasing urinary tract infection through staff development‚ outcomes‚ and nursing process. J Nurs Care Qual. 2006;21(3):272-6.
[11]Noori Sh. Comparative study of leaving early and delayed urinary catheter on recatheterization rate in patient following abdominal surgery [Dissertation]. Qazvin: Qazvin University of Medical Science; 2007. [Persian]
[12]Gönüllü NN, Gönüllü M, Utkan N Z, Dülger M, Gökgöz S, Karsli B. Postoperative retention of urine in general surgical patients: Department of General Surgery, Medical School of The Cumhuriyet University, Sivas, Turkey. Eur J Surg. 1993;159(3):145-7.
[13]Anderson JB, Grant JB. Postoperative retention of urine: A prospective urodynamic study. BMJ. 1991;302(6):864-6.
[14]Jouzi M. Assessment of the effect of massage therapy on stroke patients. Med Sci J Islamic Azad Univ Tehran Med Branch. 2009;19(4):256-61. [Persian]
[15]Shaban M, Haj Amiry P, Mehran A, Kahrary S. Evaluation of immediate effect of foot massage on patient’s vital signs in a general intensive care unit. Hayat. 2004;10(1):71-9. [Persian]
[16]Sharmeh M, Bzorgzadeh P, Ghafourian AR, Ebadi A. The effect of foot reflexology massage on pain after sternotomy coronary artery bypass graft surgery. Iran J Crit Care Nurs. 2009:2(2):51-4 [Persian]
[17]Ernst E, Posadzki P, Lee M. Reflexology: An update of a systematic review of randomized clinical trials. Maturitas. 2011;68(2):116-20.
[18]Stager L. Nurturing Massage for Pregnancy: A Practical Guide to Bodywork for the Perinatal Cycle (LWW Massage Therapy and Bodywork Educational Series). Philadelphia: Lippincott Williams & Wilkins; 2010. [Persian]
[19]Tiran D, Chummun H. The physiological basis of reflexology and its use as a potial diagnostic tool. Complement Ther Clin Prac. 2005;11(1);58-64 .
[20]Yeh CH, Chien LC, Chiang YC, Huang LC. Auricular Point Accupressure for Chronic low back pain: A feasibility Study for 1-week Treatment. Evid Based Complement Alternat Med. 2012;2012:383257.
[21]Nazemzadeh M, Jalalodini A, Rezvani Amin M, Yousefian N, Poornamdar Z, Ghaljeh M. The effect of foot reflexology massage on pain intensity in patients with chronic low back pain visited to physical therapy unit in Baghiathallah hospital in Tehran. Complement Med J Faculty Nurs Midwifery. 2012;2(3):204-11.
[22]Lee YM. Effect of self-foot reflexology massage on depression, stress responses and immune functions of middle aged women. Taehan Kanho Hakhoe Chi. 2006;36(1):179-88. [Korean]
[23]Quattrin R, Zanini A, Buchini S, Turello D, Annunziata MA, Vidotti C, et al. Use of reflexology foot massage to reduce anxiety in hospitalized cancer patients in chemotherapy treatment: methodology and outcomes. J Nurs Manag. 2006;14(2):96-105.
[24]Launsø L, Brendstrup E, Arnberg S. An exploratory study of reflexoligical treatment for headache. Altern Ther Health Med. 1999;5(3):57-65.
[25]Beygge T, Heinig TH, Collins P, Ronborg S, Gehrehen PM, Hilden J, et al. Reflexology and bronchial asthma. Respir Med. 2001;95(3):173-9.
[26]Mur E, Schmidseder J, Egger I, Bodner G, Eibl harti F, et al. Beeinflussung der Darmdurchblutung durch Fussreflexzonenmassage,gemessen mittels farbkodierter Doppler sonography. Forschende Komplementaer medizin und Klassische Naturheilkunde. 2001;8(2):86-9. [German]
[27]Sudmeier I, Bodner G, Egger I, Mur E, Ulmer H, Herold M, Changes of renal blood flow during organ-associated foot reflexology measured by color Doppler sonography. Forsch Komplementarmed. 1999;6(3):129-34. [German]
[28]McVicar AJ, Greenwood CR, Fewell F, D'Arcy V, Chandrasekharan S, Alldridge LC. Evaluation of anxiety, salivary cortisol and melatonin secretion following reflexology treatment: A pilot study in healthy individuals. Complement Ther Clin Pract. 2007;13(3):137-45.
[29]Mirzaee F, Kaviani M, Jafari P. Effect of Reflexology on Anxiety Level in Nuliparous Women. Hayat. 2010;16(1):65-71. [Persian]
[30]Li CY, Chen SC, Gau ML, Huang CM. Randomised controlled trial of the effectiveness of using foot reflexology to improve quality of sleep amongst Taiwanese postpartum women. Midwifery. 2011;27(2):181-6.
[31]Woodward S, Norton C, Barriball KL. A pilot study of the effectiveness of reflexology in treating idiopathic constipation in women. Complement Ther Clin Pract. 2010;16(1):41-6.
[32]Yosefi F. Effect of foot reflexology on the time and volume of urination in women after elective cesarean section without a urinary catheter [Dissertation]. Mashhad: Mashhad University of Medical Sciences. 2011. [Persian]
[33]Joyce B, Jane H. Medical-surgical nursing: Clinical management for positive outcome neurology. Moshtagh Z. (Translator). Tehran: Salemi; 2010.
[34]Eghbali M, Safari R, Nazari F, Abdoli S. The effects of reflexology on chronic low back pain intensity in nurses employed in hospitals affiliated with Isfahan University of Medical Sciences. Iran J Nurs Midwifery Res. 2012;17(3):239-43.
[35]Elisabeth R, Nieves T, Javier, Isabel E, Gustavo A. Cardiovascular effects of reflexology in healthy individuals: evidence for a specific increase in blood pressure. Altern Med Stud. 2012;2(1):10-7.
[36]Kesselring A, Spichiger E, Muller M, Foot Reflexology: an intervention study. Pflege. 1998;11(4):213-8. [German]
[37]Evan M. reflex zone therapy for mother. Nursing Times. 1990;86(4):29-31.
[38]Cailian L. Clinical Observation on Treatment of 40 Cases of Uroschesis with Reflexology. Beijing: China Reflexology Symposium Report; 1998.
[39]Smeltzer SC, Bare B. Brunner and suddarth textbook of medical surgical nursing. Delavarkhan M, Bisheban P. (Translators). Philadelphia: Lippincott Williams & Wilkins; 2004.