The Effects on Sleep qualıty and fatıgue Level of Foot Bath
Condition: Chronic Obstructive Pulmonary Disease
MeSH terms: Lung Diseases; Lung Diseases, Obstructive; Pulmonary Disease, Chronic Obstructive; Fatigue
Study type: Interventional

Summary: 
      Aims and objectives: To determine the effect of foot bath on sleep quality and fatigue level
      in patients with chronic obstructive pulmonary disease (COPD).

      Background: İnsomnia and fatigue are one of the most common symptoms in people with COPD and
      adversely affects their activities of daily living.

      Design: This study was conducted as a nonrandomized controlled trial. Methods:The study
      sample comprised 70 patients who met the inclusion criteria.Data were collected with Patient
      Information Form, Pittsburgh Sleep Quality Index and Piper Fatigue Scale. Intervention group;
      The 30-day foot bath was administered for 10 minutes before bedtime, while no control was
      performed in the control group. The Pittsburgh Sleep Quality Index (PUKI) and the Piper
      Fatigue Scale were administered in both groups at the beginning of the service (first
      follow-up) and four weeks later (second follow-up) at the outpatient clinic.

      Conclusions: The foot bath by individuals with COPD was determined to significantly improve
      the participants'levels sleep quality and fatigue.
    

Detailed description: 
      The physical symptoms frequently seen in COPD patients and adversely affecting routine life
      are dyspnoea, cough, phlegm, malnourishment/loss of appetite, nausea-vomiting, constipation,
      dehydration, sleeplessness, weakness/fatigue, delirium, anxiety, and depression.

      It has been stated that the patients who experience severe symptoms cannot sleep, this
      condition impairs their sleep quality and they feel fatigue all day long. It has been
      observed in the literature that there are a decrease in sleep efficiency and total sleep
      duration, an increase in sleep latency, falling asleep late, and waking up, and a decrease in
      non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep among COPD patients
      especially due to the cough and respiratory distress symptoms.

      1.2 Literature review The qualitative aspects of sleep include sleep duration, sleep latency
      and the number of awakening during the night; on the other hand, its subjective aspects
      include elements such as sleep depth and relaxation. It is important to assess these elements
      in order to assess the sleep quality of patients.

      Just like the sleep problems, fatigue is also an important problem seen in patients with
      COPD. In the studies, it has been determined that the patients with COPD have different
      levels of fatigue and their mental, physical and social functions may be affected from
      fatigue.

      It is thought that the most common symptom in patients with chronic obstructive pulmonary
      disease (COPD) is dyspnoea. However, it has been reported that fatigue is observed in the
      patients as frequent as respiratory distress. Fatigue is the main factor restricting the
      exercise tolerance of the individuals. A positive significant correlation has been determined
      between fatigue and dyspnoea. Fatigue affects the realisation of activities of daily living
      negatively and impairs quality of life as it reduces activity tolerance of patients.

      Decreased effect of the pharmacological methods mostly preferred to solve sleep problems, the
      side effects of drugs, and the necessity of using drugs continuously have led people to use
      non-pharmacological methods. These methods include the complementary and integrative
      practices such as yoga, aromatherapy, massage, energy therapy, music therapy, reflexology,
      acupuncture, and acupressure. In recent years, many complementary and integrative methods
      have come into use as the number of studies on eliminating sleep problems and enhancing sleep
      quality has increased. One of these methods is hot foot bath. It is stated that hot foot bath
      provides a relaxing body temperature by regulating blood circulation, keeping feet in hot
      water relaxes the whole body, reduces fatigue and makes sleeping easier and, therefore, it is
      a therapeutic technique frequently used in nursing.

      Important tasks of nurses include preparing the suitable environment for the patients to take
      a rest and providing to fulfil the basic physiological needs such as sleep etc. to enable the
      human body to continue its existence. For this reason, determining the factors preventing the
      patients from sleeping well in the hospital environment and eliminating these factors are of
      prime importance. Nurses who are the members of the healthcare team should solve the problems
      caused by sleeplessness and prevent the fatigue problem that may be caused by sleeplessness.

      This study was conducted to examine the effect of the hot foot bath on sleep quality and
      fatigue level of the individuals with COPD.

      The hypotheses of the study were as follows:

      H1: The foot bath applied with hot water at 38-40°C for 10 minutes before going to sleep for
      30 days is effective in enhancing sleep quality of the individuals staying in the hospital
      and receiving COPD treatment.

      H2: The foot bath applied with hot water at 38-40°C for 10 minutes before going to sleep for
      30 days is effective in decreasing fatigue level of the individuals staying in the hospital
      and receiving COPD treatment.
    

Intervention name(s): FOOT BATH
Intervention type(s): Other
Intervention description(s): In general, foot bath is a type of relaxation and care performed by putting feet in water. Feet, as the organs carrying the whole body weight are the body parts where fatigue is felt most. In this study, a specially designed foot bath bucket was used in order to apply foot bath for the patients in the experimental group.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: COPD; fatigue; foot bath; nursing; sleep quality