The Effect of Reflexology on Labor
Condition: Reflexology
Study type: Interventional

Summary: 
      Aims and Objectives: The purpose of this study was to determine the effect of reflexology,
      one of the non-pharmacological methods used in the management of labor pain, on anxiety,
      labor duration, labor pain, and labor satisfaction in primiparous pregnant women.

      Background: Labor pain is one of the most severe types of pain experienced by a woman
      throughout her life. As a result of the labor pain and birth-related stress, maternal and
      fetus health is negatively affected. Controlling of labor pain will decrease the anxiety and
      tension experienced by pregnant woman.

      Design: A randomized controlled experimental was used. Method: A total of 60 women
      participated in the study in 2 groups of 30 for reflexology and control groups. By giving
      appropriate position in the first stage of delivery to the pregnant women in the experimental
      group, 10-minute massage was applied to both feet including 5-minute massage for each foot
      starting first from the right foot by using vaseline under the supervision of a doctor to
      facilitate the hand movements, then the reflexology technique was applied by stimulating the
      nerve points by applying pressure to reflex regions of each foot for 20 minutes as totally 40
      minutes for both feet. The control group was composed of pregnant women who received routine
      treatment, care and applications of the hospital.
    

Detailed description: 
      Aims:This study was conducted as a randomized controlled experimental study in order to
      determine the effect of reflexology application in primiparous pregnant women on labor pain,
      anxiety, labor duration, and birth satisfaction.

      METHOD Participants The study was conducted with voluntary pregnant women applying to the
      delivery room unit of Gaziantep Cengiz Gökçek Maternity and Children Hospital to perform
      their first birth between 01 July 2017 and 07 July 2018. When the sample volume that would
      represent the population with the conditions of α= 0.05 risk, 1-α =0.95 accuracy rate, B=
      0.20, 1-B= 0.80 power ratio was considered with the comparison results of VAS mean scores in
      the study by Dolation et al., it was determined to be minimum 27 people for each group.

      The study was conducted with two groups including Reflexology Group (experimental) and
      Control Group. By including 30 women into each group, the study was conducted with a total of
      60 women. The drawing method was used to decide to which group the women would be assigned.
      In order to draw lots, 60 small paper pieces were prepared, control was written on 30 of
      these paper pieces, reflexology was written on the other 30 pieces of paper, and they were
      then folded and placed into a bag. Inclusion of women into groups was determined according to
      the papers women drew from the bag.

      Data Collection Tools The data of the study were collected using "Descriptive Information
      Form", "Visual Analog Scale (VAS)", "State-Trait Anxiety Scale (STAI FORM TX-I )", and "Birth
      Satisfaction Scale".

      Descriptive Information Form: The form prepared by the researcher by examining the related
      literature consists of two sections. In the first section, age, height, weight, educational
      level, and working status of the woman along with the number of birth, parity, number of
      abortus, number of living children, and modes of previous births were asked. The second
      section of the form includes questions related to the period of birth stages (Stages I, II,
      and III), interventions made in the first stage of birth and during the labor (Oxytocin
      administration, amniotomy, Fundal pressure, Vacuum etc.), perineal tear, Apgar score and the
      newborn's status of being accepted to the intensive care unit.

      Visual Analog Scale (VAS): Visual Analogue Scale (VAS) is used to describe the severity of
      pain in patients with pain. The diagnosis will be established based on subjective data
      including the patient's verbal expression. There are numbers horizontally placed varying from
      0 to 10. The pain severity is expressed in numbers ranging from 0 to 10 and no pain is
      determined with "0" and the most severe pain is determined with "10". In this method, it is
      explained that there are two endpoints and she is free to mark any point between these two
      points.

      State-Trait Anxiety Inventory: To determine state and trait anxiety levels of the
      participants, the state-trait anxiety inventory (STAI FORM TX -I) was used. The individual is
      required to indicate the feelings or behaviours that he/she has experienced in a specific
      situation according to the degree of severity by marking one of the options such as (1)
      Never, (2) Little, (3) Very and (4) Completely. The state-trait anxiety inventory requires
      the individual to describe how he/she feels at a certain moment and under certain conditions
      by considering his/ her feelings about a specific situation. While high scores indicate high
      anxiety levels, low scores indicate low anxiety levels. The state-trait anxiety inventory
      consists of 20 statements. The score obtained from the scale may vary between 20 and 80.
      While a high score represents a high anxiety level, a low score represents a low anxiety
      level.

      Birth Satisfaction Scale: Birth Satisfaction Scale was developed by Martin and Fleming in
      2009. The original language of the scale is English. The translation of the scale was
      performed by Coşar et al.,. The scale is a Likert-type scale that is scored according to the
      responses. The scale form consists of 30 items and total score obtained from the scale varies
      between 30 and 150. As the scores obtained from the scale increase, birth satisfaction level
      increases.
    

Intervention name(s): reflexology
Intervention type(s): Other
Intervention description(s): foot reflexology
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: A total of 60 women participated in the study in 2 groups of 30 for reflexology and control groups. By giving appropriate position in the first stage of delivery to the pregnant women in the experimental group, 10-minute massage was applied to both feet including 5-minute massage for each foot starting first from the right foot by using vaseline under the supervision of a doctor to facilitate the hand movements, then the reflexology technique was applied by stimulating the nerve points by applying pressure to reflex regions of each foot for 20 minutes as totally 40 minutes for both feet. The control group was composed of pregnant women who received routine treatment, care and applications of the hospital.
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Birth; Reflexology; Pain