Effectiveness of Foot Reflexology for Reduction of Physiological and Psychological Symptoms among Adult Patients with Cancer in International Cancer Centre Neyyoor at Kanyakumari District, Tamil Nadu

INTRODUCTIONS: Cancer is a group of more than 200 diseases characterized by controlled and unregulated growth of cells. It is a major health problem that occurs in people of all ethnicities. Cancer incidence overall is higher in women than in men in India. The gender difference incidence and death rates are higher for some types of cancer like head neck, breast and lung. Cancer encompasses a broad range of diseases of multiple causes that can arise in any cell of the body capable of envading regulatory control over proliferation and differentiation. Statement of the Problem An experimental study to assess the effectiveness of foot reflexology for reduction of physiological and psychological symptoms among adult patients with cancer in International Cancer Centre, Neyyoor, at Kanyakumari District, Tamil Nadu. OBJECTIVES: 1. To assess the physiological and psychological symptoms of adult patients with cancer in experimental and control group before and after foot reflexology. 2. To determine the effectiveness of foot reflexology among adult patients with cancer by comparing the physiological and psychological symptoms between experimental and control group of patients with cancer before and after foot reflexology. 3. To assess the correlation between the physiological and psychological symptoms of adult patients with cancer before and after foot reflexology among experimental and control group of patients. 4. To find out the association between the demographic variables and level of physiological and psychological symptoms of adult patients with cancer among experimental and control group before foot reflexology. 5. To find out the association between the clinical variables and level of physiological and psychological symptoms of adult patients with cancer among experimental and control group before foot reflexology. 6. To determine the level of satisfaction regarding foot reflexology among experimental group of adult patients with cancer. Research HYPOTHESES: H1: There will be a significant difference in physiological symptoms between the experimental and control group of patients with cancer before and after foot reflexology. H2: There will be a significant difference in psychological symptoms between the experimental and control group of patients with cancer before and after foot reflexology. H3: There will be a significant relationship between the level of physiological and psychological symptoms of experimental and control group of patients with cancer before and after foot reflexology. H4: There will be a significant association between the demographic variables and physiological symptoms in experimental and control group of patients with cancer before foot reflexology. H5: There will be a significant association between t he demographic variables and psychological symptoms in experimental and control group of patients with cancer before foot reflexology. H6: There will be a significant association between the clinical variables and physiological symptoms of experimental and control group of patients with cancer before foot reflexology. H7: There will be a significant association between the clinical variables and psychological symptoms of experimental and control group of patients with cancer before foot reflexology. The conceptual framework for the study was developed on the basis of Lydia Hall Care, Core and Cure Model, which has been modified for the present study. An experimental research design was undertaken for the study. The independent variable was the foot reflexology and the dependent variable was physiological (pain, nausea and vomiting) and psychological (depression and anxiety) symptoms. The samples for the study were 250 adult patients with cancer, 125 in an experimental group and 125 in control group. Random sampling technique was utilized to select the samples. The investigator first randomly selected the wards and from the hospital and all those wards two groups were selected for the study. Patients were also selected by random sampling technique. The data collection instrument was Demo graphic Proforma, Clinical Proforma, and Numerical Pain Rating scale, Modified Rhodes Nausea Vomiting Index, Modified Major Depression Inventory and Modified State Trait Anxiety Scale. The data collection tools were validated and reliability was established. The data were collected after obtaining ethical clearance, setting permission and consent of the research participant. The study was conducted at International Cancer Centre, Neyyor. The viability for research was assessed by conducti ng pilot study. Foot reflexology was applied for 15 minutes to each foot, a total of 30 minutes daily up to 10 days for each patient and this was implemented by the investigator. The tools were administered to the adult patients with cancer and the data obtained were analysed in terms of both descriptive and inferential statistics. MAJOR FINDINGS OF THE STUDY: • In the assessment of physiological symptom (pain) among adult patients with cancer in experimental group it was found that, in the pretest 125 (100%) patients had mild pain and in the post test 1 majority 123 (98.4%) had mild pain and in the post test 2 most of the patients 86 (68.8%) had no pain. While assessing pain in the control group, it was observed that in the pre test, post test 1 and post test 2 all the cancer patients 125 (100%), 125 (100%), and 125 (100%), in pre test, post test 1 and post test 2 had mild pain. • Regarding the physiological symptom (nausea and vomiting), in the pre test majority 69 (55.2%) had profound nausea and vomiting in post test 1, 72 (57.6%) had moderate nausea and vomiting and in post test 2, 123 (98.4%) had mild nausea and vomiting, among the experimental group. In the control group most of the patients with cancer in the pre test, 7 1 (56.8%), post test 1, 71 (56.8%) and in post test 2, 70 (56.8%) had profound nausea and vomiting. • As for as the psychological symptom (Depression), in the pre test most of the patients with cancer 92 (73.6%) had severe depression, in the post test 1, 94 (75.2%) had moderate depression and in post test 2, 124 (99.2%) had mild depression in the experimental group. In the control group majority of the patients with cancer in the pre test 92 (73.6%), post test 1, 92 (73.6%) and in post test 2, 70 (56%) had severe depression. • While assessing the psychological symptom (anxiety) in the experimental group, in the pre test majority, 82 (65.6%) had severe anxiety, in post test 1, 112 (89.6%) had mild anxiety and in post test 2, 12 3 (98.4%) had mild anxiety, whereas in the control group, in the pre test 88 (7 0.4%) had severe anxiety, in post test 1, 91 (72.8%) had severe anxiety and in post test 2, 91 (72.8%) had severe anxiety. • It is evident from the findings of the study revealed that the mean score of physiological symptom in the experimental group pre test was 2.5 with SD = 0.6. After administration of foot reflexology post test 1 mean score was 1.5 with SD 0.5 and post test 2 mean score was 0.3 with SD 0.5. The mean difference with standard deviation of pre test to post rest 1, post test 1 to post test 2 and pre test to post test 2 were 1, SD = 0.3 , 1.2, SD = 0.5 and 2.1, SD = 0.5 respectively. The paired ‘t’ test values were t = 40.29, t = 27.606, t = 43.904 and this is greater than the table value at p<0.001. This reveals that there is a high significance difference in post test 2 than post test 1 and pre test. In the control group there is no significant difference between pre test, post test 1 and post test 2. • The findings of the study revealed that the mean score of physiological symptom (nausea and vomiting) in the experimental group pre test was 25.8, SD = 4.3. After administration of foot reflexology in post test 1, mean score was 12.2 with SD 4.0 and in post test 2, mean score was 3.9 with SD 2.6. The mean difference from pre test to post test 1, post test 1 to post test 2 and pre test to post test 2 were 13.6 with SD 3.0, 8.3 with 2.8 and 21.9 with 3.9. The paired ‘t’ test value were t = 51.251, t = 32.821 and t = 62.84 which is greater than the table value at p0.005. • The findings of the study reveal that the psychological symptom depressions, in the experimental group the pre test mean score a nd standard deviation was 37 with SD 3.3. After administration of foot reflex ology in post test 1, mean was 13.6 with SD = 1.6 and in post test 2, mean score was 4.8 with SD 1.5. The mean difference from pre test to post test 1, post test 1 to post test 2 and pre test to post test 2, 23.3, SD = 2.8, 8.8, SD = 1.6 and 3 2.2, SD = 3.2. The paired ‘t’ test values were t = 95.529, t = 61.4 and t = 112.6 72, which is greater than the table value at P0.05. • In is evident from the findings of the study that t he psychological symptom (anxiety) in the experimental group in the pre test mean score was 62.5 with SD 3.6 and after the administration of foot reflexology, the post test 1 mean score was 37.6 with SD 3.0 and in post test 2 mean score was 34.9 with SD 2.6. The mean difference of pre test to post test 1, post test 1 to post test 2, pre test to post test 2 were 24.9 with SD 3.8, 2.7 with SD = 2.2 27.6 with SD 4.2 and the paired test ‘t’ values were t = 73.35, t = 13.6 75 and t = 73.243 which is greater than the table value at p<0.001. Thus reveals that there was a very highly significant difference between post test 2, post test 1 and pre test. In the control group there was no significant difference between pre test 1 post test 1 and post test 2 at P<0.05. • It is evident from the study that foot reflexology had a significant reduction of physiological and psychological symptom in the experimental group at P<0.001 level. • The finding of the study reveals that, while correlating the physiological symptoms (pain, nausea and vomiting), in the experimental group the pre test scores shows negative correlation and in post test 1 and post test 2 shows positive correlation. In control group there was negative correlation in the pre test, post test 1 and post test 2. • The findings of the study shows that while correlating the psychological symptom (Depression and anxiety) in the pre test experimental and control group shows negative correlation. The post test 1 a nd post test 2 of experimental group shows positive correlation where as control group shows negative correlation. • There is an association between physiological symptom (pain) and demographic variables such as gender, occupation an d hobbies in the experimental group at p