Document Type : Original Article(s)
1 Medical Intern, Student Research Committee, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
2 Associate Professor, Department of Cardiology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
3 Associate Professor, Department of Surgery, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
4 General Practitioner, Department of Internal Medicine, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
BACKGROUND: Complementary medicine interventions are now successfully used to reduce stress as well as to stabilize hemodynamic indices within different procedures. The present study aimed to examine the effect of massage therapy and reflexotherapy on reducing stress in patients before coronary angiography. METHODS: In this open-label clinical trial, 75 consecutive patients who were candidate for coronary angiography were randomly assigned to receive reflexotherapy (n = 25), or massage therapy (n = 25), or routine care (n = 25) before angiography. The Spielberger State-Trait Anxiety Inventory was used to determine the stress level of patients before and after interventions and vital signs were also measured. RESULTS: Improvement in diastolic blood pressure, heart rate, and respiratory rate was shown in the reflexotherapy group, and similar effects were observed following other interventions including massage therapy and routine resting program. In subjects who received reflexotherapy the level of stress decreased slightly compared with the other two groups. However, following interventions the level of stress in reflexotherapy group was shown to be lower than other study groups. CONCLUSION: Reflexotherapy before coronary angiography can help to stabilize vital sign as well as reduce the level of stress. The effect of massage therapy was limited to reducing stress.
- Thompson JM, McFarland GK. Mosby's clinical nursing. Philadelphia, PA: Mosby; 2002. p. 3.
- Ghalamghash R, Samavat T, Najmi M, Hojatzadeh A. Introduction to heart rehabilitation [cited 2006]. Available from URL:
- Braunwald EB, Zipes DP, Libby P. Heart disease: A textbook of cardiovascular medicine. 6th ed. Philadelphia, PA: Elsevier Science Health Science Division; 2001.
- Wood MA, Ellenbogen KA. Cardiology patient pages. Cardiac pacemakers from the patient's perspective. Circulation 2002; 105(18): 2136-8.
- Nouhi F, Tabatabaei AH. The current status of cardiovascular medicine in the Islamic republic of Iran. Iran Heart J 2001; 2(2-3): 52. [In Persian].
- Kalyani MN, Jamshidi N. Risk factors of Iranian patients with three vessels disease candidate for coronary artery bypass graft surgery (CABG). Pak J Med Sci 2010; 26(4): 837-41.
- O'Connell Smeltzer SC, Bare BG, Hinkle JL, Cheever KH. Brunner & Suddarth's Textbook of Medical-surgical Nursing. Philadelphia, PA: Lippincott Williams & Wilkins; 2010.
- Gunnarsdottir TJ, Jonsdottir H. Does the experimental design capture the effects of complementary therapy? A study using reflexology for patients undergoing coronary artery bypass graft surgery. J Clin Nurs 2007; 16(4): 777-85.
- Mitchell M. Anxiety management in adult day surgery: A nursing perspective. New York, NY: John Wiley & Sons; 2006.
- Asilioglu K, Celik SS. The effect of preoperative education on anxiety of open cardiac surgery patients. Patient Educ Couns 2004; 53(1): 65-70.
- Kim SS, Erlen JA, Kim KB, Sok SR. Nursing students' and faculty members' knowledge of, experience with, and attitudes toward complementary and alternative therapies. J Nurs Educ 2006; 45(9): 375-8.
- Brunner LS, O'Connell Smeltzer SC. Brunner & Suddarth's textbook of medical-surgical nursing. 11th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007.
- Shahriari M, Shahsavari H, Alimohammadi N, Rafieian M. Patients experiences of cardiac rehabilitation effects. Iran J Nurs Midwifery Res 2007; 12(4): 125-9.
- Maftoon F, Sedigi J, Azin SA, Montazeri A. Alternative medicine and health system. Payesh Health Monit 2007; 6(1): 55-62.
- Vahabi YS. The effect of music therapy and relaxation on hospitalized CCU patients' anxiety. Iran J Psychiatry Clin Psychol 2003; 8(3): 75-82.
- 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.
- Gambles M, Crooke M, Wilkinson S. Evaluation of a hospice based reflexology service: A qualitative audit of patient perceptions. Eur J Oncol Nurs 2002; 6(1): 37-44.
- Moyer CA, Rounds J, Hannum JW. A meta-analysis of massage therapy research. Psychol Bull 2004; 130(1): 3-18.
- Mayou RA, Gill D, Thompson DR, Day A, Hicks N, Volmink J, et al. Depression and anxiety as predictors of outcome after myocardial infarction. Psychosom Med 2000; 62(2): 212-9.
- Hazavehei S, Sabzmakan L, Hassanzadeh A, Rabiei K. The effect of PRECEDE Model-based educational program on depression level in patients with coronary artery bypass grafting. J Qazvin Univ Med Sci 2008; 12(2): 32-40. [In Persian].
- Rymazewska J, Kiejna A. Depression and stress after coronary artery bypass grafting. Pol MerkurLekarski 2003; 15(86): 193-5.
- Molavi Vardanjani M, Masoudi Alavi N, Razavi NS, Aghajani M, Azizi-Fini E, Vaghefi SM. A randomized-controlled trial examining the effects of reflexology on anxiety of patients undergoing coronary angiography. Nurs Midwifery Stud 2013; 2(3): 3-9.
- Moeini M, Kahangi LS, Valiani M, Heshmat R. The effect of reflexotherapy on patients' vital signs before coronary artery bypass graft surgery. Iran J Nurs Midwifery Res 2011; 16(1): 8-12.
- 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.
- Park HS, Cho GY. Effects of foot reflexology on essential hypertension patients. Taehan Kanho Hakhoe Chi 2004; 34(5): 739-50.
- Kuhn MA. Complementary Therapies for Health Care Providers. Philadelphia, PA: Lippincott Williams & Wilkins; 1999.
- Fritz S. Mosby's fundamentals of therapeutic massage. 2nd ed. Philadelphia, PA: Mosby; 2000.
- Field T, Hernandez-Reif M, Diego M, Schanberg S, Kuhn C. Cortisol decreases and serotonin and dopamine increase following massage therapy. Int J Neurosci 2005; 115(10): 1397-413.
- Anderson PG, Cutshall SM. Massage therapy: A comfort intervention for cardiac surgery patients. Clin Nurse Spec 2007; 21(3): 161-5.