Efficacy of Precise Foot Massage Therapy on Pain & Anxiety Following Cardiac Surgery: Pilot Study

Abstract

Pain is the most pervasive distressing symptom following cardiac surgery. Forty percent of postoperative cardiac patients report inadequate pain management. Undertreated acute pain results in increased anxiety, delayed wound healing, and increased chance of persistent chronic pain. Foot massage is a safe, visible complementary approach to manage acute pain following surgery. Guided by the theory of holistic comfort, this study evaluates the efficacy of integrating foot massage therapy for acute pain management in post-cardiac patients compared to attention control. Method: A randomized control trial was performed at a large hospital in Saudi Arabia. Active treatment was a nurse-delivered 10 minute foot massage, twice during one day (8AM and 8 PM) within 30 minutes after receiving an opioid pain medication. The control consisted of using aromatherapy and holding the patient’s foot. Primary outcomes were intensity of pain and anxiety measured via a visual analog scale. Result: Thirty-one [age M (SD) 55 (14), 74% male] post-cardiac surgery patients (16 in experimental and 15 in attention control group) were compared on baseline characteristics. No significant group differences were found. The findings of this study indicate that foot massage results in significantly (p <0 .05) lower pain intensity as compared to the attention control. Large between group effect size (?2 morning=.935, ?2 evening=.129) were observed on pain intensity. With large within group effect size comparing pre- and post-test pain scores (?2 morning=.511, ?2 evening=.623). Also large between group effect size were observed for morning anxiety scores (?2 morning=.209) with large within groups effect size as well (?2 morning=.731). Conclusion: The study findings determined that foot massage in conjunction with pharmacological intervention had a significant effect on lowering pain and anxiety. Future studies should consider focusing on frequency, dose, feasibility, acceptability, and patients’ satisfaction. In addition to comparing the effect of massage at different times/hours of the day, determining if there is any difference if patients receive massage in the morning, the afternoon, or the evening should be considered.