Abdelaziz, S.H.H., & Mohammed, H.E. (2014). Effect of foot massage on postoperative pain and vital signs in breast cancer patient. Journal of Nursing Education & Practice, 4, 115–124. 

To determine the effectiveness of foot massage on postoperative pain and vital signs for patients with breast cancer in a surgical setting

This study used a quasi-experimental design to investigate the effectiveness of foot massage on postoperative pain and vital signs. The research was conducted in 60 patients following breast surgery. Thirty patients were placed in the control arm, and 30 patients were placed in the experimental arm of the study. The experimental patients received foot massages and analgesics as needed. The control group only received analgesics. All participants filled out a questionnaire to collect demographic data and their non-steroidal anti-inflammatory drug (NSAID) use. Pain levels were assessed using the Visual Analog Scale at a baseline, after 60 minutes, and 120 minutes following the foot massage. Vital signs were taken at the same intervals. The foot massages were done for 20 minutes.

• N = 60  
• AGE = Aged greater than 20 years
• FEMALES: 100%
• KEY DISEASE CHARACTERISTICS: Breast cancer surgery; either simple mastectomy or modified radical mastectomy
• OTHER KEY SAMPLE CHARACTERISTICS: Pain level of four or higher

• SITE: Single site    
• SETTING TYPE: Inpatient    
• LOCATION: National Cancer Institute at the Cairo University Hospital

• PHASE OF CARE: Transition phase after active treatment

Quasi-experimental design with a nonrandom control comparison

• A structured questionnaire was designed by the researchers who collected data about patients' age, level of education, type of surgery, and NSAID use.
• Pain was assessed using the Visual Analog Scale (VAS).
• Vital signs were measured using a deluxe mercurial sphygmomanometer while the patient was lying supine in bed.
• Pulses were measured by counting radial artery beats, and respirations were measured by counting chest movement for a full minute.

There were no statistically significant differences between the two groups regarding age, level of education, use of analgesics, or type of surgery. There was a statistically significant difference on the VAS after one hour in both groups (p ≤ 0.05). There was reduction in pain levels for both groups at one and two hours after analgesic administration and treatment. The mean pain intensity level in both groups decreased at all measurements, but the experimental group's reduction had a higher statistical significance (p ≤ 0.001). Vital signs over time in both groups saw a statistically significant reduction of systolic and diastolic pressure. There was a higher reduction in the experimental group (p ≤ 0.001; f = 53.369 versus f = 32.112; p ≤ 0.001, respectively). There was no significant difference in either group in regard to respirations (p ≤ 0.007).

In this study, foot massages were associated with a greater reduction in pain. The strength of these findings was limited by the study's design.

• Small sample (< 100)
• Risk of bias (no blinding)
• Risk of bias (no random assignment)
• Unintended interventions or applicable interventions not described that would influence results

This study identifies a nursing intervention that may help postoperative pain and decrease blood pressure. The intervention was easy, cost effective, and time efficient. Teaching nurses or other healthcare providers would be easy and would allow for the standardization of care. The treatment would be comforting to most patients with very little risk. Nurses need to be aware of patient conditions that would not allow for foot or leg massage. Additional research needs to be done in other patient populations to make the results more generalized. These results point to new areas of research including the relationship between massage and stress reduction.