Value Of Touch In Patient Care

In a world where all we do is stand, run, walk and lift, our feet support us throughout our lifespan. Caring for feet in that respect is important. There is evidence that massage of feet causes reduction in blood pressure as well as other physiological parameters such as heart rate, respiratory rate, and pain. The study about of foot massage is called foot reflexology. It involves applying focused pressure to known reflex points located in the foot to cure or prevent disorders and discomfort.
Elizabeth and Aleen (2009, p.68) found that; foot massage is an important and much neglected aspect of nursing care. The nurse, during her practice in hospitals or even in the community can brighten up her magnificent role in helping the clients to reduce the blood pressure without the use of drugs or any invasive techniques and too at a low cost. Foot massage has physical and psychological benefits for the whole person.

1.2 Background of the study
We have forgotten the value of touch in patient care. It is necessary to use touch along with Hi-end technology as means of autonomous nursing intervention. The theme of World Health Day-2013 was 'Control your Blood Pressure'. High blood pressure is one of the most common problem in the health scenario. The statistics from Australian Health Survey conducted in 2012 shows that nearly one-third (31.6%) of all adult Australians have hypertension. Men were more likely to have hypertension than women. Hypertension was significantly more prevalent at older ages, with almost 9 in 10 (87.7%) people aged 85 years and over having hypertension (ABS, 2013, para. 3). Foot massage helps in reducing hypertension (Hughes and Krirsnakriengkrai, 2011).
Hughes and Krirsnakriengkrai (2011, para. 8) argues that the foot massage is very effective in reducing hypertension and stress. They reported the finds from their research in the journal Alternative therapies in health and medicine. The study was conducted in the Health and Rehabilitation Science Research Institute at the University of Ulster, Northern Ireland, United Kingdom. Twenty-six healthy volunteers were selected for the study. The Participants in the reflexology group received 20 minutes of reflexology, and the control group received 20 minutes of relaxation. The study results shown that there were significant reductions in systolic blood pressure (SBP) (22%) and in diastolic blood pressure (DBP) (26%) during mental stress following reflexology compared to the stress period prior to intervention.
The effectiveness of therapeutic massage on vital signs was investigated by Zahra Z and Hooman S on pre-operative patients undergoing C A B G surgery. The study found that there was a significant difference between the mean pulse rate before and after intervention in two groups. The researchers concluded that the massage can be used as a simple, cheap and applicable technique in all health care centers to help the patients (Zahra, Z., & Hooman, S, 2011, para. 2).

2. Need for the Study

Karima (2011, para.2) conducted a study to investigate the effect of foot reflexology on blood pressure and quality of life among hypertensive patients. This was a quasi-experimental study which was conducted for patients with hypertension who attended the outpatient clinic of the Specialized Medical Hospital at Mansoura University, Egypt. The results revealed that Systolic blood pressure decreased significantly in intervention group from 160 mmHg to 136 mmHg compared to (162 mmHg to 155 mmHg) in controls. This study also validated the argument that foot reflexology can reduce blood pressure levels in patients with hypertension.
Ernst, Posadzki, & Lee (2010, para. 2) argued that foot reflexology is effective in clients with essential hypertension. In their experimental study with pretest-posttest design, measures included blood pressure, serum lipid levels, and life satisfaction. The experimental group (n=eighteen) received foot reflexology twice-weekly for six weeks, followed by self-administered foot reflexology twice-weekly for four weeks. As compared to the control group (n=sixteen), the reflexology group showed decrease in diastolic pressure, triglyceride levels, and improvement in life satisfaction.
Park, & Cho (2011, para. 2) reported about a study to assess the immediate effect of a five minute long foot massage among clients in critical care. A total of 25 clients were selected by purposive sampling technique at center for research in primary and community care, UK. The data collected through observational schedule and intervention on 5 minutes foot massage was performed. Results from this study show that there was a significant decrease in heart rate, blood pressure and respiration during foot massage in the intervention group.
When this researcher worked as a Registered Nurse in the intensive care unit, she got an opportunity to attend an in-service training programme on complementary therapies. She became excited to observe the blood pressure reduction among hypertensive clients who had their foot massaged. To substantiate her observation this investigator began a study to provide a scientific, convincing and evidence base for the practice of foot massage on hypertensive clients.

3. Research question
'A study to evaluate the effectiveness of foot massage in the reduction of blood pressure among hypertensive clients admitted at selected hospitals'.
3.1 Objectives
1. To assess the blood pressure before and after the foot massage among clients with hypertension in experimental group.
2. To compare the mean difference in blood pressure among hypertensive clients between experimental and control group.
3. To test the association between the mean difference in blood pressure and selected demographic variables among clients with hypertension in experimental group.

4. Method of investigation
Ackoff (2009, p.67) states that research design is 'Planning various phases and procedure relating to formulation of research reports'. Research approach is the overall plan to carry out the research. Polit and Hungler, (2010, p. 457). Research approach tells the researcher from whom the data has to be collected, when the data has to be collected and how to analyze them. It also suggests possible conclusion and helps the researcher in answering a specific research question in the most accurate and efficient way possible. The research approach used for this study is evaluative in nature.
4.1 Research Design
The research design is the plan, structure and strategy of investigations of answering the research question. The research design selected for the current study is a systematic review one. It aims to provide an exhaustive summary of current literature relevant to a research question.
4.2 Inclusion criteria:
Refers to hypertensive clients,
' Who are admitted in selected hospitals for a minimum of 5 days of treatment.
' Who are aged between 41 -70 Years.
' Of both sexes.
' Those who were willing to participate in the study.
' Who were present at the time of data collection.
' Those who were able to understand English
4.3 Exclusion criteria:
Refers to hypertensive clients,
' Those are not having feet.
' With uncontrolled hypertension.
' Those are emotionally upset at the time of study.
' With foot ulcer &arthritis.
' Receiving any regular foot massages.

5. Plan for analysis of the findings
For the present study the researcher will collect the data by systematic reviewing of literatures, regarding the effectiveness of foot massage in reduction of blood pressure among hypertensive clients. That will be analyzed by using descriptive statistics.
6.1 Focus for discussion and conclusion
The findings of the study will be discussed based on the study objectives and the results obtained.

6.2 Conclusion
The findings from this study will be disseminated. This will contribute to a number of other research reports on this area in the field of nursing. The researcher believes that the present investigation can throw more light on the topic in question and update the evidence based knowledge in nursing domain which in the long run improves patient care.

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