Effect of Foot Reflexology on Pain and Fatigue Levels Regarding Insulin Injection among Diabetic Children

Authors

  • Marwa Mohamed Ouda Pediatric Nursing Department, Faculty of Nursing, Damanhur University, 22516 Egypt ; Department of Maternal and Child Health Nursing, College of Nursing, Jouf University, Sakaka 72388, Jouf, Saudi Arabia
  • Hend Al Ghadeer College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdulla International Medical Research Center (KAIMRC), Ministry of National Guard Health Affairs, Riyadh, 11481 Saudi Arabia
  • Manal Fahmy Hussein Pediatric Nursing Department, Faculty of Nursing, Sohag University, Sohag Governorate 1646130, Egypt
  • Reda Elfeshawy Pediatric Nursing Department, Faculty of Nursing, Menoufia University, 6131567 Egypt ; Nursing College, Al-Mustaqbal University, 51001 Hillah, Babil, Iraq
  • Naglaa Fathi Mahmoud School of Nursing Badr University in Cairo (BUC), Cairo Governorate 4942340, Egypt
  • Azza Ismail Ismail Elsayed Pediatric Nursing Department, Faculty of Nursing, Suez Canal University, Ismailia Governorate 8366004, Egypt ; College of Applied Medical Sciences, Al Qurayyat, Jouf University, Sakaka 72388, Jouf, Saudi Arabia

DOI:

https://doi.org/10.31674/mjn.2025.v16i04.027

Abstract

Background: Pain and fatigue are common side effects of insulin injections. Foot reflexology is a complementary therapy gaining popularity and acceptance since it seems to help with pain and weariness. Methods: This research aimed to evaluate the effect of foot reflexology on pain and fatigue levels regarding insulin injection among diabetic children. A quasi-experimental research design (Pre-test Post-test Design) used to conduct this study, and it was carried out at the Paediatric Medical Department at Sohag University Hospital. A convenient sample of 100 diabetic children who were receiving insulin injections will be recruited in this study; the studied children were randomly assigned into two groups, with 50 children in each group (the study and control groups). Three tools were used to collect data: Tool (1): A structured interviewing questionnaire. Tool (II): Numeric Pain Rating Scale (NPRS) and Tool (III): Fatigue Assessment Scale. Results: After receiving an insulin injection, over half of the diabetic children in the study group experienced minor pain, compared to just 8% in the control group, according to the current research. Additionally, the post-foot reflexology of the diabetic children under study showed a highly statistically significant difference in fatigue levels between the study and control groups. Also, the results demonstrated that following the foot reflexology intervention, the diabetic children under study had a very statistically significant (P < 0.001) decrease in their fatigue mean score in both the study and control groups and had very statistically significant variations in their pain scores after the foot reflexology intervention (P = < 0.001). Conclusion: Foot reflexology has an effect on pain and fatigue reduction regarding insulin injection among diabetic children. Foot reflexology could be used as a supplemental therapy and non-pharmacological approach to treat diabetic children's fatigue and pain from insulin injections.

Keywords:

Diabetic Children, Fatigue, Foot Reflexology, Insulin Injection, Pain

Downloads

Download data is not yet available.

References

Abbaszadeh, Y., Allahbakhshian, A., Seyyedrasooli, A., Sarbakhsh, P., Goljarian, S., & Safaei, N. (2018). Effects of foot reflexology on anxiety and physiological parameters in patients undergoing coronary artery bypass graft surgery: A clinical trial. Complementary Therapies in Clinical Practice, 31, 220-228. https://doi.org/10.1016/j.ctcp.2018.02.018

Arafa, S. M., & Alwakeel, M. E. (2020). Effect of caring for children with type I diabetes on parent's life. The Scientific Journal of Al-Azhar Medical Faculty, Girls, 4(1), 66-70. http://dx.doi.org/10.4103/sjamf.sjamf_4_20

Bakir, E., Baglama, S. S., & Gursoy, S. (2018). The effects of reflexology on pain and sleep deprivation in patients with rheumatoid arthritis: a randomized controlled trial. Complementary Therapies in Clinical Practice, 31, 315-319. https://doi.org/10.1016/j.ctcp.2018.02.017

Ballard, A., Khadra, C., Adler, S., Trottier, E. D., & Le May, S. (2019). Efficacy of the buzzy device for pain management during needle-related procedures: a systematic review and meta-analysis. The Clinical Journal of Pain, 35(6), 532-543. https://doi.org/10.1097/ajp.0000000000000690

Chanif, C., Petpichetchian, W., & Chongchareon, W. (2013). Does foot massage relieve acute postoperative pain? A literature review. Nurse Media Journal of Nursing, 3(1), 483-497. https://doi.org/10.14710/nmjn.v3i1.4452

Craig, M. E., Codner, E., Mahmud, F. H., Marcovecchio, M. L., DiMeglio, L. A., Priyambada, L., & Wolfsdorf, J. I. (2022). ISPAD Clinical practice consensus guidelines 2022. Pediatric Diabetes, 23(8), 1157. https://doi.org/10.1111/pedi.13441

de Kleijn, W. P., De Vries, J., Wijnen, P. A., & Drent, M. (2011). Minimal (clinically) important differences for the Fatigue Assessment Scale in sarcoidosis. Respiratory Medicine, 105(9), 1388-1395. https://doi.org/10.1016/j.rmed.2011.05.004

El-Ziny, M. A. E. M., Salem, N. A. B., El-Hawary, A. K., Chalaby, N. M., & Elsharkawy, A. A. E. (2014). Epidemiology of childhood type 1 diabetes mellitus in Nile Delta, northern Egypt-a retrospective study. Journal of Clinical Research in Pediatric Endocrinology, 6(1), 9. https://doi.org/10.4274/jcrpe.1171

Ghaljaei, F., & Jalalodini, A. (2021). The effects of foot reflexology on pain and physiological indicators in children with leukemia under chemotherapy: a clinical trial study. Reports of Practical Oncology and Radiotherapy, 26(6), 955-961. https://doi.org/10.5603/RPOR.a2021.0116

Göthesson, J., Håkansson, L., Olinder, A. L., Hanberger, L., Mörelius, E., Nilsson, S., & Forsner, M. (2023). Children's and adolescent's narratives about pain and negative experiences in diabetes treatment. Journal for Specialists in Pediatric Nursing, 28(1). https://doi.org/10.1111/jspn.12396

Hanberger, L., Tallqvist, E., Richert, A., Olinder, A. L., Forsner, M., Mörelius, E., & Nilsson, S. (2021). Needle-related pain, affective reactions, fear, and emotional coping in children and adolescents with type 1 diabetes: A cross-sectional study. Pain Management Nursing, 22(4), 516-521. https://doi.org/10.1016/j.pmn.2021.01.007

Hull, R. (2023). The Complete Guide to Reflexology. Simon and Schuster. Healing Arts Press, USA.

Jazayeri, Z., Sajadi, M., Dalvand, H., & Zolfaghari, M. (2021). Comparison of the effect of foot reflexology and body massage on physiological indicators and bilirubin levels in neonates under phototherapy. Complementary Therapies in Medicine, 59. https://doi.org/10.1016/j.ctim.2021.102684

Karamisefat, M., Cheraghi, F., Soltanian, A., & Hasan Tehrani, T. (2021). The effect of foot massage on pain of preschoolers undergoing venipuncture: a clinical trial. Evidence Based Care, 10(4), 49-58. https://doi.org/10.22038/ebcj.2021.55893.2462

Keet, L. (2009). The reflexology bible: the definitive guide to pressure point healing (Vol. 15). Sterling Publishing Company, Inc. Retrieved from: https://pdfarchived.net/list/the-reflexology-bible-louise-keet-4900260. Accessed on 29th December 2024.

Kishore M. F., Valli G., Nalini S. J., Renuka K., Radhakrishnan, H., & Arul, J. (2021). Effectiveness of Foot Reflexology on Pain among Hemodialysis Patients. International Journal of Advanced Research, 9(8), 495-499. http://dx.doi.org/10.21474/IJAR01/13296

Koç, T., & Gözen, D. (2015). The effect of foot reflexology on acute pain in infants: a randomized controlled trial. Worldviews on Evidence‐Based Nursing, 12(5), 289-296. https://doi.org/10.1111/wvn.12099

Kotani, N., Hashimoto, H., Sato, Y., Sessler, D. I., Yoshioka, H., Kitayama, M., Yasuda, T., & Matsuki, A. (2001). Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses. Anesthesiology, 95(2), 349–356. https://doi.org/10.1097/00000542-200108000-00015

Kruger, D. F., LaRue, S., & Estepa, P. (2015). Recognition of and steps to mitigate anxiety and fear of pain in injectable diabetes treatment. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 49-56. https://doi.org/10.2147/DMSO.S71923

Mahfouz, E. M., Kamal, N. N., Mohammed, E. S., & Refaei, S. A. (2018). Effects of mothers’ knowledge and coping strategies on the glycemic control of their diabetic children in Egypt. International Journal of Preventive Medicine, 9(1). https://doi.org/10.4103/ijpvm.IJPVM_336_17

Majidi, S., Driscoll, K. A., & Raymond, J. K. (2015). Anxiety in children and adolescents with type 1 diabetes. Current Diabetes Reports, 15(8), 1-6. https://doi.org/10.1007/s11892-015-0619-0

Mao, H., Bao, T., Shen, X., Li, Q., Seluzicki, C., Im, E. O., & Mao, J. J. (2018). Prevalence and risk factors for fatigue among breast cancer survivors on aromatase inhibitors. European Journal of Cancer, 101, 47-54. https://doi.org/10.1016/j.ejca.2018.06.009

McCaffery, M., Beebe, A., (1989): Pain: Clinical Manual for Nursing Practice. St. Louis, MO: Mosby. https://doi.org/10.7748/ns.9.11.55.s69

McLenon, J., & Rogers, M. A. (2019). The fear of needles: A systematic review and meta‐analysis. Journal of Advanced Nursing, 75(1), 30-42. https://doi.org/10.1111/jan.13818

McMurtry, C. M., Riddell, R. P., Taddio, A., Racine, N., Asmundson, G. J., Noel, M., ... & Team, H. A. (2015). Far from “just a poke”: common painful needle procedures and the development of needle fear. The Clinical Journal of Pain, 31, S3-S11. https://doi.org/10.1097/ajp.0000000000000272

Momeni, M., Arab, M., Dehghan, M., & Ahmadinejad, M. (2020). The Effect of Foot Massage on Pain of the Intensive Care Patients: A Parallel Randomized Single‐Blind Controlled Trial. Evidence‐Based Complementary and Alternative Medicine, 2020(1), 1-8. https://doi.org/10.1155/2020/3450853

Myśliwiec, A., Jarosz-Chobot, P., Myśliwiec, M., Strojek, K., Piątkiewicz, P., Walczak, M., ... & Więckowska, B. (2018). Pediatric diabetes care: inpatient care in the Maps of Health Needs of Poland in 2014. Clinical Diabetology, 7(6), 259-271. http://dx.doi.org/10.5603/DK.2018.0028

Omara, H. M., Eman, S. E. F., Mohamed, F. A. E. E., & Ghada, E. (2018). Effect of foot reflexology on stress and anxiety during pregnancy. The Medical Journal of Cairo University, 86(June), 1607-1611. https://doi.org/10.21608/mjcu.2018.56366

Öztürk, R., Sevil, Ü., Sargin, A., & Yücebilgin, M. S. (2018). The effects of reflexology on anxiety and pain in patients after abdominal hysterectomy: A randomised controlled trial. Complementary Therapies in Medicine, 36, 107-112. https://doi.org/10.1016/j.ctim.2017.12.005

Patterson, C. C., Harjutsalo, V., Rosenbauer, J., Neu, A., Cinek, O., Skrivarhaug, T., ... & Green, A. (2019). Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25 year period 1989–2013: A multicentre prospective registration study. Diabetologia, 62, 408-417. https://doi.org/10.1007/s00125-018-4763-3

Ramadan E. M. N., Youssef El-Sheikh, O., Farouk Mohamed, M., & Mohamed Ahmed Ayed, M. (2023). Effect of foot reflexology massage on pain and anxiety levels regarding insulin injection among diabetic children. Egyptian Journal of Health Care, 14(1), 1297-1312. https://doi.org/10.21608/ejhc.2023.300280

Rambod, M., Pasyar, N., & Shamsadini, M. (2019). The effect of foot reflexology on fatigue, pain, and sleep quality in lymphoma patients: a clinical trial. European Journal of Oncology Nursing, 43. https://doi.org/10.1016/j.ejon.2019.101678

Rankin, D., Harden, J., Barnard, K., Bath, L., Noyes, K., Stephen, J., & Lawton, J. (2018). Barriers and facilitators to taking on diabetes self-management tasks in pre-adolescent children with type 1 diabetes: a qualitative study. BMC Endocrine Disorders, 18, 1-9. https://doi.org/10.1186/s12902-018-0302-y

Sayari, S., Nobahar, M., & Ghorbani, R. (2021). Effect of foot reflexology on chest pain and anxiety in patients with acute myocardial infarction: A double blind randomized clinical trial. Complementary Therapies in Clinical Practice, 42. https://doi.org/10.1016/j.ctcp.2020.101296

Taheri, H., Naseri-Salahshour, V., Abedi, A., & Sajadi, M. (2019). Comparing the effect of foot and hand reflexology on pain severity after appendectomy: A randomized clinical trial. Iranian Journal of Nursing and Midwifery Research, 24(6), 451-456. https://doi.org/10.4103/ijnmr.IJNMR_85_18

van Dijk, J. F., Vervoort, S. C., van Wijck, A. J., Kalkman, C. J., & Schuurmans, M. J. (2016). Postoperative patients’ perspectives on rating pain: A qualitative study. International Journal of Nursing Studies, 53, 260-269. https://doi.org/10.1016/j.ijnurstu.2015.08.007

Published

30-04-2025

How to Cite

Ouda, M. M. ., Ghadeer, H. A. ., Hussein, M. F. ., Elfeshawy, R. ., Mahmoud, N. F. ., & Elsayed, A. I. I. (2025). Effect of Foot Reflexology on Pain and Fatigue Levels Regarding Insulin Injection among Diabetic Children. The Malaysian Journal of Nursing (MJN), 16(4), 274-285. https://doi.org/10.31674/mjn.2025.v16i04.027

Metrics