Physiological and psychological evaluation of the wrapped warm footbath as a complementary nursing therapy to induce relaxation in hospitalized patients with incurable cancer: a pilot study.
BACKGROUND
The wrapped warm footbath (WW-footbath) was originally designed as a means to promote relaxation, positive emotion, comfort, pleasure, and enjoyment in hospitalized patients with incurable stomach cancer during palliative care.


OBJECTIVE
This study examined the physiological and psychological effects of the WW-footbath as complementary nursing intervention to induce relaxation in hospitalized patients with incurable cancer.


METHODS
Eighteen subjects were divided into a footbath group (n=9) and a control group (n=9). Heart rate variability analysis (per second) with wavelet transformation was used for evaluation of autonomic, sympathetic, and parasympathetic activities. Salivary secretory immunoglobulin A and salivary cortisol levels were used as neuroimmunological parameters. Pain and psychological conditions were measured using a visual analog scale and Face Scale (FS).


RESULTS
The high-frequency component of heart rate variability was not significantly increased in either group. However, the low-frequency component versus high-frequency ratio was significantly decreased in the footbath group at periods after footbath (P=.017, P=.000, P=.000, P=.003). In the footbath group, the salivary secretory immunoglobulin A level was significantly increased (P=.019), and the cortisol level tended to be reduced. Changes in visual analog scale and FS scores showed that the footbath group experienced significant pain relief and relaxation (pain, P=.047; relaxation, P=.042; comfortability, P=.008; FS, P=.013).


CONCLUSIONS
The WW-footbath significantly decreased sympathetic activity in hospitalized patients with incurable cancer and may have secondary benefit for pain relief.


CONCLUSIONS
The WW-footbath can promote relaxation in hospitalized patients with incurable cancer. Moreover, the WW-footbath appears to afford pain relief associated with enhanced overall comfort.
International University of Health and Welfare, 1-2-25, Shiroyama, Odawara-city, Kanagawa 250-8588, Japan. yamamoto-k@iuhw.ac.jp
Keiko
K
Yamamoto
Shinya
S
Nagata
D000223:Adaptation, Psychological; D000368:Aged; D001494:Baths; D005260:Female; D006339:Heart Rate; D006760:Hospitalization; D006801:Humans; D006854:Hydrocortisone / Q000737:chemistry; D007070:Immunoglobulin A / Q000097:blood; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing* / Q000523:psychology; D010147:Pain Measurement; D010166:Palliative Care / Q000379:methods*; D010865:Pilot Projects; D012063:Relaxation; D012463:Saliva / Q000737:chemistry; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000379:methods*
D007070:Immunoglobulin A; D006854:Hydrocortisone