RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

A STUDY TO ASSESS THE EFFECTIVENESS OF REFLEXOLOGY ON PAIN

AMONG OSTEOARTHRITIS PATIENTS IN SELECTED HOSPITALS, AT
BANGALORE.

SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

SRI SHARADA COLLEGE OF NURSING,

MS. P. GANGA DEVI

I YEAR M.SC NURSING
MEDICAL SURGICAL NURSING

UTTARAHALLI, BANGALORE -61.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.
SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION.

1. Name of the Candidate and

Ms. P. Ganga Devi

Address

I Year M.Sc Nursing

Medical Surgical Nursing
Sri Sharada College Of Nursing,
Uttarahalli, Bangalore-61.

2.Name of the Institution

Sri Sharada College Of Nursing,

Uttarahalli, Bangalore-61.
Master Of Science In Nursing

3. Course of the study and subject

Medical Surgical Nursing

4.Date of Admission to the Course

01/10/2011

A Study to Assess the Effectiveness

5. Title of the Topic

of Reflexology on Pain among

Osteoarthritis Patients in Selected
Hospitals, at Bangalore.

6. BRIEF RESUME OF THE INTENDED WORK

2

INTRODUCTION
Vision without action is merely a dream. Action without vision just
passes the time. Vision with action can change the world.
- Joel A. Barker.

Margo Mc Caffery, a nurse and pioneer in pain management, defined pain

as, whatever the person experiencing the pain says it as, existing whenever the
person says it does.1
Osteoarthritis is the most common form of arthritis. Osteoarthritis mostly
affects cartilage, the hard but slippery tissue that covers the ends of bones
where they meet to form a joint. Healthy cartilage allows bones to glide over
one another. It also absorbs energy from the shock of physical movement. In
osteoarthritis, the surface layer of cartilage breaks and wears away. This allows
bones under the cartilage to rub together, causing pain, swelling, and loss of
motion of the joint. Over time, the joint may lose its normal shape. Also, small
deposits of bonecalled osteophytes or bone spursmay grow on the edges of
the joint. Bits of bone or cartilage can break off and float inside the joint space.
This causes more pain and damage. People with osteoarthritis usually have joint
pain and stiffness.2
Osteoarthritis mostly often affects middle-aged and older people, involving
the neck, lower back, knees, hips and fingers. 3It is the major cause of morbidity
and disability in the elderly.4Epidemiological radiographic assessment studies
shows that 80% of male and female population will be affected. 5 Women are
generally affected at a younger age than men.6
Patients with Osteoarthritis experience pain and loss of function especially
in early morning almost for 30 minutes. The basic activities of everyday life,
such as walking, running, housework, and the ability to exercise are impacted
greatly for many Osteoarthritis sufferers. 72% respondents report being limited
in doing everyday or routine things.6

Treating Osteoarthritis patients with advanced Medical and surgical therapy

will ends pain and restore the functional mobility. Less often but still worth are
non-conventional therapies. One of these is reflexology.

Reflexology is an alternative treatment for osteoarthritis. Once you learn

what it is and how it works, you may wonder how reflexology could help
osteoarthritis.
Reflexology

is

an

alternative,

non-conventional

treatment

given

by

reflexologist. According to the Reflexology Association of America, "It can be

used with any medical or alternative therapy, or it can stand alone as an
effective health maintenance technique. It is the systematic, manual stimulation
of the reflex maps located on the feet, hands and outer ears that resemble the
shape of a human body. Pressure is applied using thumbs and fingers in small
movements to stimulate an area far removed from the reflex point. It is believed
to work through the nervous and subtle energy systems of the body."
Reflexology was initially practiced by Indians, Chinese, and Egyptians in ancient
times. William Fitzgerald, M.D., introduced reflexology to the west in 1913.
Based on his knowledge that applying pressure to specific parts of the body
could affect other related areas, he divided the body into 10 equal, vertical
zones. Dr. Fitzgerald theorized that applying pressure on part of a zone could
affect everything within the same zone.
Reflexology is based on the theory that the body is capable of healing itself. With
a chronic illness like osteoarthritis, the body is in a state of "imbalance." Not
only that, vital energy pathways are blocked, causing the body to function less
effectively. Reflexology is believed to work with the bodys systems to improve
function.7
According to Wang et al., (2008),by pressing the reflex zones, energy blocks
disturbances such as calcium, lactate or uric acid crystals are reabsorbed and
later eliminated a process referred to as detoxification. It has also been
suggested that reflexology may help relieve stress and tension, improve blood
flow, and promote homeostasis.8

Through Foot Reflexology, by stimulating the reflex points 7000 nerves and
26 bones in the feet release blockages and re balance the energy flow in the
body. This brings the body back into natural equilibrium, which promotes the
bodys natural healing power. This is because the body contains an energy field,
as invisible life forces.9
6.1. NEED FOR THE STUDY
Global statistics reveals over 100 million people worldwide suffers from
osteoarthritis. As per World health Organization Osteoarthritis is the fourth
leading cause of death. Up to 40% people over 70 years of age suffers by
Osteoarthritis of the knee. Almost 80% of patients with osteoarthritis have some
degree of limitation of movement and 25% cannot perform their major daily
activities of life.

10

Reflexology is a natural, holistic therapy based on the discovery that there are
points on the feet and hands which correspond to organs and systems of the
body.

11

In 2007 October survey shows across 15 major cities in India found that,
there is high incidence of osteoarthritis and 75% of OA sufferers are not
satisfied with their current treatment.12

According to 'TNS Arogya (2006-07), the Health Monitor survey, conducted

by an ISO-accredited market research agency said that, osteoarthritis is the
second most prevalent disease after diabetes in age group of 25-35 years. 6
Centers for Disease Control and Prevention (2002) say that, 1 of every 3
people is affected by painful arthritis and long term use of Osteoarthritis
medication caused side effects. These effects may be minimized by adjuvant non
pharmacological modalities, such as reflexology, a complementary therapy.13
The effects of reflexology treatment are different for everyone and depend
on the type of Osteoarthritis condition. The reflexologist does not use any kind
of medication, so less side effects.14
By receiving regular reflexology treatments, the patient may have a
greater range of motion in the knee, have less pain in the area and be able to
move around easier.15
The use of reflexology by nurse is easy and practical, it enhance the nurse
patient inter relationship. It can be performed at any location and does not
interfere with patients privacy. The causal use of reflexology by nurses has now
been explored through research, creating an evidence base for its uses. Touch
has always been a part of the nursing mandate; Reflexology offers a strategy to
fulfill the goals for human touch and holistic nursing care. 16
Reflexology is a noninvasive, non pharmacological therapy; it can be
applied as hand reflexology or foot reflexology or self foot reflexology. so nurses
are in a position to do research on that to make decisions about its clinical
effectiveness.17
In reflexology nobody knows sure how the connection is made between the
feet and the body, only by experimenting on an individual, one will be coming to
know about the effects of reflexing from their reactions. 18
Based on the evidence of the theories and effectiveness of reflexology and
a personal interest in the subject matter, the investigator wishes to evaluate the
effectiveness of reflexology on pain among Osteoarthritis patients.

6.2 REVIEW OF LITERATURE

The review of literature has been organized under the following headings:
a) Literature related to Reflexology.
b) Literature related to effects of reflexology on pain.
c) Literature related to effects of reflexology on pain among Osteoarthritis
patients.
a) Literature related to Reflexology:
American Holistic Nurse Association says that, More than two thirds of
Americans with chronic pain are now using complementary and alternative
therapies, In that reflexology has a long history and has been found useful on a
case-by-case basis.19
Reflexology also used to be known as 'zone therapy'. Therapeutic massage
of the feet may have roots in Ancient Egypt and China around 4000 BC. The
concept of zone therapy appears to date back to 1500 AD but a number of books
were published about zone therapy in the 16th century. However, it did not gain
much popularity until around the turn of the 20th century. Reflexology as we
know it today is attributed to the work of Eunice Ingham, an American Therapist
who developed its practice in the 1930s and 40s. 17
The Reflexology Association of Canada defines it as "A natural healing art,
based on the principle that there are reflexes in the feet and hands which
correspond to every part of the body." By stimulating and applying pressure to
the feet or hands, you are increasing circulation and promoting specific bodily
and muscular functions.17
Devaki Berkson says, The feet are one of the most effective body areas
on which to practice reflexology because they are strong energy poles of the
body - they link with the energy which emanates from the earth, specially the
grass, sand and snow.20
Reflexology is the science of stimulating specific points on the surface of
the body which have a link with the internal organs of the body. However, unlike
7

acupuncture or acupressure, no needles or special instruments are required. You

can treat yourself, anywhere at any time.18
Reflexology helps restore and maintain the bodies natural equilibrium and
encourages the body to work naturally to restore its own healthy balance.
Reflexology has been shown to be effective for Back Pain, Migraine headaches,
Infertility, Arthritis, Sleep disorders, Hormonal imbalances, Sports injuries,
Digestive disorders, Stress-related conditions. Reflexology in Arthritis stimulates
the circulation, thus aids in joint mobility.21
Though the body looks symmetrical and normal from outside, inside the
body things are very different. Safe and amazingly effective reflexology helps to
preserve health, alleviate pain and control and cure diseases. It cans longer
fuller life without drugs. It explains the gift of natural touch and its vast
potential for cure.18
The 1996 China Reflexology Symposium Report has found foot reflexology
to be 93.63% effective in treating 63 disorders. After an analysis of 8,096
clinical cases, Dr. Wang Liang reported that reflexology was significantly
effective (the cure) in 48.68% of all the cases, and an effective/improved
treatment in 44.95% of the cases
Another study, in Britain, conducted in fifteen women who were received
half-hour reflexology sessions for eight weeks. The findings included noticeable
physical and emotional improvements, increased self-esteem and confidence, an
ability to stay motivated and be heard and taken seriously, and an improvement
in concentration.17
18 Reflexology studies in Korea (2000-2007) by Barbara and Kevin Kunz,
showed that the application of reflexology work creates significant changes in
health of individuals in all ages. Positive results were obtained following
reflexology

work

dysmenorrhoea;

for:

college

constipation/

students

anxiety/

(premenstrual

depression);

syndrome

postpartum

women;

working women (fatigue and sleep); menopausal women; middle-aged women

(incontinence, osteoarthritis) and the elderly (hypertension, sleep.) Significant
results were reached for patients undergoing treatments for: cancer and
chemotherapy, diabetes, hypertension, pneumoconiosis, and stroke. 16
8

The therapy brings relief to a wide range of acute and chronic conditions,
and is suitable for all ages. Once your body is in-tune, it is wise to have regular
treatments in order to help maintain health and well-being. An increasing
number of people are using this safe, natural therapy as a way of relaxing,
balancing and harmonizing the body.3
b) Literature related to effects of reflexology on pain.
Researchers tested the effect of foot reflexology on pain relief in 36
hospitalized adult cancer patients with chronic pain level of 2 or more on a 0 to
10 scale. The patient sample was 56% female and Most of the patients dont
have prior knowledge about reflexology in relieving pain. A certified foot
reflexologist delivered 30 minutes foot reflexology. Immediately after the
treatment, the pain scores were dropped by an average of 2.4 points. However,
no differences in the pain scores were found at 3 or 24 hours . 22
A Quasi-experimental study by using pre/post test crossover design
conducted to test the effects of foot reflexology on anxiety and pain in 23 breast
and lung cancer patients at a medical/oncology unit in the southeastern United
States hospital. The majority of the sample were female, Caucasian, and 65
years or older and were receiving regularly scheduled opioids and adjuvant
medications on the control and intervention day. Foot reflexology done by a
certified reflexologist for 30 minutes duration with a control condition for each
patient (with at least a two-day break). No changes were made in patients'
regular schedule or medications. After the foot reflexology intervention, patients
experienced a significant decrease in anxiety and pain.23
A quasi-experimental study was conducted to investigate the effect of foot
reflexology on sternotomy pain among 90 coronary artery bypass graft surgery
undergone patients. The samples randomly divided into three groups of case,
control and placebo. The reflexology group received a 10-minute right foot
massage, twice a day with 6-hours interval for 2 days. The placebo group
received a 10-minute left foot massage and the control group received no
intervention. The pain was measured by using visual analogue scale. Results
shown that average of pain intensity in the case group before and after the
intervention were 6.4(2.1) and 3.4(5.1) respectively. The mean of pain
9

intensity in control group before and after intervention was respectively

5.1(1.7) and 5(1.9). So Foot reflexology appears to be a useful method for
reducing sternotomy pain in patients after coronary artery bypass graft
surgery.24
Niels Baekgaard and Vibe Hansen, conducted a study at Glostrop hospital
to identify the effectiveness of reflexology on acute pain among 30 patients with
kidney stones, they were divided in to 3 groups, Participants in the study were
divided equally into three groups as reflexology group, placebo treatment and
control group. If no pain relief was experienced within 5 minutes, the treatment
would end for analgesic medications, but those who experienced a benefit within
5 minutes, treatment was continued for a further 10 minutes. The results
showed that 9 out of the 10 patients in the reflexology group experienced
complete pain relief after the treatment over an hour and 5 of the patients pain
was relieved for 4 hours. The researcher concluded that, "Reflexology treatment
of acute ureterolithiasis has a pain relieving effect" and when compared to
Baralgin (a commonly administered analgesic), the findings revealed that
reflexology actually works faster at alleviating pain although the effects last for a
shorter duration.25
A systematic review and meta-analysis were conducted to evaluate the
effectiveness of foot reflexology on fatigue, sleep and pain. Electronic database
and manual searches were conducted on all published studies reporting the
effects of foot reflexology on fatigue, sleep, and pain. Forty four studies were
eligible including 15 studies associated with fatigue, 18 with sleep, and 11 with
pain. The effects of foot reflexology were analyzed by using Comprehensive
Meta-Analysis Version 2.0. The homogeneity and the fail-safe N were calculated.
Result shown that the effects on fatigue, sleep, and pain were not homogeneous
and ranged from 0.63 to 5.29, 0.01 to 3.22, and 0.43 to 2.67, respectively. The
weighted averages for fatigue, sleep, and pain were 1.43, 1.19, and 1.35,
respectively. No publication bias was detected by fail-safe N and funnel plot.
Foot reflexology had a larger effect on fatigue and sleep and a smaller effect on
pain.26
A quasi experimental research design was used with 2 month follow-up to
measure the effect of reflexology on pain and quality of life in 39 female adult
10

rheumatoid arthritis patients without deformity of bone or destruction of joints

at Rheumatoid arthritis out patient clinic at Zagazig University Hospitals. The
patients with other chronic illness conditions such as diabetes, ischemic heart
disease, chronic obstructive pulmonary disease, and stroke were excluded.
Perceived pain and quality of life were assessed by using Bio-socio-demographic
and

disease

characteristics,

the

Rheumatoid

Arthritis

Quality

of

Life

questionnaire, Numerical pain assessment Rating Scale questionnaire and Health

assessment questionnaire. 8-week course of reflexology treatments were given.
The study results revealed hands and foot reflexology improved

patients'

quality of life, pain and health status in the post-intervention and follow-up
phase. These positive impacts are not affected by patients age and duration of
illness.

Therefore, reflexology must

be

considered

as

a complementary

treatment modality in rheumatoid arthritis. It should be introduced to nursing

and medical students, and in postgraduate staff development programs. 27
The randomized clinical trial study conducted in 220 samples as 118 in
control group and 102 in conventional medicine study group for 2 to 3 months
duration and then follow up period started to estimate the efficacy of reflexology
in managing pain under 4 diseased conditions as mastalgia, osteoarthritis,
neuropathy with type-II diabetic mellitus and lower limb pain involving
intractable epilepsy. The efficiency of reflexology was determined by the
improvement of pain score, quality of life and the other associated symptoms.
The data collected prior to the therapy, intermittent and at the end of follow up
period. The data were analyzed and statistically and compared. The study result
shown that at least two fold improvements in the pain management, quality of
life and other symptoms. The results conclude that reflexology in addition to or
alone may offer a holistic therapy in pain management with least cost and
insignificant side effects.28
c) Literature related to effects of reflexology on pain among Osteoarthritis
patients:
An experimental pre testpost test controlled clinical trial study was
conducted

to

determine

the

effect

of

foot

reflexology on

self-reported

osteoarthritis joint pain. A convenience 119 sample were randomly assigned to

three groups

(41 in treatment-foot reflexology, 39 in placebo- foot massage,

11

and 39 in control-arthritis information).Pain was measured before and after the

15-minute intervention by using Short Form McGill Pain Questionnaire. The
effect may be explained by the gate control theory. A power analysis & multiple
regression were used to analyze the hypothesis. The study result shown that
reflexology group had 8 to 18% improvement (less pain on all pain scales),
compared with those in the massage group.12
An experimental study conducted to examine the effects of foot reflexology
on pain and depression among 41 middle- aged women with Osteoarthritis in
the Jinju city from March to May, 2005. The foot reflexology was applied to the
experimental group 3 times a week for 4 weeks, 30 minutes each. For the data
analysis, chi-square-test, t-test, paired t-test and repeated measures ANOVA
were used. The study result shown that after foot reflexology, the experimental
group

shown

significant

improvement

in

pain

(F=155.77,

p=.000)

and

depression (F=20.00, p=.000). The results suggest that the foot reflexology is
effective in relieving of pain and depression. Therefore, it is necessary to
develop foot reflexology as an independent nursing intervention. 29
In a randomized controlled trial adults with Osteoarthritis of the knee were
assigned either to treatment (twice-weekly sessions of Swedish massage for 1-4
weeks and once-weekly sessions for 5-8 weeks or to control (delayed
intervention) The study result shown that the group receiving massage therapy
improved pain, stiffness, physical function domains, range of motion and time to
walk 50 feet.30
Twenty-two adults with wrist/hand arthritis were randomly assigned to a
massage therapy or a control group. The massage therapy group was massaged
on the affected wrist/hand once a week for 4-weeks period and were also taught
self-massage on the wrist/hand to do daily at home. The study result shown that
the massage therapy group versus the control group had lower anxiety and
depressed mood scores after the first and last sessions, reported less pain and
greater grip strength after their sessions. The massage therapy group showed
greater improvement than the control group on all of these measures across the
study period.31

12

A quasi Experimental with simple cross over design used to study the
effect of reflexology on joint pain in knee osteoarthritis patients .30 samples
were selected by using purposive sampling technique during July 2002 to
February 2003 at the orthopedic clinic and outpatient department of Phrae
hospital.

During experimental period patients received reflexology for 1 hour

per day for 7 days and in the control period patients did not received reflexology
for 7 days. The instruments used for data collection were demographic data,
information about knee osteoarthritis, daily record of joint pain, medication used
and daily activities. The data analyzed by using frequency, mean, standard
deviation and ANOVA. The results of the study shown that the joint pain score in
the experimental period after receiving reflexology was statistically lower than
during the control period (P<.001). So the study revealed that reflexology can
be used as a complementary therapy to relieve joint pain and decrease the use
of pain relieving drugs.32
STATEMENT OF THE PROBLEM:
A Study to Assess the Effectiveness of Reflexology on Pain among
Osteoarthritis Patients in Selected Hospitals, at Bangalore.

6.3. OBJECTIVES OF THE STUDY:

To assess the level of pain among osteoarthritis patients in both

Experimental and Control group before and after the intervention.

To determine the effectiveness of reflexology on pain among osteoarthritis

patients, compare the level of pain between the experimental and control group
before and after the intervention.

To find out the association of the level of pain with selected baseline
variables in both Experimental and Control group.

OPERATIONAL DEFINITIONS:
Assess:
It refers to the statistical measurement of level of pain among
osteoarthritis patient as observed from the scores based on rating scale.
13

Effectiveness:
It denotes the ability of reflexology, as a Non-pharmacological intervention,
to bring a change in the level of pain among osteoarthritis patients and it can be
measured by using a numerical pain intensity scale rated by the patient.
Reflexology:
It refers to the application of pressure to the upper, middle and lower arch
of the feet of osteoarthritis patient for duration of 30 minutes duration 15
minutes in each foot based on a system of zones and reflex areas as per
Reflexology foot chart &which will be administered by the investigator who has
undergone a basic training in reflexology.
Pain:
Pain refers to the unpleasant experience perceived by the osteoarthritis
patients, which is measured by the scores rated by them in a numerical pain
intensity scale.
Osteoarthritis patient:
It refers to the patient suffers by osteoarthritis joint pain booked &
attending OPD or admitted in in-patient units at selected hospital, Bangalore.

RESEARCH HYPOTHESIS:
H1: There will be a significant difference in the level of pain between the
Experimental and control group before and after the reflexology.
H2: There will be a significant association between the level of pain of
Osteoarthritis patients and their Demographic variables and selected base
line variables.
ASSUMPTIONS:
1. Pain is a subjective feeling, every individuals expression of pain may varies
based on their different Pain tolerance level.
2. Osteoarthritis patients experience joint pain.
3. Reflexology may have some effects on pain.

14

RESEARCH VARIBALES:
Independent variable: Reflexology.
Dependent varible: level of pain in Osteoarthritis patients.
Extraneous variable: Demographic variables and selected base line variables
such as age, sex, education, occupation, duration of osteoarthritis, pain relieving
drugs etc.

DELIMITATIONS:
The study will be limited to Osteoarthritis patients:
1. Age group between 35-55 yrs.
2. Those who willing to participate in this study.
3. Patients attending regularly to the OPD in selected hospitals, at Bangalore.
7. MATERIALS AND METHODS:
7.1. Source of Data:
Data will be collected from Osteoarthritis patients; those are
attending regularly to the OPD in selected hospitals, at Bangalore.
7.2. METHOD OF DATA COLLECTION.
Research Approach: Quantitative Approach.
Research Design: Quasi Experimental Non Randomized Control group Design.
Setting: The Study will be conducted in OPD of selected Hospitals, in Bangalore.
Population: The Population will be osteoarthritis patients in the OPD.
Sample: The osteoarthritis patients attending regularly to the OPD of selected
Hospitals, in Bangalore will be the samples for the study.
Sampling Technique: Non-Probability, Purposive Sampling technique.

15

Sample Size: The sample size will be 60(30 in Experimental and 30 in Control
group) osteoarthritis patients regularly attending OPD of selected hospitals, in
Bangalore.
Sampling Criteria:
Inclusion criteria:
Osteoarthritis patients,
1. Age group between 35-55 yrs.
2. Those who are willing to participate in study.
3. Able to speak or to understand Kannada or English or Tamil.
4. Who can able to do Reflexology by themselves.
Exclusion criteria:
Osteoarthritis Patients who are
1.
2.
3.
4.
5.

Unconscious or Critically ill.

Having edema, gangrene, foot ulcers, and unhealed wounds in foot.
Pregnant or Arthritis in Ankle joint.
Suffer by Unstable Blood Pressure.
Having Deep vein thrombosis.

DATA COLLECTION TOOL:

Section I: Demographic & selected Baseline Variables.
Section II: Visual Analogue Scale (VAS) will be used to assess the level of pain
among Osteoarthritis patients.
Data collection Procedure:
Prior to the data collection period, the investigator will obtain written
permission from concerned authorities of the selected hospitals, at Bangalore.
Then the subjects will be identified according to the inclusion & exclusion criteria
by purposive sampling technique and assigned in to either experimental and
control group by flipping a coin. After initial rapport established, the purpose of
the study will be explained to the study participants& informed consent will be
obtained.
The Demographic& selected baseline variables data & pre test pain
level will be assessed before intervention in both experimental and Control
group by using data collection tool. Then the intervention (that is the
16

Reflexology) will be administered by the investigator for 5 days only to the

experimental group. The intervention will be given minimum 3 hours after the
administration of analgesics, by the investigator 30 minutes duration 15 minutes
for each foot. The post test pain level will be assessed after 5 days of
intervention in both Experimental and Control group by the investigator herself.
At the end of the Foot Reflexology Procedure the investigator will distribute
Pamphlets

regarding

foot

reflexology

to

all

the

study

participants

in

experimental group for further follow up.

DATA ANALYSIS METHODS:
The investigator Planned to do data analysis by using both the
Descriptive and Inferential Statistics.
Descriptive statistics:
Mean, Mean Percentage, standard deviation will be used to explain
about the Demographic, selected baseline variables& the pain level.
Inferential statistics:
Chi-Square test, t test will be used to find out the association or
relationship between the demographic, selected baseline variables and pre test
post test pain level. The findings will be presented in the form of graphs, figures
and tables.

7.3.

DOES

THE

STUDY

REQUIRE

ANY

INVESTIGATION

OR

INTERVENTION TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS

OR ANIMALS? IF SO, PLEASE DESCRIBE BRIEFLY.
Yes. The study requires the use of reflexology as an intervention among
osteoarthritis patients in selected hospitals, Bangalore.

7.4.

HAS

ETHICAL

CLEARANCE

INSTITUTION IN CASE OF 7.3? Yes.

17

BEEN

OBTAINED

FROM

YOUR

1. Ethical clearance will be obtained from the institutional ethical Research

committee of Sri Sharada college of Nursing, Bangalore.
2. prior to the study permission will be obtained from the concerned Authority of
the selected hospital, Bangalore.
3. And also informed consent will be obtained from concerned Osteoarthritis
patients, who participate in the study. Privacy, confidentiality and anonymity will
be guarded. Scientific objectivity of the study will be maintained with honesty
and impartiality.
ETHICAL COMMITTEE:

Title of the topic

A Study to Assess the Effectiveness of

Reflexology on Pain among Osteoarthritis
Patients in Selected Hospitals, at Bangalore.

Name of the candidate

Ms. P. Ganga Devi.

Course and the subject

Master of Science in Nursing,

Medical Surgical Nursing.

Name of the guide

Mrs. K. Padmavathi M. Sc(N)

Head of the Department
Department of Medical Surgical Nursing
Sri Sharada College of Nursing, Uttarahalli,
Bangalore.

Ethical committee

Approved

MEMBERS OF THE ETHICAL COMMITTEE:

1. Prof. B. Maheshwari Bai M. Sc(N)
Principal& Head of the Department
Department of Mental Health Nursing
18

Sri Sharada College of Nursing, Bangalore 61.

2. Mrs. K. Padmavathi M. Sc(N)
Vice Principal &Head of the Department
Department of Medical Surgical Nursing
Sri Sharada College of Nursing, Bangalore 61.
3. Mrs. B. Ramasundari M. Sc(N)
Head of the Department
Department of Child Health Nursing
Sri Sharada College of Nursing, Bangalore 61.
4. Dr. Ganga Boriah
Statistician
Department of community medicine
Kempe Gowda Institute of Medical Science, Bangalore.
5. Dr.K.C. Tharun M.S
Chairman, Vishwabharathi hospital Pvt Ltd,
Sri Sharada Nursing College, Bangalore-61.
8. LIST OF REFERENCES:
1.

Lewis,

Heitkemper,

Dirksen,Medical

surgical

nursing

assessment

and

management of clinical problems, sixth edition, Mosby publications, 2004:132.

2. Hand out on Health: osteoarthritis. www.niams.nih.gov.com.
3. Reflexology for Osteoarthritis. www.arthritis-treatment-and-relief.com.
4.

Samuel L, Tureks. Orthopaedics, Principles and their application, J.B Lippincott

Company, 4th Edition, Vol.1:484.

5. Felson D. Osteoarthritis. Rheum Dis Clin North America 1990; 16: 499 512.
6.

Osteoarthritis is India's No. 1 ailment

THE TIMES OF INDIA TNN Sep 6, 2007,

12.00am IST.
7. Reflexology for osteoarthritis. www.osteoarthritis.about.com
8. Jakobsson life science journal.2011; 8(2) and Hall berg 2002.Available at
www.lifesciencesite.com.

19

9. Reflexology. Available at www.ask.com

10.

WHO 50 facts and global burden of disease. Available at www.who.int.com

11.

Reflexology foot chart. Available at www.google.com

12.

Meenakshi Sinha ,'30-plus more prone to osteoarthritis now', TNN Sep 22,
2009, 04.03 am IST Tags: osteoarthritis.

13. Gov US national Library of Medicine, National Institutes of Health, Journal of

Korean Academy of Nursing 2011 Dec; 41(6):821-33.
14.

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15.

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9.

SIGNATURE OF THE
CANDIDATE

10.

REMARKS OF THE
GUIDE

11.1

NAME AND

Mrs. K. Padmavathi M. Sc(N)

DESIGNATION OF
GUIDE.

Vice Principal& HOD

Department of Medical Surgical Nursing
Sri Sharada College of Nursing, Uttarahalli,
Bangalore

11.2

SIGNATURE OF THE
GUIDE.

11.3

CO GUIDE (IF ANY)

11.4

SIGNATURE OF THE CO-

11.5

GUIDE
HEAD OF THE

Mrs. K. Padmavathi M. Sc(N)

DEPARTMENT

Head of the Department

Department of Medical Surgical Nursing
Sri Sharada College of Nursing, Uttarahalli,
Bangalore

11.6

SIGNATURE OF THE
HEAD OF THE
DEPARTMENT

12.1

REMARKS OF THE
PRINCIPAL

12.2

SIGNATURE OF THE
PRINCIPAL

22