Paper
Tuesday, November 6, 2007
633
The Efficacy of Reflexology as a Palliative Treatment in Nursing Home Residents
Nancy A. Hodgson, RN, PhD, CS, Madlyn and Leonard Abramson Center for Jewish Life, Polisher Research Institute, North Wales, PA, USA
| Learning Objective #1: identify potential complementary therapy interventions in the palliative care of nursing home residents |
| Learning Objective #2: describe the role of salivar biomarkers in assessing the efficacy of complementary therapies in the nursing home population |
Alleviation of symptoms of distress is a primary goal of palliative care. Complementary and alternative medicine (CAM) therapies may offer practitioners great promise in treating end stage illnesses without the side effects of pharmaceuticals. Touch therapies are examples of sensory integration techniques that can influence the activity of the sympathoadrenal medullary system (SAM) and hypothalamic pituitary adrenal (HPA) systems. Although touch treatments offer great promise in treating the palliative care needs of patients, further scientific study needs to be done in order to assess their clinical efficacy in high risk populations. This study evaluated the effectiveness of reflexology for relief of distress in nursing home residents with dementia using neuroendocrinological and behavioral evaluations. Reflexology was compared in a sample of 20 nursing home residents with dementia using a randomized, cross-over design. Two distinct types of data were collected: 1) saliva samples from which cortisol and alpha amylase were measured; and 2) observations of affect (e.g., anger, depression, anxiety) using the Apparent Affect Rating Scale (AARS). Outcome measures were collected over 4 weeks, 4 times a day, on awakening, mid-morning, early afternoon and late afternoon, to allow for longitudinal assessment and to capture the diurnal variation in neuroendocrine markers. Hypothesis testing was conducted using repeat-measures ANOVA, with treatment nested within subjects. Four sessions of reflexology showed a statistically significant reduction in salivary alpha amylase (p < .01) and in observations of depressed affect compared to the control condition. These results suggest that further research is required to establish the duration of outcomes of treatment and the comparison of reflexology to other “touch therapies” The information obtained from the study can be used as a foundation for understanding the neuroendocrinological and behavioral effects of complementary therapies in residents with dementia.