THE EFFECTS OF FOOT REFLEXOLOGY APPLIED TO INFANTILE

THE EFFECTS OF FOOT REFLEXOLOGY APPLIED TO INFANTILE COLIC INFANTS ON COLIC SYMPTOMS 1 Nimet KARATAŞ, Ayşegül İŞLER DALGIÇ2 1 Süleyman Demirel University , Faculty of Health Sciences, Department of Nursing, Isparta/TURKEY 2 Akdeniz University, Faculty of Nursing, Pediatric Nursing Department Antalya/TURKEY(aisler@akdeniz. edu. tr)

Infantile Colic; • Represents one of the most common problems within the first 3 months of life. • It affects approximately %5 -19 of infants aged 2 weeks to 3 months. 1. • Theories about its caused range from feeding problems, dietary intolerance, immaturity of the digestive and cantral nervous system. 2. 3 days 3 hours 3. 3 weeks • The standard diagnostic criteria—known as the “rule of three”—is crying more than three hours per day, more than three days per week, for longer than three weeks. 1. 2. 3. Lucassen PLBJ, Assendelft WJJ, van Eijk JTh. M, Gubbels JW, Douwes AC, van Geldrop WJ. Systematic review of the occurrence of infantile colic in the community. Arch. Dis. Child. 2001; 84: 398– 403. Kavanagh, W. Baby Touch. London: Octopus Publishing Group. 2005. pg: 94. Wessel M. A, C. J. Paroxysmal Fussing in Infancy, Sometimes Called ''Colic''. Pediatrics, 1954, 14(5), 421434.

Reflexology; is the scientific study of reflexes and the application of specific techniques that work reflexes in a particular way to produce a specific outcome. Reflexologists do not diagnose, prescribe, treat, nor cure. The chief outcome of reflexology is to relax the body in order to improve the flow of blood, nerve impulses, and bioelectrical energy throughout the body to allow the body to normalize, balance and heal itself. Stone, P. S. Therapeutic Reflexolog: A Step-By-Step Guide to Professional Competence. USA: Pearson. 2011. pg: 16.

Reflexology; 1 JRA , Infantile Pneumonia 2, Constipation 3, Cerebral Palsy 4, 1. Martin, M. The Art and Science of Reflexology Juvenile Chronic Arthritis. Positive Health, 2001, 68(19). 5 2. Hui-ming, W. Treatment of Infantle Pneumonia and Bronchitis with Reflexotherapy. China Reflexology Symposium Report. Beijing: China Epilepsy , Preventive Medical Association and the Chinese Society of Reflexology. 2002, 19, p: 12 -13. 3. Bishop , E. , Mc. Kinnon , E. , Weir , E. , & Brown , D. W. Reflexology in the Management of Encopresis and Chronic 6 Constipation. Journal of Pediatric Nursing, 2003, 15(3), 20 -21. Pain , 4. Ukhanova, T. A. , & Gorbunov, F. E. Efficacy of Reflexology in the Combination With Neuroprotective Treatment in Hemiparetic Form of Children Studies Cerebral Palsy. Zhurnal Nevrologii Psikhiatrii Imeni S. S. Korsakova, 2012, 112(7), 28 -31. 7, 8 5. Bishop , E. , Mc. Kinnon , E. , Weir , E. , & Brown , D. W. Reflexology in the Management of Encopresis and Chronic Constipation. Journal of Pediatric Nursing, 2003, 15(3), 20 -21. 6. Koç, T. Süt Çocukluğunda Refleksoloji Tekniği ile Uygulanan Ayak Masajının Akut Ağrıya Etkisi. İstanbul Üniversitesi. Department of Child Health Nursing. 2013. Graduate Thesis. , Istanbul, Türkiye. 7. İçke, S. Study the Effect of Reflexology On the Removal of Infantile Colic. , Ege University. Health Science Institue. Department of Midwifery. Graduate Thesis. , 2014, Thesis Advisor Consultant : Doç. Dr. Rabia Ekti Genç. İzmir, Türkiye. 8. Bennedbaek, O. , Viktor, J. , Carlsen, K. , & Lundbye-Christensen, S. Infants with colic. A heterogenous group possible to cure? Treatment by pediatric consultation followed by a study of the effect of zone therapy on incurable colic. Ugeskrift for Leager, 2006, 163(27), 3773 -8. Infantile Colic

The purpose of this study is to determine the effect of foot reflexology on infantile colic. The researcher received a reflexology certificate with international validity (ITEC Level-3). 5

Materials and Methods 6 -Single blinded (Parent) -Randomized Controlled Trial -The study was conducted on a tertiary hospital in Turkey in June 2016 – March 2017. -Infants who had infantile colic with regard to Wessel Criteria -20 control and 20 study group for a total of 40 infants

Data Collection Tools: Infantile Colic Scale (ICS) Face, Legs, Activity, Cry, Consolability (FLACC) Pain Scale Daily sleep follow up form Daily crying follow up form 7

Twice a week for four times during two weeks Study Group Foot reflexology that contains stimulation of digestive system, applied by the researcher Infantile colic scale was evaluated 4 times in total FLACC Pain Scale was evaluated 8 times in total (Both before and after intervention) Parents filled sleep follow up form every day during two weeks Parents filled cry follow up form every day during two weeks 8 Researcher received feedback about colic symptom form parent after a month of the end of practice.

Twice a week for four times during two weeks Control Group Noneffective touch to foot applied by the researcher 9 Infantile colic scale was evaluated 4 times in total FLACC Pain Scale was evaluated 8 times in total (Both before and after intervention) Parents filled sleep follow up form every day during two weeks Parents filled cry follow up form every day during two weeks Researcher received feedback about colic symptom form parent after a month of the end of practice.

Ethics: The data were collected by the researcher through the data collection tools after written consent was taken from Ethics Committee, and the hospital where the research has been carried out. 10

Results 11

Results-1 After reflexology; Infant Colic Scale average points, FLACC average points, Averages of crying time and violence Averages of sleep time, When feedback averages were analyzed, very meaningful differences were detected. 12

Results-2 It is detected on study group infants; Ø Their colic situation had recovery, Ø Pain sense decreased, Ø Crying time and violence decreased, Ø Sleep time increased, Ø 60% of infants did not have crying attacks from infantile colic, Ø Crying time and frequency decreased in 40% of them. There was no meaningful difference on control group infants in all parameters. 13

Negative medium strong relation was detected between crying and sleep times. When the crying time increased, sleep time decreased or vice versa interaction was defined. (Pearson Correlation: -606). 14

ICS Average Point Divisions According to Observations Control Group Study Group Follows Z p Mean±Sd First Follow 100, 20± 5, 34 102, 70± 6, 53 -1, 42 0, 157 Second Follow 101, 65± 6, 01 89, 20± 8, 40 -4, 10 0, 000 Third Follow 101, 60± 6, 76 65, 50± 9, 66 -5, 39 0, 000 Fourth Follow 99, 95± 6, 72 53, 00± 7, 97 -5, 41 0, 000 15

Comparison of Point Averages of FLACC Scale at All Observations Follows Z P Intervention Control Group Study Group Before 5, 05± 2, 78 6, 25± 3, 91 -1, 87 0, 68 After 4, 55± 2, 48 1, 40± 1, 69 -3, 87 0, 00 Before 5, 05± 2, 13 4, 95± 1, 50 -0, 10 0, 93 Second Follow After 5, 05± 2, 16 2, 35± 1, 53 -3, 87 0, 00 Before 5, 10± 1, 94 3, 30± 1, 34 -3, 21 0, 01 Third Follow After 4, 45± 2, 23 1, 20± 1, 19 -4, 16 0, 00 Before 5, 10± 1, 25 2, 25± 1, 77 -4, 27 0, 00 Fourth Follow After 5, 25± 1, 37 0, 75± 1, 06 -5, 38 0, 00 First Follow 16 Mean± Sd

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C-Sleep S-Sleep C-Cry S-Cry C-Cry Violence S-Cry Violence C-ICS S-ICS C-FLACC S-FLACC 18 Follow-1 Follow-2 Follow-3 Follow-4 Follow-5

According to their mother’s expressions, Curative Effects of Applications (Reflexology and Ineffective Touching) on Colic Attacks of Infants Feedback Effective n % Noneffective n % Total n % Control (n: 20) 5 25, 0 100, 0 15 75, 0 0 0, 0 20 100, 0 x²: 24, 000; df: 1; p: 0, 000 19 Study (n: 20) 20

Recommendations Reflexology application becoming one of the separate roles of nurse, Appointing bachelor’s degree nurses with reflexology certificate as authorized personnel to apply reflexology in Regulation on Traditional and Complementary Medicine Applications. 20

Thank you… Antalya/TURKEY