Sinhgad e Journal of Nursing, Vol. III, Issue II, December 2013.

Effect of foot and hand massage on post operative

pain of patients with chest surgery
Ms. Vaishali Kale
M. Sc. Medical Surgical Nursing, Clinical Instructor,
Sinhgad College of Nursing, Pune,
vaishalirkale@yahoo.com
Abstract

Numerical Rating Scale, the mean score of pain

Research aim: To assess baseline level of post-

in control group and experimental group were

operative pain of patients

7.25 and 7.85 respectively. In pre intervention

with chest surgery

phase the mean score of heart rate in control and

in experimental

experimental

and

respectively, respiratory rate was 18.7 and 19.45

control

respectively,

group.

group
SBP

was

was

87.75

132.45

and
and

86.6
129.8

determine

respectively and DBP was 89.5 and 87.1

the effect of foot and hand massage on post-

respectively. It indicates that the mean score of

operative pain of patients with chest surgery in

heart rate, SBP and DBP is more in control group

experimental

and the mean score of respiratory rate is more in

To

group.

To

compare

post

intervention changes on post-operative pain of

experimental

patients

between

intervention mean score of pain in experimental

experimental and control group. Methods: The

group was 7.85 and 3.892 respectively. The pre

tools used for data collection were demographic

and

profile, interview schedule and Numerical Rating

biophysiological parameters in experimental

Scale and biophysiological parameters. Quasi

group was 6.25 and 4.6 respectively. It reveals

experimental pre test post test control group

that foot and hand massage intervention is

design on forty samples (twenty in the control

highly significant in reduction of pain of patients

group and twenty in the experimental group)

with chest surgery in experimental group. The p

who were in 3rd post operative day by non

value of pain intensity was 0.000** and

probability

technique.

biophysiological parameters was 0.0039** which

Results shows 100% subjects had pain on

is less than 0.01 at 1% level of significance. It

operated site. In that most of the subjects were

reveals that there is highly significant difference

having pain during deep breathing exercise. The

in the level of post operative pain and

pre intervention data of pain measured with

biophysiological parameters of patients with

with

chest

purposive

surgery

sampling

post

group.

The

intervention

pre

mean

and

score

post

of

chest surgery after giving foot and hand massage

53

2013. Sinhgad College of Nursing, Pune. All rights reserved.

Sinhgad e Journal of Nursing, Vol. III, Issue II, December 2013.

in experimental group. On the basis of the study

The nurses play an integral member of the

we can draw the following conclusion. This study

multidisciplinary team to provide intervention

supported the use of foot and hand massage for

that can be used by all those recovering from

reducing post operative pain of patients with

chest surgery. So, the investigator felt the need

chest surgery.

to find out a simple, easy and effective

intervention to reduce the post operative pain

Introduction:
Pain is a complex,

and conducted a study to evaluate the effect of

multifaceted

foot and hand massage on post operative pain of

It

subjects with chest surgery in selected hospitals

is an individual,

of Pune city as a partial fulfilment for the decree

phenomenon.
unique

of Masters in Nursing, as per MUHS, Nashik.

experience

Title:

that may be difficult for

clients to describe or explain and is
often

difficult

for

others

to

Effect of foot and hand massage on post

recognize,

operative pain of patients

understand and assess. Unrelieved acute pain

with

leads to debilitation, diminished quality of life

selected hospital of Pune

and depression. Unrelieved acute postoperative

city.

pain leads to development of chronic pain

chest

surgery

in

Objectives of the study:

syndrome and increased complication.

1. To assess baseline level of post-operative pain

Uncontrolled post operative pain may lead to

of patients with chest surgery in experimental

variety of complications in cardiovascular,

and control group.

immunity, respiratory, metabolic, endocrine,

2. To determine the effect of foot and hand

mentality systems and also increase immobility,

massage on post-operative pain of patients with

thrombosis, emboli, lengthened hospitalization

chest surgery in experimental group.

and

increased

costs.

Non

pharmacologic

3. To compare

treatment modalities like massage therapy is

post

increasingly applied to relieve the symptoms of

changes on post-

pain in postoperative patients. Massage is the

operative pain of

systematic manipulation of the soft tissues of the

patients with chest

body, particularly the muscles, tendons and skin.

surgery

Massage, through touch, is one way that nurses

experimental and

communicate with patients. Pain associated with

control group.

intervention

between

chest surgery has been poorly controlled in

many surgical patients and this area has been
less researched by the nursing personnel.
54

2013. Sinhgad College of Nursing, Pune. All rights reserved.

Sinhgad e Journal of Nursing, Vol. III, Issue II, December 2013.

Hypotheses

experimental group). The sampling criteria were

H0: There will be no significant difference in the

inclusion criteria: The post chest surgery

levels of postoperative pain of patients with

subjects who were on 3rd post operative day and

chest surgery after foot and hand massage in

complaining of pain, subject with following chest

both groups (experimental and control group).

surgery admitted in the cardiac recovery unit

H1: There will be significant difference in the

and wards for the next three days and subjects

who were conscious and well oriented. Exclusion

levels of postoperative pain of patients with

criteria: Subjects who are having chronic pain

chest surgery after foot and hand massage in

and who are hemodynamically unstable. Non

experimental group.

probability purposive sampling technique was

H2: There will be significant difference in the

adopted. The tools used for data collection were

biophysiological parameters in patients with

demographic

chest surgery in experimental group.

interview

schedule,

Numerical Rating Scale and biophysiological

H3: There will be association between the

parameters. To ensure the content validity the

findings and selected background variables.

instruments were given to 15 experts from

Assumptions:

different fields. The reliability of the tools was

1. The patients undergone chest surgery

established by using data collected from 6

suffering with pain.

research subjects who underwent chest surgery.

2. Majority of the patients do not have adequate

Reliability was established by Split half method.

pain control with pharmacological measures.

The reliability of the Numerical Rating Scale was

3. Foot and hand massage may help to reduce

the level of pain among patients

profile,

0.94

undergone

and

biophysiological

parameter

measurement was 0.9.

chest surgery.

Significant findings of the study:

Research methodology:

It was observed that majority (50%)

subjects were between the age group above 60
years in control group and 30% subjects were
between the age group of 40-50 years in
experimental group. Most of the subjects were
male, married and educated. Majority of subjects

In this study quasi experimental pre test

post test control group design was adopted. The

were serviceman. It also interpreted that

post surgery patients who were in 3rd post

majority of the subjects were having coronary

operative day were chosen as the target

artery disease and operated for CABG. Most of

the subjects were receiving Tramadol as an

population. The sample consisted of forty

analgesic.

(twenty in the control group and twenty in the

55

2013. Sinhgad College of Nursing, Pune. All rights reserved.

Sinhgad e Journal of Nursing, Vol. III, Issue II, December 2013.

Pre and post intervention data of post operative pain:
100% subjects had pain on operated site. In that most of the subjects were having pain during
deep breathing exercise and none of them complained of pain on first day of surgery. 100% subjects were
having sharp and aching pain in both the groups.

Pre and post intervention pain intensity

100

100
No. of subjects (in %)

90
80

65

70
60
50

35

40

30
20
10

0
No pain

Mild pain

Moderate
pain

Severe pain

Worst
possible
pain

Pre intervention %
Post intervention %
Figure: Bar diagram showing pre and post intervention pain intensity in experimental group.
Distribution of pain scores and biophysiological parameters observed in the pre intervention phase in both
groups:
The pre intervention data of pain measured with Numerical Rating Scale, the mean score
of pain in control group and experimental group were 7.25 and 7.85 respectively in the pre intervention
phase. It reveals that there is statistical significance difference before intervention in both groups.
In pre intervention phase the mean score of heart rate in control and experimental group was 87.75 and
86.6 respectively, the mean score of respiratory rate in control and experimental group was 18.7 and
19.45 respectively, the mean score of systolic blood pressure in control and experimental group was
132.45 and 129.8 respectively and the mean score of diastolic blood pressure in control and experimental
was 89.5 and 87.1 respectively. It indicates that the mean score of heart rate, systolic blood pressure and
diastolic blood pressure is more in control group and the mean score of respiratory rate is more in
experimental group.
56

2013. Sinhgad College of Nursing, Pune. All rights reserved.

Sinhgad e Journal of Nursing, Vol. III, Issue II, December 2013.

Distribution of pain scores and biophysiological parameters observed in the post intervention phase in
experimental group:
The pre and post intervention mean score of pain in experimental group was 7.85 and 3.892 respectively.
The pre and post intervention mean score of biophysiological parameters in experimental group was 6.25
and 4.6 respectively. It reveals that there is significant decrease in pain and biophysiological parameters
in experimental group after intervention. It also reveals that foot and hand massage intervention is highly
significant in reduction of pain of patients with chest surgery in experimental group.
In post intervention data of changes in pain pattern, 75% subjects were having reduction in pain,
60% subjects were having relief in pain and inducing sleep. This indicates that most of the subjects were
having reduction in pain and none of them having increasing pain in experimental group in post
intervention phase.

Pre and post intervention data

10

Median pain

6
5

3.83

0
Pre intervention

Post intervention
Pain by NRS

Figure: Bar diagram showing pre and post intervention data of pain by Numerical Rating Scale and
biophysiological parameters in experimental group.
Comparison of pre and post intervention changes on post operative pain of patients with chest surgery in
experimental group:
The pre and post intervention mean score of pain in experimental group was 7.85 and
3.892 respectively. The pre and post intervention mean score of biophysiological parameters in
experimental group was 6.25 and 4.6 respectively. It reveals that there is significant decrease in pain and
biophysiological parameters in experimental group after intervention. The p value of pain was p = 0.000**
and biophysiological parameters was p = 0.004** is less than reasonable choice i.e. less than 0.01 at 1%
level of significance. It reveals that foot and hand massage intervention is highly significant in reduction of
pain of patients with chest surgery in experimental group.

57

2013. Sinhgad College of Nursing, Pune. All rights reserved.

Sinhgad e Journal of Nursing, Vol. III, Issue II, December 2013.

Pre and post intervention pain and biophysiological

parametrs in control and experimental group.
10

Median

6.375

6
4

3.833

Control
Experimental

2
0
Pre

Post

Pre

Pain by NRS

post

Biophysiological
Parameters

Figure: Bar diagram showing pre and post intervention pain and biophysiological parameters in control
and experimental group.
Comparison of post operative pain of patients

References

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Hospitals:

Summary

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2008.

pain intensity was 0.000** and biophysiological

2. Chen et al., p.2 2007, Archives of Physical

parameters was 0.0039**which is less than

Medicine and Rehabilitation.

reasonable choice i.e. less than 0.01 at 1% level

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Massage

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This study supported the use of foot and

study

in

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Surg. 2003;197

hand massage for reducing post operative pain

of patients with chest surgery.

58

2013. Sinhgad College of Nursing, Pune. All rights reserved.

Am

Coll