Nina Gartika, Sari Fatimah, Titis Kurniawan


Intrcoduction :The prevalence of pain in patients with breast cancer remains high at an average of 40-89%. Pain experienced by patients with breast cancer during her lifetime and if not managed properly will have a negative impact on quality of life. Pharmacological therapy is given still cause side effects so other therapies needed that could minimize dependence on analgesic drugs. Foot reflexology in other studies has been shown to reduce pain intensity, but no studies to determine the duration of the proposed interventions in reducing pain, especially in patients with breast cancer. This study aimed to identify the effect of foot reflexology towards pain intensity in breast cancer patients at  Dr. Hasan Sadikin Hospital. Methods : This quasi-experimental study used the model of a one-group time series design involving 15 breast cancer patients recruited with purposive sampling. Each respondent received foot reflexology three times in three days sequentially, in which the reflection point massage are the pituitary gland, vertebrae area, thyroid gland, adrenal, breast, diaphragm and lymphatic system. Massage is performed for 30 minutes (15 minutes per foot) with each reflection point given massage 30x/sec. Scores of pain intensity were measured using a numeric rating scale instruments before and after each treatment. The data were analyzed using descriptive analysis and inferential test (Friedman and Wilcoxon Post Hoc). Results : Results showed the characteristics of respondents mostly middle-aged adults, are married, have a problem in financial status, had experienced pain before and less than half of the cancer stage III B. The pain intensity after third treatment significantly lower than that after 2nd treatment (p-value = 0.0001), 1st treatment (p-value = 0.001) as well as pain scores before the treatment (p-value = 0.001). Also pain intensity after 2nd treatment significantly lower than 1st treatment (p-value = 0.002), and before treatment (p-value = 0.0001). Conclusion : It can be concluded that there is a significant effect of foot reflexology on reducing pain intensity, especially after 2nd treatment. Results of this study make that foot reflexology important as part of nonpharmacological pain management in breast cancer patients.


breast cancer, foot reflexology, pain.

Full Text:



Aggarwal, B. B., Shishodia, S., Sandur, S. K., Pandey, M. K., & Sethi, G. (2006). Inflammation and Cancer: How Hot Is the Link? Biochem Pharmacol,, 72, 1605-1621.

Becerra, C. R., Frenkel, E. P., Ashfaq, R., & Gaynor, R. B. (2003). Increased toxicity and lack of efficacy of Rofecoxib in combination with chemotherapy for treatment of metastatic colorectal cancer: A phase II study. Int J Cancer, 105(6), 868-873.

Bredal, S. I., Smeby, A. N., Ottesen, S., Warncke, T., & Schlichting, E. (2014). Chronic Pain in Breast Cancer Survivors: Comparison of Psychosocial, Surgical, and Medical Characteristics Between Survivors. Journal of Pain and Symptom Management, 48(5).

Chang, H. K. (2007). Effect of foot reflexology on patient’s pain and mood following a mastectomy. J Korean Oncol Nurs., 1, 204-216.

Dahlan, M. S. (2012). Statistik untuk kedokteran dan kesehatan Jakarta: Salemba Medika.

Dalal, K., Maran, V. B., Pandey, R. M., & Tripathi, M. (2014). Determination of efficacy of reflexology in managing patients with diabetic neuropathy: a randomized controlled clinical trial. . Evidence-Based Complementary and Alternative Medicine, 84, 30-36. doi:

Desen, W. (2008). Buku Ajar Onkologi Klinis. Jakarta: Balai Penerbit FKUI.

Edrington, J., Sun, A., Wong, C., Dodd, M., Padilla, G., Paul, S., & Miaskowski, C. (2010). A pilot study of relationships among pain characteristics, mood disturbances, and acculturation in a community sample of Chinese American patients with cancer. Oncology Nursing Forum, 37(2), 172-181.

Eghbali, M., Safari, R., Nazari, F., & Abdoli, S. (2012). The effects of reflexology on chronic low back pain intensity in nurses employed in hospitals affiliated with Isfahan University of Medical Sciences. Iranian Journal Nursing Midwifery Research, 17(3), 239-243.

Embong, H. N., Soh, C. Y., Ming, C. L., & Wong, W. T. (2015). Revisiting reflexology: Concept, evidence, current practice, and practitioner training. Journal of Traditional and Complementary Medicine, 5, 197-206. doi:

Ferlay, J., Soerjomataram, I., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., & Parkin, M. D. (2014). Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 136(5), 359-386. doi: 10.1002/ijc.29210

Hendro, G. S., & Ariani, Y. (2015). Materi ajar : Ilmu pijat pengobatan refleksi relaksasi, bagi asisten refleksolog (level 2 - KKNI). Jakarta: LSK PRI.

Hermayanti, Y. (2013). Efek model asuhan keperawatan holistik adaptif terhadap kemampuan adaptasi pasien kanker serviks di rumah sakit umum Bandung. Ringkasan Disertasi Program Doktor pada Fakultas Ilmu Keperawatan Universitas Indonesia: Tidak diterbitkan

Jeongsoon, L., Misook, H., Younghae, C., Jinsun, K., & Jungsook, C. (2011). Effects of foot reflexology on fatigue, sleep and pain: a systematic review and meta-analysis. J Korean Acad Nurs, 41 (6), 821-833. doi:

Kemenkes. (2014). Riset Kesehatan Dasar. Jakarta : Kemenkes RI.

Kim, H. J., Jenrow, A. K., & Brown, L. S. (2014). Mechanisms of radiation-induced normal tissue toxicity and implications for future clinical trials. Radiation Oncology Journal, 32(3), 103-115. doi:

Ko, J. H., Seo, J. S., Youn, H. C., Kim, M. H., & Chung, E. S. (2013). The Association between Pain and Depression, Anxiety, and Cognitive Function among Advanced Cancer Patients in the Hospice Ward. Korean J Fam Med, 34, 347-356. doi: 10.4082/kjfm.2013.34.5.347

O'Connor, M. F., Bower, J. E., Cho, H. J., Creswell, J. D., Dimitrov, S., Hamby, M. E., . . . Irwin, M. R. (2009). To assess, to control, to exclude: Effects of biobehavioural factors on circulating inflammatory markers. Brain Behav Immun, 23(7), 887-897. doi: doi:10.1016/j.bbi.2009.04.005.

Paice, J. A., & Ferrel, B. (2011). The management of cancer pain. Cancer Journal Clinic, 61, 157-162.

Potter, A. P., & Perry, G. A. (2010). Fundamentals of Nursing. Singapore: Elsevier Inc.

Samuel, C. (2011). An investigation into the efficacy of reflexology on acute pain in healthy human subjects. (Doctor Of Philosophy), University of Portsmouth, Portsmouth, England.

Satija, A., Ahmed, M. S., Gupta, R., Ahmed, A., Rana, S. P. S., Singh, P. S., . . . Bhatnagar, S. (2014). Breast cancer pain management - A review of current & novel therapies. Indian J Med Res, 103, 216-225.

Somchock, J. (2012). Effect of foot reflexology on pain reduction in older Thai people. (Doctor of Philosophy), Flinders University, Adelaide, Australia.

Stephenson, N. L. N., & Dalton, A. J. (2006). Using reflexology for pain management. Journal Of Holistic Nursing, 21(2), 179-191. doi: 10.1177/0898010103252380

Stephenson, N. L. N., Swanson, M., Dalton, J., Keefe, J. F., & Engelke, M. (2007). Partner-delivered reflexology: effects on cancer pain and anxiety. Oncology Nursing Forum, 34(1), 127-132. doi: 10.1188/07.ONF.127-132

Taha, M. N., & Ali, H. Z. (2011). Effect of reflexology on pain and quality of life in a patient with rheumatoid arthritis. Life Science Journal, 8(2), 357-365.

Tang, N. K. Y. (2008) Insomnia Co-Occurring with Chronic Pain: Clinical Features, Interaction, Assessments and Possible Interventions. Reviews in Pain, 2(1), 2-7.

Tennant, F. (2013). The physiologic effects of pain on the endocrine system. Pain Ther, 2, 75-86. doi: DOI 10.1007/s40122-013-0015-x

Tiran, D., & Chummun, H. (2005). The physiological basis of reflexology and its use as a potential diagnostic tool. Complementary Therapies in Clinical Practice, 11, 58-64.

Tsay, L. S., Chen, L. H., Chen, C. S., Lin, R. H., & Lin, C. K. (2008). Effects of reflexotherapy on acute postoperative pain and anxiety among patients with digestive cancer. Cancer Nursing, 31(2), 109-115. doi: 10.1097/01.NCC.0000305694.74754.7b

Van den Beuken-van Everdingen, M. H. J., Peters, M. L., de Rijke, J. M., Schouten, H., C., K., M., , & Patijin, J. (2008). Concerns of former beast cancer patients about disease recurrence: a validation and prevalence study. Psycho-Oncology, 17, 1137-1145.

Wu, K. B. (2009). Effect of foot reflexology on dysmenorrhoea in adolescents: A randomised controlled trial in Taiwan. (Doctor of Philosophy), Griffith University, South East Queensland, Australia.

Wyatt, G., Sikorskii, A., Rahbar, H. M., Victorson, D., & You, M. (2012). Health-related quality-of-life outcomes: A reflexology trial with patients with advanced-stage breast cancer. Oncology Nursing Forum, 39(6), 568-577.

Yang, P., Sun, L., Lu, Q., Pang, D., & Ding, Y. (2012). Quality of life in cancer patients with pain in Beijing Chin J Cancer Res, 24(1), 60-66. doi: 10.1007/s11670-0120060-8


  • There are currently no refbacks.