• Bao-Kuan Wu Bao-Kuan Wu

Dysmenorrhoea is the most common gynaecological complaint among adolescent females. Although many drugs are available and approved for the use in treatment of primary dysmenorrhoea, Taiwanese adolescents are influenced by traditional Chinese beliefs and tend to choose more natural ways to manage primary dysmenorrhoea. Foot reflexology, a non-pharmacological folk therapy, has been claimed to alleviate primary dysmenorrhoea. To date, no randomised trials have been conducted to investigate the effect of foot reflexology on primary dysmenorrhoea. This randomised controlled trial was designed to examine the effect of Father Josef‘s method of reflexology on primary dysmenorrhoea in Taiwanese adolescent students. Data were collected from three secondary high schools and one junior college in 2008 in Taiwan with approval from Griffith University Human Research Ethics Committee. Participants aged 15 to 19 years with a pain score of 40 or more on the 0 to 100 Numeric Rating Scale for Period Pain (NRS for Period Pain) were asked to participate. One-hundred and twenty-two adolescent students were randomly allocated to a reflexology group or a massage group. The reflexology group received Father Josef‘s method of foot reflexology (n = 61); the massage group received foot massage with light touch (n = 61). Both groups received one treatment of 30 minutes duration within the first 48 hours of menstruation for two menstrual periods. Outcome measures included the Demographic Information Questionnaire, the NRS for Period Pain, the Chinese Menstrual Distress Questionnaire, the Chinese Menstrual Attitudes Questionnaire, and the Self-Care Scale for Dysmenorrhic Adolescents, along with eardrum temperature, heart rate and blood pressure. Ninety-seven participants completed this study with 50 in the foot reflexology group and 47 in the foot massage group. The average age of menarche was 12.2 years. The majority of adolescents experienced their first episode of painful menstruation within two years after menarche. In addition, the prevalence of dysmenorrhoea positively correlates to a family history of dysmenorrhoea. The physician consultation rate in this study (46.7%) is higher than in previous studies (7.1% to 23.4%). Adolescents‘ attitudes toward menstruation and self-care behaviours for dysmenorrhoea are multidimensional and influenced by cultural factors, health beliefs, educational background and menstrual discomfort. The use of the Internet to search for health information among Taiwanese adolescents is becoming more popular. The study also found that the most frequently reported methods perceived as effective in managing dysmenorrhoea were heat application, rest and pain medication. In addition, Taiwanese adolescents most frequently turned to their mother for advice regarding methods for dealing with dysmenorrhoea. Among health professionals, nurses are most frequently asked for help by adolescents with dysmenorrhoea. Using a mixed between–within subjects analysis of variance, NRS for Period Pain decreased significantly over the two treatment sessions and the six menstrual cycles in both the foot reflexology group and foot massage group. In treatment session 2, changes for NRS for Period Pain were statistically significantly lower in the foot reflexology group as compared with the foot massage group. Menstrual distress symptoms, heart rate and systolic blood pressure decreased significantly over time but group differences were not significant. Furthermore, there were no significant differences observed between the two groups on eardrum temperature or diastolic blood pressure; however, a within-group comparison identified that foot reflexology significantly elevated eardrum temperature and reduced diastolic blood pressure immediately after the treatment. In comparison, an increase in eardrum temperature in the foot massage group was not significant. Furthermore, a decrease in diastolic blood pressure in the foot massage group was significant in treatment session 1, but it was not significant in treatment session 2. No serious adverse events occurred during this study. Additional benefits of receiving foot reflexology are relaxation, improving quality of sleep and improving bowel habits. In conclusion, this study has contributed to the body of knowledge about gynaecological characteristics, attitudes toward menstruation, self-care behaviours in managing dysmenorrhoea and effect of foot reflexology on Taiwanese adolescents with primary dysmenorrhoea. Although duplication of this study is needed, this is the first controlled study to provide evidence that foot reflexology and foot massage can be effective non-invasive interventions for relieving dysmenorrhoea. Findings from this study provide nurses with additional nursing interventions to offer young women with primary dysmenorrhoea.