| Objective: To observe and explore the effect of foot reflex zone massage on defecation function andlife quality of postoperative patients with low anterior resection.Methods: A prospective randomized controlled study method was adopted.44patients with lowanterior resection were recruited from April2011to December2011in the Fujian Province ProvincialHospital.21cases were randomly admitted into experimental group and23cases into control grouprespectively. The patients in experimental group were treated by foot reflex zone massage androutine care1week after surgery. The massage was performed for30minutes one time per day, theentire course of treatment last for3months. The control group received routine care daily. Evaluationmethods:①Evaluation of defecation in patients by the Hsu’s anal and rectal function evaluationquestionnaire, which includes the ability of anal control, defecation time, defecation frequency,defecation feeling, and desire to defecate. Each result was scored by10points and classified to4ranks.②Evaluation of the life quality of patients by the QLICP-CR questionnaire developed by Yanget al.. It contains5dimensions of life quality which are physical function, psychological function,social function, common symptoms and side effects (nausea, vomiting, alopecia et al.), as well asitems about defecation condition and abdominal distention and pain. There were46items in total,each item was scored from1~5points. The total score was calculated after all. Defecation functionand life quality were evaluated at the end of the1st,2nd, and3rdmonth after surgery. Research datawas analyzed by SPSS16.0. Statistical descriptive analysis, chi-square test, two independent samplest-test, paired-t test, Wilcoxon rank sum test and repeated measure with analysis of variance were used.A P value of less than0.05was considered statistically significant.Results: There is no significant difference between two groups in the general information andclinical characteristics. Three subjects were lost to follow up, the drop-out rate was6.38%.1.Comparison of defecation function and life quality between two groups:①No significantdifference was found in defecation function between two groups (P>0.05) one month after surgery.②However,2months after surgery in the aspects of physical function, psychological function, socialfunction, total score of life quality had significant differences between two groups(P<0.05), theexperimental group showed better performance than control group, but common symptoms, sideeffects, stool situation, abdominal pain and distension had no difference (P>0.05).③At the end of the third month, in the aspects of physical function, mental status, social function and the overall qualityof life the patients in the experimental group showed better performance than control group (p<0.05).2.Comparison of defecation function and life quality at different time within each group:①theresults showed that the defecation function in both groups were gradually improving with the timepassing. There was significant difference between the bowel movement function1week after surgeryand that at the time of2nd and3rd month postoperatively(P<0.05). Especially for the interventiongroup, the subjects recovered more quickly and they showed better defecation function from onemonth after surgery (P<0.05).②With the time passing,two groups of patients life quality in physicalfunction score trend is different, the intervention group scoring trend gradually rise, the functionrecovered, and the control group tended to be decreasing at first and then gradually increased, theintervention group showed no significant difference in physical function after2month(P<0.05)whereas the control group still had statistical difference at that time(P>0.05).③With the time passing,the evaluation scores of life quality were increasing gradually in both groups, which includedpsychological function, social function, defecation condition and abdominal distention and pain. Thedefecation functions were improved and symptoms were relieved gradually. At the same time theintervention group showed much better than the control group. social function group with significantdifference after2month (P <0.05), and the control group with significant difference after3month (P<0.05).④The scores of common symptoms and side effects of both groups tended to be decreasing atfirst and then gradually increased, which means the symptoms were aggravated first and then relieved,and the results showed significant difference1month postoperatively(P<0.05). However, the scoresshowed no statistical difference at the end of2nd and3rd month(P>0.05).⑤the scores of overall lifequality decreased first and then increased with time passing by, which predicted the life qualitydecreased first and then improved afterwards, and that of intervention group was better than thecontrol group. The intervention group showed no significant difference in life quality after3month(P<0.05) whereas the control group still had statistical difference at that time(P>0.05).Conclusion:1. Massage of foot reflex zone can improve the defecation function of postoperative patients with lowrectal anastomosis.2. Foot reflex zone massage can improve the life quality of postoperative patients with low rectal anastomosis, particularly in the aspects of physical, mental and social function. |
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