The Effect of Foot Reflexology Massage on Fatigue and Sleep Quality in Hemodialysis Patients

doi:10.1177/23779608251364099

. 2025 Aug 6:11:23779608251364099.

doi: 10.1177/23779608251364099. eCollection 2025 Jan-Dec.

The Effect of Foot Reflexology Massage on Fatigue and Sleep Quality in Hemodialysis Patients

Raheleh Rajabi^{1

2}, Fatemeh Akhlaghi³, Neda Asadi⁴, Fatemeh Zamani Babgohari⁵, Fatemeh Arabpoor⁶

Affiliations

¹ Department of Nursing, Zarand School of Nursing, Kerman University of Medical Sciences, Kerman, Iran.
² Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Student Research Committee, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
⁴ Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.
⁵ Department of Physical Education, Faculty of Physical Education, Kerman National and Skill Girls' University, Kerman, Iran.
⁶ Student Research Committee, Department of Nursing, Zarand School of Nursing, Kerman University of Medical Sciences, Kerman, Iran.

PMID: 40786836
PMCID: PMC12332255
DOI: 10.1177/23779608251364099

The Effect of Foot Reflexology Massage on Fatigue and Sleep Quality in Hemodialysis Patients

Raheleh Rajabi et al. SAGE Open Nurs. 2025.

. 2025 Aug 6:11:23779608251364099.

doi: 10.1177/23779608251364099. eCollection 2025 Jan-Dec.

Authors

Raheleh Rajabi^{1

2}, Fatemeh Akhlaghi³, Neda Asadi⁴, Fatemeh Zamani Babgohari⁵, Fatemeh Arabpoor⁶

Affiliations

¹ Department of Nursing, Zarand School of Nursing, Kerman University of Medical Sciences, Kerman, Iran.
² Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Student Research Committee, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
⁴ Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.
⁵ Department of Physical Education, Faculty of Physical Education, Kerman National and Skill Girls' University, Kerman, Iran.
⁶ Student Research Committee, Department of Nursing, Zarand School of Nursing, Kerman University of Medical Sciences, Kerman, Iran.

PMID: 40786836
PMCID: PMC12332255
DOI: 10.1177/23779608251364099

Abstract

Background and aim: Hemodialysis patients experience fatigue due to factors such as toxic compounds in the bloodstream, fluid, and electrolyte disorders. Despite resting, they still feel tired and report poor sleep quality. This study aimed to investigate the effect of foot reflexology massage on reducing fatigue and improving sleep quality in hemodialysis patients.

Methods: This quasi-experimental study was conducted on hemodialysis patients in southeastern Iran. Eligible patients were selected through purposive sampling and allocated to either the intervention group (n = 25) or the control group (n = 25). The intervention group received foot reflexology massage three times weekly for three weeks, while the control group received routine care. Data were collected using the Pittsburgh Sleep Quality Index (PSQI) and Piper Fatigue Scale at three time points: pre-intervention, immediately post-intervention, and two weeks after intervention.

Results: The findings showed that the mean score of sleep quality in the intervention group decreased from 16.23 before the intervention to 3.31 two weeks after the intervention (p < .001). Furthermore, the mean fatigue score in the intervention group decreased from 8.63 before the intervention to 3.11 two weeks after the intervention (p < .001).

Conclusion: The results of this study showed that foot reflexology can reduce fatigue and increase sleep quality in hemodialysis patients. As a simple, feasible, and non-invasive method without complications, reflexology can be used by nurses to reduce fatigue and increase sleep quality in HD patients.

Keywords: fatigue; foot reflexology massage; hemodialysis; sleep quality.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

**Figure 1.**
Recruitment and Retention of Participants in the Study.

See this image and copyright information in PMC

References

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1. Al Sharji A., Alaloul F., Al Yazeedi B. (2022). Coping strategies in end-stage renal disease patients on hemodialysis in Oman: Optimistic, supportive, confrontive, and prayerful. Journal of Religion and Health, 61(3), 2072–2082. 10.1007/s10943-022-01579-5 - DOI - PubMed
1. Asltoghiri M., Ghodsi Z. (2012). The effects of reflexology on sleep disorder in menopausal women. Procedia - Social and Behavioral Sciences, 31, 242–246. 10.1016/j.sbspro.2011.12.049 - DOI
1. Azimpour S., Hosseini H. S., Eftekhari A., Kazemi M. (2019). The effects of vibration and massage on severity of symptoms of restless leg syndrome and sleep quality in hemodialysis patients; a randomized cross-over clinical trial. Journal of Renal Injury Prevention, 8(2), 106–111. 10.15171/jrip.2019.20 - DOI
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[1] Alinia-Najjar R., Bagheri-Nesami M., Shorofi S. A., Mousavinasab S. N., Saatchi K. (2020). The effect of foot reflexology massage on burn-specific pain anxiety and sleep quality and quantity of patients hospitalized in the burn intensive care unit (ICU). Burns, 46(8), 1942–1951. 10.1016/j.burns.2020.04.035 - DOI - PubMed

[2] Alinia-Najjar R., Bagheri-Nesami M., Shorofi S. A., Mousavinasab S. N., Saatchi K. (2020). The effect of foot reflexology massage on burn-specific pain anxiety and sleep quality and quantity of patients hospitalized in the burn intensive care unit (ICU). Burns, 46(8), 1942–1951. 10.1016/j.burns.2020.04.035 - DOI - PubMed

[3] Al Sharji A., Alaloul F., Al Yazeedi B. (2022). Coping strategies in end-stage renal disease patients on hemodialysis in Oman: Optimistic, supportive, confrontive, and prayerful. Journal of Religion and Health, 61(3), 2072–2082. 10.1007/s10943-022-01579-5 - DOI - PubMed

[4] Al Sharji A., Alaloul F., Al Yazeedi B. (2022). Coping strategies in end-stage renal disease patients on hemodialysis in Oman: Optimistic, supportive, confrontive, and prayerful. Journal of Religion and Health, 61(3), 2072–2082. 10.1007/s10943-022-01579-5 - DOI - PubMed

[5] Asltoghiri M., Ghodsi Z. (2012). The effects of reflexology on sleep disorder in menopausal women. Procedia - Social and Behavioral Sciences, 31, 242–246. 10.1016/j.sbspro.2011.12.049 - DOI

[6] Asltoghiri M., Ghodsi Z. (2012). The effects of reflexology on sleep disorder in menopausal women. Procedia - Social and Behavioral Sciences, 31, 242–246. 10.1016/j.sbspro.2011.12.049 - DOI

[7] Azimpour S., Hosseini H. S., Eftekhari A., Kazemi M. (2019). The effects of vibration and massage on severity of symptoms of restless leg syndrome and sleep quality in hemodialysis patients; a randomized cross-over clinical trial. Journal of Renal Injury Prevention, 8(2), 106–111. 10.15171/jrip.2019.20 - DOI

[8] Azimpour S., Hosseini H. S., Eftekhari A., Kazemi M. (2019). The effects of vibration and massage on severity of symptoms of restless leg syndrome and sleep quality in hemodialysis patients; a randomized cross-over clinical trial. Journal of Renal Injury Prevention, 8(2), 106–111. 10.15171/jrip.2019.20 - DOI

[9] Buysse D. J., Reynolds C. F., 3rd, Monk T. H., Berman S. R., Kupfer D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. 10.1016/0165-1781(89)90047-4 - DOI - PubMed

[10] Buysse D. J., Reynolds C. F., 3rd, Monk T. H., Berman S. R., Kupfer D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. 10.1016/0165-1781(89)90047-4 - DOI - PubMed

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The Effect of Foot Reflexology Massage on Fatigue and Sleep Quality in Hemodialysis Patients

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The Effect of Foot Reflexology Massage on Fatigue and Sleep Quality in Hemodialysis Patients

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