Journal List > J Korean Acad Nurs > v.41(1) > 1002688

Lee: Effects of Self-Foot Reflexology on Stress, Fatigue, Skin Temperature and Immune Response in Female Undergraduate Students



The purpose of this study was to evaluate the effects of self-foot reflexology on stress (perceived stress, urine cortisol level, and serum cortisol level), fatigue, skin temperature and immune response in female undergraduate students.


The research design was a nonequivalent control group pretest-post test design. Participants were 60 university students: 30 in the experiment group and 30 in the control group. The period of this study was from April to June 2010. The program was performed for 1 hr a session, three times a week for 6 weeks. The data were analyzed using the SPSS/WIN 17.0 program.


The results showed that self-foot reflexology was effective in reducing perceived stress and fatigue, and raised skin temperature in female undergraduate students. But cortisol levels and immune response were not statistically significant different.


The results of this study indicate that self-foot reflexology is an effective nursing intervention in reducing perceived stress and fatigue and, in improving skin temperature. Therefore, it is recommended that this be used in clinical practice as an effective nursing intervention for in female undergraduate students.

Figures and Tables

Table 1
Homogeneity Test of General Characteristics (N=60)

*Fisher's test:

Exp=experimental group; Cont=control group.

Table 2
Homogeneity Test of Pre-test Dependent Variables (N=60)

Exp=experimental group; Cont=control group.

Table 3
Changes in Stress, Fatigue, Skin temperature, Natural Killer Cell Before and After Self-Foot Reflexology (N=60)

Exp=experimental group; Cont=control group; SBP=Systolic Blood Pressure (mmHg); DBP=Diastolic Blood Pressure (mmHg).


1. Cameron L, Leventhal EA, Leventhal H. Seeking medical care in response to symptoms and life stress. Psychosomatic Medicine. 1995. 57:37–47.
2. Chon YJ, Kim SJ. Study on the stress and coping method of the university students at the Inha University. Journal of Student Guidance. 1999. 1:37–49.
3. Cline ME, Herman J, Shaw E, Morter RD. Standardization of visual analogue scale. Nursing Research. 1992. 41:378–380.
4. Crane B. Reflexology. The definitive practitioner's manual. 1997. Shaftesbury, Dorset: Element Books.
5. Field T, Grizzle N, Scafidi F, Schanberg S. Massage and relaxation therapies effects on depressed adolescent mothers. Touch Research Institute, University of Miami School of Medicine, Florida 33101, USA. Adolescence. 1996. 31:903–911.
6. Guyton AC, Hall JE. Text book of medical physiology. 2002. 10th ed. Singapore: W.B. Saunders.
7. Janeway CA, Travers P, Walport M, Shlomchik MJ. Immunebiology. 2002. 5th ed. Seoul: Lifescience.
8. Jang SH, Kim KH. Effects of self-foot reflexology on stress, fatigue and blood circulation in premenopausal middle-aged women. Journal of Korean Academy of Nursing. 2009. 39:662–672.
9. Jeong IS. Effect of self-foot reflexology on peripheral blood circulation and peripheral neuropathy in patients with diabetes mellitus. Journal of Korean Academy of Fundamentals Nursing. 2006. 13:225–234.
10. Kang DH. Physiology. 1992. 4th ed. Seoul: ShinKwang Publishing Co.
11. Kiecolt-Glaser JK, Cacioppo JT, Malarkey WB, Glaser R. Acute psychologic stressors and short-term immune changes: What, why, for whom, and to what extent (editorial). Psychosomatic Medicine. 1992. 54:680–685.
12. Koh KB, Park JK, Kim CH. Development of the stress response inventory. Journal of Korean Neuropsychiatric Association. 2000. 39:707–719.
13. Lasarus RS, Folkman S. Stress, appraisal, and coping. 1984. NY: Springer Publishing Co.
14. Lee EH. Life stress and depressive symptoms among college students: Testing for moderating effects of coping style university students with structural equations. Korean Journal of Health Psychology. 2004. 9:25–52.
15. Lee JR. Effects of aromatherapy and foot reflex massage on stress, depression, and sleep pattern of the institutionalized elderly. 2005. Daegu: Kyungpook National University;Unpublished Doctoral Dissertation.
16. Lee SH. Effects of back massage with lavender essence oil on the stress response of the ICU nurses. Journal of Korean Academy of Nursing. 2001. 31:770–780.
17. Lee YM. Effects of self-foot reflexology massage on depression, stress responses and immune functions of middle aged women. Journal of Korean Academy of Nursing. 2006. 36:179–188.
18. Mackey BT. Massage therapy and reflexology awareness. The Nursing Clinics of North America. 2001. 36:159–170.
19. Norman L, Cowan T. The reflexology handbook-A complete guide. 1989. London: Piatkus.
20. Oh JS. Self-massage on hands and feets. 1997. Seoul: Sam Sa Dang.
21. Oleson T, Flocco W. Randomized controlled study of premenstrual symptoms treated with ear, hand, and foot reflexology. Obstetrics and Gynecology. 1993. 82:906–911.
22. Pawlow LA, Jones GE. The impact of abbreviated progressive muscle relaxation on salivary cortisol. Biological Psychology. 2002. 60:1–6.
23. Piper BF, Lindsey A, Dodd M. Fatigue mechanism on cancerpatients: Developing nursing theory. Oncology Nursing Forum. 1987. 14:17–23.
24. Powell LH, Lovallo WR, Matthews KA, Meyer P, Midgley AR, Baum A, et al. Physiologic markers of chronic stress in premenopausal middle-aged women. Psychosomatic Medicine. 2002. 64:502–509.
25. Stevens RC, Soelberg SD, Near S, Fuelong CE. Detection of cortisol in saliva with a flow-filtered, portable surface plasmon resonance biosensor system. Analytical Chemistry. 2008. 80:6747–6751.
26. Varricchio CG. Selecting a tool for measuring fatigue. Oncology Nursing Forum. 1985. 12:122–127.
27. Wichianson JR, Bughi SA, Unger JB, Spruijt-Metz D, Nguyen-Rodriguez ST. Perceived stress, coping and night-eating in college students. Stress and Health. 2009. 25:235–240.
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