Journal List > J Korean Acad Nurs > v.45(4) > 1003098

Choi and Lee: Effects of Foot-Reflexology Massage on Fatigue, Stress and Postpartum Depression in Postpartum Women



To identify the effects of foot reflexology massage on fatigue, stress and depression of postpartum women.


A nonequivalent control group pre-post design was used. A total of 70 women in a postpartum care center were recruited and were assigned to the experimental group (35) or control group (35). Foot reflexology massage was provided to the experimental group once a day for three days. Data were collected before and after the intervention program which was carried out from December, 2013 to February, 2014. Data were analyzed using Chi-square test, Fisher's exact test, and t-test.


The level of fatigue in the experimental group was significantly lower than the control group (t= - 2.74, p =.008). The level of cortisol in the urine of women in the experimental group was significantly lower than the control group (t= - 2.19, p =.032). The level of depression in the experimental group was significantly lower than the control group (t= - 3.00, p =.004).


The results show that the foot reflexology massage is an effective nursing intervention to relieve fatigue, stress, and depression for postpartum women.

Figures and Tables

Table 1

Homogeneity Test for General Characteristics (N=70)


*Fisher's exact test; Exp.=Experimental group; Cont.=Control group.

Table 2

Homogeneity Test for Pregnancy, Delivery and Postpartum Care (N=70)


*Fisher's exact test; Exp.=Experimental group; Cont.=Control group.

Table 3

Homogeneity Test for Dependent Variables between Two Groups (N=70)


Exp.=Experimental group; Cont.=Control group.

Table 4

Differences in Fatigue, Cortisol, and Postpartum Depression between Two Groups (N=70)


Exp.=Experimental group (n=35); Cont.=Control group (n=35).


This manuscript is a condensed form of the first author's master's thesis from Gachon University.


1. Lee DJ. The effect of aromatherapy on postpartum mothers' body weight, depression and stress [master's thesis]. Jeonju: Jeonju University;2011.
2. Song JE. Influencing factors of postpartum depression between 4 to 6 weeks after childbirth in the postpartum women. Korean J Women Health Nurs. 2009; 15(3):216–223. DOI: 10.4069/kjwhn.2009.15.3.216.
3. Kim SJ, Jeong GH, Kim EH. Mothers perception of fatigue in postpartum period. Korean J Women Health Nurs. 2001; 7(4):461–472.
4. Lee JY. Fatigue, parenting stress and sleep patterns of women according to period of postpartum [master's thesis]. Daegu: Keimyung University;2006.
5. Choi SY, Gu HJ, Ryu EJ. Effects of fatigue and postpartum depression on maternal perceived quality of life (MAPP-QOL) in early postpartum mothers. Korean J Women Health Nurs. 2011; 17(2):118–125. DOI: 10.4069/kjwhn.2011.17.2.118.
6. Shin HS, Ryu KH, Song YA. Effects of laughter therapy on postpartum fatigue and stress rsponses of postpartum women. J Korean Acad Nurs. 2011; 41(3):294–301. DOI: 10.4040/jkan.2011.41.3.294.
7. Assel MA, Landry SH, Swank PR, Steelman L, Miller-Loncar C, Smith KE. How do mothers' childrearing histories, stress and parenting affect children's behavioural outcomes? Child Care Health Dev. 2002; 28(5):359–368.
8. Lee YE, Kang YH, Park HS, Kang IS. The relationship of stress and infant perception of mothers in postpartum period. Korean Parent Child Health J. 2006; 9(2):91–100.
9. Ahn OS, Oh WO. Relationship among postpartum depression, parenting stress and self-esteem in mothers during puerperium. J Korean Soc Matern Child Health. 2006; 10(1):58–68.
10. Bang KS. Infants' temperament and health problems according to maternal postpartum depression. J Korean Acad Nurs. 2011; 41(4):444–450. DOI: 10.4040/jkan.2011.41.4.444.
11. Wang MJ, Kim JA, Lee JO, Lee AH, Lee CH, Cha NH. Foot management for health promotion. Seoul: Hyunmoonsa;2002.
12. Mackey BT. Massage therapy and reflexology awareness. Nurs Clin North Am. 2001; 36(1):159–170.
13. Kim JO, Kim IS. Effects of aroma self-foot reflexology massage on stress and immune responses and fatigue in middle-aged women in rural areas. J Korean Acad Nurs. 2012; 42(5):709–718. DOI: 10.4040/jkan.2012.42.5.709.
14. Lee YM. Effects of self-foot reflexology on stress, fatigue, skin temperature and immune response in female undergraduate students. J Korean Acad Nurs. 2011; 41(1):110–118. DOI: 10.4040/jkan.2011.41.1.110.
15. Cho GY, Park HS. Effects of 6-week foot reflexology on the blood pressure and fatigue in elderly patients with hypertension. J Korean Acad Fundam Nurs. 2004; 11(2):138–147.
16. Song MR, Song HM. The effects of foot reflexology on ADL and fatigue in stroke patients. Korean J Rehabil Nurs. 2005; 8(2):139–148.
17. Jung YR. Foot reflexology. Seoul: Taiwoong;1997.
18. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987; 150:782–786.
19. Kim JI. A validation study on the translated Korean version of the Edinbergh Postnatal Depression Scale. Korean J Women Health Nurs. 2006; 12(3):204–209.
20. Kim GD. Meta-analysis on the foot reflexology intervention program [dissertation]. Daegu: Kyungpook National University;2009.
21. Jang SH, Kim KH. Effects of self-foot reflexology on stress, fatigue and blood circulation in premenopausal middle-aged women. J Korean Acad Nurs. 2009; 39(5):662–672. DOI: 10.4040/jkan.2009.39.5.662.
22. Ko YS, Park MK. Effects of self-foot reflexology on fatigue and sleep states in women nurses. Korean J Women Health Nurs. 2007; 13(1):21–27.
23. Lee YM, Sohng KY. The effects of foot reflexology on fatigue and insomnia in patients suffering from coal workers' pneumoconiosis. J Korean Acad Nurs. 2005; 35(7):1221–1228.
24. Park S, Kim D. Relationship between physiological response and salivary cortisol level to life stress. J Ergon Soc Korea. 2007; 26(1):11–18.
25. Kim KS, Won JS, Jeong lS, Choi WH, Kang JY. Effect of foot reflexology on the vital signs, blood cortisol, lymphocytes and natural killer cell of female cancer patients. J Korean Biol Nurs Sci. 2004; 6(1):5–15.
26. Eom MR, Kim EK, Oh HY, Kim HS, Kwak KH. The effects of self foot reflexology on depression, sleep and low back pain in community dwelling elderly women. J Korean Acad Fundam Nurs. 2008; 15(4):504–512.
27. Yang HJ, Kang HY, Kim IS. The effects of aroma foot reflex massage on sleep, depression and problem behaviors on elderly with dementia. Korean J Adult Nurs. 2011; 23(6):574–583.
28. Oh HS, Ahn SA. The effects of foot reflexology on pain and depression of middle-aged women with osteoarthritis. Korean J Rehabil Nurs. 2006; 9(1):25–33.
29. Kim KE, Choi JH, Kim YH. Effect of infant health problem, mother's depression and marital relationship on infant abuse in Korea: Mediating pathway of marital relationship. Asian Nurs Res. 2014; 8(2):110–117. DOI: 10.1016/j.anr.2014.05.001.
30. Youn JH, Jeong IS. Predictors of postpartum depression: Prospective cohort study. J Korean Acad Nurs. 2013; 43(2):225–235. DOI: 10.4040/jkan.2013.43.2.225.
Similar articles