หน้า 200 Discussion Hypothesis one:There is a decrease in meanblood pressure level between the foot reflexologyand control groups at the end of four weeks oftreatment. Analyses of data in this study indicated that there was a statistically significant difference in mean blood pressure between the foot reflexol-ogy group and control group at the end of fourweeks of treatment. The mean diastolic bloodpressure in the foot reflexology group was statis-tically significantly lower than in the control group( p<0.05). Frankel[35]explored the effects of foot reflex-ology on the baroreceptor reflex, which controlsblood pressure. He found that baroreceptor reflexsensitivity was significantly lowered in the inter-vention groups (foot reflexology and foot massage),compared with the control group. Baroreceptorreflex sensitivity was measured using sinus arrhyth-mia and phase IV of the Valsalva maneuver, a period in the Valsalva maneuver during which blood pressure is substantially raised above thebaseline. These blood pressure results are differentto those outlined by Frankel[35]who found that,between foot reflexology and foot massage, therewas no significant difference in resting bloodpressure after intervention. The results of our study supported the hypoth-esis that foot reflexology decreases blood pressurein patients with hypertension. In this study, theresults in relation to blood pressure are comparableto those of Park and Cho[24]who found in theirresearch that there were no significant differencesin diastolic blood pressure and LDL cholesterolbetween the foot reflexology group and the controlgroup (who received no intervention). In contrastwith this study, however, Park and Cho found thatsystolic blood pressure and triglyceride levelssignificantly decreased in their foot reflexologygroup compared to their control group. In addition,life satisfaction was significantly improved in the foot reflexology group.Compared to Park and Cho’s[24]study (2004),our study was performed using a bigger samplesize and with control as a comparison intervention(Park and Cho[24], provided foot reflexology only in a small group of 34 hypertensive patients-18 inthe foot reflexology group and 16 in the control group who received no intervention). From bothstudies, we can conclude that foot reflexology hasbeen proved to lower diastolic and systolic bloodpressure. However, its effects on quality of life orlife satisfaction in patients with hypertension areambiguous.Our study showed that foot reflexology wasmore likely to reduce diastolic and systolic bloodpressure than control group. Previous studies sup-porting these results were a study by Hayes & Cox[36]and another by Jirayingmongkol et al.[37].However, these two studies used different measure-ment and foot massage procedures to test blood pressure. Hayes and Cox[36]used mean arterialblood pressure as an indicator of measurement of physiological and psychological stress in patientsin a critical care unit. They found that there wasa significant decrease in heart rate, mean arterialblood pressure and respirations during the foot massage intervention in participants in the footmassage group compared to those in the controlgroup who received no intervention. Jirayingmon-gkol et al.[37]used Thai foot massage which is quite different in style and procedure from thecurrent study to measure vital signs in older sub- jects. They found that Thai foot massages signifi-cantly decreased blood pressure, pulse rate andrespiratory rate in these people. Given the differ-ences in measuring, procedures and samples, wecan not conclude that foot massage can lower bloodpressure in patients with hypertension. Hypothesis two:There is an improvement inmean quality of life between the foot reflexologyand control groups at the end of four weeks oftreatment p>0.05. Results from this study showedno significant difference in mean quality of lifefor both groups. These results differed markedlyfrom study results of Park & Cho[24]and Hodgson[12]. Park & Cho[24]showed that foot reflexologysignificantly improved life satisfaction in 34 pa-tients with hypertension. This study did not supportPark and Cho’s[24]conclusions.Similarly, Hodgson[12]found that foot reflex-ology could improve quality of life. However,Hodgson’s study was based on cancer patients andis difficult therefore to compare with the effects of foot reflexology on quality of life in patientswith hypertension. In addition, the sample size inher study was small-only twelve subjects includingsix in the foot reflexology group, and six in thegentle foot massage group. Hodgson used the visualanalogue scales for cancer patients to measurequality of life, as contrasted from the current study’suse of the WHOQOLBREF World Health Organi-zation[30]which is suitable for use with people who have a general chronic disease. There is alittle difference in mean quality of life betweenthe foot reflexology and control groups at the end of four weeks of treatment. The evidence relatingto foot reflexology, quality of life and patients withhypertension did not indicate that foot reflexology
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