The purpose of this study was to evaluate the effectiveness of foot reflexology on fatigue, sleep and pain.

A systematic review and meta-analysis were conducted. Electronic database and manual searches were conducted on all published studies reporting the effects of foot reflexology on fatigue, sleep, and pain. Forty four studies were eligible including 15 studies associated with fatigue, 18 with sleep, and 11 with pain. The effects of foot reflexology were analyzed using Comprehensive Meta-Analysis Version 2.0. The homogeneity and the fail-safe N were calculated. Moreover, a funnel plot was used to assess publication bias.

The effects on fatigue, sleep, and pain were not homogeneous and ranged from 0.63 to 5.29, 0.01 to 3.22, and 0.43 to 2.67, respectively. The weighted averages for fatigue, sleep, and pain were 1.43, 1.19, and 1.35, respectively. No publication bias was detected as evaluated by fail-safe N. Foot reflexology had a larger effect on fatigue and sleep and a smaller effect on pain.

This meta-analysis indicates that foot reflexology is a useful nursing intervention to relieve fatigue and to promote sleep. Further studies are needed to evaluate the effects of foot reflexology on outcome variables other than fatigue, sleep and pain.

The purposes of this study were to develop an educational program to reduce the use of physical restraints for caregivers in geriatric hospitals and to evaluate the effects of the program on cargivers' knowledge, attitude and nursing practice related to the use of physical restraints.

A quasi experimental study with a non-equivalent control group pretest-posttest design was used. Participants were recruited from two geriatric hospitals. Eighteen caregivers were assigned to the experimental group and 20 to the control group. The data were collected prior to the intervention and at 6 weeks after the intervention through the use of self-administered questionnaires. Descriptive statistics, χ² test, Fisher's exact probability test, and Mann-Whitney U test were used to analyze the data.

After the intervention, knowledge about physical restraints increased significantly in experimental group compared to the control group. However, there were no statistically significant differences between the groups for attitude and nursing practice involving physical restraints.

Findings indicate that it is necessary to apply knowledge acquired through educational programs to nursing practice to reduce the use of physical restraints. User friendly guidelines for physical restraints, administrative support of institutions, and multidisciplinary approaches are required to achieve this goal.