ABSTRACT
Background:
The study investigates the impact of effleurage massage using coconut oil on pain in chronic renal failure (CRF) patients undergoing hemodialysis. The research aims to explore the potential therapeutic benefits of this intervention in alleviating pain associated with hemodialysis.
Methods:
A quasi-experimental design was used, with 150 individuals with mild to moderate leg discomfort aged 30–70 chosen. The Wong–Baker pain scale was used for pretest. After a month, a posttest was conducted.
Results:
Results showed that 70% of the patients had moderate levels of leg pain, while 30% had mild pain. After the intervention, 36% had no pain, 42% had mild pain, and 22% had moderate pain.
Conclusion:
The study concluded that effleurage massage with coconut oil is effective in reducing leg pain among CRF patients undergoing hemodialysis.
KEYWORDS: Chronic kidney disease, hemodialysis, pain, virgin coconut oil, Wong–Baker pain scale
INTRODUCTION
Hemodialysis, a treatment for chronic kidney failure, presents numerous health challenges. Combining treatments like effleurage massage with coconut oil could potentially manage pain in hemodialysis patients.[1]
This study investigates the potential of effleurage massage with coconut oil in alleviating pain in chronic renal failure (CRF) patients. The research aims to fill the gap in pain management by utilizing massage therapy’s efficacy in reducing pain and promoting relaxation, as demonstrated in a meta-analysis on cancer pain.[2]
Hashemi et al.’s[3] study on lavender oil massage’s impact on restless leg syndrome in hemodialysis patients supports the use of effleurage massage with coconut oil as a nonpharmacological approach to alleviate pain in CRF patients. A study by Muliani et al.[4] explores the use of coconut oil in alleviating pruritus in hemodialysis patients, aiming to improve pain management strategies for chronic respiratory disease (CRF) patients undergoing hemodialysis.
The study aims to improve pain management strategies for hemodialysis patients by investigating leg discomfort pretest scores, comparing pre- and posttest scores, evaluating coconut oil’s effectiveness in reducing discomfort, and exploring the relationship between background characteristics.
METHODS
This study aims to evaluate the effectiveness of effleurage massage with coconut oil on 150 CRF patients undergoing hemodialysis with leg pain. The research design involved was a quasi-experimental one-group pretest and posttest design, using both qualitative and quantitative methods. The study involved 150 patients randomly assigned to either the intervention group receiving effleurage massage sessions three times a week for four weeks, administered by licensed massage therapists trained in the standardized effleurage technique, or the control group receiving standard care.
Pain intensity was assessed using the Wong–Baker faces pain rating scale to measure pain levels. The study also discusses the use of effleurage massage with coconut oil, which involves deeply pressing coconut oil from the foot to the knee and back down to the feet with light pressure. Pain scales before and after each massage session, and participants’ overall well-being and quality of life was measured using standardized instruments. Data were collected through structured interviews, observational assessments, and self-report questionnaires, with trained research assistants ensuring consistency and accuracy in data collection.
RESULTS
Figure 1 bar chart provides a demographic overview of CRF patients undergoing hemodialysis, illustrating their characteristics such as access type, frequency, and age.Table 1 study analyzed the impact of coconut oil massage on leg pain using the Wong–Baker scale. Initially, 70% of participants reported moderate pain, while 30% experienced mild pain. After treatment, pain levels significantly shifted, with 36% experiencing no pain, 42% experiencing mild pain, and 22% still experiencing moderate pain. The mean differences in pain scores were statistically significant, with a significant improvement from moderate to less pain. The shift from mild to less pain was also significant but to a lesser extent.
Figure 1.
Frequency distribution of demographic variables in chronic renal failure patients undergoing hemodialysis
Table 1.
Leg pain distribution by Wong–Baker scale (pre- and posttest pain scores with coconut oil massage
| Level of pain | Pretest | Posttest | Mean difference | Independent t-test P | ||||
|---|---|---|---|---|---|---|---|---|
|
|
|
|||||||
| Frequency (%) | Mean | SD | Frequency (%) | Mean | SD | |||
| No pain | 0 (0%) | 0 | 0 | 54 (36%) | 2.67 | 1.19 | 2.67 | t=13.62, P=0.001*** (HS) |
| Mild pain | 45 (30%) | 7.33 | 3.01 | 63 (42%) | 5.17 | 2.11 | 2.16 | t=2.00, P=0.05*(S) |
| Moderate pain | 105 (70%) | 9.3 | 6.21 | 33 (22%) | 6.09 | 4.88 | 3.21 | t=3.46, P=0.001*** (HS) |
*Significant, ***Highly Significant
Table 2 shows that the study found significant associations between leg pain and demographic variables among hemodialysis patients. Habits, such as drug abuse and tobacco chewing, were associated with higher instances of mild and moderate leg pain. The duration of hemodialysis also showed a significant association, with patients undergoing 1–5 years experiencing more leg pain. However, the nature of work, frequency of hemodialysis, and type of dialysis access did not show significant associations.
Table 2.
Association of leg pain scores with demographics in hemodialysis patients
| Demographic variables | Leg pain (mild pain) | Leg pain (moderate pain) | Chi-square (χ2) | Degrees of freedom (DF) | P |
|---|---|---|---|---|---|
| Habits | 14.2 | 3 | P<0.05 (S)* | ||
| Smoking | 12 (8%) | 15 (10%) | |||
| Drinking alcohol | 30 (20%) | 21 (14%) | |||
| Drug abuse/Tobacco chewing | 27 (18%) | 6 (4%) | |||
| None | 15 (10%) | 24 (16%) | |||
| Nature of Work | 3.91 | 3 | P>0.05 (NS) | ||
| Sedentary | 15 (10%) | 9 (6%) | |||
| Moderate | 42 (28%) | 12 (8%) | |||
| Strenuous/Heavy | 12 (8%) | 27 (18%) | |||
| Retired/Not Working | 15 (10%) | 18 (12%) | |||
| Duration of hemodialysis | 11.73 | 3 | P<0.05 (S)* | ||
| <1 year | 18 (12%) | 12 (8%) | |||
| 1–5 years | 42 (28%) | 30 (20%) | |||
| 6–10 years | 18 (12%) | 21 (14%) | |||
| >10 years | 6 (4%) | 3 (2%) | |||
| How often is hemodialysis done | 4.12 | 3 | P>0.05 (NS) | ||
| Daily | 0 (0%) | 0 (0%) | |||
| Once a week | 54 (36%) | 39 (26%) | |||
| Twice a week | 27 (18%) | 24 (16%) | |||
| Three times a week | 3 (2%) | 3 (2%) | |||
| Type of dialysis access | 4.63 | 2 | P>0.05 (NS) | ||
| Central venous catheter | 0 (0%) | 0 (0%) | |||
| Arterio-venous fistula | 63 (42%) | 60 (40%) | |||
| Arterio-venous graft | 21 (14%) | 6 (4%) |
*Significant, NS=Not significant
DISCUSSION
The study investigates the efficacy of virgin coconut oil effleurage in alleviating pain in hemodialysis patients with chronic kidney disease, contributing to the growing research on pain management in this patient population.
Chronic kidney disease patients undergoing hemodialysis often experience debilitating symptoms like depression and pain, impacting their quality of life.[5] Pain is a common concern, with prevalence rates ranging from 50% to 80%.[5,6] This can negatively affect their physical, emotional, and social well-being, emphasizing the need for effective pain management strategies.
The study found that virgin coconut oil, applied through effleurage massage, effectively reduced pain intensity in hemodialysis patients, a finding consistent with previous research highlighting the pain-relieving effects of massage and topical oil applications in chronic pain conditions.[7]
The mechanism by which virgin coconut oil effleurage can alleviate pain in hemodialysis patients is unclear, but its anti-inflammatory and analgesic properties may contribute to pain reduction.[7] Massage technique offers physical stimulation that can enhance blood circulation, alleviate muscle tension, and activate the body’s natural pain-relieving mechanisms.[5,6]
The holistic approach to hemodialysis patients, incorporating massage and natural oils, aligns with patient-centered dialysis care, which prioritizes not only the medical aspects of the condition but also the patient’s overall well-being and quality of life.[8,9]
CONCLUSION
The study reveals that effleurage massage with coconut oil can effectively alleviate leg discomfort in hemodialysis patients with chronic kidney disease. The nonpharmacological intervention, which improves blood circulation and relaxation, has been found to be beneficial in reducing pain levels and providing a promising alternative to conventional pain management strategies.
Conflicts of interest
There are no conflicts of interest.
Acknowledgements
The authors would like to thank all of the study participants and the administration of Vinayaka Mission Annapoorna College Nursing Salem, and Department of, Vinayaka Mission’s Research Foundation (Deemed to Be University), Salem India for granting permission to carry out the research work.
Funding Statement
Nil.
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