{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T02:46:50Z","timestamp":1785552410719,"version":"3.56.0"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Chronic lymphocytic leukemia (CLL) frequently causes a range of physical and psychological symptoms, including disrupted sleep. Foot reflexology is thought to promote relaxation and improve sleep quality. This study evaluated its effectiveness in patients with CLL undergoing chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A single\u2010blind randomized controlled trial was conducted with 68 participants (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200968), who were assigned either to an intervention group or a control group. The intervention group received daily 10\u2010min foot reflexology sessions for 4 weeks using sweet almond oil, while the control group received standard routine care, including monitoring of vital signs, symptom management, medication administration, psychological support, and general patient education according to oncology ward protocols. Sleep quality was assessed at baseline and after the intervention using the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed with SPSS version 25, using chi\u2010square tests, Fisher's exact test, and\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, there was no significant difference in PSQI scores between groups (Reflexology: 16.30\u2009\u00b1\u20091.29 vs. Control: 16.78\u2009\u00b1\u20091.38;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.143). After the intervention, the reflexology group showed a marked improvement in sleep quality compared to the control group (11.78\u2009\u00b1\u20091.47 vs. 16.21\u2009\u00b1\u20091.40;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The effect size was very large and clinically meaningful (Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20093.08, 95% CI: 2.55\u20133.61). Within\u2010group analysis confirmed significant improvement in the reflexology group (\n                      <jats:italic>t<\/jats:italic>\n                      \u2009=\u20096.161,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; Cohen's\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20093.50), whereas no significant change was observed in the control group (\n                      <jats:italic>t<\/jats:italic>\n                      \u2009=\u2009\u22121.559,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.136).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Foot reflexology appears to be a safe and effective complementary intervention to improve sleep quality in patients with CLL. However, the study's limitations, including the lack of a sham control, short\u2010term follow\u2010up, and a relatively small sample size, should be considered. Healthcare providers may cautiously incorporate reflexology into supportive care, ensuring integration with standard treatments and professional guidance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.71404","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T05:10:36Z","timestamp":1761109836000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Effect of Foot Reflexology on Sleep Quality in Patients With Chronic Lymphocytic Leukemia Under Chemotherapy: A Randomized Controlled Trial"],"prefix":"10.1002","volume":"8","author":[{"given":"Naser","family":"Parizad","sequence":"first","affiliation":[{"name":"Patient Safety Research Center, Clinical Research Institute, Urmia University of Medical Sciences Urmia Iran"},{"name":"Nursing and Midwifery Faculty, Campus Nazlu Urmia West Azerbaijan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amireh","family":"Hassanpour","sequence":"additional","affiliation":[{"name":"Nursing and Midwifery Faculty, Campus Nazlu Urmia West Azerbaijan Iran"},{"name":"Department of nursing School of Nursing and Midwifery, Urmia University of Medical Sciences Urmia Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7843-0084","authenticated-orcid":false,"given":"Rasoul","family":"Goli","sequence":"additional","affiliation":[{"name":"Nursing and Midwifery Faculty, Campus Nazlu Urmia West Azerbaijan Iran"},{"name":"Department of Medical\u2010Surgical Nursing School of Nursing and Midwifery, Urmia University of Medical Sciences Urmia Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamidreza","family":"Khalkhali","sequence":"additional","affiliation":[{"name":"Biostatistics and Epidemiology Department School of Medicine, Urmia University of Medical Sciences Urmia Iran"},{"name":"Medicine Faculty, Campus Nazlu Urmia West Azerbaijan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aysan","family":"Nozad","sequence":"additional","affiliation":[{"name":"Medicine Faculty, Campus Nazlu Urmia West Azerbaijan Iran"},{"name":"Urmia University of Medical Sciences Urmia 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