1
|
Saltan A, Mert S, Topbaş Ö, Aksu B. The investigation of effect on foot plantar massage on functional recovery in older adults with general surgery, randomized clinical trial. Aging Clin Exp Res 2024; 36:118. [PMID: 38780814 PMCID: PMC11116172 DOI: 10.1007/s40520-024-02770-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Foot massage is known to be effective on the emotional state (anxiety, depression, etc.) in the postoperative period. However, studies on its effect on functional level are insufficient. AIM The study aimed to investigate the impact of foot plantar massage on functional recovery in older adults undergoing general surgery, employing a randomized clinical trial design. METHODS A total of 70 older adults aged 65 years and above who underwent abdominal surgery were included. Various assessments were conducted, including pain levels (Visual Analogue Scale), fear of mobility (Tampa Scale for Kinesiophobia), functional independence (Functional Independence Measure), balance (Berg Balance Scale), basic mobility (Rivermead Mobility Index), mental function status (Standardized Mini-Mental State Examination), and delirium (Nu-DESC). RESULTS Statistically significant differences were observed in some assessment parameters within the groups during the 2nd and 3rd measurement times, with the intervention group demonstrating significant mean differences. DISCUSSIONS The literature underscores the increase in kinesiophobia scores post-general/abdominal surgery in older adults, emphasizing the importance of evaluating functional level and kinesiophobia to expedite discharge processes and potentially plan early post-discharge rehabilitation to mitigate readmissions for functional reasons. CONCLUSIONS Ultimately, foot massage was found to be effective in reducing kinesiophobia, improving balance, mobility, daily living skills, and mental status in older adults post-abdominal surgery, thereby advocating for the facilitation of post-discharge rehabilitation programs or the reduction of readmission rates. THE CLINICAL TRIALS NUMBER NCT05534490.
Collapse
Affiliation(s)
- Asuman Saltan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Yalova University, Yalova, Turkey.
| | - Selda Mert
- Department of Nursing, Faculty of Health Sciences, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Önder Topbaş
- Department of Medical Services and Techniques, Kocaeli Vocational School of Health Services, Kocaeli University, Kocaeli, Turkey
| | - Beyza Aksu
- Vocational School of Health Services, Kocaeli University Hospital, Kocaeli University, Kocaeli, Turkey
| |
Collapse
|
2
|
Wheibe E, Dalkin BH, Meltzer HC, Russ-Sellers R, Grier JT. The Multisystem effects of Long COVID Syndrome and Potential Benefits of Massage Therapy in Long COVID Care. Int J Ther Massage Bodywork 2024; 17:19-42. [PMID: 38486840 PMCID: PMC10911825 DOI: 10.3822/ijtmb.v17i1.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
Background A major complication of infection with Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, is the potential for Long COVID Syndrome. While the pathophysiology of Long COVID Syndrome has yet to be described, the disease presentation is characterized by long-term symptoms with debilitating effects on human health. A better understanding of Long COVID symptomology may open up new avenues for patient treatment such as massage therapy. Methods From the PubMed database, cohort studies that examined post-infection COVID sequelae published between January 1st, 2021 and April 30th, 2021 were selected to investigate patient demographics and symptoms. A review of massage therapy literature since 2000 in conjunction with identified Long COVID symptoms was performed. Results This systematic review identified 17 cohort studies across the world that investigated the symptomatology of patients suffering from post-COVID sequelae in multiple organ systems. We identified the pulmonary and nervous systems to be the organ systems most affected with post-COVID sequelae, with PTSD, fatigue, dyspnea, cough, sleep disturbances, loss of smell, abdominal pain, and decreased appetite as the most common symptoms reported by >20% of Long COVID patients. Massage therapy was historically found to provide benefits to patients experiencing similar symptoms to those identified in Long COVID. Conclusions Recognizing the need for new approaches to treatment for Long COVID Syndrome, we identify massage therapy as a potential therapeutic treatment to positively impact the organ systems affected by Long COVID, especially the high-incident symptoms, and improve patient quality of life.
Collapse
Affiliation(s)
- Elias Wheibe
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC
| | - Benjamin H. Dalkin
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC
| | - Haley C. Meltzer
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC
| | | | - Jennifer T. Grier
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC
| |
Collapse
|
3
|
Fang CS, Chang SL, Fang CJ, Chou FH. Effect of massage therapy on sleep quality in critically ill patients: A systematic review and meta-analysis. J Clin Nurs 2023. [PMID: 36823692 DOI: 10.1111/jocn.16660] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 11/26/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023]
Abstract
AIM The aim of the study was to compare the effects of massage interventions on sleep quality among patients in the adult critical care unit. BACKGROUND Massage interventions have positive effects when applied to manage sleep quality in critical care units. However, research identifying the effect of massage intervention is limited. DESIGN This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. METHODS Five databases were searched from their inception to 15 April 2022 (the last search was conducted on 15 November 2022, but it yielded no additional eligible studies). The literature search was conducted using Embase, MEDLINE, the Cochrane Library, CINAHL, PsycINFO and additional sources such as Google Scholar. The Cochrane risk of bias tool for randomised trials (RoB 2.0) was used to assess the risk of bias. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system assessed the certainty of evidence and recommendations. RESULTS In total, ten randomised controlled trials comprising 569 participants were used in the systematic review, and eight trials were included in the meta-analysis. Subgroup analysis revealed significant effects of foot reflexology massage on subjective sleep quality. Massage therapy for a two-night duration in cardiac care unit patients exhibited a significant effect on subjective sleep quality. The overall GRADE certainty of evidence was low. CONCLUSION Massage intervention, particularly foot reflexology massage, with a two-night duration showed improvement in subjective sleep quality among critically ill patients. Although evidence quality was low, the results suggest that massage interventions provide a non-invasive, low-cost and effective way to promote sleep quality in critically ill adult patients. RELEVANCE TO CLINICAL PRACTICE Massage interventions can enable nurses to recommend and implement strategies promoting and improving sleep quality among critically ill patients. STUDY REGISTRATION The review protocol was registered a priori and published online in the PROSPERO database of systematic reviews (www.crd.York.ac.uk/Prospero with the registration number # CRD42022332371). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution if such details are not necessary or do not apply to your work and state why.
Collapse
Affiliation(s)
- Chiu-Shu Fang
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shih-Lun Chang
- Department of Otorhinolaryngology, Chi-Mei Medical Center, Tainan, Taiwan.,Department of Pet Care and Grooming, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Ching-Ju Fang
- Department of Secretariat, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Medical Library, National Cheng Kung University, Tainan, Taiwan
| | - Fan-Hao Chou
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| |
Collapse
|
4
|
Liu C, Chen X, Wu S. The effect of massage therapy on pain after surgery: A comprehensive meta-analysis. Complement Ther Med 2022; 71:102892. [PMID: 36309174 DOI: 10.1016/j.ctim.2022.102892] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/30/2022] [Accepted: 10/17/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Findings on the usefulness of massage therapy (MT) in postoperative pain management are often inconsistent among studies. OBJECTIVES This study's aim is to conduct a meta-analysis of randomized controlled trials (RCT) to clarify the effects of massage therapy in the treatment of postoperative pain. METHODS Three databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) were searched for RCTs published from database inception through January 26, 2021. The primary outcome was pain relief. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The random-effect model was used to calculate the effect sizes and standardized mean difference (SMD) with 95 % confidential intervals (CIs) as a summary effect. The heterogeneity test was conducted through I2. Subgroup and sensitivity analyses were used to explore the source of heterogeneity. Possible publication bias was assessed using visual inspection of funnel plot asymmetry. RESULTS The analysis included 33 RCTs and showed that MT is effective in reducing postoperative pain (SMD, -1.32; 95 % CI, -2.01 to -0.63; p = 0.0002; I2 = 98.67 %). A similar significant effect was found for both short (immediate assessment) and long terms (assessment performed 4-6 weeks after the MT). Remarkably, we found neither the duration per session nor the dose had an impact on the effect of MT and there seemed to be no difference in the effects of different MT types. In addition, MT seemed to be more effective for adults. Furthermore, MT had better analgesic effects on cesarean section and heart surgery than orthopedic surgery. LIMITATIONS Publication bias is possible due to the inclusion of studies in English only. Additionally, the included studies were extremely heterogeneous. Double-blind research on MT is difficult to implement, and none of the included studies is double-blind. There was some heterogeneity and publication bias in the included studies. In addition, there is no uniform evaluation standard for the operation level of massage practitioners, which may lead to research implementation bias. CONCLUSIONS MT is effective in reducing postoperative pain in both short and long terms.
Collapse
Affiliation(s)
- Chunhua Liu
- Department of Cancer Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui, Zhejiang, China.
| | - Xiang Chen
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Simin Wu
- Department of Cancer Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui, Zhejiang, China.
| |
Collapse
|
5
|
van der Heijden MJE, O’Flaherty L, van Rosmalen J, de Vos S, McCulloch M, van Dijk M. Aromatherapy massage seems effective in critically ill children: an observational before‐after study. PAEDIATRIC AND NEONATAL PAIN 2022; 4:61-68. [PMID: 35719220 PMCID: PMC9189908 DOI: 10.1002/pne2.12073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 01/11/2022] [Accepted: 01/24/2022] [Indexed: 11/29/2022]
Abstract
Children treated in a pediatric intensive care unit (PICU) are at risk of distress and pain. This study investigated if aromatherapy massage can reduce children's distress and improve comfort. This observational before‐after study was performed in a 22‐bed PICU in Cape Town, South Africa. The aromatherapy massage consisted of soft massaging using the “M‐technique” and a 1% blend of essential oils of Lavender (Lavandula angustifolia), German Chamomile (Matricatia recutita) and Neroli (Citrus aurantium) mixed with a grapeseed carrier oil. All present children were eligible, except those who had recently returned, were asleep or deemed unstable. The primary outcome was distress measured with the COMFORT‐Behavior scale (COMFORT‐B). Secondary outcomes were heart rate, oxygen saturation (SatO2), the Numeric Rating Scale (NRS)‐Anxiety and pain assessed by the NRS‐Pain scale. Outcomes variables were evaluated with Wilcoxon signed‐rank test and multiple regression analysis. The intervention was applied to 111 children, fifty‐one of whom (45.9%) were younger than three years old. The group median COMFORT‐B score before intervention was 15 (IQR 12–19), versus 10 (IQR 6–14) after intervention. Heart rate and NRS‐Anxiety were significantly lower after the intervention (P < 0.001). Multiple regression analysis showed that interrupted massages were less effective than the uninterrupted massages. Parental presence did not influence the outcome variables. We did not find a significant change on the NRS‐Pain scale or for SatO2. Aromatherapy massage appears beneficial in reducing distress, as measured by the COMFORT‐B scale, heart rate and the NRS‐Anxiety scale, in critically ill children. Thus, the potential of aromatherapy in clinical practice deserves further consideration.
Collapse
Affiliation(s)
- Marianne J. E. van der Heijden
- Department of Internal Medicine and Department of Paediatric Surgery Erasmus MC Sophia Children’s Hospital Rotterdam the Netherlands
| | - Linda‐Anne O’Flaherty
- Division of Pain Management Red Cross War Memorial Children’s Hospital Cape Town South Africa
| | | | - Simone de Vos
- Department of Paediatric Surgery Erasmus MC‐Sophia Children’s Hospital Rotterdam the Netherlands
| | - Mignon McCulloch
- Division of Paediatric Nephrology Red Cross War Memorial Children’s Hospital Cape Town South Africa
| | - Monique van Dijk
- Department of Internal Medicine and Department of Paediatric Surgery Erasmus MC Sophia Children’s Hospital Rotterdam the Netherlands
- Department of Paediatric Surgery Red Cross Children’s Hospital Cape Town South Africa
| |
Collapse
|
6
|
Mijatovic D, Bhalla T, Farid I. Post-thoracotomy analgesia. Saudi J Anaesth 2021; 15:341-347. [PMID: 34764841 PMCID: PMC8579496 DOI: 10.4103/sja.sja_743_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 07/10/2020] [Indexed: 11/05/2022] Open
Abstract
Thoracotomy is considered one of the most painful operative procedures. Due to anatomical complexity, post-thoracotomy pain requires multimodal perioperative treatment to adequately manage to ensure proper postoperative recovery. There are several different strategies to control post-thoracotomy pain including interventional techniques, such as neuraxial and regional injections, and conservative treatments including medications, massage therapy, respiratory therapy, and physical therapy. This article describes different strategies and evidence base for their use.
Collapse
Affiliation(s)
- Desimir Mijatovic
- Pain Center, Akron Children's Hospital, Department of Anesthesia and Pain Medicine, Akron, Ohio, USA
| | - Tarun Bhalla
- Pain Center, Akron Children's Hospital, Department of Anesthesia and Pain Medicine, Akron, Ohio, USA
| | - Ibrahim Farid
- Pain Center, Akron Children's Hospital, Department of Anesthesia and Pain Medicine, Akron, Ohio, USA
| |
Collapse
|
7
|
Application of Deep Neural Network Factor Analysis Model in Operating Room Management Nursing Analysis of Postoperative Infection Nursing after Thoracic Surgery. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:4622064. [PMID: 34737787 PMCID: PMC8563115 DOI: 10.1155/2021/4622064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/06/2021] [Accepted: 10/16/2021] [Indexed: 11/18/2022]
Abstract
Thoracic surgery is the main surgical method for the treatment of respiratory diseases and lung diseases, but infections caused by improper care are prone to occur during the operation, which can induce pulmonary edema and lung injury and affect the effect of the operation and the subsequent recovery. Therefore, it is necessary to control the disease in time and adopt more scientific and comprehensive nursing measures. Based on the neural network algorithm, this paper constructs a neural network-based factor analysis model and applies the operating room management nursing to postoperative infection nursing after thoracic surgery and verifies the effect through the neural network model. The statistical parameters in this article mainly include the postoperative infection rate of thoracic surgery, patient satisfaction, postoperative rehabilitation effect, and complications. Through statistical analysis, it can be known that operating room management and nursing can play an important role in postoperative infection nursing after thoracic surgery, effectively reducing postoperative infection nursing after thoracic surgery, and improving the recovery effect of patients after infection.
Collapse
|
8
|
Analysis Model of the Impact of Refined Intervention in Operating Room on Patients' Recovery Quality and Complications after Thoracic Surgery Based on Deep Neural Network. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:7006120. [PMID: 34580606 PMCID: PMC8464422 DOI: 10.1155/2021/7006120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/28/2021] [Accepted: 09/07/2021] [Indexed: 11/18/2022]
Abstract
To improve the nursing effect in patients after thoracic surgery, this paper proposes a refined intervention method in the operating room based on traditional operating room nursing and applies this method to the nursing of patients after thoracic surgery. Moreover, this paper improves the traditional neural network algorithm and uses the deep neural network algorithm to process test data. In addition, it includes patients accepted by the hospital as samples for test analysis and formulates detailed intervention methods for the operating room. Finally, this paper collects the corresponding test data by setting up test and control groups and visually displays the data using mathematical statistics. The statistical parameters of the experiment in this paper include the quality of recovery, complications, satisfaction score, and recovery effect. The comparative test shows that the refined intervention in the operating room based on the neural network proposed in this paper can achieve a certain effect in the postoperative nursing of thoracic surgery, effectively promote the quality of recovery, and reduce the possibility of complications.
Collapse
|
9
|
Application of Rapid Rehabilitation Nursing in Thoracic Surgery Nursing. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6351170. [PMID: 34512938 PMCID: PMC8433021 DOI: 10.1155/2021/6351170] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/08/2021] [Accepted: 08/20/2021] [Indexed: 11/22/2022]
Abstract
To study the application effect of rapid rehabilitation nursing intervention in thoracic surgery nursing, this paper researches controlled trials. First, this paper sets up a control group and a test group. The control group uses traditional nursing methods for thoracic surgical nursing intervention, and the test group adds rapid rehabilitation nursing intervention based on traditional nursing intervention. In addition, the operation and rehabilitation conditions of the control group and the test group are the same. Moreover, this paper records rehabilitation information in real time, performs data processing through statistical methods, and conducts follow-up surveys on the rehabilitation process of patients. In addition, this paper compares nursing effects through data comparison and histogram comparison. From the research results, various parameters of the patient's recovery process and the user satisfaction of the rapid rehabilitation can be seen. Furthermore, nursing is higher than those of the control group, which shows that the rapid rehabilitation nursing method can positively affect the nursing of thoracic surgery.
Collapse
|
10
|
Nordness MF, Hayhurst CJ, Pandharipande P. Current Perspectives on the Assessment and Management of Pain in the Intensive Care Unit. J Pain Res 2021; 14:1733-1744. [PMID: 34163231 PMCID: PMC8214553 DOI: 10.2147/jpr.s256406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/12/2021] [Indexed: 12/02/2022] Open
Abstract
Critical illness is often painful, both from the underlying source of illness, as well as necessary procedures performed for the monitoring and care of these patients. Pain is often under-recognized in the critically ill, especially among those who cannot self-report, so accurate assessment and management continue to be major consideration in their care. Pain management in the intensive care unit (ICU) is an evolving practice, with a focus on accurate and frequent pain assessment, and targeted pharmacologic and non-pharmacologic treatment methods to maximize analgesia and minimize sedation. In this review, we will evaluate several validated methods of pain assessment in the ICU and present management options. We will review the evidence-based recommendations put forth by the largest critical care societies and several high-quality studies related to both the in-hospital approach to pain, as well as the short- and long-term consequences of untreated pain in ICU patients. We conclude with future directions.
Collapse
Affiliation(s)
- Mina F Nordness
- Department of General Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christina J Hayhurst
- Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Anesthesiology, Division of Anesthesiology Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pratik Pandharipande
- Department of General Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Anesthesiology, Division of Anesthesiology Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
11
|
American Society of Hematology 2020 guidelines for sickle cell disease: management of acute and chronic pain. Blood Adv 2021; 4:2656-2701. [PMID: 32559294 DOI: 10.1182/bloodadvances.2020001851] [Citation(s) in RCA: 164] [Impact Index Per Article: 54.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/09/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The management of acute and chronic pain for individuals living with sickle cell disease (SCD) is a clinical challenge. This reflects the paucity of clinical SCD pain research and limited understanding of the complex biological differences between acute and chronic pain. These issues collectively create barriers to effective, targeted interventions. Optimal pain management requires interdisciplinary care. OBJECTIVE These evidence-based guidelines developed by the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in pain management decisions for children and adults with SCD. METHODS ASH formed a multidisciplinary panel, including 2 patient representatives, that was thoroughly vetted to minimize bias from conflicts of interest. The Mayo Evidence-Based Practice Research Program supported the guideline development process, including updating or performing systematic reviews. Clinical questions and outcomes were prioritized according to importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used, including GRADE evidence-to-decision frameworks, to assess evidence and make recommendations, which were subject to public comment. RESULTS The panel reached consensus on 18 recommendations specific to acute and chronic pain. The recommendations reflect a broad pain management approach, encompassing pharmacological and nonpharmacological interventions and analgesic delivery. CONCLUSIONS Because of low-certainty evidence and closely balanced benefits and harms, most recommendations are conditional. Patient preferences should drive clinical decisions. Policymaking, including that by payers, will require substantial debate and input from stakeholders. Randomized controlled trials and comparative-effectiveness studies are needed for chronic opioid therapy, nonopioid therapies, and nonpharmacological interventions.
Collapse
|
12
|
Ren N, Yang G, Ren X, Li L. Effects of foot massage on relieving pain, anxiety and improving quality of life of patients undergone a cervical spine surgery. Health Qual Life Outcomes 2021; 19:22. [PMID: 33468148 PMCID: PMC7814554 DOI: 10.1186/s12955-021-01667-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/01/2021] [Indexed: 11/10/2022] Open
Abstract
Background Long-term recovery of patients undergone cervical spine surgery is of paramount importance to improve their quality of life. In this study we aimed to evaluate the effects of foot massage on relieving pain and anxiety of patients with anterior cervical discectomy and fusion (ACDF). Methods Enrolled patients undergone ACDF and diagnosed with anxiety disorder at least six months before surgery were treated with 10-min foot massage on a daily basis for four weeks using sweet almond oil. Patients were assessed by neck pain visual analog pain scale (NP-VAS), neck disability index (NDI) and self-rating anxiety scale. Results More significant relief in NP-VAS was observed in patients who received foot massage treatment. No significant difference in NDI reduction was seen in patients with or without the treatment. Intervention group demonstrated less anxiety during follow-up (p = 0.021) compared to the control group and more reduction compared to baseline (p = 0.046). In terms of quality of life, while both groups demonstrated improvement in pain relief (p = 0.015 for the intervention group and p = 0.037 for the control group), only the intervention group showed improved mental function (p = 0.031). Conclusion This study found that foot massage was effective in alleviating pain and anxiety, while improving quality of life in patients undergone ACDF, indicating that this intervention should be considered in the clinical management of these patients.
Collapse
Affiliation(s)
- Nana Ren
- Department of Spinal Surgery, Liaocheng People's Hospital, No. 67 Dongchang Xi Road, Liaocheng, 252000, Shandong, China
| | - Guangmin Yang
- Department of Spinal Surgery, Liaocheng People's Hospital, No. 67 Dongchang Xi Road, Liaocheng, 252000, Shandong, China
| | - Xiaofeng Ren
- Department of Spinal Surgery, Liaocheng People's Hospital, No. 67 Dongchang Xi Road, Liaocheng, 252000, Shandong, China.
| | - Lekun Li
- Department of Spinal Surgery, Liaocheng People's Hospital, No. 67 Dongchang Xi Road, Liaocheng, 252000, Shandong, China.
| |
Collapse
|
13
|
Abstract
BACKGROUND Pain management is an essential component of care for pediatric patients following surgery. Massage reduces self-reported postoperative pain in adults with heart disease but has received little attention in postoperative pediatric patients with complex congenital heart disease (CCHD). OBJECTIVES The aim of the study was to evaluate the effectiveness of massage compared to a rest period on postoperative pain scores and physiological responses in infants with CCHD. METHODS We used a two-group randomized clinical trial design with a sample of 60 infants with CCHD between 1 day and 12 months of age following their first cardiothoracic surgery. Both groups received standard postoperative care. Group 1 received a daily 30-minute restriction of nonessential caregiving (quiet time), and Group 2 received a daily 30-minute massage. Interventions continued for seven consecutive days. Pain was measured six times daily using the Face, Legs, Activity, Cry, Consolability Pain Assessment Tool (FLACC). Average daily doses of analgesics were recorded. Heart rates (HRs), respiratory rates (RRs), and oxygen saturations (SpO2) were recorded continuously. Daily averages, pre- and postintervention FLACC scores, and physiological responses were analyzed using descriptive statistics, generalized linear mixed models repeated measures, latent growth models, and/or regression discontinuity analysis. Fentanyl-equivalent narcotic values were used as a time-varying covariate. RESULTS Adjusted pain scores were lower for the massage group on all days except Day 7. Overall, there were no group effects on level of pain or differential rate of change in pain. However, the massage group had lower daily pain scores with small to medium effect size differences, largest at Days 4, 5, and 6, and lower average daily HR and RR. There was little difference between groups in SpO2. Infants demonstrated immediate effects of massage, with HR and RR decreasing and oxygen saturations increasing. DISCUSSION This study provides beginning evidence that postoperative massage may reduce pain and improve physiological parameters in infants with congenital heart disease. This nonpharmacological adjunct to pain management may provide a particular benefit for this population by reducing demand on the cardiorespiratory system.
Collapse
|
14
|
Martorella G. Characteristics of Nonpharmacological Interventions for Pain Management in the ICU: A Scoping Review. AACN Adv Crit Care 2020; 30:388-397. [PMID: 31951665 DOI: 10.4037/aacnacc2019281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Pain relief in the intensive care unit (ICU) is of particular concern since patients are exposed to multiple painful stimuli associated with care procedures. Considering the adverse effects of pharmacological approaches, particularly in vulnerable populations such as the elderly, the use of non-pharmacological interventions has recently been recommended in the context of critical care. The main goal of this scoping review was to systematically map the research done on non-pharmacological interventions for pain management in ICU adults and describe the characteristics of these interventions. A wide variety of non-pharmacological interventions have been tested, with music and massage therapies being the most frequently used. An interesting new trend is the use of combined or bundle interventions. Lastly, it was observed that these interventions have not been studied in specific subgroups, such as the elderly, women, and patients unable to self-report.
Collapse
Affiliation(s)
- Geraldine Martorella
- Geraldine Martorella is Assistant Professor, College of Nursing, Florida State University, Office 104F - Vivian M. Duxbury Hall, TMH Center for Research and Evidence-Based Practice, 98 Varsity Way, Tallahassee, FL 32306
| |
Collapse
|
15
|
Richard-Lalonde M, Gélinas C, Boitor M, Gosselin E, Feeley N, Cossette S, Chlan LL. The Effect of Music on Pain in the Adult Intensive Care Unit: A Systematic Review of Randomized Controlled Trials. J Pain Symptom Manage 2020; 59:1304-1319.e6. [PMID: 31881291 DOI: 10.1016/j.jpainsymman.2019.12.359] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/11/2019] [Accepted: 12/13/2019] [Indexed: 10/25/2022]
Abstract
CONTEXT Multimodal analgesic approaches are recommended for intensive care unit (ICU) pain management. Although music is known to reduce pain in acute and chronic care settings, less is known about its effectiveness in the adult ICU. OBJECTIVES Determine the effects of music interventions on pain in the adult ICU, compared with standard care or noise reduction. METHODS This review was registered on PROSPERO (CRD42018106889). Databases were searched for randomized controlled trials of music interventions in the adult ICU, with the search terms ["music*" and ("critical care" or "intensive care")]. Pain scores (i.e., self-report rating scales or behavioral scores) were the main outcomes of this review. Data were analyzed using a DerSimonian-Laird random-effects method with standardized mean difference (SMD) of pain scores. Statistical heterogeneity was determined as I2 > 50% and explored via subgroup analyses and meta-regression. RESULTS Eighteen randomized controlled trials with a total of 1173 participants (60% males; mean age 60 years) were identified. Ten of these studies were included in the meta-analysis based on risk of bias assessment (n = 706). Music was efficacious in reducing pain (SMD -0.63 [95% CI -1.02, -0.24; n = 10]; I2 = 87%). Music interventions of 20-30 minutes were associated with a larger decrease in pain scores (SMD -0.66 [95% CI -0.94, -0.37; n = 5]; I2 = 30%) compared with interventions of less than 20 minutes (SMD 0.10 [95% CI -0.10, 0.29; n = 4]; I2 = 0%). On a 0-10 scale, 20-30 minutes of music resulted in an average decrease in pain scores of 1.06 points (95% CI -1.56, -0.56). CONCLUSION Music interventions of 20-30 minutes are efficacious to reduce pain in adult ICU patients able to self-report.
Collapse
Affiliation(s)
| | - Céline Gélinas
- McGill University and Jewish General Hospital, Montreal, Quebec, Canada
| | | | | | - Nancy Feeley
- McGill University and Jewish General Hospital, Montreal, Quebec, Canada
| | - Sylvie Cossette
- Université de Montréal, Montreal Heart Institute, Montreal, Quebec, Canada
| | | |
Collapse
|
16
|
Kaye AD, Granier AL, Garcia AJ, Carlson SF, Fuller MC, Haroldson AR, White SW, Krueger OL, Novitch MB, Cornett EM. Non-Opioid Perioperative Pain Strategies for the Clinician: A Narrative Review. Pain Ther 2020; 9:25-39. [PMID: 31933147 PMCID: PMC7203361 DOI: 10.1007/s40122-019-00146-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Indexed: 12/11/2022] Open
Abstract
Alternative and non-opioid options for pain management are necessary in perioperative patient care. Opioids are no longer touted as cure-all medications, and furthermore, there have been tremendous advances in alternative therapies such as in interventional pain, physical therapy, exercise, and nutritional counseling that have proven benefits to combat pain. The center for disease control now strongly recommends the use of multimodal analgesia and multidisciplinary approaches based on the individual needs of patients: personalized medicine. In this manuscript, the specifics of non-opioid pharmacological and non-pharmacological analgesic approaches will be discussed as well as their possible indications and uses to reduce the need for excessive use of opioids for adequate pain control.
Collapse
Affiliation(s)
- Alan David Kaye
- Anesthesiology and Pharmacology, Toxicology, and Neurosciences, LSU School of Medicine, Shreveport, LA, USA
- Anesthesiology and Pharmacology, LSU School of Medicine, New Orleans, LA, USA
- Anesthesiology and Pharmacology, Tulane School of Medicine, New Orleans, LA, USA
| | | | - Andrew J Garcia
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | | | | | | | | | | | - Matthew B Novitch
- Department of Anesthesiology, University of Washington, Seattle, WA, USA
| | - Elyse M Cornett
- Department of Anesthesiology, LSU Health Shreveport, Shreveport, LA, USA.
| |
Collapse
|
17
|
Jackson HJ, Reneau M. Complementary therapies for acute pain management: What does the evidence say? Nurse Pract 2019; 44:8-11. [PMID: 31764469 DOI: 10.1097/01.npr.0000605532.19434.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Heather J Jackson
- Heather J. Jackson is an NP and administrative director of advanced practice, Vanderbilt Ingram Cancer Center and associate in anesthesiology, pain division at Vanderbilt University Medical Center, Nashville, Tenn. Marcelaine Reneau is an NP at Ralph H. Johnson Veterans Administration Medical Center, Integrative Pain Clinic, Department of Anesthesia, Charleston, S.C
| | | |
Collapse
|
18
|
Massage therapy reduces arterial puncture-induced pain: the randomized cross-over bi-center TORREA study. Intensive Care Med 2019; 46:138-139. [PMID: 31713060 DOI: 10.1007/s00134-019-05838-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2019] [Indexed: 10/25/2022]
|
19
|
Naruse SM, Moss M. Effects of couples positive massage programme on wellbeing, perceived stress and coping, and relation satisfaction. Health Psychol Behav Med 2019; 7:328-347. [PMID: 34040854 PMCID: PMC8114367 DOI: 10.1080/21642850.2019.1682586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 10/09/2019] [Indexed: 10/28/2022] Open
Abstract
Objectives: Although supporting preventative self-regulation and self-care activity for daily stress is important as dyadic coping, there seems a paucity of exploration of non-verbal interventions such as tactile communication. This preliminary experimental study assessed the efficacy of a short educational massage programme for healthy but stressed couples. The study aimed to investigate if the educational mutual massage (Positive Massage) programme has any acute and sustained effects on wellbeing, perceived stress and coping, and relationship satisfaction among couples. Design: A pseudo randomised two group design employing a delayed treatment element assessed the effects of the Positive Massage programme and subsequent at-home application. Thirty-eight participants completed a three-week massage course. Main Outcome Measures: Measurements of the Warwick-Edinburgh Mental Well-being Scale, the Rhode Island Stress and Coping Inventory, and the Positive Feelings Questionnaire were collected online using Qualtrics at three time points (the start, the end, and three weeks after the course). Data were analysed with mixed ANOVAs. Results: Mental wellbeing, and perceived stress and coping significantly improved from before to after the Positive Massage programme. There was no significant decline after the cessation of the massage programme. Relationship satisfaction did not show significant changes from the initial assessment. Conclusions: The overall effects of the Positive Massage programme indicate the importance of developing further large scale studies of mutual massage as a safe and beneficial self-care activity. This innovative study has laid the groundwork for future studies into the possibility of mutual massage as a self-regulation dyadic coping strategy for home use to improve overall wellbeing.
Collapse
Affiliation(s)
- Sayuri M. Naruse
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Mark Moss
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| |
Collapse
|
20
|
Boitor M, Martorella G, Maheu C, Laizner AM, Gélinas C. Effects of Massage in Reducing the Pain and Anxiety of the Cardiac Surgery Critically Ill-a Randomized Controlled Trial. PAIN MEDICINE 2019; 19:2556-2569. [PMID: 29618079 DOI: 10.1093/pm/pny055] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objective To evaluate the effectiveness of hand massage on the pain and anxiety of the cardiac surgery critically ill. Design A three-arm randomized controlled trial. Setting This study was conducted in a medical-surgical intensive care unit in Canada. Subjects Adult patients who underwent elective cardiac surgery, who were able to speak French/English and to self-report symptoms, without a high risk of postoperative complications were eligible. Methods Patients were randomly allocated to standard care plus either two 20-minute hand massages (experimental), two 20-minute hand holdings (active control), or two 20-minute rest periods (passive control/standard care). Pain intensity, pain unpleasantness, anxiety, muscle tension, and vital signs were evaluated before, after, and 30 minutes later for each intervention. Results From the 83 patients recruited, 60 were randomized (20 massage, 19 hand holding, 21 standard care). After controlling for baseline scores, the massage group reported significantly lower pain intensity, pain unpleasantness, and anxiety for the first data collection set compared with both hand holding and standard care (analysis of covariance, P < 0.02), with an average decrease of two points on a 0-10 scale. No statistically significant differences were noted between hand holding and standard care for any of the symptoms. Similar results were observed for the second data collection set (N = 43). Patients had decreased muscle tension post massage. Vital signs did not differ significantly between groups. Conclusions Findings suggest that a 20-minute hand massage in addition to routine postoperative pain management can concomitantly reduce pain intensity, pain unpleasantness, and anxiety by two points on average on a 0-10 scale.
Collapse
Affiliation(s)
- Madalina Boitor
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montréal, Québec, Canada
| | - Géraldine Martorella
- College of Nursing, Florida State University, 104F - Vivian M. Duxbury Hall, Florida, USA
| | - Christine Maheu
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montréal, Québec, Canada
| | - Andréa Maria Laizner
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montréal, Québec, Canada
| | - Céline Gélinas
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montréal, Québec, Canada
| |
Collapse
|
21
|
Giannitrapani KF, Holliday JR, Miake-Lye IM, Hempel S, Taylor SL. Synthesizing the Strength of the Evidence of Complementary and Integrative Health Therapies for Pain. PAIN MEDICINE 2019; 20:1831-1840. [DOI: 10.1093/pm/pnz068] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Abstract
Objective
Pain and opioid use are highly prevalent, leading for calls to include nonpharmacological options in pain management, including complementary and integrative health (CIH) therapies. More than 2,000 randomized controlled trials (RCTs) and many systematic reviews have been conducted on CIH therapies, making it difficult to easily understand what type of CIH therapy might be effective for what type of pain. Here we synthesize the strength of the evidence for four types of CIH therapies on pain: acupuncture, therapeutic massage, mindfulness techniques, and tai chi.
Design
We conducted searches of English-language systematic reviews and RCTs in 11 electronic databases and previously published reviews for each type of CIH. To synthesize that large body of literature, we then created an “evidence map,” or a visual display, of the literature size and broad estimates of effectiveness for pain.
Results
Many systematic reviews met our inclusion criteria: acupuncture (86), massage (38), mindfulness techniques (11), and tai chi (21). The evidence for acupuncture was strongest, and largest for headache and chronic pain. Mindfulness, massage, and tai chi have statistically significant positive effects on some types of pain. However, firm conclusions cannot be drawn for many types of pain due to methodological limitations or lack of RCTs.
Conclusions
There is sufficient strength of evidence for acupuncture for various types of pain. Individual studies indicate that tai chi, mindfulness, and massage may be promising for multiple types of chronic pain. Additional sufficiently powered RCTs are warranted to indicate tai chi, mindfulness, and massage for other types of pain.
Collapse
Affiliation(s)
- Karleen F Giannitrapani
- VA Palo Alto Healthcare System, Center for Innovation to Implementation, Menlo Park, California
- Stanford University, Stanford, California
| | - Jesse R Holliday
- VA Palo Alto Healthcare System, Center for Innovation to Implementation, Menlo Park, California
| | | | | | - Stephanie L Taylor
- VA Greater Los Angeles Healthcare System, Center for the Study of Healthcare Innovation, Implementation and Policy, Los Angeles, California
- UCLA Department of Health Policy and Management, Los Angeles, California, USA
| |
Collapse
|
22
|
Palese A, Rossettini G, Colloca L, Testa M. The impact of contextual factors on nursing outcomes and the role of placebo/nocebo effects: a discussion paper. Pain Rep 2019; 4:e716. [PMID: 31583342 PMCID: PMC6749917 DOI: 10.1097/pr9.0000000000000716] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/23/2018] [Accepted: 01/05/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Placebo and nocebo effects represent one of the most fascinating topics in the health care field. OBJECTIVES the aims of this discussion paper were (1) to briefly introduce the placebo and nocebo effects, (2) to elucidate the contextual factors able to trigger placebo and nocebo effects in the nursing field, and (3) to debate the impact of contextual factors on nursing education, practice, organisation, and research. METHODS a narrative review was conducted based on the available evidence. RESULTS Placebo responses (from Latin "I shall please") are a beneficial outcome(s) triggered by a positive context. The opposite are the nocebo effects (from Latin "I shall harm"), which indicates an undesirable outcome(s) caused by a negative context. Both are complex and distinct psychoneurobiological phenomena in which behavioural and neurophysiological changes arise subsequent to an interaction between the patient and the health care context. CONCLUSION Placebo and nocebo concepts have been recently introduced in the nursing discipline, generating a wide debate on ethical issues; however, the impact on nursing education, clinical practice, nursing administration, and research regarding contextual factors triggering nocebo and placebo effects has not been debated to date.
Collapse
Affiliation(s)
- Alvisa Palese
- Department Biological and Medical Science, University of Udine, Italy, Udine, Italy
| | - Giacomo Rossettini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Italy, Savona, Italy
| | - Luana Colloca
- Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, USA
- Departments of Anesthesiology and Psychiatry, School of Medicine, Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD, USA
| | - Marco Testa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, Italy, Savona, Italy
| |
Collapse
|
23
|
Harris SJ, Papathanassoglou EDE, Gee M, Hampshaw SM, Lindgren L, Haywood A. Interpersonal touch interventions for patients in intensive care: A design-oriented realist review. Nurs Open 2019; 6:216-235. [PMID: 30918674 PMCID: PMC6419112 DOI: 10.1002/nop2.200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/11/2018] [Accepted: 08/07/2018] [Indexed: 12/17/2022] Open
Abstract
AIM To develop a theoretical framework to inform the design of interpersonal touch interventions intended to reduce stress in adult intensive care unit patients. DESIGN Realist review with an intervention design-oriented approach. METHODS We searched CINAHL, MEDLINE, EMBASE, CENTRAL, Web of Science and grey literature sources without date restrictions. Subject experts suggested additional articles. Evidence synthesis drew on diverse sources of literature and was conducted iteratively with theory testing. We consulted stakeholders to focus the review. We performed systematic searches to corroborate our developing theoretical framework. RESULTS We present a theoretical framework based around six intervention construction principles. Theory testing provided some evidence in favour of treatment repetition, dynamic over static touch and lightening sedation. A lack of empirical evidence was identified for construction principles relating to intensity and positive/negative evaluation of emotional experience, moderate pressure touch for sedated patients and intervention delivery by relatives versus healthcare practitioners.
Collapse
Affiliation(s)
- Sansha J. Harris
- School of Health and Related Research (ScHARR)University of SheffieldSheffieldUK
| | | | - Melanie Gee
- Faculty of Health and WellbeingSheffield Hallam UniversitySheffieldUK
| | - Susan M. Hampshaw
- School of Health and Related Research (ScHARR)University of SheffieldSheffieldUK
| | | | - Annette Haywood
- School of Health and Related Research (ScHARR)University of SheffieldSheffieldUK
| |
Collapse
|
24
|
Miake-Lye IM, Mak S, Lee J, Luger T, Taylor SL, Shanman R, Beroes-Severin JM, Shekelle PG. Massage for Pain: An Evidence Map. J Altern Complement Med 2019; 25:475-502. [PMID: 30892910 PMCID: PMC6533778 DOI: 10.1089/acm.2018.0282] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objectives: Massage therapy has been proposed for painful conditions, but it can be difficult to understand the breadth and depth of evidence, as various painful conditions may respond differently to massage. The authors conducted an evidence mapping process and generated an "evidence map" to visually depict the distribution of evidence available for massage and various pain indications to identify gaps in evidence and to inform future research priorities. Design: The authors searched PubMed, Embase, and Cochrane for systematic reviews reporting pain outcomes for massage therapy. The authors assessed the quality of each review using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) criteria. The authors used a bubble plot to depict the number of included articles, pain indication, effect of massage for pain, and strength of findings for each included systematic review. Results: The authors identified 49 systematic reviews, of which 32 were considered high quality. Types of pain frequently included in systematic reviews were cancer pain, low back pain, and neck pain. High quality reviews concluded that there was low strength of evidence of potential benefits of massage for labor, shoulder, neck, low back, cancer, arthritis, postoperative, delayed onset muscle soreness, and musculoskeletal pain. Reported attributes of massage interventions include style of massage, provider, co-interventions, duration, and comparators, with 14 high-quality reviews reporting all these attributes in their review. Conclusion: Prior reviews have conclusions of low strength of evidence because few primary studies of large samples with rigorous methods had been conducted, leaving evidence gaps about specific massage type for specific pain. Primary studies often do not provide adequate details of massage therapy provided, limiting the extent to which reviews are able to draw conclusions about characteristics such as provider type.
Collapse
Affiliation(s)
- Isomi M Miake-Lye
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA.,2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | - Selene Mak
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA.,2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | | | - Tana Luger
- 2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | - Stephanie L Taylor
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA.,2 Fielding School of Public Health, Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA
| | - Roberta Shanman
- 4 Southern California Evidence-Based Practice Center, RAND Corporation, Santa Monica, CA
| | | | - Paul G Shekelle
- 1 West Los Angeles Veterans Affairs Medical Center, Los Angeles, CA
| |
Collapse
|
25
|
Jagan S, Park T, Papathanassoglou E. Effects of massage on outcomes of adult intensive care unit patients: a systematic review. Nurs Crit Care 2019; 24:414-429. [PMID: 30829459 DOI: 10.1111/nicc.12417] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 12/19/2018] [Accepted: 12/21/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND The critical care experience is particularly stressful for patients, which can result in a number of physiological and psychological consequences, including haemodynamic instability, increased pain, agitation and delirium, leading to prolonged mechanical ventilation, length of stay and subsequent complications. Massage therapy encompasses different techniques to promote relaxation and to counter stress, therefore potentially affecting several patients' outcomes. AIMS To systematically review evidence on the effects of massage on outcomes of adult critically ill patients. The outcome measures included pain, vital signs (VS), haemodynamic measurements, level of consciousness, sleep quality, muscle tension, anxiety, feelings of calm and relaxation, coping, arterial blood gases and serum biomarkers. METHOD This was a systematic review based on focused literature searches (PubMed, CINAHL, Scopus, EMBASE-Ovid databases, Google Scholar). The Cochrane Collaboration's tool was used to assess the risk of bias. Eligibility criteria included published experimental and quasi-experimental studies reporting on the physiological and psychological outcomes of critically ill patients. RESULTS Based on the selection criteria, 12 studies were included in the review. The main findings are as follows: 8 of 12 studies used randomized control designs with high internal validity, and there was a high level of evidence of favourable effects with respect to improvements in VS and a reduction in pain and anxiety. Outcomes that need to be more rigorously pursued include quality of sleep, analgesic and sedative dosages and level of consciousness. CONCLUSION The results suggest that massage interventions can have positive effects on critically ill patients' outcomes. However, there are several gaps in the literature, along with methodological limitations, that require further consideration in critical care settings. RELEVANCE TO CLINICAL PRACTICE The results of this systematic review can inform implementation of massage interventions in critical care, which can be challenging as a result of several barriers.
Collapse
Affiliation(s)
- Sameera Jagan
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Canada
| | - Tanya Park
- Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Canada
| | | |
Collapse
|
26
|
The Effect of Foot Massage on Pain Intensity and Anxiety in Patients Having Undergone a Tibial Shaft Fracture Surgery: A Randomized Clinical Trial. J Orthop Trauma 2018; 32:e482-e486. [PMID: 30444801 DOI: 10.1097/bot.0000000000001320] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the effect of massage therapy on pain intensity and anxiety in patients who have undergone tibial shaft fracture surgery. DESIGN This study was a randomized clinical trial with a pre-post design. As the study included 2 treatment groups, it was a parallel study. SETTING Khatam-Al-Anbia Hospital in Zahedan, Iran, between July and August 2017. PATIENTS In all, 66 patients who underwent a tibial shaft fracture surgery were enrolled and randomly assigned to intervention and control groups (33 patients each). INTERVENTION The intervention included a 10-minute foot massage (5 minutes per leg) using sweet almond oil, the most common lubricant used in massage therapy. MAIN OUTCOME MEASUREMENTS Data were collected using pain numeric rating scale and Spielberger State-Trait Anxiety Inventory before and after intervention. RESULTS After intervention, the mean scores for pain intensity, and anxiety in the intervention and control groups were 4.72 (0.97) and 5.72 (0.91), and 42.84 (6.50) and 58.36 (10.37), respectively. A significant difference was noted between the intervention and control groups concerning pain intensity and anxiety. CONCLUSIONS The results indicated that massage therapy reduced pain intensity and anxiety in patients who underwent tibial shaft fracture surgery. Therefore, using massage as a noninvasive and acceptable intervention is suggested in orthopaedic surgery, especially after tibial shaft fracture surgeries. LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Collapse
|
27
|
Massage and reflexology for post-operative cancer cystectomy patients: Evaluation of a pilot service. Complement Ther Clin Pract 2018; 34:109-112. [PMID: 30712712 DOI: 10.1016/j.ctcp.2018.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 10/16/2018] [Accepted: 11/13/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND and purpose: Radical cystectomy is a gold standard treatment for invasive bladder cancer. However the length of the operation is long and recovery is usually slow and painful. There is growing recognition of the importance of health related quality of life among patients undergoing invasive surgical procedures. In response, a massage and reflexology service was piloted and evaluated. MATERIALS AND METHODS One hour of massage, reflexology or a combination of both was provided twice to 38 cystectomy patients by a trained therapist in their acute post-operative phase (day one and day three). Self-reported concerns, well-being and pain were measured before and immediately after the therapy. Pain was measured once more in the early evening of each therapy day. RESULTS Self-reported concerns and pain were significantly reduced following the intervention on both days treatments were given. Pain was measured again on the evening of each of the intervention days, and this reduction was maintained on day one but not day three. Well-being scores were also significantly improved pre to post intervention on both day one and day three. Qualitative comments highlighted that this complementary therapy service was viewed both beneficial and relaxing. There were no significant differences between the different therapies used (massage, reflexology, or a combination of the two). CONCLUSION The findings of this pilot evaluation very tentatively support the benefits of cancer cystectomy patients receiving massage and/or reflexology in their acute postoperative recovery period. There are many limitations to this evaluation. Further research utilising a randomised control methodology alongside medical, independent markers is warranted, and currently in development.
Collapse
|
28
|
Zubrzycki M, Liebold A, Skrabal C, Reinelt H, Ziegler M, Perdas E, Zubrzycka M. Assessment and pathophysiology of pain in cardiac surgery. J Pain Res 2018; 11:1599-1611. [PMID: 30197534 PMCID: PMC6112778 DOI: 10.2147/jpr.s162067] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Analysis of the problem of surgical pain is important in view of the fact that the success of surgical treatment depends largely on proper pain management during the first few days after a cardiosurgical procedure. Postoperative pain is due to intraoperative damage to tissue. It is acute pain of high intensity proportional to the type of procedure. The pain is most intense during the first 24 hours following the surgery and decreases on subsequent days. Its intensity is higher in younger subjects than elderly and obese patients, and preoperative anxiety is also a factor that increases postoperative pain. Ineffective postoperative analgesic therapy may cause several complications that are dangerous to a patient. Inappropriate postoperative pain management may result in chronic pain, immunosuppression, infections, and less effective wound healing. Understanding and better knowledge of physiological disorders and adverse effects resulting from surgical trauma, anesthesia, and extracorporeal circulation, as well as the development of standards for intensive postoperative care units are critical to the improvement of early treatment outcomes and patient comfort.
Collapse
Affiliation(s)
- Marek Zubrzycki
- Department of Cardiac Surgery, University of Ulm Medical Center, Ulm, Germany,
| | - Andreas Liebold
- Department of Cardiac Surgery, University of Ulm Medical Center, Ulm, Germany,
| | - Christian Skrabal
- Department of Cardiac Surgery, University of Ulm Medical Center, Ulm, Germany,
| | - Helmut Reinelt
- Department of Cardiac Anesthesiology, University of Ulm Medical Center, Ulm, Germany
| | - Mechthild Ziegler
- Department of Cardiac Anesthesiology, University of Ulm Medical Center, Ulm, Germany
| | - Ewelina Perdas
- Department of Cardiovascular Physiology, Medical University of Lodz, Lodz, Poland
| | - Maria Zubrzycka
- Department of Cardiovascular Physiology, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
29
|
|
30
|
The Impact of Massage and Reading on Children's Pain and Anxiety After Cardiovascular Surgery: A Pilot Study. Pediatr Crit Care Med 2018; 19:725-732. [PMID: 29912070 PMCID: PMC6086725 DOI: 10.1097/pcc.0000000000001615] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES The purpose of this pilot study was three-fold: 1) to evaluate the safety and feasibility of instituting massage therapy in the immediate postoperative period after congenital heart surgery, 2) to examine the preliminary results on effects of massage therapy versus standard of care plus three reading visits on postoperative pain and anxiety, and 3) to evaluate preliminary effects of opioid and benzodiazepine exposure in patients receiving massage therapy compared with reading controls. DESIGN Prospective, randomized controlled trial. SETTING An academic children's hospital. SUBJECTS Sixty pediatric heart surgery patients between ages 6 and 18 years. INTERVENTIONS Massage therapy and reading. MEASUREMENT AND MAIN RESULTS There were no adverse events related to massage or reading interventions in either group. Our investigation found no statistically significant difference in Pain or State-Trait Anxiety scores in the initial 24 hours after heart surgery (T1) and within 48 hours of transfer to the acute care unit (T2) after controlling for age, gender, and Risk Adjustment for Congenital Heart Surgery 1 score. However, children receiving massage therapy had significantly lower State-Trait Anxiety scores after receiving massage therapy at time of discharge (T3; p = 0.0075) than children receiving standard of care plus three reading visits. We found no difference in total opioid exposure during the first 3 postoperative days between groups (median [interquartile range], 0.80 mg/kg morphine equivalents [0.29-10.60] vs 1.13 mg/kg morphine equivalents [0.72-6.14]). In contrast, children receiving massage therapy had significantly lower total benzodiazepine exposure in the immediate 3 days following heart surgery (median [interquartile range], 0.002 mg/kg lorazepam equivalents [0-0.03] vs 0.03 mg/kg lorazepam equivalents [0.02-0.09], p = 0.0253, Wilcoxon rank-sum) and number of benzodiazepine PRN doses (0.5 [0-2.5] PRN vs 2 PRNs (1-4); p = 0.00346, Wilcoxon rank-sum). CONCLUSIONS Our pilot study demonstrated the safety and feasibility of implementing massage therapy in the immediate postoperative period in pediatric heart surgery patients. We found decreased State-Trait Anxiety scores at discharge and lower total exposure to benzodiazepines. Preventing postoperative complications such as delirium through nonpharmacologic interventions warrants further evaluation.
Collapse
|
31
|
Dusek JA, Griffin KH, Finch MD, Rivard RL, Watson D. Cost Savings from Reducing Pain Through the Delivery of Integrative Medicine Program to Hospitalized Patients. J Altern Complement Med 2018; 24:557-563. [PMID: 29474095 PMCID: PMC6006422 DOI: 10.1089/acm.2017.0203] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES An important task facing hospitals is improving pain management without raising costs. Integrative medicine (IM), a promising nonpharmacologic pain management strategy, is yet to be examined for its cost implications in an inpatient setting. This institution has had an inpatient IM department for over a decade. The purpose was to examine the relationship between changes in patients' pain, as a result of receiving IM therapy, and total cost of care during an inpatient hospital admission. DESIGN In this retrospective analysis, data from an EPIC-based electronic health record (EHR) patient demographics, length of stay (LOS), and All Patient Refined Diagnosis Related Groups (APR-DRG) severity of illness measures were utilized. IM practitioners collected and entered patient-reported pain scores into the EHR. The authors regressed the demographic, change in pain, LOS, and APR-DRG variables with changes in pain on total cost for the hospital admission. To estimate cost savings to the hospital, they computed the average reduction in cost associated with reduction in pain by multiplying the coefficient for change in pain by average total cost. SETTING/LOCATION A large, tertiary care hospital in Minneapolis, MN. SUBJECTS Adult inpatient admissions, 2730, during the study period where patients received IM for pain and met eligibility criteria. INTERVENTION IM services provided to inpatients. OUTCOME MEASURES Change in pain on an 11-point numeric rating scale before and after initial IM sessions; total costs for hospital admissions. RESULTS Both LOS and age were found to increase cost, as did being white, male, married, and having APR-DRG severity coded as extreme. For patients receiving IM therapies, pain was reduced by an average of 2.05 points and this pain reduction was associated with a cost savings of $898 per hospital admission. CONCLUSIONS For patients receiving IM therapies, pain was significantly reduced and costs were lowered by about 4%.
Collapse
Affiliation(s)
- Jeffery A Dusek
- 1 Allina Health, Integrative Health Research Center, Penny George Institute for Health and Healing , Minneapolis, MN
| | - Kristen H Griffin
- 1 Allina Health, Integrative Health Research Center, Penny George Institute for Health and Healing , Minneapolis, MN
| | - Michael D Finch
- 2 Children's Minnesota, Children's Minnesota Research Institute , Minneapolis, MN
| | - Rachael L Rivard
- 1 Allina Health, Integrative Health Research Center, Penny George Institute for Health and Healing , Minneapolis, MN
| | - David Watson
- 2 Children's Minnesota, Children's Minnesota Research Institute , Minneapolis, MN
| |
Collapse
|
32
|
Vergo MT, Pinkson BM, Broglio K, Li Z, Tosteson TD. Immediate Symptom Relief After a First Session of Massage Therapy or Reiki in Hospitalized Patients: A 5-Year Clinical Experience from a Rural Academic Medical Center. J Altern Complement Med 2018; 24:801-808. [PMID: 29620922 DOI: 10.1089/acm.2017.0409] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES There is an increasing demand for and use of alternative and complementary therapies, such as reiki and massage therapy, in hospital-based settings. Most controlled studies and practice-based reports include oncology and surgical patient populations; thus the effect in a more heterogeneous hospitalized patient population is hard to estimate. We examined the immediate symptom relief from a single reiki or massage session in a hospitalized population at a rural academic medical center. DESIGN Retrospective analysis of prospectively collected data on demographic, clinical, process, and quality of life for hospitalized patients receiving massage therapy or reiki. SETTINGS/LOCATION A 396-bed rural academic and tertiary medical center in the United States. SUBJECTS Hospitalized patients requesting or referred to the healing arts team who received either a massage or reiki session and completed both a pre- and post-therapy symptom questionnaire. INTERVENTIONS First session of routine reiki or massage therapy during a hospital stay. OUTCOME MEASURES Differences between pre- and postsession patient-reported scores in pain, nausea, fatigue, anxiety, depression, and overall well-being using an 11-point Likert scale. RESULTS Patients reported symptom relief with both reiki and massage therapy. Analysis of the reported data showed reiki improved fatigue (-2.06 vs. -1.55 p < 0.0001) and anxiety (-2.21 vs. -1.84 p < 0.001) statistically more than massage. Pain, nausea, depression, and well being changes were not statistically different between reiki and massage encounters. Immediate symptom relief was similar for cancer and noncancer patients for both reiki and massage therapy and did not vary based on age, gender, length of session, and baseline symptoms. CONCLUSIONS Reiki and massage clinically provide similar improvements in pain, nausea, fatigue, anxiety, depression, and overall well-being while reiki improved fatigue and anxiety more than massage therapy in a heterogeneous hospitalized patient population. Controlled trials should be considered to validate the data.
Collapse
Affiliation(s)
- Maxwell T Vergo
- 1 Section of Palliative Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.,2 Geisel School of Medicine , Lebanon, New Hampshire
| | - Briane M Pinkson
- 1 Section of Palliative Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Kathleen Broglio
- 1 Section of Palliative Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.,2 Geisel School of Medicine , Lebanon, New Hampshire
| | - Zhongze Li
- 3 Division of Biostatistics, Department of Biomedical Data Science, Lebanon, New Hampshire
| | - Tor D Tosteson
- 3 Division of Biostatistics, Department of Biomedical Data Science, Lebanon, New Hampshire
| |
Collapse
|