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de Andrade ÉV, Oliveira LM, Dos Santos Felix MM, Raponi MBG, de Faria MF, Calegari IB, da Silva KFN, Barbosa MH. Nonpharmacologic Therapies for Postoperative Pain in Cardiac Surgery: A Systematic Review. Pain Manag Nurs 2024; 25:e59-e75. [PMID: 38336527 DOI: 10.1016/j.pmn.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/30/2023] [Accepted: 12/20/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To search for studies that address the efficacy of nonpharmacologic methods for pain relief in adults undergoing cardiac surgeries. DESIGN A systematic review registered in the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42020168681. DATA SOURCE PubMed, LILACS, CINAHL, the Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials. REVIEW/ANALYSIS METHODS The review used a PRISMA guideline that selected primary randomized controlled trials on the efficacy of nonpharmacologic pain relief therapies in patients undergoing cardiac surgery, with no time or language restrictions. The Joanna Briggs Institute Critical Appraisal Checklist for Randomized Clinical Trials was used to assess methodological rigor. RESULTS After screening, 23 of the 140 studies found in the databases were selected. The studies examined the efficacy of 13 different nonpharmacologic therapies, as well as a combination of therapies, with massage therapy being the most commonly examined, followed by musical intervention and hypnosis. CONCLUSIONS Some interventions, when combined with pharmacologic therapy, were effective in relieving postoperative pain after cardiac surgeries, according to the studies analyzed. However, most studies had significant methodological flaws, and further studies with high methodological quality are needed.
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Affiliation(s)
- Érica Vieira de Andrade
- Stricto sensu Graduate Program Health Care, Federal University of Triângulo Mineiro. Av. Getúlio Guaritá, Uberaba, Minas Gerais, Brazil
| | - Letícia Modesto Oliveira
- Undergraduate Program in Nursing, Federal University of Triângulo Mineiro, Praça Manoel Terra, Uberaba, Minas Gerais, Brazil
| | - Márcia Marques Dos Santos Felix
- Stricto sensu Graduate Program Health Care, Federal University of Triângulo Mineiro. Av. Getúlio Guaritá, Uberaba, Minas Gerais, Brazil
| | | | - Maíla Fidalgo de Faria
- Stricto sensu Graduate Program Health Care, Federal University of Triângulo Mineiro. Av. Getúlio Guaritá, Uberaba, Minas Gerais, Brazil
| | - Isadora Braga Calegari
- Stricto sensu Graduate Program Health Care, Federal University of Triângulo Mineiro. Av. Getúlio Guaritá, Uberaba, Minas Gerais, Brazil
| | - Karla Fabiana Nunes da Silva
- Professional Education Center, Federal University of Triângulo Mineiro. Av. Getúlio Guaritá, Minas Gerais, Brazil
| | - Maria Helena Barbosa
- Teaching and Scientific Department of Nursing in Hospital Care, Institute of Health Sciences, Federal University of Triângulo Mineiro. Av. Getúlio Guaritá, Minas Gerais, Brazil.
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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.
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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.
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Harorani M, Salehi M, Shahrodi M, Rafiei F. Effect of localized acupressure massage on anxiety during chemotherapy in patients with breast cancer: A single-blind randomized clinical trial. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Harorani M, Garshasbi M, Sediqi M, Farahani Z, Habibi D, Farahani M, Amini N, Velashjerdi Z. The effect of Shiatsu massage on agitation in mechanically ventilated patients: A randomized controlled trial. Heart Lung 2021; 50:893-897. [PMID: 34403892 DOI: 10.1016/j.hrtlng.2021.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 07/14/2021] [Accepted: 07/25/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patients admitted to the intensive care units encounter many complications due to the nature of the disease and invasive medical procedures such as intubation and mechanical ventilation. Among these complications, agitation is a frequently-observed and serious problem. OBJECTIVES This study aimed to investigate the effect of Shiatsu massage on agitation in mechanically ventilated patients. METHODS In this randomized controlled trial, a total of 68 mechanically ventilated patients were selected and then randomly assigned to two groups of intervention and control. Patients in the intervention group received three 5-minute periods of Shiatsu massage with a 2-minute break between them, while patients in the control group only received a touch on the area considered for the message. Data were collected before and after the intervention using the Richmond Agitation-Sedation Scale (RASS) and then analyzed using IBM SPSS Statistics for Windows, version 25.0 (IBM Corp., Armonk, N.Y., USA). RESULTS The results showed that the level of agitation significantly decreased in the intervention group compared to the control group (p=.001). CONCLUSION Application of shiatsu massage seems to be effective in managing agitation in mechanically ventilated patients. Further studies with greater sample size and longer follow-up period are needed to confirm the current findings.
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Affiliation(s)
- Mehdi Harorani
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran; Traditional and Complementary Medicine Research Center (TCMRC), Arak University of Medical Sciences, Arak, Iran.
| | - Masoumeh Garshasbi
- Student Research Committee, Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Mohamad Sediqi
- Student Research Committee, Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Zohreh Farahani
- Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Danial Habibi
- Department of Biostatistics and Epidemiology, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahtab Farahani
- Student Research Committee, Department of Nursing, School of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Nazanin Amini
- Department of paramedicine, Arak University of Medical Sciences, Arak, Iran
| | - Zahra Velashjerdi
- Master of Nursing, Valiasr Arak Hospital, Arak University of Medical Sciences, Arak, Iran
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Investigation of the Role of Complementary Medicine on Anxiety of Patients Before and After Surgery: A Review Study. Holist Nurs Pract 2021; 34:365-379. [PMID: 33060499 DOI: 10.1097/hnp.0000000000000414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Every year millions of patients undergo surgery worldwide. Anxiety is a common pre- and postoperative problem. Nonpharmacologic anxiety control has been demonstrated to be more suitable in patients. The objective of this study was to apprise the evidence of the effect of various complementary therapies on pre- and postoperative anxiety among patients. A comprehensive literature search was made on Web of Science, Scopus, Cochrane, PubMed Irandoc, SID Science, ScienceDirect, Ovid, Mag Iran, and Google Scholar for original research studies published between 1980 and 2019. Original articles that reported the effect of complementary therapies in patients undergoing surgery were included. Ninety-six studies were analyzed. All of the studies have documented the effects of complementary therapies on improving pre- and postoperative outcomes of patients. Although methods varied considerably, most of the studies included in this review reported positive results. Therefore, there is some evidence that complementary therapies can lead to positive pre- and postoperative outcomes. Therefore, the efficiency and use of complementary medicine, along with the use of therapeutic techniques in classical medicine, can provide a new model for reducing anxiety before and after surgery. It is recommended that nurses conduct additional reviews or clinical studies so that effective approaches to integrated medical care can be developed and patients' health enhanced.
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Icke S, Genc R. Effect of Foot Massages on Postpartum Comfort and Pain Level of Mothers After Vaginal Delivery: A Randomized Trial. Holist Nurs Pract 2021; 35:140-149. [PMID: 33853098 DOI: 10.1097/hnp.0000000000000441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study conducted on 66 mothers aimed to investigate the effect of foot massages postpartum using an introductory information form, the Postpartum Comfort Scale, the visual analog scale, and a drug follow-up card. It was concluded that foot massages positively improved comfort, reduced pain levels, and reduced unnecessary medications.
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Affiliation(s)
- Sibel Icke
- Department of Midwifery, Faculty of Health Sciences, Mardin Artuklu University, Mardin, Turkey (Dr Icke); and Department of Midwifery, Faculty of Health Sciences, Ege University, Izmir, Turkey (Dr Genc)
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Han X, Liu X, Zhong F, Wang Y, Guan H, Zhang Q. Comparison of efficacy and safety of complementary and alternative therapies for coronary heart disease complicated with anxiety or depression disorder: A protocol for Bayesian network meta-analysis. Medicine (Baltimore) 2021; 100:e25084. [PMID: 33761669 PMCID: PMC9282060 DOI: 10.1097/md.0000000000025084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 02/17/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND With the acceleration of the pace of life, the phenomenon of anxiety and depression in patients with coronary heart disease (CHD) is more and more common, and "psycho-cardiology" arises spontaneously. At present, the drug treatments of psycho-cardiology are difficult to achieve satisfactory results, and the side effects are obvious. Complementary and replacement therapies of CHD complicated with anxiety or depression disorder play an increasingly positive role, but there is a lack of comparison among different complementary and alternative therapies. In this study, Bayesian network meta-analysis (NMA) analysis method will be used for the first time to synthesize all the evidences of direct and indirect comparison among a variety of interventions, and rank their effectiveness and safety. METHODS Two independent researchers will search from the beginning to January 2021 mainly including randomized controlled trials (RCTs) and closely related ongoing RCTs of complementary and alternative therapies for CHD complicated with anxiety or depression disorder. And then identify, select and extract the data. The primary outcome measures are frequency of acute attack angina, severity of angina pectoris; the changed score in the validated scales, which can assess severity of anxiety or depression. Secondary outcomes include total efficacy rate, electrocardiogram improvement, traditional Chinese medicine symptoms score, changes of dosage of nitroglycerin and adverse effects. Using softwares WinBUGS 1.4.3 and STATA 16.0 for pairwise meta-analysis and NMA to comprehensively evaluate various interventions. The quality of evidences will be evaluated through the Grading of Recommendations Assessment, Development and Evaluation. RESULTS This NMA will comprehensively compare and rank the efficacy and safety of a series of complementary and alternative therapies in the treatment of CHD complicated with anxiety or depression disorder. CONCLUSION Supplementary and replacement therapies play an essential role in improving CHD complicated with anxiety or depression disorder. We expect that the NMA will provide reliable evidences of evidence-based medicine for treatment of CHD complicated with anxiety or depression disorder. PROTOCOL REGISTRATION NUMBER INPLASY202120046. ETHICAL APPROVAL This review does not require ethical approval.
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Affiliation(s)
- Xueyan Han
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province
| | - Xinxin Liu
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province
| | - Fengxing Zhong
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing
| | - Yiguo Wang
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing
| | - Hui Guan
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province
| | - Qiming Zhang
- Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
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Effects of a theory of planned behavior-based intervention on breastfeeding behaviors after cesarean section: A randomized controlled trial. Int J Nurs Sci 2021; 8:152-160. [PMID: 33997128 PMCID: PMC8105542 DOI: 10.1016/j.ijnss.2021.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/21/2021] [Accepted: 03/18/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives To examine the efficacy of an intervention based on the theory of planned behavior (TPB) in improving breastfeeding behavior among women with cesarean sections (C-sections). Methods This research was a randomized controlled trial. Women with planned elective C-sections were recruited to participate in a randomized controlled trial between June and September 2020. One hundred thirty-two women were divided randomly into the intervention (n = 66) and control group (n = 66) by systematic random sampling. In the intervention group, an intervention project was implemented after the C-section to establish positive breastfeeding attitudes, cultivate supportive subjective norms, enhance perceived behavioral control, and strengthen breastfeeding intention to change behaviors. Those in the control group received routine pre-and post-delivery care. Exclusive breastfeeding rate and breast problem were collected at 5 days, 2 weeks, and 1 month after C-section. The modified Breastfeeding Attrition Prediction Tool (BAPT) on the first day in the hospital, two weeks, and one month after C-section and Numerical Rating Scale (NRS) 24 h postoperatively were used to compare the intervention effect between the two groups. Results After the intervention, the intervention group had significantly higher exclusive breastfeeding rates than the control group at five days (86.4% vs. 60.6%), two weeks (77.3% vs. 57.6%), and one month (74.2% vs. 50.0%) after the C-section. Besides, the intervention group was less likely to have sore nipples at five days (6.1% vs. 18.2% in the control group, P < 0.05) and two weeks (9.1% vs. 12.1% in the control group, P < 0.05). After two weeks of intervention, attitude scores (90.64 ± 8.31 vs. 87.20 ± 8.15, P < 0.05), subjective norm scores (88.07 ± 24.65 vs. 79.42 ± 19.47, P < 0.05)and behavior control scores in the intervention group were significantly higher than those in the control group. After one month of intervention, attitude scores (90.34 ± 10.35 vs. 84.22 ± 10.51, P < 0.05) and behavior control scores (43.13 ± 5.02 vs. 39.15 ± 4.69, P < 0.05)in the intervention group were significantly higher than those in the control group, which resulted in the higher breastfeeding intention in the intervention group. Conclusion This study indicated that the TPB-based interventions effectively improved women's breastfeeding behaviors after C-sections.
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Effects of deep tissue massage on pain and comfort after cesarean: A randomized controlled trial. Complement Ther Clin Pract 2021; 43:101320. [PMID: 33548749 DOI: 10.1016/j.ctcp.2021.101320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/29/2020] [Accepted: 01/25/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE In this study, it was aimed to determine the effect of deep tissue massage (DTM) applied by midwife on pain and comfort after cesarean section. MATERIAL AND METHODS This study was designed as a randomized controlled trial conducted with experimental and control groups. The data were collected using a personal information form, visual analogue scale (VAS), the Postpartum Comfort Questionnaire (PPCQ). DTM was applied to participants in the experimental group twice (at the 10th and 22nd h) after cesarean. No applications were performed in the control group. RESULTS According to the measurements, the mean VAS score of the mother in the experimental group was lower than that of the control group (17.51 ± 6.15, 56.16 ± 9.53; respectively) and PPCQ total and sub-dimension mean scores were found to be statistically significant in favor of the experimental group (p < 0.001). CONCLUSIONS It was indicated that DTM application decreased the levels of pain and increased the comfort levels of the women who had cesarean sections.
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Effect of Foot Reflexology Intervention on Depression, Anxiety, and Sleep Quality in Adults: A Meta-Analysis and Metaregression of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:2654353. [PMID: 33014101 PMCID: PMC7512096 DOI: 10.1155/2020/2654353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 08/20/2020] [Accepted: 09/05/2020] [Indexed: 12/25/2022]
Abstract
Objectives The aim of this study was to conduct a systematic review, meta-analysis, and metaregression to determine the current best available evidence of the efficacy and safety of foot reflexology for adult depression, anxiety, and sleep quality. Methods Electronic databases (PubMed, ClinicalKey, ScienceDirect, EMBASE, PsycINFO, and the Cochrane Library) were searched till August, 10, 2020, and the validity of the eligible studies was critically appraised. Randomized controlled trials comparing foot reflexology groups with control groups for adult depression, anxiety, and sleep quality were included. Twenty-six eligible studies were included to assess the effect of foot reflexology intervention on the reducing symptoms of depression and anxiety and improving quality of sleep, respectively, as the primary outcome. Results Twenty-six randomized controlled trials involving 2,366 participants met the inclusion criteria. The meta-analyses showed that foot reflexology intervention significantly improved adult depression (Hedges' g = −0.921; 95% CI: −1.246 to −0.595; P < 0.001), anxiety (Hedges' g = −1.237; 95% CI −1.682 to −0.791; P < 0.001), and sleep quality (Hedges' g = −1.665; 95% CI −2.361 to −0.970; P < 0.001). Metaregression reveals that an increase in total foot reflexology time (P = 0.002) and duration (P = 0.01) can significantly improve sleep quality. Conclusions Foot reflexology may provide additional nonpharmacotherapy intervention for adults suffering from depression, anxiety, or sleep disturbance. However, high quality and rigorous design RCTs in specific population, along with an increase in participants, and a long-term follow-up are recommended in the future.
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Pieczynski J, Cosio D, Pierce W, Serpa JG. Mind-Body Interventions for Rehabilitation Medicine: Promoting Wellness, Healing, and Coping with Adversity. Phys Med Rehabil Clin N Am 2020; 31:563-575. [PMID: 32981579 DOI: 10.1016/j.pmr.2020.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Physical medicine providers work to cure organic aspects of disease while simultaneously enhancing quality of life and well-being. Mind-body interventions are evidence-based, cost-effective approaches to serve these aims. This article enhances provider knowledge and acceptance of the most effective and prevalent mind-body modalities: meditation, guided imagery, clinical hypnosis, and biofeedback. The scientific evidence is strongest for mind-body applications for chronic pain, primary headache, cardiac rehabilitation, and cancer rehabilitation, with preliminary evidence for traumatic brain injury and cerebrovascular events. Mind-body interventions are well-tolerated by patients and should be considered part of standard care in physical medicine and rehabilitation settings.
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Affiliation(s)
- Jessica Pieczynski
- Greater Los Angeles VA Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA.
| | - David Cosio
- Jesse Brown VA Medical Center, 820 South Damen Avenue, Chicago, IL 60612, USA
| | - Whitney Pierce
- VA St. Louis Healthcare System, 915 North Grand Boulevard, St Louis, MO 63106, USA
| | - J Greg Serpa
- Greater Los Angeles VA Healthcare System, UCLA Department of Psychology, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
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Guo PP, Fan SL, Li P, Zhang XH, Liu N, Wang J, Chen DD, Sun WJ, Yu L, Yang S, Zhang W. The effectiveness of massage on peri-operative anxiety in adults: A meta-analysis of randomized controlled trials and controlled clinical trials. Complement Ther Clin Pract 2020; 41:101240. [PMID: 32977216 DOI: 10.1016/j.ctcp.2020.101240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 09/05/2020] [Accepted: 09/14/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE and purpose: Massage has gained increasing attention for reducing peri-operative anxiety. We aimed to investigate the effectiveness of massage for peri-operative anxiety in adults. METHODS Six English electronic databases were comprehensively searched from their inception to February 2020. Subgroup analysis, quality assessment, sensitivity analysis, meta-regression and publication bias assessment were performed. RESULTS Twenty-five controlled trials comprising 2494 participants were included. The meta-analysis indicated that massage could significantly reduce peri-operative anxiety for most types of surgical patients. Specifically, it was effective for pre-, intra- and post-operative anxiety. Acupoint or specific body reflex area massage showed a larger effect than general massage did. Massage delivered by professionals and non-professionals were both effective. Massage lasting 10-20 min per session was the most worthy of recommendation. Massage was concomitant with the improvement of peri-operative vital signs and post-operative pain. CONCLUSION Massage is a promising complementary therapy for ameliorating peri-operative anxiety in adults.
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Affiliation(s)
- Ping-Ping Guo
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Shu-Li Fan
- Department of Obstetrics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang province, 325006, China.
| | - Ping Li
- Department of Developmental Pediatrics, The Second Hospital of Jilin University, Changchun, Jilin province, 130041, China.
| | - Xue-Hui Zhang
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Na Liu
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Jie Wang
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Dan-Dan Chen
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Wei-Jia Sun
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Lin Yu
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Shu Yang
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Wei Zhang
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
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Effects of foot massage and patient education in patients undergoing coronary artery bypass graft surgery: A randomized controlled trial. Complement Ther Clin Pract 2020; 40:101215. [PMID: 32891291 DOI: 10.1016/j.ctcp.2020.101215] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 06/11/2020] [Accepted: 06/16/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Anxiety, pain, and fatigue are common postoperative problems that disturb the recovery and quality of life in patients undergoing coronary artery bypass graft (CABG) surgery. These postoperative problems are associated with prolonged recovery and decreased quality of life. This study was aimed at evaluating the combined effects of foot massage and patient education on anxiety, fatigue, pain, self-efficacy, and quality of life in patients undergoing CABG surgery. MATERIAL AND METHODS In this randomized controlled trial (RCT), 130 participants were randomly allocated to experimental (n = 65) and control (n = 65) groups. The experimental group received a combination of foot massage and patient education as interventions and the control group received usual care of the hospital. RESULTS The experimental group had a significant decrease in anxiety (p = 0.001), fatigue (p = 0.001), pain (p = 0.001), and increased self-efficacy (p = 0.001) and quality of life (p = 0.001). CONCLUSION The combined form of foot massage and patient education is effective in decreasing anxiety, fatigue, pain, and increasing self-efficacy and the quality of life. These interventions will support the recovery of patients and reduce their suffering.
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Zimpel SA, Torloni MR, Porfírio GJ, Flumignan RL, da Silva EM. Complementary and alternative therapies for post-caesarean pain. Cochrane Database Syst Rev 2020; 9:CD011216. [PMID: 32871021 PMCID: PMC9701535 DOI: 10.1002/14651858.cd011216.pub2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pain after caesarean sections (CS) can affect the well-being of the mother and her ability with her newborn. Conventional pain-relieving strategies are often underused because of concerns about the adverse maternal and neonatal effects. Complementary alternative therapies (CAM) may offer an alternative for post-CS pain. OBJECTIVES To assess the effects of CAM for post-caesarean pain. SEARCH METHODS We searched Cochrane Pregnancy and Childbirth's Trials Register, LILACS, PEDro, CAMbase, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) (6 September 2019), and checked the reference lists of retrieved articles. SELECTION CRITERIA Randomised controlled trials (RCTs), including quasi-RCTs and cluster-RCTs, comparing CAM, alone or associated with other forms of pain relief, versus other treatments or placebo or no treatment, for the treatment of post-CS pain. DATA COLLECTION AND ANALYSIS Two review authors independently performed study selection, extracted data, assessed risk of bias and assessed the certainty of evidence using GRADE. MAIN RESULTS We included 37 studies (3076 women) which investigated eight different CAM therapies for post-CS pain relief. There is substantial heterogeneity among the trials. We downgraded the certainty of evidence due to small numbers of women participating in the trials and to risk of bias related to lack of blinding and inadequate reporting of randomisation processes. None of the trials reported pain at six weeks after discharge. Primary outcomes were pain and adverse effects, reported per intervention below. Secondary outcomes included vital signs, rescue analgesic requirement at six weeks after discharge; all of which were poorly reported, not reported, or we are uncertain as to the effect Acupuncture or acupressure We are very uncertain if acupuncture or acupressure (versus no treatment) or acupuncture or acupressure plus analgesia (versus placebo plus analgesia) has any effect on pain because the quality of evidence is very low. Acupuncture or acupressure plus analgesia (versus analgesia) may reduce pain at 12 hours (standardised mean difference (SMD) -0.28, 95% confidence interval (CI) -0.64 to 0.07; 130 women; 2 studies; low-certainty evidence) and 24 hours (SMD -0.63, 95% CI -0.99 to -0.26; 2 studies; 130 women; low-certainty evidence). It is uncertain whether acupuncture or acupressure (versus no treatment) or acupuncture or acupressure plus analgesia (versus analgesia) has any effect on the risk of adverse effects because the quality of evidence is very low. Aromatherapy Aromatherapy plus analgesia may reduce pain when compared with placebo plus analgesia at 12 hours (mean difference (MD) -2.63 visual analogue scale (VAS), 95% CI -3.48 to -1.77; 3 studies; 360 women; low-certainty evidence) and 24 hours (MD -3.38 VAS, 95% CI -3.85 to -2.91; 1 study; 200 women; low-certainty evidence). We are uncertain if aromatherapy plus analgesia has any effect on adverse effects (anxiety) compared with placebo plus analgesia. Electromagnetic therapy Electromagnetic therapy may reduce pain compared with placebo plus analgesia at 12 hours (MD -8.00, 95% CI -11.65 to -4.35; 1 study; 72 women; low-certainty evidence) and 24 hours (MD -13.00 VAS, 95% CI -17.13 to -8.87; 1 study; 72 women; low-certainty evidence). Massage We identified six studies (651 women), five of which were quasi-RCTs, comparing massage (foot and hand) plus analgesia versus analgesia. All the evidence relating to pain, adverse effects (anxiety), vital signs and rescue analgesic requirement was very low-certainty. Music Music plus analgesia may reduce pain when compared with placebo plus analgesia at one hour (SMD -0.84, 95% CI -1.23 to -0.46; participants = 115; studies = 2; I2 = 0%; low-certainty evidence), 24 hours (MD -1.79, 95% CI -2.67 to -0.91; 1 study; 38 women; low-certainty evidence), and also when compared with analgesia at one hour (MD -2.11, 95% CI -3.11 to -1.10; 1 study; 38 women; low-certainty evidence) and at 24 hours (MD -2.69, 95% CI -3.67 to -1.70; 1 study; 38 women; low-certainty evidence). It is uncertain whether music plus analgesia has any effect on adverse effects (anxiety), when compared with placebo plus analgesia because the quality of evidence is very low. Reiki We are uncertain if Reiki plus analgesia compared with analgesia alone has any effect on pain, adverse effects, vital signs or rescue analgesic requirement because the quality of evidence is very low (one study, 90 women). Relaxation Relaxation may reduce pain compared with standard care at 24 hours (MD -0.53 VAS, 95% CI -1.05 to -0.01; 1 study; 60 women; low-certainty evidence). Transcutaneous electrical nerve stimulation TENS (versus no treatment) may reduce pain at one hour (MD -2.26, 95% CI -3.35 to -1.17; 1 study; 40 women; low-certainty evidence). TENS plus analgesia (versus placebo plus analgesia) may reduce pain compared with placebo plus analgesia at one hour (SMD -1.10 VAS, 95% CI -1.37 to -0.82; 3 studies; 238 women; low-certainty evidence) and at 24 hours (MD -0.70 VAS, 95% CI -0.87 to -0.53; 108 women; 1 study; low-certainty evidence). TENS plus analgesia (versus placebo plus analgesia) may reduce heart rate (MD -7.00 bpm, 95% CI -7.63 to -6.37; 108 women; 1 study; low-certainty evidence) and respiratory rate (MD -1.10 brpm, 95% CI -1.26 to -0.94; 108 women; 1 study; low-certainty evidence). We are uncertain if TENS plus analgesia (versus analgesia) has any effect on pain at six hours or 24 hours, or vital signs because the quality of evidence is very low (two studies, 92 women). AUTHORS' CONCLUSIONS Some CAM therapies may help reduce post-CS pain for up to 24 hours. The evidence on adverse events is too uncertain to make any judgements on safety and we have no evidence about the longer-term effects on pain. Since pain control is the most relevant outcome for post-CS women and their clinicians, it is important that future studies of CAM for post-CS pain measure pain as a primary outcome, preferably as the proportion of participants with at least moderate (30%) or substantial (50%) pain relief. Measuring pain as a dichotomous variable would improve the certainty of evidence and it is easy to understand for non-specialists. Future trials also need to be large enough to detect effects on clinical outcomes; measure other important outcomes as listed lin this review, and use validated scales.
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Affiliation(s)
| | - Maria Regina Torloni
- Cochrane Brazil, Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde, São Paulo, Brazil
| | - Gustavo Jm Porfírio
- Cochrane Brazil, Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde, São Paulo, Brazil
| | - Ronald Lg Flumignan
- Department of Surgery, Division of Vascular and Endovascular Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Edina Mk da Silva
- Emergency Medicine and Evidence Based Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
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Abstract
Multimodal pain management of cardiac surgical patients is a paradigm shift in postoperative care. This promising approach features complementary medications and techniques that spare opioids and improves symptomatic and functional recovery. Although the specific elements remain to be defined, the collaboration of the health care team and patient and continuous iterative programmatic improvements are important pillars of this approach.
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Alameri R, Dean G, Castner J, Volpe E, Elghoneimy Y, Jungquist C. Efficacy of Precise Foot Massage Therapy on Pain and Anxiety Following Cardiac Surgery: Pilot Study. Pain Manag Nurs 2020; 21:314-322. [PMID: 31734151 DOI: 10.1016/j.pmn.2019.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 07/18/2019] [Accepted: 09/16/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Pain is the most pervasive distressing symptom following cardiac surgery. Forty percent of postoperative cardiac patients report inadequate pain management. Undertreated acute pain results in increased anxiety, delayed wound healing, and increased chance of persistent chronic pain. Foot massage is a safe, visible complementary approach to manage acute pain following surgery. AIM The aim of this study is to evaluate the efficacy of integrating foot massage therapy for managing postcardiac pain. METHOD A randomized placebo controlled single blinded trial comparing foot massage to placebo was conducted at a large hospital in Saudi Arabia. Thirty-one patients who had undergone cardiac surgery (16 in experimental and 15 in placebo group) participated in the study. Ten-minute foot massage was delivered to the experimental group by a nurse researcher, twice during one day, within 30 minutes after receiving an opioid pain medication. RESULTS The findings of this study indicate that foot massage significantly (p < .05) decreases pain intensity and anxiety in patients who have undergone cardiac surgery compared with a placebo control group. CONCLUSION Providing non-pharmacologic interventions for pain is the responsibility of the nursing staff. Foot massage is within the scope of nursing practice and is a safe and effective manner of improving patient care. Foot massage in conjunction with pharmacological interventions is effective in improving pain and anxiety. Future studies should consider focusing on frequency, dose, feasibility, acceptability, and participants' satisfaction.
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Affiliation(s)
- Rana Alameri
- Department of Fundamental Nursing, College Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Grace Dean
- School of Nursing, The State University of New York, Buffalo, New York, USA
| | - Jessica Castner
- School of Nursing, The State University of New York, Buffalo, New York, USA
| | - Ellen Volpe
- School of Nursing, The State University of New York, Buffalo, New York, USA
| | - Yasser Elghoneimy
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Carla Jungquist
- School of Nursing, The State University of New York, Buffalo, New York, USA
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Neumeister EL, Beason AM, Thayer JA, El Bitar Y. Perioperative Pain Management in Hand and Upper Extremity Surgery. Clin Plast Surg 2020; 47:323-334. [DOI: 10.1016/j.cps.2019.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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18
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Farmahini Farahani M, Noruzi Zamenjani M, Nasiri M, Shamsikhani S, Purfarzad Z, Harorani M. Effects of Extremity Massage on Preoperative Anxiety: A Three-Arm Randomized Controlled Clinical Trial on Phacoemulsification Candidates. J Perianesth Nurs 2020; 35:277-282. [PMID: 32057627 DOI: 10.1016/j.jopan.2019.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/24/2019] [Accepted: 10/26/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE The present study aimed to compare the effects of foot and hand massage on preoperative anxiety. DESIGN Three-arm randomized, nonblinded, placebo-controlled, parallel group trial. METHODS This study was conducted on 90 female candidates waiting for phacoemulsification cataract surgery in Arak Amirkabir Hospital, Iran. Patients were consecutively selected and randomly divided into three groups of hand (n = 30), foot (n = 30), and placebo (n = 30), using a random number generator software program. In each group, massage was performed 5 minutes for each hand or foot in the surgical waiting room about 10 minutes before surgery. Anxiety was measured before and after the intervention by visual analog scale and also assessing physiological indicators (heart rate, respiratory rate, systolic and diastolic blood pressures). FINDINGS All the 90 patients completed the study and were included in the final analysis. Both hand and foot massage resulted in a significant decrease compared with placebo massage in anxiety and heart rate. However, no significant difference was found between hand and foot massage in any of the measured parameters. In the foot group and hand group, a significant reduction was observed in heart rate and anxiety after the intervention, whereas the anxiety increased significantly in the placebo group after the intervention. Moreover, systolic blood pressure in the foot group and the respiratory rate in the hand group significantly decreased after the intervention. CONCLUSIONS Application of hand or foot massage seems to be effective in managing anxiety in patients waiting for phacoemulsification cataract surgery.
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Affiliation(s)
- Moloud Farmahini Farahani
- Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
| | - Masoomeh Noruzi Zamenjani
- Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
| | - Morteza Nasiri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Operating Room Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soheila Shamsikhani
- Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran
| | - Zahra Purfarzad
- Department of Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mehdi Harorani
- Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran.
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20
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Effect of Benson Relaxation on the Intensity of Spinal Anesthesia–Induced Pain After Elective General and Urologic Surgery. J Perianesth Nurs 2019; 34:1232-1240. [DOI: 10.1016/j.jopan.2019.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 05/19/2019] [Accepted: 05/19/2019] [Indexed: 11/24/2022]
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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.
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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
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Abstract
Integrative medicine (IM) has developed an increasingly significant role in health care worldwide, including cardiovascular diseases (CVD). This review describes the commonly used IM in CVD, with particular attention placed with dietary supplements and mind-body therapies. More rigorous research continues to be needed to determine the mechanisms and efficacy of IM cardiovascular morbidity and mortality. Health care providers will need to develop skills in open communication and nonjudgmental dialogue around IM use in discussing treatment plans with their patients.
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Affiliation(s)
- Darshan Mehta
- Osher Center for Integrative Medicine, Brigham and Women's Hospital, Harvard Medical School, 900 Commonwealth Avenue East, 3rd Floor, Boston, MA 02215, USA; Benson-Henry Institute for Mind-Body Medicine, Massachusetts General Hospital, 151 Merrimac Street, 4th Floor, Boston, MA 02114, USA.
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23
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Parmar R, Brewer BB, Szalacha LA. Foot Massage, Touch, and Presence in Decreasing Anxiety during a Magnetic Resonance Imaging: A Feasibility Study. J Altern Complement Med 2018; 24:268-275. [DOI: 10.1089/acm.2016.0274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Rajni Parmar
- College of Nursing, University of Arizona, Tucson, AZ
- Southern Arizona Veterans Affairs Health Care System, Tucson, AZ
| | | | - Laura A. Szalacha
- Research Methods and Statistics, College of Nursing, University of Arizona, Tucson, AZ
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Yılar Erkek Z, Aktas S. The Effect of Foot Reflexology on the Anxiety Levels of Women in Labor. J Altern Complement Med 2018; 24:352-360. [PMID: 29474093 DOI: 10.1089/acm.2017.0263] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This research was conducted to analyze the effect of foot reflexology on the anxiety levels of women during labor. DESIGN, SETTING AND SUBJECTS The study was conducted as a semiexperimental study. It was conducted with 154 nulliparous pregnant women who applied to a maternity unit of a state hospital in the north-western part of Turkey to give birth. INTERVENTIONS Foot reflexology was applied once to the pregnant women in the experimental group when cervical dilation was 3-4 cm. The treatment was applied to the right foot and left foot reflex points for 15 min, for a total of 30 min. The data in the study were collected using the "Pregnant Women Introductory Information Form" and the "Spielberger State-trait Anxiety Inventory" (STAI TX-1). In evaluating the data, number, percentage, Chi-square, independent samples t-test, and repeated measure analysis of variance test were used. MAIN OUTCOME MEASURES The mean scores of the STAI TX-1 were used to analyze the results. RESULTS The mean STAI TX-1 scores were measured before reflexology, in the latent and active phases of labor and early in postpartum period (four times in total). The mean STAI TX-1 scores were higher in the experimental group than in the control group (p < 0.001). The mean STAI TX-1 scores postreflexology application (when cervical dilation was 3-4 cm) and during the active phase of the labor (when cervical dilation was 6-8 cm) of the pregnant women in the experimental group were lower than those of the control group (respectively p = 0.010, p < 0.001). In the experimental group, there was no statistically significant difference between the mean STAI TX-1 scores pre- and postreflexology (p = 0.820). The mean STAI TX-1 scores in the early postpartum period were similar in the experimental and control groups (p = 0.080). CONCLUSION Foot reflexology was found to have a positive effect in lowering the total anxiety scores of the pregnant women. Reflexology is a noninvasive and economical method, which may be used by health professionals to reduce problems during labor. A decrease in anxiety experienced at birth improves women's positive birth experiences, promotes a secure mother-infant attachment, and protects postpartum mental health.
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Affiliation(s)
| | - Songul Aktas
- 2 Faculty of Health Sciences, Department of Obstetrics and Women Health Nursing, Karadeniz Technical Universty , Trabzon, Turkey
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The Effects of Massage Therapy on Pain and Anxiety after Surgery: A Systematic Review and Meta-Analysis. Pain Manag Nurs 2018; 18:378-390. [PMID: 29173797 DOI: 10.1016/j.pmn.2017.09.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 08/16/2017] [Accepted: 09/09/2017] [Indexed: 11/22/2022]
Abstract
Pain management is critical for patients after surgery, but current pain management methods are not always adequate. Massage therapy may be a therapeutic complementary therapy for pain. Many researchers have investigated the effects of massage therapy on post-operative pain, but there have been no systematic reviews and meta-analysis of its efficacy for post-operative patients. Our objective was to assess the effects of massage therapy on pain management among post-operative patients by conducting a systematic review and meta-analysis. The databases searched included MEDLINE, CINAHL, and the Cochrane Library's CENTRAL. To assess the effects of massage therapy on post-operative pain and anxiety, we performed a meta-analysis and calculated standardized mean difference with 95% CIs (Confidential Intervals) as a summary effect. Ten randomized controlled trials were selected (total sample size = 1,157). Meta-analysis was conducted using subgroup analysis. The effect of single dosage massage therapy on post-operative pain showed significant improvement (-0.49; 95% confidence intervals -0.64, -0.34; p < .00001) and low heterogeneity (p = .39, I2 = 4%), sternal incisions showed significant improvement in pain (-0.68; -0.91, -0.46; p< .00001) and low heterogeneity (p = .76, I2 = 0%). The anxiety subgroups showed substantial heterogeneity. The findings of this study revealed that massage therapy may alleviate post-operative pain, although there are limits on generalization of these findings due to low methodological quality in the reviewed studies.
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The Effect of Massage on Acute Postoperative Pain in Critically and Acutely Ill Adults Post-thoracic Surgery: Systematic Review and Meta-analysis of Randomized Controlled Trials. Heart Lung 2017; 46:339-346. [PMID: 28619390 DOI: 10.1016/j.hrtlng.2017.05.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 05/10/2017] [Accepted: 05/11/2017] [Indexed: 02/08/2023]
Abstract
Critical care practice guidelines identify a lack of clear evidence on the effectiveness of massage for pain control. To assess the effect of massage on acute pain in critically and acutely ill adults post-thoracic surgery. Medline, Embase, CINAHL, PsychInfo, Web of Science, Scopus and Cochrane Library databases were searched. Eligible studies were randomized controlled trials (RCTs) evaluating the effect of massage compared to attention control/sham massage or standard care alone on acute pain intensity post-thoracic surgery. Twelve RCTs were included. Of these, nine evaluated massage in addition to standard analgesia, including 2 that compared massage to attention control/sham massage in the intensive care unit (ICU), 6 that compared massage to standard analgesia alone early post-ICU discharge, and 1 that compared massage to both attention control and standard care in the ICU. Patients receiving massage with analgesia reported less pain (0-10 scale) compared to attention control/sham massage (3 RCTs; N = 462; mean difference -0.80, 95% confidence interval [CI] -1.25 to -0.35; p < 0.001; I2 = 13%) and standard care (7 RCTs; N = 1087; mean difference -0.85, 95% CI -1.28 to -0.42; p < 0.001; I2 = 70%). Massage, in addition to pharmacological analgesia, reduces acute post-cardiac surgery pain intensity.
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Richards SH, Anderson L, Jenkinson CE, Whalley B, Rees K, Davies P, Bennett P, Liu Z, West R, Thompson DR, Taylor RS. Psychological interventions for coronary heart disease. Cochrane Database Syst Rev 2017; 4:CD002902. [PMID: 28452408 PMCID: PMC6478177 DOI: 10.1002/14651858.cd002902.pub4] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Coronary heart disease (CHD) is the most common cause of death globally, although mortality rates are falling. Psychological symptoms are prevalent for people with CHD, and many psychological treatments are offered following cardiac events or procedures with the aim of improving health and outcomes. This is an update of a Cochrane systematic review previously published in 2011. OBJECTIVES To assess the effectiveness of psychological interventions (alone or with cardiac rehabilitation) compared with usual care (including cardiac rehabilitation where available) for people with CHD on total mortality and cardiac mortality; cardiac morbidity; and participant-reported psychological outcomes of levels of depression, anxiety, and stress; and to explore potential study-level predictors of the effectiveness of psychological interventions in this population. SEARCH METHODS We updated the previous Cochrane Review searches by searching the following databases on 27 April 2016: CENTRAL in the Cochrane Library, MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), and CINAHL (EBSCO). SELECTION CRITERIA We included randomised controlled trials (RCTs) of psychological interventions compared to usual care, administered by trained staff, and delivered to adults with a specific diagnosis of CHD. We selected only studies estimating the independent effect of the psychological component, and with a minimum follow-up of six months. The study population comprised of adults after: a myocardial infarction (MI), a revascularisation procedure (coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI)), and adults with angina or angiographically defined coronary artery disease (CAD). RCTs had to report at least one of the following outcomes: mortality (total- or cardiac-related); cardiac morbidity (MI, revascularisation procedures); or participant-reported levels of depression, anxiety, or stress. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts of all references for eligibility. A lead review author extracted study data, which a second review author checked. We contacted study authors to obtain missing information. MAIN RESULTS This review included 35 studies which randomised 10,703 people with CHD (14 trials and 2577 participants added to this update). The population included mainly men (median 77.0%) and people post-MI (mean 65.7%) or after undergoing a revascularisation procedure (mean 27.4%). The mean age of participants within trials ranged from 53 to 67 years. Overall trial reporting was poor, with around a half omitting descriptions of randomisation sequence generation, allocation concealment procedures, or the blinding of outcome assessments. The length of follow-up ranged from six months to 10.7 years (median 12 months). Most studies (23/35) evaluated multifactorial interventions, which included therapies with multiple therapeutic components. Ten studies examined psychological interventions targeted at people with a confirmed psychopathology at baseline and two trials recruited people with a psychopathology or another selecting criterion (or both). Of the remaining 23 trials, nine studies recruited unselected participants from cardiac populations reporting some level of psychopathology (3.8% to 53% with depressive symptoms, 32% to 53% with anxiety), 10 studies did not report these characteristics, and only three studies excluded people with psychopathology.Moderate quality evidence showed no risk reduction for total mortality (risk ratio (RR) 0.90, 95% confidence interval (CI) 0.77 to 1.05; participants = 7776; studies = 23) or revascularisation procedures (RR 0.94, 95% CI 0.81 to 1.11) with psychological therapies compared to usual care. Low quality evidence found no risk reduction for non-fatal MI (RR 0.82, 95% CI 0.64 to 1.05), although there was a 21% reduction in cardiac mortality (RR 0.79, 95% CI 0.63 to 0.98). There was also low or very low quality evidence that psychological interventions improved participant-reported levels of depressive symptoms (standardised mean difference (SMD) -0.27, 95% CI -0.39 to -0.15; GRADE = low), anxiety (SMD -0.24, 95% CI -0.38 to -0.09; GRADE = low), and stress (SMD -0.56, 95% CI -0.88 to -0.24; GRADE = very low).There was substantial statistical heterogeneity for all psychological outcomes but not clinical outcomes, and there was evidence of small-study bias for one clinical outcome (cardiac mortality: Egger test P = 0.04) and one psychological outcome (anxiety: Egger test P = 0.012). Meta-regression exploring a limited number of intervention characteristics found no significant predictors of intervention effects for total mortality and cardiac mortality. For depression, psychological interventions combined with adjunct pharmacology (where deemed appropriate) for an underlying psychological disorder appeared to be more effective than interventions that did not (β = -0.51, P = 0.003). For anxiety, interventions recruiting participants with an underlying psychological disorder appeared more effective than those delivered to unselected populations (β = -0.28, P = 0.03). AUTHORS' CONCLUSIONS This updated Cochrane Review found that for people with CHD, there was no evidence that psychological treatments had an effect on total mortality, the risk of revascularisation procedures, or on the rate of non-fatal MI, although the rate of cardiac mortality was reduced and psychological symptoms (depression, anxiety, or stress) were alleviated; however, the GRADE assessments suggest considerable uncertainty surrounding these effects. Considerable uncertainty also remains regarding the people who would benefit most from treatment (i.e. people with or without psychological disorders at baseline) and the specific components of successful interventions. Future large-scale trials testing the effectiveness of psychological therapies are required due to the uncertainty within the evidence. Future trials would benefit from testing the impact of specific (rather than multifactorial) psychological interventions for participants with CHD, and testing the targeting of interventions on different populations (i.e. people with CHD, with or without psychopathologies).
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Affiliation(s)
- Suzanne H Richards
- Leeds Institute of Health Sciences, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds, UK, LS2 9LJ
- Primary Care, University of Exeter Medical School, St Luke's Campus, Magdalen Road, Exeter, Devon, UK, EX1 2LU
| | - Lindsey Anderson
- Institute of Health Research, University of Exeter Medical School, Veysey Building, Salmon Pool Lane, Exeter, UK, EX2 4SG
| | - Caroline E Jenkinson
- Primary Care, University of Exeter Medical School, St Luke's Campus, Magdalen Road, Exeter, Devon, UK, EX1 2LU
| | - Ben Whalley
- School of Psychology, University of Plymouth, Plymouth, UK
| | - Karen Rees
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK, CV4 7AL
| | - Philippa Davies
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, UK, BS8 2PS
| | - Paul Bennett
- Department of Psychology, University of Swansea, Singleton Park, Swansea, UK, SA2 8PP
| | - Zulian Liu
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Robert West
- Wales Heart Research Institute, Cardiff University, Heath Park, Cardiff, UK, CF14 4XN
| | - David R Thompson
- Department of Psychiatry, University of Melbourne, St Vincent's Hospital, Melbourne, Victoria, Australia, VIC 3000
| | - Rod S Taylor
- Institute of Health Research, University of Exeter Medical School, Veysey Building, Salmon Pool Lane, Exeter, UK, EX2 4SG
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Hadjibalassi M, Lambrinou E, Papastavrou E, Papathanassoglou E. The effect of guided imagery on physiological and psychological outcomes of adult ICU patients: A systematic literature review and methodological implications. Aust Crit Care 2017; 31:73-86. [PMID: 28365068 DOI: 10.1016/j.aucc.2017.03.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 02/28/2017] [Accepted: 03/10/2017] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Guided imagery (GI) is a relaxation technique that is being increasingly explored in various patients' populations. We systematically reviewed evidence on the effects of GI on physiological and psychological outcomes of adult critically ill patients and extracted implications for future research. REVIEW METHOD USED Systematic literature review of published studies based on the Cochrane Guidelines. DATA SOURCES Studies were located through literature searches of CINAHL, PubMed, Embase, Cochrane Database of Systematic Reviews and Psych-Info. REVIEW METHODS We explored effects of GI in critically illness. The outcome measures included pain, anxiety, hemodynamic measurements, stress neuropeptides, length of stay, sleep quality, inflammatory markers, patient satisfaction and cost of care. The Cochrane Collaboration's tool for assessing risk of bias was employed. Extracted data included pathophysiological framework, sample, diagnoses of participants, specifics of intervention, design, experimental groups, analyses and main outcomes. RESULTS Based on the selection criteria, 10 studies were identified, involving N=1391 critically ill patients. The main limitations include incomplete outcome data and selective reporting, incomplete blinding and lack of experimental group allocation concealment. Due to heterogeneity and incomplete reporting, a meta-analysis was not feasible. Our findings included: (a) favourable effects of the intervention with regard to decrease of pain, anxiety and LOS; (b) many studies employing randomised controlled trial designs; (c) a predominant focus on patients with cardiac surgery; (d) large heterogeneity in measurement of outcomes. Moreover, the evidence suggests that improvements in sleep quality, patient satisfaction and cost of care merit further investigation. Methodological implications include the need to clarify the underlying physiological framework, the use of repeated measure designs and the adjustment for confounders. CONCLUSIONS On the basis of these results, and of the absence of reported side-effects, we conclude that GI is a promising patient-centered approach for the improvement of a number of patients' outcomes that merits further investigation in critical care.
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Affiliation(s)
- Maria Hadjibalassi
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus.
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Effect of a Brief Massage on Pain, Anxiety, and Satisfaction With Pain Management in Postoperative Orthopaedic Patients. Orthop Nurs 2017. [PMID: 26213879 DOI: 10.1097/nor.0000000000000163] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The majority of massage therapy studies have evaluated 20- to 45-minute interventions in nonsurgical patients. Studies are needed to evaluate the effects of a brief massage intervention that would be more clinically feasible for bedside clinicians to administer as an adjunct to pharmacologic pain management in acutely ill surgical patients. PURPOSE To evaluate the impact of a brief massage intervention in conjunction with analgesic administration on pain, anxiety, and satisfaction with pain management in postoperative orthopaedic inpatients. METHODS A convenience sample of postoperative orthopaedic patients was studied during two therapeutic pain treatments with an oral analgesic medication. A pretest, posttest, randomized, controlled trial study design, with crossover of subjects, was used to evaluate the effect of a 5-minute hand and arm massage at the time of analgesic administration. Each patient received both treatments (analgesic administration alone [control]; analgesic administration with massage) during two sequential episodes of postoperative pain. Prior to administration of the analgesic medication, participants rated their level of pain and anxiety with valid and reliable tools. Immediately after analgesic administration, a study investigator provided the first, randomly assigned treatment. Pain and anxiety were rated by the participant 5 and 45 minutes after medication administration. Satisfaction with pain management was also rated at the 45-minute time point. Study procedures were repeated for the participant's next requirement for analgesic medication, with the participant receiving the other randomly assigned treatment. Analysis of variance was used to determine whether pain, anxiety, and/or satisfaction with pain management differed between the two treatment groups and/or if treatment order was a significant factor. The level of significance for all tests was set at p < .05. RESULTS Twenty-five postoperative patients were studied during two sequential episodes of pain, which required analgesic medication administration (N = 25 analgesic alone; N = 25 analgesic with massage). Patient ages ranged from 32 to 86 years (average ±SD = 61.2 ± 11.5 years). Pain and anxiety scores after medication administration decreased in both groups, with no significant differences found between the analgesic alone or analgesic with massage treatments (p > .05). Patient satisfaction with pain management was higher for pain treatment with massage than medication only (F = 6.8, df = 46, p = .012). CONCLUSION The addition of a 5-minute massage treatment at the time of analgesic administration significantly increased patient satisfaction with pain management.
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Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. THE JOURNAL OF PAIN 2016; 17:131-57. [PMID: 26827847 DOI: 10.1016/j.jpain.2015.12.008] [Citation(s) in RCA: 1554] [Impact Index Per Article: 194.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 12/11/2015] [Accepted: 12/14/2015] [Indexed: 12/11/2022]
Abstract
UNLABELLED Most patients who undergo surgical procedures experience acute postoperative pain, but evidence suggests that less than half report adequate postoperative pain relief. Many preoperative, intraoperative, and postoperative interventions and management strategies are available for reducing and managing postoperative pain. The American Pain Society, with input from the American Society of Anesthesiologists, commissioned an interdisciplinary expert panel to develop a clinical practice guideline to promote evidence-based, effective, and safer postoperative pain management in children and adults. The guideline was subsequently approved by the American Society for Regional Anesthesia. As part of the guideline development process, a systematic review was commissioned on various aspects related to various interventions and management strategies for postoperative pain. After a review of the evidence, the expert panel formulated recommendations that addressed various aspects of postoperative pain management, including preoperative education, perioperative pain management planning, use of different pharmacological and nonpharmacological modalities, organizational policies, and transition to outpatient care. The recommendations are based on the underlying premise that optimal management begins in the preoperative period with an assessment of the patient and development of a plan of care tailored to the individual and the surgical procedure involved. The panel found that evidence supports the use of multimodal regimens in many situations, although the exact components of effective multimodal care will vary depending on the patient, setting, and surgical procedure. Although these guidelines are based on a systematic review of the evidence on management of postoperative pain, the panel identified numerous research gaps. Of 32 recommendations, 4 were assessed as being supported by high-quality evidence, and 11 (in the areas of patient education and perioperative planning, patient assessment, organizational structures and policies, and transitioning to outpatient care) were made on the basis of low-quality evidence. PERSPECTIVE This guideline, on the basis of a systematic review of the evidence on postoperative pain management, provides recommendations developed by a multidisciplinary expert panel. Safe and effective postoperative pain management should be on the basis of a plan of care tailored to the individual and the surgical procedure involved, and multimodal regimens are recommended in many situations.
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Boitor M, Martorella G, Laizner AM, Maheu C, Gélinas C. The Effectiveness of Hand Massage on Pain in Critically Ill Patients After Cardiac Surgery: A Randomized Controlled Trial Protocol. JMIR Res Protoc 2016; 5:e203. [PMID: 27821384 PMCID: PMC5118583 DOI: 10.2196/resprot.6277] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 09/19/2016] [Accepted: 09/19/2016] [Indexed: 01/20/2023] Open
Abstract
Background Postoperative pain is common in the intensive care unit despite the administration of analgesia. Some trials suggest that massage can be effective at reducing postoperative pain in acute care units; however, its effects on pain relief in the intensive care unit and when pain severity is highest remain unknown. Objective The objective is to evaluate the effectiveness of hand massage on the pain intensity (primary outcome), unpleasantness and interference, muscle tension, anxiety, and vital signs of critically ill patients after cardiac surgery. Methods A 3-arm randomized controlled trial will be conducted. A total of 79 patients who are 18 years or older, able to speak French or English and self-report symptoms, have undergone elective cardiac surgery, and do not have a high risk of postoperative complications and contraindications to hand massage will be recruited. They will be randomly allocated (1:1:1) to standard care plus either 3 20-minute hand massages (experimental), 3 20-minute hand holdings (active control), or 3 20-minute rest periods (passive control). Pain intensity, unpleasantness, anxiety, muscle tension, and vital signs will be evaluated before, immediately after, and 30 minutes later for each intervention administered within 24 hours postoperatively. Peer-reviewed competitive funding was received from the Quebec Nursing Intervention Research Network and McGill University in December 2015, and research ethics approval was obtained February 2016. Results Recruitment started in April 2016, and data collection is expected to be complete by January 2017. To date, 24 patients were randomized and had data collection done. Conclusions This study will be one of the first randomized controlled trials to examine the effect of hand massage on the pain levels of critically ill patients after cardiac surgery and to provide empirical evidence for the use of massage among this population. ClinicalTrial ClinicalTrials.gov NCT02679534; https://clinicaltrials.gov/ct2/show/NCT02679534 (Archived by WebCite at http://www.webcitation.org/6l8Ly5eHS)
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Affiliation(s)
- Madalina Boitor
- Ingram School of Nursing, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | | | - Andréa Maria Laizner
- Ingram School of Nursing, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Christine Maheu
- Ingram School of Nursing, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Céline Gélinas
- Ingram School of Nursing, Faculty of Medicine, McGill University, Montreal, QC, Canada
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Faurot KR, Gaylord SA, Mann JD. Training Family Caregivers in Hand and Foot Massage for Hospitalized Patients: Feasibility, Challenges, and Lessons Learned. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/1533210107307154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Increasingly, research is demonstrating the safety, efficacy, and patient satisfaction associated with use of nonpharmacological, complementary interventions for pain management in hospital settings. One such intervention, massage, has been found to be effective for pain and anxiety reduction in limited forms, such as described here, massage is relatively easy to learn and apply. The pilot project was designed to develop and assess a clinical intervention using hand and foot massage for management of pain and anxiety in inpatients on a rehabilitation unit. Methods included formal training of staff nurses in hand and foot massage and subsequently having them teach key family caregivers of the patient how to deliver hand or foot massage in response to reports of pain and anxiety. The report describes study rationale, project development, challenges to implementation in an academic, tertiary care, inpatient rehabilitation facility, and lessons learned for future project design and implementation. The need for a community-based participatory research perspective is addressed.
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Affiliation(s)
- Keturah R. Faurot
- Department of Physical Medicine and Rehabilitation,
Program on Integrative Medicine, University of North Carolina School,
| | - Susan A. Gaylord
- Department of Physical Medicine and Rehabilitation,
UNC School of Medicine
| | - J. Douglas Mann
- UNC Integrative Medicine Consult Service and codirector
of the UNC Mindfulness-Based Stress and Pain Management Program
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Boyd C, Crawford C, Paat CF, Price A, Xenakis L, Zhang W. The Impact of Massage Therapy on Function in Pain Populations-A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Part III, Surgical Pain Populations. PAIN MEDICINE (MALDEN, MASS.) 2016; 17:1757-1772. [PMID: 27165970 PMCID: PMC5013820 DOI: 10.1093/pm/pnw101] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Pain is multi-dimensional and may be better addressed through a holistic, biopsychosocial approach. Massage therapy is commonly practiced among patients seeking pain management; however, its efficacy is unclear. This systematic review and meta-analysis is the first to rigorously assess the quality of the evidence for massage therapy's efficacy in treating pain, function-related, and health-related quality of life outcomes in surgical pain populations. METHODS Key databases were searched from inception through February 2014. Eligible randomized controlled trials were assessed for methodological quality using SIGN 50 Checklist. Meta-analysis was applied at the outcome level. A professionally diverse steering committee interpreted the results to develop recommendations. RESULTS Twelve high quality and four low quality studies were included in the review. Results indicate massage therapy is effective for treating pain [standardized mean difference (SMD) = -0.79] and anxiety (SMD = -0.57) compared to active comparators. CONCLUSION Based on the available evidence, weak recommendations are suggested for massage therapy, compared to active comparators for reducing pain intensity/severity and anxiety in patients undergoing surgical procedures. This review also discusses massage therapy safety, challenges within this research field, how to address identified research gaps, and next steps for future research.
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Affiliation(s)
| | | | | | | | - Lea Xenakis
- Samueli Institute, Alexandria, Virginia, USA
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Saatsaz S, Rezaei R, Alipour A, Beheshti Z. Massage as adjuvant therapy in the management of post-cesarean pain and anxiety: A randomized clinical trial. Complement Ther Clin Pract 2016; 24:92-8. [PMID: 27502807 DOI: 10.1016/j.ctcp.2016.05.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 05/24/2016] [Accepted: 05/24/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The present study was conducted to determine the effect of massage on post-cesarean pain and anxiety. METHODS The present single-blind clinical trial was conducted on 156 primiparous women undergone elective cesarean section. The participants were randomly divided into three groups, including a hand and foot massage group, a foot massage group and a control group (n = 52 per group). The patients' intensity of pain, vital signs and anxiety level were measured before, immediately after and 90 min after the massage. RESULTS A significant reduction was observed in the intensity of pain immediately and 90 min after massage (P < 0.001). Moreover, changes in some of the physiological parameters, including blood pressure and respiration rate, were significant after massage (P < 0.001); however, this change was not significant for pulse rate. A significant reduction was also observed in the level of anxiety (P < 0.001) and a significant increase in the frequency of breastfeeding (P < 0.001) after massage. CONCLUSION As an effective nursing intervention presenting no side-effects, hand and foot massage can be helpful in the management of postoperative pain and stress.
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Affiliation(s)
- Sussan Saatsaz
- Faculty of Nursing and Midwifery Department of Amol, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Rozita Rezaei
- Faculty of Nursing and Midwifery Department of Amol, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Abbas Alipour
- Thalassemia Research Center, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Zahra Beheshti
- Faculty of Nursing and Midwifery Department of Amol, Mazandaran University of Medical Sciences, Sari, Iran.
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Gozuyesil E, Baser M. The effect of foot reflexology applied to women aged between 40 and 60 on vasomotor complaints and quality of life. Complement Ther Clin Pract 2016; 24:78-85. [PMID: 27502805 DOI: 10.1016/j.ctcp.2016.05.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 05/09/2016] [Accepted: 05/20/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE This study aims to identify the effects of foot reflexology applied to women on their vasomotor complaints and quality of life. METHODS A randomised controlled study was conducted with 120 women. The experimental group received foot reflexology treatment, while the control group received nonspecific foot massage. RESULTS The mean scores for hot flashes, sweats, and night sweats, were lower in the reflexology group than the control group after the practice; and the difference between the groups was statistically significant (p < 0.001). The mean scores for the sub-groups of the MENQOL demonstrated improvements in both groups after the application (p < 0.001). As for the sexual domain, there was a significant improvement in the reflexology group (p < 0.05), but no improvements were found in the control group (p > 0.05). CONCLUSION Results showed that reflexology might be effective in decreasing vasomotor problems and increasing quality of life in women in the menopausal period.
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Affiliation(s)
- Ebru Gozuyesil
- Cukurova University, Vocational School of Health Services, Adana, Turkey.
| | - Muruvvet Baser
- Erciyes University Faculty of Health Sciences Nursing Department Gynecology and Obstetric Nursing, Kayseri, Turkey.
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Klainin-Yobas P, Ng SH, Stephen PDM, Lau Y. Efficacy of psychosocial interventions on psychological outcomes among people with cardiovascular diseases: a systematic review and meta-analysis. PATIENT EDUCATION AND COUNSELING 2016; 99:512-521. [PMID: 27045976 DOI: 10.1016/j.pec.2015.10.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 10/20/2015] [Accepted: 10/28/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVES This systematic review aimed to examine empirical evidence concerning the efficacy of psychosocial interventions in ameliorating the psychosocial problems of people with cardiovascular diseases (CVDs). METHODS A comprehensive literature search was undertaken to identify both published and non-published English randomised controlled trials (RCTs) from 2000 to 2015. Two reviewers independently screened, assessed risks for bias, and extracted data. Comprehensive meta-analysis software was used to analyse the extracted data. Hedges's g effect size was used to determine the effects of psychosocial interventions. RESULTS Thirty studies were included in the review but only 18 studies reported significant short-term effects of psychosocial interventions in CVD patients. Most studies did not report long-term effects. Average effect sizes for stress, anxiety, depression, and combined depression/anxiety were 0.34, 1.04, 0.42 and 0.67 respectively at post-tests. Those numbers became 0.09, 0.65, 0.22 and 0.09 at follow-up assessments. Psychosocial programmes with psychoeducation and stress management helped reduce patients' stress and anxiety levels. Programmes including psychotherapy, counselling, mindfulness-based intervention (MBI), and stress management helped mitigate depression and anxiety. CONCLUSIONS The findings support the efficacy of some psychosocial interventions in people with CVDs. PRACTICE IMPLICATIONS Healthcare providers should monitor patients' psychological problems and may integrate psychosocial interventions as part of treatment plans.
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Affiliation(s)
| | | | | | - Ying Lau
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
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Effectiveness of integrating individualized and generic complementary medicine treatments with standard care versus standard care alone for reducing preoperative anxiety. J Clin Anesth 2016; 29:54-64. [DOI: 10.1016/j.jclinane.2015.10.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 10/08/2015] [Accepted: 10/29/2015] [Indexed: 11/16/2022]
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Ozolins LL, Hörberg U, Dahlberg K. Caring touch - patients' experiences in an anthroposophic clinical context. Scand J Caring Sci 2015; 29:834-42. [DOI: 10.1111/scs.12242] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 04/06/2015] [Indexed: 12/12/2022]
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Heidari Gorji MA, Ashrastaghi OG, Habibi V, Charati JY, Ebrahimzadeh MA, Ayasi M. The effectiveness of lavender essence on strernotomy related pain intensity after coronary artery bypass grafting. Adv Biomed Res 2015; 4:127. [PMID: 26261829 PMCID: PMC4513328 DOI: 10.4103/2277-9175.158050] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 05/19/2014] [Indexed: 11/15/2022] Open
Abstract
Background: Considering the side effects of pharmacological methods, there has been a suggestion to use nonpharmacological methods such Aromatherapy following coronary artery bypass grafting (CABG). This study aims to evaluate the effectiveness of lavender 2% aromatherapy on sternotomy pain intensity after coronary artery bypass graft surgery in patients who have undergone surgery. Materials and Methods: During this clinical trial, 50 patients who were candidates for CABG, were randomly divided into two equal groups, that is, the control group (n = 25) and the case group (n = 25). Following CABG, the case group received two drops of 2% lavender oil every 15 minutes with supplemental oxygen and the control group received only supplemental oxygen through a face mask. The data collection tools comprised of the demographic check list and visual analog scale (VAS) for evaluating the pain intensity. The pain intensity were assessed pre- and five, 30, and 60 minutes post aromatherapy. The final data were analyzed by the t-test and chi-squared test. Results: The findings showed that the pain perception intensity in the case group was lower than that in the control group at the 30- and 60-minute phases after intervention (P < 0.0001). Conclusion: The result indicated that aromatherapy can be used as a complementary method in postoperative pain reduction, as it reduced pain. The patients require two sedative drugs, and moreover, it avoids expenses of treatment.
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Affiliation(s)
- Mohammad Ali Heidari Gorji
- Department of Nursing and Midwifery, Nasibeh, and Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Om Golsum Ashrastaghi
- Department of Nursing and Midwifery, Nasibeh, and Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Valiollah Habibi
- Faculty of Medicine, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Jamshid Yazdani Charati
- Department of Biostatistics, School of Health, Mazandran University of Medical Science, Sari, Iran
| | - Mohammad Ali Ebrahimzadeh
- Department of Medicinal Chemistry, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mitra Ayasi
- Department of Nursing and Midwifery, Nasibeh, and Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Airosa F, Falkenberg T, Öhlén G, Arman M. Tactile Massage as Part of the Caring Act: A Qualitative Study in Short-Term Emergency Wards. J Holist Nurs 2015; 34:13-23. [PMID: 25858896 DOI: 10.1177/0898010115579769] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to illuminate the nursing staff's lived experiences and meaning in giving tactile massage (TM) while caring for patients in short-term emergency ward. METHOD Data were collected through individual qualitative interviews with six nurses and eight assistant nurses working with TM in short-term emergency wards in two hospitals in Sweden. The narratives were analyzed using a phenomenological hermeneutical method. FINDINGS Nurses experienced providing TM to patients as a present awareness in connection with compassion for the patient. TM provided the nurses with a tool to ease patient suffering and pain. Three dimensions were found where touch became a tool of doing, was an aware presence as a mindful being, and was embodied in a human-to-human connection with a changed caregiver. CONCLUSION Given the current high-tech health care system with overcrowded units and a shortage of nursing staff, TM could be included as a caring tool to improve the caring in caregiving, allowing nurses to act in aware presence by touch to encourage health and well-being for both the patient and themselves.
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Affiliation(s)
- Fanny Airosa
- Karolinska Institutet, SwedenKarolinska University Hospital, Sweden
| | - Torkel Falkenberg
- Karolinska Institutet, SwedenThe Integrative Care Science Center, Sweden
| | | | - Maria Arman
- Karolinska Institutet, SwedenThe Integrative Care Science Center, Sweden
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Johnson JR, Crespin DJ, Griffin KH, Finch MD, Rivard RL, Baechler CJ, Dusek JA. The effectiveness of integrative medicine interventions on pain and anxiety in cardiovascular inpatients: a practice-based research evaluation. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:486. [PMID: 25494710 PMCID: PMC4301797 DOI: 10.1186/1472-6882-14-486] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 12/10/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Pain and anxiety occurring from cardiovascular disease are associated with long-term health risks. Integrative medicine (IM) therapies reduce pain and anxiety in small samples of hospitalized cardiovascular patients within randomized controlled trials; however, practice-based effectiveness research has been limited. The goal of the study is to evaluate the effectiveness of IM interventions (i.e., bodywork, mind-body and energy therapies, and traditional Chinese medicine) on pain and anxiety measures across a cardiovascular population. METHODS Retrospective data obtained from medical records identified patients with a cardiovascular ICD-9 code admitted to a large Midwestern hospital between 7/1/2009 and 12/31/2012. Outcomes were changes in patient-reported pain and anxiety, rated before and after IM treatments based on a numeric scale (0-10). RESULTS Of 57,295 hospital cardiovascular admissions, 6,589 (11.5%) included IM. After receiving IM therapy, patients averaged a 46.5% (p-value < 0.001) decrease in pain and a 54.8% (p-value < 0.001) decrease in anxiety. There was no difference between treatment modalities on pain reduction; however, mind-body and energy therapies (p-value < 0.01), traditional Chinese medicine (p-value < 0.05), and combination therapies (p-value < 0.01) were more effective at reducing anxiety than bodywork therapies. Each additional year of age reduced the odds of receiving any IM therapy by two percent (OR: 0.98, p-value < 0.01) and females had 96% (OR: 1.96, p-value < 0.01) higher odds of receiving any IM therapy compared to males. CONCLUSIONS Cardiovascular inpatients reported statistically significant decreases in pain and anxiety following care with adjunctive IM interventions. This study underscores the potential for future practice-based research to investigate the best approach for incorporating these therapies into an acute care setting such that IM therapies are most appropriately provided to patient populations.
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Report on a membership audit of the Association of Chartered Physiotherapists in Reflex Therapy (ACPIRT). Complement Ther Clin Pract 2014; 20:172-7. [PMID: 25129885 DOI: 10.1016/j.ctcp.2014.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 04/19/2014] [Accepted: 04/24/2014] [Indexed: 11/22/2022]
Abstract
Reflex Therapy (RT), akin to reflexology, is a non-invasive physiotherapy modality approved by the UK Chartered Society of Physiotherapists. One hundred members of the Association of Chartered Physiotherapists in Reflex Therapy (ACPIRT) participated in an audit to establish a baseline of practice. Findings indicate that experienced therapists use RT in conjunction with their professional skills to induce relaxation (95%) and reduce pain (86%) for patients with conditions including whiplash injury and chronic pain. According to 68% of respondents, RT is "very good," "good" or "as good as" orthodox physiotherapy practices. Requiring minimal equipment, RT may be as cost effective as orthodox physiotherapy with regards to duration and frequency of treatment.
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Zimpel SA, Torloni MR, Porfirio G, da Silva EMK. Complementary and alternative therapies for post-caesarean pain. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2014. [DOI: 10.1002/14651858.cd011216] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sandra A Zimpel
- Alagoas State University of Health Sciences; Rua Antônio S. de Mendonça Jr. Nº99, apto. 201 Maceió Alagoas Brazil 57036-420
| | - Maria R Torloni
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde; Brazilian Cochrane Centre; Rua Borges Lagoa, 564 cj 63 São Paulo SP Brazil 04038-000
| | - Gustavo Porfirio
- Centro de Estudos de Saúde Baseada em Evidências e Avaliação Tecnológica em Saúde; Brazilian Cochrane Centre; Rua Borges Lagoa, 564 cj 63 São Paulo SP Brazil 04038-000
| | - Edina MK da Silva
- Universidade Federal de São Paulo; Emergency Medicine and Evidence Based Medicine; Rua Borges Lagoa 564 cj 64 Vl. Clementino São Paulo São Paulo Brazil 04038-000
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Ucuzal M, Kanan N. Foot Massage: Effectiveness on Postoperative Pain in Breast Surgery Patients. Pain Manag Nurs 2014; 15:458-65. [DOI: 10.1016/j.pmn.2012.03.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Revised: 02/25/2012] [Accepted: 03/06/2012] [Indexed: 11/28/2022]
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Abbaspoor Z, Akbari M, Najar S. Effect of Foot and Hand Massage In Post–Cesarean Section Pain Control: A Randomized Control Trial. Pain Manag Nurs 2014; 15:132-6. [DOI: 10.1016/j.pmn.2012.07.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Revised: 07/16/2012] [Accepted: 07/25/2012] [Indexed: 10/27/2022]
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Airosa F, Falkenberg T, Öhlén G, Arman M. Tactile massage or healing touch: Caring touch for patients in emergency care – A qualitative study. Eur J Integr Med 2013. [DOI: 10.1016/j.eujim.2013.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jones J, Thomson P, Lauder W, Howie K, Leslie SJ. Reflexology has no immediate haemodynamic effect in patients with chronic heart failure: A double blind randomised controlled trial. Complement Ther Clin Pract 2013; 19:133-8. [DOI: 10.1016/j.ctcp.2013.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 03/22/2013] [Accepted: 03/27/2013] [Indexed: 11/15/2022]
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Jones J, Thomson P, Irvine K, Leslie SJ. Is there a specific hemodynamic effect in reflexology? A systematic review of randomized controlled trials. J Altern Complement Med 2012; 19:319-28. [PMID: 23072265 DOI: 10.1089/acm.2011.0854] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Reflexology claims that the feet are representative of the body and that massage to specific points of the feet increases blood supply to "mapped" organs in the body. This review provides the first systematic evaluation of existing reflexology randomized controlled trials (RCTs) to determine whether there is any evidence to suggest the existence of a reflexology treatment-related hemodynamic effect; to examine whether reflexology researchers used study designs that systematically controlled for nonspecific effects in order to isolate this specific component; and to highlight some of the methodological challenges that need to be overcome to demonstrate specific and beneficial hemodynamic effects. DESIGN Fifty-two RCTs of reflexology published from 1990 to September 2011 were initially retrieved. SETTING/LOCATION Cardiorespiratory Department, Highland Heartbeat Centre, Raigmore Hospital, Inverness. SUBJECTS Adult subjects. INTERVENTIONS Studies using reflexology foot massage techniques as the intervention versus sham reflexology treatment, simple foot massage, conventional treatment, or no treatment as the control were then selected. OUTCOME MEASURES OUTCOME MEASURES included any hemodynamic parameter potentially involved in the regulation of circulating blood volume and flow, including heart rate and systolic and diastolic arterial blood pressure. RESULTS Seven RCTs suggested that reflexology has an effect on selected cardiovascular parameters; however, five of these delivered the reflexology intervention as a whole complex treatment, with the data collector often delivering the intervention themselves. CONCLUSIONS This systematic review found that although reflexology has been shown to have an effect on selected hemodynamic variables, the lack of methodological control for nonspecific general massage effects means that there is little convincing evidence at this time to suggest the existence of a specific treatment-related hemodynamic effect. Furthermore, the review found that few studies of reflexology controlled for nonspecific effects in order to isolate any specific active component, despite the hemodynamic claim being a key part of the therapeutic value of reflexology. Therefore, further research approaches using more innovative designs and robust methods that can allow a treatment-induced, therapeutically beneficial hemodynamic effect to reveal itself are needed to help reflexology purchasers make a more informed decision about the safety and product quality of the reflexology hemodynamic claim and for reflexologists to be able to guarantee minimum product quality, validity, and safety standards in their practice.
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Affiliation(s)
- Jenny Jones
- School of Nursing, Midwifery & Health, University of Stirling, Highland Campus, Inverness, United Kingdom.
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The Effects of Massage Therapy by the Patient’s Relative on Vital Signs of Males Admitted in Critical Care Unit. Nurs Midwifery Stud 2012. [DOI: 10.5812/nms.7903] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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