The Effect of Back Massage Applied to Palliative Care Patients on Sleep Quality and Pain

Yıl 2023, Cilt: 45 Sayı: 6, 963 - 977, 24.10.2023

Hilal Durmaz , Sevil Pamuk Cebeci

https://doi.org/10.20515/otd.1361722

Cited By: 1

Öz

Aim: The study was conducted to examine the effect of back massage applied to palliative care patients on sleep quality and pain.

Methods: The study was conducted among patients receiving inpatient treatment in the palliative care service of a hospital in Bilecik, Turkey, between November 2021 and April 2022. It was planned as a randomized controlled experimental study with a pretest-posttest control group design. The sample consisted of a total of 52 volunteer patients, 26 experimental and 26 control. Patient Diagnosis Form, Pittsburgh Sleep Quality Index, McGill Pain Scale-Short Form were used to collect data. Statistical significance level was accepted as p<0.05.

Results: When the socio-demographic characteristics of the experimental and control groups were examined, it was seen that both groups were equivalent in terms of individual characteristics such as age, gender, level of education and medical diagnosis. When the 7-day follow-up results regarding sleep and pain of the patients in the experimental and control groups were examined, a significant difference began between the two groups in favor of the experimental group after the 4th day (p <.001). When the average sleep quality scores of the patients were compared; According to 2*2 MIX ANCOVA test results, both in interaction (F(1,50)= 15.899, p<.001, η²=.016) and between groups (F(1,50)= 27.271, p<.001 , η²=.10) a statistically significant difference was found. When the average pain scores of the patients were compared; According to 2*3 MIX ANOVA test results, both measurement time (F(1,50)= 7.619, p<.001, η²=.013) and interaction (F(1,50)= 48.751, p<.001, A statistically significant difference was found (η²=.083).

Conclusion: In this study, back massage was applied to palliative care patients for 7 days, and it was determined that there was a statistically significant increase in the sleep quality of the patients and a statistically significant decrease in pain levels starting from the 4th day of the application.

Anahtar Kelimeler

Back massage, palliative care, sleep quality, pain, holistic care, nursing care

Proje Numarası

Project No: TYL-2022-2284

Palyatif Bakım Hastalarına Uygulanan Sırt Masajının Uyku Kalitesi ve Ağrıya Etkisi

Öz

Aim: Çalışma, palyatif bakım hastalarına uygulanan sırt masajının uyku kalitesi ve ağrıya etkisini incelemek amacıyla yapıldı.

Methods: Çalışma Kasım 2021- Nisan 2022 tarihleri arasında Türkiye’de Bilecik ilinde bir hastanenin palyatif bakım servisinde yatarak tedavi gören hastalar ile yapıldı. Ön test-son test kontrol gruplu desene sahip randomize kontrollü deneysel çalışma olarak planlandı. Örneklemi 26 deney, 26 kontrol olmak üzere toplam 52 gönüllü hasta oluşturdu. Verilerin toplanmasında Hasta Tanı Formu, Pittsburgh Uyku Kalitesi İndeksi, McGill Ağrı Ölçeği-Kısa Formu kullanıldı. İstatistiksel anlamlılık düzeyi p<0.05 kabul edildi.

Results: Deney ve kontrol grubunun sosyo-demografik özellikleri incelendiğinde, her iki grubun yaş, cinsiyet, eğitim durumu ve tıbbi tanı gibi bireysel özellikler bakımından denk olduğu görüldü. Deney ve kontrol gruplarındaki hastaların uykuya ve ağrıya ilişkin 7 günlük izlem sonuçları incelendiğinde; her iki grup arasında 4. günden sonra deney grubu lehine anlamlı farklılaşma başlamıştır (p<.001). Hastaların uyku kalitesi puan ortalamaları karşılaştırıldığında; 2*2 MİX ANCOVA test sonuçlarına göre; hem etkileşimde (F(1,50)= 15.899, p<.001, η²=.016), hem de gruplar arasında (F(1,50)= 27.271, p<.001, η²=.10) istatistiksel olarak anlamlı farklılık bulundu. Hastaların ağrı puan ortalamaları karşılaştırıldığında; 2*3 MİX ANOVA test sonuçlarına göre hem ölçüm zamanı (F(1,50)= 7.619, p<.001, η²=.013), hem de etkileşimde (F(1,50)= 48.751, p<.001, η²=.083) istatistiksel olarak anlamlı farklılık bulundu.

Conclusion: Bu çalışmada, palyatif bakım hastalarına 7 gün boyunca sırt masajı uygulanmış, uygulamanın 4. gününden itibaren hastaların uyku kalitesinde istatistiksel açıdan anlamlı artış olduğu ve ağrı düzeylerinde istatistiksel açıdan anlamlı azalış olduğu belirlendi.

Anahtar Kelimeler

Sırt masajı, palyatif bakım, uyku kalitesi, ağrı, holistik bakım, hemşirelik bakımı

Etik Beyan

Bu makale Yüksek Lisans Tez çalışmasından üretilmiştir. Eskişehir Osmangazi Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimince Desteklenmiştir (Proje Numarası: TYL-2022-2284). ClinicialTrials.gov PRS Protocol Registration and Results System, Protokol no: NCT05168514

Destekleyen Kurum

Bu makale Yüksek Lisans Tez çalışmasından üretilmiştir. Eskişehir Osmangazi Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimince Desteklenmiştir (Proje Numarası: TYL-2022-2284).

Proje Numarası

Project No: TYL-2022-2284

Kaynakça

• 1. Potter PA, Perry AG. Fundamentals of Nursing, 9th Edition, Mosby, 2016: 293-784.
• 2. Elçigil A. Palliative care nursing. Gulhane Medical Journal, 2012; 54, 329-334.
• 3. Uysal N, Şenel G, Karaca S, Kadıoğulları N, Koçak N, Oğuz G. Symptoms seen in patients hospitalized in the palliative care clinic and the effect of palliative care on symptom control. Pain Journal, 2015; 27(2), 104-110.
• 4. Carvalho AS, Martins Pereira S, Jácomo A, Magalhães S, Araújo J, Hernández-Marrero P, … Schatman M. Ethical decision making in pain management: a conceptual framework. Journal of Pain Research, 2018; 11, 967-976.
• 5. Yılbaş AA, Celebi N. Pain and problems in palliative care. Journal of Anesthesia – JARSS, 2014; 22 (3),124- 134.
• 6. Ergan M, Başkurt Z. Physiotherapy of pain in patients with cancer receiving palliative care. Acta Oncologica Turcica, 2019; 348- 355.
• 7. Kıvanc MM. Palliative care services in Turkey. Journal of Health Sciences and Professions (HSP), 2017; 4(2), 132-135.
• 8. Arslan GG, Yucel SC. Hand massage application in nursing care and systematic analysis of studies. Journal of Izmir Katip Celebi University Faculty of Health Sciences, 2017; 2(1), 15-20.
• 9. Ovayolu O, Ovayolu N. Integrative approaches in pain management of cancer patients receiving palliative care. Hacettepe University Faculty of Nursing Journal, 2017; 4(3), 54-64.
• 10. Yıldırım D, Kocatepe V, Can G, Sulu E, Akış H, Şahin G, Aktay E. The effect of lavender oil on sleep quality and vital signs in palliative care: a randomized clinical trial. Complementary Medicine Research, 2020; 1–8.
• 11. Atabek Aştı T, Karadağ A. (Çev. Eds). Clinical Nursing Skills and Methods, 1nd Edition, Adana: Nobel Bookstore, 2011:166-188.
• 12. Mercadante S, Adile C, Ferrera P, Masedu F, Valenti M, Aielli F. Sleep disturbances in advanced cancer patients admitted to a supportive/palliative care unit. Supportive Care in Cancer, 2017; 25(4), 1301-1306.
• 13. Yavuzşen T, Alacacıoğlu A, Çeltik A, Yılmaz U. Cancer and insomnia. Turkish Journal of Oncology, 2014; 29(3), 112–119.
• 14. Watson J. Viewpoint: caring science meets heart science: a guide to authentic caring practice. American Nurse Today, 2012; 7(8).
• 15. Gul A, Aslan FE. Evidence-based approach to pain control; massage and aromatherapy. Turkey Clinics J Nurs, 2012; 4(1), 30-6.
• 16. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28, 193-213.
• 17. Agargun YM, Kara H, Anlar O. Validity and reliability of the Pittsburg sleep quality index. Turkish Journal of Psychiatry, 1996; 7(2), 107- 111.
• 18. Melzack R. The short-form McGill pain questionnaire. Pain J, 1987; 30(2), 191–197.
• 19. Yakut Y, Yakut E, Bayar K, Uygur F. Reliability and validity of the turkish version short-form mcgill pain questionnaire in patients with rheumatoid arthritis. Clinical Rheumatology, 2006; 26(7), 1083–1087.
• 20. Regulation on Amendments to the Nursing Regulation. 2011. T.R. Official Gazette (27910, 19 April 2011).
• 21. Kemppainen LM, Kemppainen TT, Reippainen JA, et.al. Use of complementary and alternative medicine in Europe: health-related and sociodemographic determinants. Scand J Public Health, 2018; 46(4): 448–455.
• 22. Candy B, Armstrong M, Flemming K, et al. The effectiveness of aromatherapy, massage and reflexology in people in need of palliative care: A systematic review. Palliative Medicine, 2020;34(2):179-194.
• 23. Kashani F, Kashani P. The effect of massage therapy on the quality of sleep-in breast cancer patients. Iranian Journal of Nursing and Midwifery Research, 2014; 19(2), 113.
• 24. Miladinia M, Baraz S, Shariati A, Malehi AS. Effects of slow-stroke back massage on symptom cluster in adult patients with acute leukemia: supportive care in cancer nursing. Cancer Nursing, 2017; 40(1), 31-38.
• 25. Unal KS, Akpinar RB. The effect of foot reflexology and back massage on hemodialysis patients' fatigue and sleep quality. Complementary Therapies in Clinical Practice, 2016; 24, 139-144.
• 26. Miladinia M, Jahangiri M, Kennedy AB, et al. Determining massage dose-response to improve cancer-related symptom cluster of pain, fatigue, and sleep disturbance: A 7-arm randomized trial in palliative cancer care. Palliative Medicine, 2023; 37(1):108-119.
• 27. Jane SW, Chen SL, Wilkie DJ, et al. Effects of massage on pain, mood status, relaxation, and sleep in Taiwanese patients with metastatic bone pain: a randomized clinical trial. Pain J, 2011; 152(10): 2432–2442.
• 28. Kwekkeboom KL, Cherwin CH, Lee JW, Wanta B. Mind-body treatments for the pain-fatigue-sleep disturbance symptom cluster in persons with cancer. Journal of pain and symptom management, 2010; 39(1), 126–138.
• 29. Buyukyılmaz F, Atabek Aştı T. The effect of relaxation techniques and back massage on pain and anxiety in Turkish total hip or knee arthroplasty patients. Pain Management Nursing, 2013; 14(3), 143-154.
• 30. Han MS, Lee, KY. The effect of back massage on degree of pain, state anxiety and quality of sleep of postoperative patients with gastrectomy. Asian Oncology Nursing, 2012; 12(1), 69-76.
• 31. Mok E, Pang Woo C. The effects of slow-stroke back massage on anxiety and shoulder pain in elderly stroke patients. Complementary Therapies in Nursing and Midwifery, 2004; 10(4), 209–216.
• 32. Kutner J, Smith M, Corbin L, et al. Simple touch versus massage therapy to improve pain and mood in patients with advanced cancer: a randomized trial. Ann Intern Med, 2008; 149(6): 369–379.
• 33. Cherkin DC, Sherman KJ, Kahn J, Wellman MR, Cook AJ, Johnson ME, et al. Comparison of the effects of RA 2 types of massage and usual care on chronic low back pain. Ann. Intern. Med, 2011; 155.
• 34. Walach H, Guthlin C, Konig M. Effectiveness of massage therapy in chronic pain: A pragmatic, randomized trial. J.Altern. Complement. Med, 2003; 9, 837–846.
• 35. Hamre HJ, Witt CM, Glockmann A, Ziegler R, Willich SN, Kiene H. Rhythmic massage therapy in chronic disease: a 4-year prospective cohort study. J.Altern. Complement. Med, 2007; 13, 635–642.
• 36. Soden K, Vincent K, Craske S, et al. A randomized controlled trial of aromatherapy massage in a hospice setting. Palliat Med, 2004; 18(2): 87–92.
• 37. Toth M, Marcantonio ER, Davis RB, et al. Massage therapy for patients with metastatic cancer: a pilot randomized controlled trial. J Altern Complement Med, 2013; 19(7): 650–656.
• 38. Cronfalk BS, Strang P, Ternestedt BM, et al. Existential experiences of receiving soft tissue massage in palliative home care – an intervention. Support Care Cancer, 2009; 17(9): 1203–1211.
• 39. Armstrong M, Flemming K, Kupeli N, et al. Aromatherapy, massage and reflexology: a systematic review and thematic synthesis of the perspectives of people in need of palliative care. Palliat Med, 2019; 33(7): 757–769.