Karagozoglu, S., & Kahve, E. (2013). Effects of back massage on chemotherapy-related fatigue and anxiety: Supportive care and therapeutic touch in cancer nursing. Applied Nursing Research, 26, 210–217.

To determine efficacy of back massage on fatigue and anxiety in patients receiving chemotherapy

Before chemotherapy infusions were started, patients completed study data collection in face-to-face interviews. During chemotherapy administrations, patients in the intervention group received a back massage for 15 minutes before the infusions and between 25–40 minutes of each one-hour period of chemotherapy administration. Data collection was repeated immediately after the massage intervention, and patients were interviewed by phone 24 hours after the chemotherapy treatment for the completion of postintervention data collection. Patients were not randomly assigned to treatment and control groups.

• N = 40  
• MEAN AGE = 49.94 years (SD = 11.31 years)
• MALES: 45% (intervention group); 50% (control group), FEMALES: 55% (intervention group); 50% (control group)
• KEY DISEASE CHARACTERISTICS: Breast and lung cancers were the most frequent diagnoses.
• OTHER KEY SAMPLE CHARACTERISTICS: All patients were receiving single-day chemotherapy. Massage interventions were done during the third or fourth chemotherapy treatment. None of the patients were actively working at the time.

• SITE: Single-site    
• SETTING TYPE: Outpatient    
• LOCATION: Turkey

• PHASE OF CARE: Active antitumor treatment

Quasi-experimental, cross-sectional cohort study

• Spielberger State-Trait Anxiety Inventory (STAI)
• Brief Fatigue Inventory (BFI)

Fatigue scores were significantly different between groups at baseline and higher in the control group the day after chemotherapy. There were no significant differences between groups in the change of fatigue pre- and postintervention. Mean anxiety scores in the control group increased after chemotherapy while those in the intervention group declined. Differences between groups were not statistically significant.

Findings provide limited evidence that back massages may be helpful in reducing anxiety and fatigue experienced during treatment with chemotherapy.

• Small sample (< 100)
• Baseline sample/group differences of import
• Risk of bias (no blinding)
• Risk of bias (no random assignment) 
• Risk of bias (no appropriate attentional control condition)  
• Other limitations/explanation: Completion of data collection forms by investigators increases potential bias. Only very short-term effects were measured.

Massage is a low-risk intervention that may be helpful to some patients during active chemotherapy treatment to reduce anxiety or fatigue. This study, however, does not provide strong supportive evidence due to multiple study design limitations.