Massage therapy involves the manipulation of the soft-tissue with various hand movements (e.g., rubbing, kneading, pressing, rolling, slapping, tapping). Massage therapy can elicit a relaxation response as measured by decreases in heart rate, blood pressure, and respiration. Often, massage is complemented with aromatherapy (i.e., essential oils combined with a carrier cream or oil to manipulate the soft tissues). Aromatherapy has been used together with massage in some studies. An aromatherapy massage is massage therapy delivered by a therapist while aromatherapy oils are administered by inhalation. Massage with or without aromatherapy has been studied in patients with cancer for management of anxiety, caregiver strain and burden, constipation, chemotherapy-induced nausea and vomiting, depression, lymphedema, pain, sleep-wake disturbances, and fatigue.
Cronfalk, B.S., Ternestedt, B., & Strang, P. (2010). Soft tissue massage: Early intervention for relatives whose family members died in palliative cancer care. Journal of Clinical Nursing, 19, 1040–1048.
To explore how bereaved relatives experienced early intervention with soft tissue massage during the first four months since the death of a family member who received palliative cancer care
Study data resulted from two interactions with Swedish-speaking relatives of deceased patients with cancer who had received care in a large palliative care unit. Demographic and baseline data were collected in an initial 60-minute visit to the relative. Hand or foot soft tissue massage, which is defined as a gentle but firm movement of the skin that activates touch receptors, was done in slow strokes, light pressure, and circling movement using lightly scented vegetable oil.
One week after an eight-week intervention involving either protocol-driven or relative election of either hand or foot soft tissue massage, the first author audiotaped hour-long interviews with the 18 study participants. Open-ended interviews focused on the experience of receiving the massages via a dialectical validation approach to ensure understanding of relatives’ experience. The authors supported trustworthiness and qualitative credibility factors during interviews and data analysis processes based on interview transcriptions and close attention text. An additional follow-up telephone call six to eight months after the interview was intended to encourage participants to reflect on their current life situation in relation to the grieving process.
A prospective, descriptive, qualitative design was used.
A qualitative content analysis allowed various levels of interpretation and abstraction to support one predominant theme: Bereaved relatives felt “feelings of consolation and help in learning to restructure everyday life.” The theme derived from four categories: (a) a helping hand at the right time, (b) something to rely on, (c) moments of rest, and (d) moments of retaining energy. Overall, soft tissue massage supported relatives’ need for comfort, as well as hope during a difficult transition time for relatives who sought a balance of grieving and moving on with their lives after the death of a loved one. No analysis of the follow-up telephone conversations appeared in the article.
Early interventions for relatives who grieve the loss of a family member’s death, including sequential soft tissue hand or foot massage, may facilitate relatives’ feelings of belonging, human connection to healthcare staff who cared for their family member before death, sense of self, and energy to structure life after a family member’s death. Too often, delayed interventions cause unnecessary worry and suffering of bereaving relatives. The offering of soft tissue massage to those relatives at a desired time may constitute a cost-effective way to support bereaved relatives early in their grieving process.
Early support, including that inherent in the delivery of soft tissue massage, to grieving relatives of a family member who died from cancer or other chronic illnesses, offers a cost-effective intervention that may improve the health of those relatives. This intervention needs further testing to determine its efficacy but does highlight the importance of grieving relatives reconnecting with the healthcare professional, physical touch, and getting needed support. Further research with diverse populations in other global communities may extend understanding and acceptance of this potentially future intervention to add quality-of-life care to relatives and other family members. Testing of a soft tissue massage intervention could support evidence for the effectiveness of this intervention and nurses’ referral of caregivers to this intervention for improved quality of life.
Lopez, G., Liu, W., Milbury, K., Spelman, A., Wei, Q., Bruera, E., & Cohen, L. (2017). The effects of oncology massage on symptom self-report for cancer patients and their caregivers. Supportive Care in Cancer, 25, 3645–3650.
To examine the effect of a massage session on physical, psychological, and global distress among cancer patients and their caregivers
Conventional Swedish massage with unscented hypoallergenic lotion and adjusted for location and pressure based the caregivers feedback to the therapist. The session lasted either 30 or 60 minutes based on caregivers choice. A 60-minute session was recommended for the first session. Music and/or a bolstering pillow could be used based on preference. The majority of caregivers received a 60-minute massage (81.6%).
PHASE OF CARE: Not specified in the report
Pre-/post design. Patients and caregivers.
Edmonton Symptom Assessment Scale (ESAS)
Massage therapy significantly decreased caregivers symptoms of pain, fatigue, sleep, depression, anxiety, drowsiness, appetite, and spiritual pain. The reduction was considered clinically significant (reduction greater than 1) for pain, fatigue, anxiety, well-being, and sleep and for all ESAS subscales (global distress, physical distress, and psychological distress). The duration of massage did not make a significant difference (30 versus 60 minutes) on reduction in symptom burden.
Massage offers as much benefit to caregivers as to patients. The largest improvement for caregivers was in their anxiety, pain, and fatigue. A 30-minute massage seems to be as effective as a 60-minute massage.
Offer massage to patients and their caregivers. Massage seems to improve symptom control (immediate effect). Additional study the accumulative effects of massage on caregivers and identify the "right" frequency and dose. Larger randomized controlled trials would provide additional assessment of the intervention.
Pinar, R., & Afsar, F. (2015). Back massage to decrease state anxiety, cortisol level, blood pressure, heart rate and increase sleep quality in family caregivers of patients with cancer: A randomised controlled trial. Asian Pacific Journal of Cancer Prevention, 16, 8127–8133.
To study the effectiveness of back massage on anxiety, stress markers, and sleep quality in the caregivers of patients with cancer
Caregivers were randomized to treatment and control groups. Caregivers in the treatment group rested for 10 minutes in a silent room then were given a 15-minute back massage each evening. The control group rested quietly in a separate silence room. Study measures were obtained at baseline and on day 7. Blood samples were obtained on day 7 for cortisol levels.
Randomized, controlled trial
Overall, 100% of the intervention group had moderate levels of anxiety at baseline, and those in the control group had low to high anxiety. Anxiety declined in the intervention group (p = 0.000) and remained essentially stable in the control group. Cortisol levels declined in the intervention group (p = 0.01) and were within reference levels. At baseline, 77.3% of caregivers in both groups had PSQI scores of 5 or greater, indicating poor sleep quality. Sleep quality scores declined in the intervention group (p = 0.000) and increased in the control group (p = 0.003) among those with initial scores greater than 5.
Daily back massages for caregivers reduced anxiety and improved sleep quality.
Back massage is a simple technique that nurses can use to help reduce anxiety and stress for the caregivers of patients with cancer. This is a complementary nursing action that can be used to support caregivers.
Rexilius, S.J., Mundt, C., Erickson Megel, M., & Agrawal, S. (2002). Therapeutic effects of massage therapy and healing touch on caregivers of patients undergoing autologous hematopoietic stem cell transplant. Oncology Nursing Forum, 29, E35–E44.
In the control group, one of the researchers visited caregivers for about 10 minutes twice a week for three weeks and asked, “How are you doing?”
In the massage therapy and Healing Touch groups, caregivers were provided with six 30-minute sessions. A certified massage therapist administered massage therapy, and a certified therapist provided Healing Touch treatments.
Outpatient oncology clinic