The effects of foot and facial massage on sleep induction, blood pressure, pulse and respiratory rate: crossover pilot study

The study aimed to compare the effects of facial massage with that of foot massage on sleep induction and vital signs of healthy adults and to test a methodology that could be used by a lone researcher in such a study. A randomised within-group crossover pilot study of six healthy female volunteers was conducted. The interventions were a 20 min foot and a 20 min facial massage using peach-kernel base oil Prunus persica. A drop in systolic blood pressure of 8.5 mmHg was recorded immediately after facial massage compared to that of 1 mmHg recorded after foot massage. Both treatments were equally effective in reducing subjective levels of alertness during the interventions, with face massage marginally better at producing subjective sleepiness. A lone researcher using these methods would be able objectively to measure vital signs before and after interventions, but not during; and would be able subjectively to measure sleep induction in non-sleep-laboratory contexts.     

Massage as adjuvant therapy in the management of post-cesarean pain and anxiety: A randomized clinical trial

ObjectiveThe present study was conducted to determine the effect of massage on post-cesarean pain and anxiety.MethodsThe 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.ResultsA 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.ConclusionAs an effective nursing intervention presenting no side-effects, hand and foot massage can be helpful in the management of postoperative pain and stress.     

The effects of foot reflexology massage on anxiety in patients following coronary artery bypass graft surgery: A randomized controlled trial

ObjectiveTo examine the effects of foot reflexology massage on anxiety in patients following CABG surgery.MethodsIn this randomized controlled trial, 80 patients who met the inclusion criteria were conveniently sampled and randomly allocated to the experimental and control groups after they were matched on age and gender. On the days following surgery, the experimental group received foot reflexology massage on their left foot 20 min a day for 4 days, while the control group was given a gentle foot rub with oil for one minute. Anxiety was measured using the short-form of the Spielberger State-Trait Anxiety Inventory and the Visual Analogue Scale-Anxiety.ResultsBoth measurement instruments confirmed a significant decrease in anxiety following the foot reflexology massage.ConclusionThe significant decrease in anxiety in the experimental group following the foot reflexology massage supports the use of this complementary therapy technique for the relief of anxiety.     

Immediate effects of a five-minute foot massage on patients in critical care

Critical care can be considered to be a stressful environment at both physiological and psychological levels for patients. In this article, a research study in which a five-minute foot massage was offered to 25 patients (68 sessions in total) as a stress-reduction intervention is described. A quasi-experimental repeated measures design was used to collect data before, during and after the intervention. Physiological data (heart rate, mean arterial blood pressure, respirations and peripheral oxygen saturation) were obtained from the patient bedside monitoring system. Repeated measures analysis of variance indicated there was no significant effect from the intervention on peripheral oxygen saturation. However, a significant decrease in heart rate, blood pressure and respirations was observed during the foot massage intervention. Results indicated foot massage had the potential effect of increasing relaxation as evidenced by physiological changes during the brief intervention administered to critically ill patients in intensive care.     

Practical aspects of hospice care at home

While much of hospice care, from a medical professional viewpoint, is concentrated on the physiology and pharmacology of maximal symptom management in hospital or at home, families and those caring for the day-to-day aspects of dying face different barriers to care. Achieving an environment that is both the safest and the most efficient for care at home is not often considered and the elements of achieving that environment are the focus of this chapter. What general equipment needs, what 'nursing' skills and what practical advice can we give to families and care-givers who care for dying patients at home? It is important that physicians understand the details of home care planning and needs so they can provide the best counsel for patients and their families as they make choices about terminal care.     

A Cross-Cultural Look at Pregnancy, Labor, and Delivery

This article reviews sonic: pertinent cross-cultural literature that may give the maternity nurse the wider perspective of the practices and beliefs of many cultures in regard to childbirth. Such a perspective may help the nurse formulate solutions to certain problems encountered in caring for families during the maternity cycle. For example, learning about practices of other cultures regarding such things us delivery positions or the role of the father can help one loosen one's rigid concepts. We may first recognize a phenomenon that seems peculiar to other cultures, only to find on closer observation that it also occurs in our own.     

Training parents of children with life-long and life-limiting conditions in the art of massage

The aim of this study was to explore the experience of being a massage therapist on the Training and Support Programme (TSP) in relation to Continued Professional Development (CPD). The TSP instructs parents caring for children with life-long and life-limiting conditions in simple massage techniques. Data were collected by semi-structured interviews with six massage therapists who had worked on the TSP for between 112 and 4 years. Therapists reported a number of beneficial gains including increased knowledge about 'disabilities' in general and a greater understanding of caring for children with life-long and life-limiting conditions, more patience, enhanced confidence of their practice, ability to adapt, and compassion. All therapists felt privileged to be a part of the process of change that occurred for parents and their children during the TSP. The results of this study will add to the scarce literature concerning massage therapists' CPD and provide insight into their experiences of working with parents and their children with a range of life-long and life-limiting conditions.     

Aromatherapy for deaf and deafblind people living in residential accommodation

This article looks at ways in which aromatherapy and therapeutic massage have been found to be beneficial for a group of deaf and deafblind adults with special needs, living in residential accommodation. Our basic aim is to promote confidence and communication as well as enhancing a sense of well-being through the judicial use of aromatic plant materials and therapeutic massage. Aromatherapy sessions have become an accepted enjoyable and therapeutic part of the residents' lifestyle. It is our belief that this gentle, non-invasive therapy can benefit deaf and deafblind people, especially as their intact senses can be heightened. This paper explores both professional and caring issues related to the use of aromatherapy in this environment.     

Affirming Motherhood: Validation and Invalidation in Women’s Perinatal Hospice Narratives

Abstract: Background: Perinatal hospice is an option for women who learn during pregnancy that their fetuses are affected by terminal conditions and choose to continue their affected pregnancies. These women face emotional pain and the impending loss of their fetuses or infants. The aims of this study were to explore the experiences of perinatal hospice mothers, to gather knowledge useful to health professionals, and to guide future research. Methods: Narrative analysis was performed using the personal stories of 15 women who continued pregnancies affected by lethal fetal anomalies. Results: The participants identified themselves as mothers and their fetuses or newborns as babies. Mothers valued caring for and interacting with their babies. Health professionals who affirmed their status as mothers, the value of their babies, and the significance of their losses were perceived as supportive. Invalidating attitudes and behavior caused significant distress among mothers. Conclusions: Optimal care of perinatal hospice mothers supports the development of maternal identity and contact between mothers and newborns when desired. Professionals who care for perinatal hospice mothers can affirm their motherhood through their behavior and attitudes. (BIRTH 38:3 September 2011)     

The effect of foot reflexology and back massage on hemodialysis patients' fatigue and sleep quality

ObjectiveThe aim of this study is to examine the effectiveness of foot reflexology and back massage on optimizing the sleep quality and reducing the fatigue of hemodialysis patients.MethodsThe study includes 105 volunteer patients who were registered at a private dialysis clinic and were receiving hemodialysis treatment. Foot reflexology and back massage were administered to the patients two times a week for four weeks. The Visual Analogue Scale for Fatigue and the Pittsburg Sleep Quality Index were used to collect data.ResultsThe differences between the pretest and posttest score averages of the patients on the Visual Analogue Scale for Fatigue and the Pittsburg Sleep Quality Index were statistically significant (p < 0.001).ConclusionFoot reflexology and back massage were shown to improve the sleep quality and reduce the fatigue of hemodialysis patients. Compared to back massage, foot reflexology was determined to be more effective.     

Professional liability. Etiology

Once again, I find Mr. Cooper quote-worthy for his statement, "It is incumbent upon the trial bar not to support the status quo merely because it is in our economic interest. Change is in the wind, and our tort system will be blown away on the winds of change for change's sake unless we participate in correcting deficiencies in the tort system and civil jury trial process." I suggest that we cannot ask for change for our own economic interest, nor can we lay blame exclusively to the other etiologic elements. We must improve those elements within our purview. The prayer of serenity may serve us well: God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. In the game of professional liability litigation as played by the rules extant there are clearly winners and losers. The winners are the legal profession, both plaintiff and defense, and the insurers, who in the face of adversity simply increase premiums or withdraw from the market. The losers are the medical profession, the patients for whom they care and, in the broadest sense, our society as a whole. So as not to close on a note of gloom, one last quote. Lawrence H. Cooke, former Chief Judge of New York State, in remarks to the April 1986 National Symposium on Civil Justice Issues stated, "Our justice systems are beset with very real problems.(ABSTRACT TRUNCATED AT 250 WORDS)     

Research unwrapped. Obstetric skills and drills

Although I have highlighted some issues with this study and the wider context in which it sits. I do not believe that it is a bad piece of research per se. As above, the biggest problem with this study for me is that the researchers have omitted to discuss some of its limitations. No research is perfect, and perfection is not the aim. The aim is to increase knowledge, and this can only be done where we look at research findings alongside consideration of how they might have been affected by research design and decisions. This study shows, for the first time, that obstetric 'skills and drills' training does make a difference. On average, participants got 20.6 more questions right in a 185-question multiple-choice test after training than before. Does this mean they will be better equipped to look after women and babies in practice? We don't know. Is this the best kind of training that they could have undertaken? We don't know. What do the people who participated--and those who chose not to participate--in this study think and feel about these things? We don't know that either. But this study is a step on the road towards finding out if the courses that everybody is having to go on as a result of the CNST requirement are actually of any value, and that can surely only be a good thing.     

Massage as an orthodox medical treatment past and future

Massage has had a long history within orthodox medicine and is not an unknown, untried therapy of dubious origin. Writers on massage usually refer to its long history in ancient cultures but stop with Ling, to whom they attribute the development of modern massage in the early 19th century. Little attention is given to the rich massage literature of the late 19th and early 20th centuries, which reveals massage to have been an orthodox medical therapy practised by doctors and nurses. Analysis of that literature shows massage to have been significantly different in its application to most of today's practice, despite similarity of definition and terminology. Lack of detailed specification of a massage is a limitation of much current research, and this paper suggests a framework, or template, for that specification based on the earlier literature, so that future massages used in research can be replicated and implemented more reliably than at present. Massage as an orthodox therapy almost disappeared after WWII, but has recently reemerged as a complementary therapy which requires a full re-evaluation and audit. The template for its specification, together with the utilization and reconsideration of earlier modes of delivery, offers significant research opportunities for nurses and midwives of today.     

That loving touch

Early massage and positive touch in pregnancy can play a big part in helping to build closeness within a family group. I have witnessed an increasing number of dads bringing their babies to baby massage classes--but the power of positive touch can and should start long before that. If the father is encouraged to connect with his baby throughout the pregnancy using positive touch and simple massage, as their baby grows the mother, father and baby will all benefit.     

Midwives and human rights: dream or reality?

Midwives as predominantly women caring for other women are subject to the same human rights violations and abuse that affect all the women of the world. They need to know and recognise these human rights violations before being able to take action that will reduce or eliminate such harmful practices. In this article, I address gender-based violations of the basic human rights of particular concern to women during their childbearing years, such as personal safety, respect for human dignity, fair and equitable access to health services, along with autonomous decision-making based on complete and unbiased information. The ethical and legal foundations of human rights are discussed in relation to viewing women as fully human, fully persons. Guidance for midwives taken from key documents of the International Confederation of Midwives are offered as midwives work together with women to end gender-based violations of one's human rights.     

Die Herausforderung des Sterbens annehmen

The theme of this pastoral letter is the relationship between mankind and dying. The fact that both modern society, as well as the individual, judge people primarily by their productivity is criticized. The conscious acceptance of the reality of suffering and dying, which are irrevocably bound with life, provides mankind with the dignity to which it is entitled independently of productivity. Relatives and those caring for patients show real solidarity with the dying when they help him or her to accept this reality. This is also the concern of the hospice movement. It additionally implies the requirement for assessing when therapy should change from curative to palliative. Nevertheless, the physician is forbidden to kill the patient or help him or her to commit suicide. Suffering and death are part of the reality of life and it is thus an expression of the dignity of mankind when one helps a patient through this time as well as when one goes through it oneself.     

Disparities in hospice care among older women dying with ovarian cancer

Background

Timely hospice referral is an essential component of quality end-of-life care, although a growing body of research suggests that for patients with various types of cancer, hospice referrals often occur very late in the course of care, and are marked by sociodemographic disparities. However, little is known about the ovarian cancer patient population specifically. We examined the extent and timing of hospice referrals in ovarian cancer patients over age 65, and the factors associated with these outcomes.

Methods

We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to identify 8211 women aged 66 + with ovarian cancer who were diagnosed between 2001 and 2005 and died by December 31, 2007. We excluded women who were not eligible for Medicare A continuously during the 6 months prior to death. Outcomes studied included overall hospice use in the last 6 months of life and late hospice enrollment, defined as within 3 days of death. We examined variations in these two measures based on year of diagnosis and sociodemographic characteristics (age, race, marital status, rural residence, income, education) and type of Medicare received (fee-for-service vs. managed care).

Results

Among 8211 women in the cohort who died from ovarian cancer, 39.7% never received hospice care (3257/8211). Overall hospice care increased over the period of observation, from 49.7% in 2001 to 74.9% in 2005, but the proportion of women receiving hospice care within 3 days of death did not improve. Among those who received hospice care, 11.2% (556/4954) and 26.2% (1299/4954) received such care within 3 and 7 days of death, respectively. A higher proportion of black women (46.5% vs. 38.4% among whites), women in the lowest income group (42.8% vs. 37.0% in the highest income group), and those receiving fee-for-service Medicare (41.3% vs.33.5% for women in managed care) never received hospice care. In multivariable models, factors associated with lack of hospice care included age younger than 80 years (OR 1.27, 95% CI 1.15-1.40), non-white race (OR 1.44, 95% CI 1.26-1.65), low income (OR 1.17, 95% CI 1.04-1.32) and enrollment in fee-for-service Medicare compared with managed care (OR 1.39, 95% CI 1.24-1.56).

Conclusion

More older women with ovarian cancer are receiving hospice care over time, however, a substantial proportion receive such care very near death, and sociodemographic disparities in hospice care exist. Our data also support the need to target lower-income and minority women in efforts to increase optimally timed hospice referrals in this population. Our finding that ovarian cancer patients enrolled in managed care plans were more likely to receive hospice care suggests the importance of health care system factors in the utilization of hospice services.     

The influence of the training and support programme on the self-efficacy and psychological well-being of parents of children with disabilities: a controlled trial

The purpose of the study was to examine the effectiveness of an intervention for parents of children with disabilities in a controlled study focusing on parents' self-efficacy, psychological well-being and perceptions of change in children's sleeping, eating and mobility. The Training and Support Programme (TSP) was designed to equip parents with a simple massage skill that they could use with their children in the home environment. Parents were trained in massage by therapeutic massage therapists in 8-weekly sessions, each lasting 1h. The sample comprised 95 parents (49 in the Intervention Group, 46 in the Waiting-list Control Group) who attended the TSP with their children. Data were collected by self-administered questionnaires at baseline (before commencing the TSP), and at 8-week follow-up. The TSP demonstrated statistically significant positive effects on parents' anxious mood, self-efficacy for managing children's psychosocial well-being, self-efficacy in giving massage therapy, and perceptions of children's sleeping and eating. Relatively high levels of psychological distress were found among parents, particularly mothers. Overall, findings suggest that wider implementation of the Programme is warranted, and greater attention needs to paid to the psychological well-being of parents caring for children with disabilities.     

Resource utilization for ovarian cancer patients at the end of life: how much is too much?

OBJECTIVE: End-of-life (EOL) medical care consumes 10-12% of national health care expenditures and 27% of Medicare dollars annually. Studies suggest that hospice services decrease EOL expenditures by 25-40%. The goal of this study was to compare the total cost of hospital-based resources utilized in ovarian cancer patients during their last 60 days of life for those enrolled in hospice versus those not on hospice. METHODS: Study eligibility included patients who expired from ovarian cancer from 1999 to 2003. Medical records were reviewed for demographic data as well as treatment, response and recurrence rates, histologic type, grade and stage. Billing records were analyzed for costs of inpatient and outpatients visits, including radiologic, laboratory and pharmacy charges. Total cost of hospital resources was compared between patients managed on hospice for >10 days (hospice group) versus <10 days (non-hospice group) using the following methods: Mann-Whitney U, Kruskal-Wallis and Student's t tests. Overall survival was compared using Kaplan-Meier statistics. RESULTS: Of the 84 patients analyzed, 67 (79.8%) were in the non-hospice group and 17 (20.2%) were in the hospice group. Demographic, histologic and staging characteristics as well as platinum sensitivity were similar between the two groups before the last 60 days of life. Mean number of chemotherapy cycles before the study period was also similar (20.4 and 21.0, respectively). However, during the study period, the mean total cost per patient in the non-hospice group was dollar 59,319 versus dollar 15,164 in the hospice group (P = 0.0001). A significant difference in cost was noted for mean inpatient days (dollar 6584 vs. dollar 1629, P = 0.0007), radiology (dollar 6063 vs. dollar 2343, P = 0.003), laboratory (dollar 12,281 vs. dollar 2026, P = 0.0004) and pharmacy charges (dollar 13,650 vs. dollar 4465, P = 0.0017) as well as for treating physician per patient (dollar 112,707 vs. dollar 34,677, P = 0.04). Overall survival for the two groups was the same. CONCLUSIONS: Our findings demonstrate that there is a significant cost difference with no appreciable improvement in survival between ovarian cancer patients treated aggressively versus those enrolled in hospice at the EOL. These data suggest that earlier hospice enrollment is beneficial. Furthermore, cost variations between physicians and patients imply that education may be an important variable.