Mothers' experience of infant massage in child health care: A qualitative interview study.

AIM: To investigate mothers' experience of infant massage. DESIGN: This was an exploratory-descriptive qualitative study based on individual interviews. METHODS: A qualitative interview study with an inductive approach was used according to the COREQ guidelines. The participants in the study were mothers (n = 11) residing in Sweden who received training in infant massage from the child health care nurse in the child health care services. The transcribed interviews were analysed using a qualitative content analysis. RESULTS: The collected material resulted in two categories and eight subcategories. The categories were learning infant massage and using infant massage as a tool. The eight subcategories were massaging in a parent group, massaging at home, massage movements and the child health care nurse's supporting hand, reading the child's signals, creating time and relaxation together, interaction and connection between the child and the parent, relief from stomach problems and anxiety and continuing to massage the older child. The study showed that mothers experienced that the relationship created through infant massage brought more joy, tenderness and security to the child. The child health care nurse had an important role in supporting the mothers, especially when it came to different views on doing infant massage at home and in groups. PATIENT OR PUBLIC CONTRIBUTION: Mothers with experience of infant massage were interviewed.

[Touch-Massage®, an original approach in psychiatric nursing homes]. / Le Toucher-massage®, une approche originale en Ehpad psychiatrique.

The practice of Touch-Massage® in a residential unit for dependent elderly people, specialized in psychiatry, requires an adapted and thoughtful approach. A nursing assistant experienced in this type of care and institutional trainer shares her experience. Beyond the technical nature of the approach, Touch-Massage® is above all an informal approach. The primary goal is to establish a relationship of trust, which is synonymous with well-being for the resident.

Effect of Foot Massages on Postpartum Comfort and Pain Level of Mothers After Vaginal Delivery: A Randomized Trial.

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.

Effects of Forest Therapy on Health Promotion among Middle-Aged Women: Focusing on Physiological Indicators.

Women experience more stress in middle age than in other life stages, and health in middle age is vital, because it influences the quality of life in old age. In this study, the effects of a forest therapy program on physiological changes in 53 middle-aged women (divided into two groups) who lived in the city were examined. One group participated in a three-day program in the forest, followed by three days in the city; the other group participated in a three-day program in the city, followed by three days in the forest. Forest experiments were conducted in a "healing forest," and urban experiments were conducted near a university campus. Blood tests were performed to evaluate the physiological effects of forest therapy. Differences in serotonin levels and vitamin D levels were verified before and after the forest (experimental group) and urban (control group) programs through paired t-tests. Statistically significant increases in serotonin levels were noted for participants in the forest program; vitamin D levels also increased, but not by statistically significant values. The findings of this study verify that forest therapy programs promote health among middle-aged women, and may prevent disease and improve quality of life.

The Perceived Credibility of Complementary and Alternative Medicine: A Survey of Undergraduate and Graduate Students.

The popularity of complementary and alternative medicine (CAM) appears to be increasing, especially among college students. We surveyed 146 undergraduate and graduate students with the CAM Health Belief Questionnaire and obtained credibility and frequency ratings for a select group of CAM therapies: yoga, meditation, massage, chiropractic medicine, biofeedback, hypnosis, acupuncture, spirituality/religion, therapeutic touch, the use of herbs/vitamins, and aromatherapy/essential oils. Graduate students held more favorable views about integrating CAM into conventional medical practice. Female students reported using a wider variety of therapies than male students. Spirituality/religion and herbs/vitamins were the most popular CAM approaches. Students rated yoga, meditation, and massage as being highly credible practices. They rated hypnosis and therapeutic touch low in credibility. We discuss hypnosis as an example of a therapy that suffers from poor public perception despite having a relatively strong evidentiary base.

Teaching Father-Infant Massage during Postpartum Hospitalization: A Randomized Crossover Trial.

PURPOSE: The purpose of this study was to evaluate acceptability and impact of infant massage video instruction on fathers' behaviors in early postpartum. METHODS: A randomized crossover design was used. Participants were fathers of healthy term infants born at a Magnet hospital in Southern California. Measures included a demographic survey, Father-to-Infant Bonding Scale, Father-Infant Observation Scale, and postdischarge phone interview. Study nurses observed father-infant interactions for 5 minutes. Fathers were randomized to one of two groups: fathers in group 1 saw the massage video before they were observed with their infants and fathers in group 2 saw the video after. Fathers completed the Bonding Scale at baseline in person and again within a week of discharge by phone. Statistics were descriptive and comparative. Responses to interview questions were categorized and described. RESULTS: Ninety-eight fathers aged 18 to 44 years participated. Over half of fathers identified as Hispanic and the majority spoke English at home. Most fathers had positive responses to infants on individual Bonding Scale items. Fathers differed significantly in observed interactions with infants depending upon timing of massage instruction; fathers observed immediately after the video had more total interactions, specifically fingertip touching. Poststudy evaluations were predominantly positive. CLINICAL IMPLICATIONS: We found a brief infant massage instruction offered by video was well accepted by fathers and increased observed father-infant interactions.

Effects of Massage and Acupressure on Relieving Labor Pain, Reducing Labor Time, and Increasing Delivery Satisfaction.

BACKGROUND: Several recent studies have documented the effects of massage and acupressure in reducing labor pain and labor time and in satisfaction with the delivery. However, few studies have investigated the comparative effects of these two therapies. PURPOSE: The aim of this study was to compare the effects of massage and acupressure on labor-related pain management, duration, and satisfaction with delivery. METHODS: This randomized controlled trial (n = 120) included three intervention groups (massage only, acupressure only, and massage + acupressure) and one control group, in which patients received no massage or acupressure treatment. A personal information form, Pregnant Watch Form, and Visual Analog Scale (VAS) were used to collect data. Frequency and percentage calculations, chi-square test, Student's t test, Tukey's honestly significant difference test, and one-way variance analysis were used for data analysis. RESULTS: In the latent phase of labor, the mean VAS scores of the massage-only group and massage + acupressure group were lower (4.56 ± 1.36 and 4.63 ± 1.52, respectively) than that of the control group (6.16 ± 1.46; p < .01). In the active and transition phases, the mean VAS scores of the massage-only group, acupressure-only group, and massage + acupressure group were significantly lower than that of the control group (p < .01 and p < .001, respectively). During postpartum, the mean VAS score of the massage + acupressure group was lower (2.30 ± 0.70) than that of the control group (2.96 ± 0.72; p = .003). Cervical dilatation completion time and 1- and 5-minute Apgar scores were similar among all of the groups (p > .05). The three intervention groups reported relatively more positive feelings than the control group, and all three of the interventions were found to be effective in improving satisfaction. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results of this study indicate that the dual application of massage and acupressure is relatively more effective than either therapy applied alone and that massage is more effective than acupressure.

The Effect of Hand Massage Before Cataract Surgery on Patient Anxiety and Comfort: A Randomized Controlled Study.

PURPOSE: This study aimed to determine the effectiveness of hand massage on patient anxiety and comfort before cataract surgery. DESIGN: A randomized controlled trial. METHODS: The 140 patients in this study were assigned to the intervention group (n = 70), which received a 10-minute hand massage before cataract surgery, and to the control group (n = 70), which received routine nursing care. The visual analog scale (VAS) and Spielberger State-Trait Anxiety Inventory (STAI) were used to collect data. FINDINGS: The median STAI state scores of the intervention and control groups were found to be 46.0 (44.7 to 48.0) and 57.0 (55.75 to 59.00), respectively. The VAS comfort score of the intervention group after hand massage (4.0 [1.7-5.0]) was lower than that of the control group immediately before surgery (8.0 [6.0-10.0]) (P < .05). In addition, except oxygen saturation, the remaining vital signs were lower in the intervention group. CONCLUSIONS: Hand massage reduced the anxiety of patients, positively affected their vital signs, and increased their comfort.

Associations between psychological symptoms and treatment outcomes of a massage therapy intervention: Secondary analyses of a randomized controlled trial.

Massage therapy (MT) may be more effective for certain subgroups of advanced cancer patients, but this is not well-studied. Psychological symptoms are one potential moderator of MT outcomes, as they occur frequently in MT patients. Therefore, we conducted a secondary analysis of data from a multi-site study which compared MT to simple touch in 380 adults with advanced cancer. We examined whether the presence of depression or baseline psychological symptom frequency moderated outcomes of change in pain, interference of pain, quality of life, 60-second heart and respiratory rates, and physical distress. We found significant main effects of depression and baseline psychological symptom frequency on changes in pain, 60-second heart and respiratory rates, quality of life, and physical distress for both MT and simple touch, but did not find differential responses between groups in moderator analyses. Results imply that psychological interventions could be targeted to patients with cancer who are receiving any type of touch therapy to improve outcomes.

The perceived therapeutic benefits of complementary medicine in eating disorders.

OBJECTIVES: The purpose of this study was to investigate the perception of Complementary Medicines (CMs) in community women; to identify which CM approaches people perceived as the most beneficial; and the impact of Eating Disorder (ED) symptoms on one's perception of treatment. DESIGN & SETTING: Electronic and paper-based surveys were distributed to a pre-existing cohort of community women (n = 100) aged 18 years and over. The survey included questions about the perception of CMs' benefits in EDs regarding a vignette of a women with Anorexia Nervosa (AN), and whether CMs helped the participant's own personal health. MAIN OUTCOME MEASURE: The mental health literacy of women with regards to the recognition, evidence-based and CM treatment, and outcomes of a fictional person with AN. RESULTS: Exercise, yoga, meditation, relaxation, vitamins and minerals, massage and creative therapy were perceived as very helpful for someone with AN and for general health. Excluding meditation, there was no significant relationship between the levels of ED symptoms and perceived helpfulness of the therapies. Positive benefits were perceived for the use of CMs for AN. CONCLUSION: Considering the positive regard for these approaches, empirical studies are required to test their efficacy in the treatment of EDs.

A Study Using Visual Art Methods to Explore the Perceptions and Barriers of Self-Management in Children and Adolescents with Lymphedema.

Background: The aims of this study were to explore, using visual art methodology, how children and adolescents perceive their lymphedema and conceptualize the barriers and enablers in self-management and to explore the role of an educational camp in promoting self-efficacy. Methods: Participants (speaking English, French, and Italian) were recruited during an educational camp for children with lymphedema. Children and adolescents used different methodologies to depict living and self-managing their condition. Younger children (aged 5-12 years) drew pictures, and all children and adolescents (aged 5-18 years) were given cameras and asked to take photographs that depicted their experience of learning self-management of their condition during the camp. Rose's critical visual methodology framework was used for analysis. Results: Analysis of the data produced five categories: Normal versus altered childhood, living with lymphedema; perceptions of lymphedema and self-care in younger children; adolescents' perception of living and managing lymphedema; learning self-efficacy; and insights into cultural differences in self-care. Conclusions: The study has shown that self-management is complex. Children and adolescents face many daily challenges and frustrations in managing their condition in addition to the normal challenges of development and growth that impact on: home life, time with friends, school activities, and relationships. Children expressed a deep longing for cure and a recognition that their lives were altered by having the condition that led to limitations in sport and wearing fashionable clothes and shoes. The importance of relationships with professionals was critical as was the experience of meeting and learning with other children through the camp experience. Attempts to simplify self-management techniques would appear to be a key priority as would a greater understanding of the self-beliefs young people have of their ability to influence and control their condition and its impact on their life.

A Study to Explore the Professional Conceptualization and Challenges of Self-Management in Children and Adolescents with Lymphedema.

Background: The aim of this study was to explore the professional experience of caring for children and adolescents with lymphedema and to explore the way in which they understand and implement self-management strategies and the influence of their own self-efficacy beliefs on this process. Methods and Results: Participants were recruited during an educational camp for children with lymphedema. Three individual semistructured focus groups were undertaken in English, French, and Italian with simultaneous translation. Data were analyzed using interpretative phenomenological analysis (IPA). Analysis of the data produced three superordinate themes: professional concepts of self-management, professional practice, and redefining the cornerstone of lymphedema care. An additional seven subthemes were as follows: readiness to self-management, professional perspectives on self-management, defining success and treatment failure, emotional burden, traditional views on complex decongestive therapy, new ways to practice, and sole practitioner versus multidisciplinary teams. Conclusions: The purpose of the study was to explore the challenges professionals face when introducing self-management to children and adolescents with lymphedema and their parents and to explore their own sense of self-efficacy in approaching this. The research allowed in-depth discussion about the ways they conceptualize self-management and faced professional challenges. The research highlighted the need to define what is considered an acceptable outcome within a complex and uncertain condition and the self-management strategies that are needed to support this.

A Study to Explore the Parental Impact and Challenges of Self-Management in Children and Adolescents Suffering with Lymphedema.

Background: Limited research has shown the impact lymphedema has on children and families. The aim of this study was to explore the parental experience of caring for a child or adolescent with lymphedema and the daily challenges of self-management and self-efficacy. Methods and Results: Participants were recruited during an educational camp for children with lymphedema (N = 26). Three individual semistructured focus groups were undertaken in English, French, and Italian with simultaneous translation. Data were analyzed using interpretative phenomenological analysis. Analysis identified four superordinate themes; the journey, treatment management, independence, and psychosocial impact. Ten subthemes were identified: bandaging/compression, professional support, holistic care, fear, self-efficacy, acceptance, friendship, guilt, distress, and hope. Conclusions: Parental self-management of children with lymphedema is complex and invades many aspects of life. Lack of professional agreement over what constitutes self-management leads to parental confusion and anxiety. Self-management is demanding, and parents are ambivalent to its effectiveness, but choose to persevere through fear of their child's condition deteriorating. Self-efficacy is evident in complex problem solving, despite parents believing that they are not adequately prepared for this.

The Effect of Single-Dose Massage Session on Autonomic Activity, Mood, and Affective Responses in Major Depressive Disorder.

Background: Massage therapy (MT) is a holistic procedure that includes hand pressure (HP), therapeutic communication (TC), and attentive care (AC); together, these procedures could decrease symptoms of depression. Purpose: To study the influence of TC and AC during MT. Methods: Within-subject experimental design with counterbalancing order of treatment. Comparison analysis of the effect of a typical Swedish massage session (SM) with a "sham" massage (ShM; without HP) on the heart rate variability (HRV) mood and affective responses of patients with major depressive disorder (N = 11). During the ShM, clay stones were randomly placed on the body, and the patients were informed about the (sham) therapeutic effect of stones. Findings: A main effect of time showed that after intervention, both SM and ShM increased the HRV (high-frequency power; F[1, 10] = 7.58, p = .02) and reduced scores for anxiety (F[1, 10] = 37.57, p < .001), other feelings (F[1, 10] = 22.64, p = .001), and physical sedation (F[1, 10] = 10.72, p = .008). The SM was associated with more positive affective responses than ShM (qualitative analysis). Conclusions: AC and TC included in MT session improved mood and HRV in the absence of HP. Additional effect on affective responses was observed owing to the HP.

Mothers' experiences learning and performing infant massage-A qualitative study.

AIMS AND OBJECTIVE: To explore the experience of learning infant massage among mothers who are having insecurity and stress in their transition to motherhood. BACKGROUND: Secure attachment is essential for healthy infant development. An interaction with the caregiver, characterised by sensitivity, engagement and adequate responding, is necessary for the development of attachment. However, transition to parenting can be a major challenge and create insecurity and stress for some mothers. This can interfere with mother's attachment and sensitivity to the baby's cues, which in turn can affect the mother-infant interaction. Mothers who struggled postpartum were invited to participate in a group called Mamma Mia, a programme where mothers learn infant massage as targeted measure for improving interaction between the mother and baby. To date, there is limited knowledge how mothers receiving this group programme experience infant massage. DESIGN AND METHOD: A qualitative and explorative approach was used, based on interviews with 12 mothers who had participated in Mamma Mia group facilitated by public health nurses at Well Child Clinics in Norway. We used qualitative content analysis with manifest and latent content to analyse the transcripts. RESULT: One main theme emerged: "A relief with an opportunity for emotional and physical connection with the baby" and four categories were identified to highlight the mothers' experiences through (a) appreciating the structure, (b) providing self-esteem and self-confidence, (c) connecting with the baby and (d) discovering the baby's presence. CONCLUSIONS: Mothers in this study in Norway enjoyed the experience of learning infant massage and felt closer to their babies as a result. RELEVANCE TO CLINICAL PRACTICE: Training of health professionals to provide infant massage to mothers in a Mamma Mia group or similar groups can be a low cost and efficient intervention in primary care.

Interventions to Improve Maternal-Infant Relationships in Mothers With Postpartum Mood Disorders.

INTRODUCTION: During the postpartum period, women may have changes in their mental health and experience postpartum mood disorders. Postpartum depression (PPD) is an especially prevalent postpartum mood disorder, affecting 10% to 15% of new mothers. Although PPD has detrimental effects on women's health, it can also affect maternal-infant attachment, bonding, and interaction, which influence the maternal-infant relationship and can lead to poor outcomes for infants later in life. The purpose of this review is to identify effective strategies for improving the maternal-infant relationship for mothers with postpartum mood disorders. METHODS: A literature search was conducted via three databases: PubMed, Cochrane Library, and Medline using key search terms. A total of 1,347 articles were scanned to determine their relevance; 19 articles were selected for review. Inclusion criteria included articles in English that focused in the postpartum period and measured outcomes related to the maternal-infant relationship. RESULTS: Infant massage appears to benefit the maternal-infant relationship, whereas psychotherapy and education had mixed results. Pharmacological interventions were not found to improve maternal-infant relationships. Family involvement was shown to improve infant attachment, but not the maternal-infant relationship. CLINICAL IMPLICATIONS: Nurses should be aware of the importance of including interventions targeted at improving the maternal-infant relationship for women with postpartum mood disorders, especially PPD. However, data are limited, thus more research is needed to develop evidence-based strategies that can be implemented to support women experiencing postpartum mood disorders and their infants.

Model structure for protocol adherence utilizing a manualized therapeutic massage intervention.

Background The Protocol Training and Assessment Model (Model) was developed through collaboration between Emory University School of Medicine and Atlanta School of Massage to minimize intra- and inter-therapist variability for two research massage therapist (rMT) applied intervention arms in the Massage for Cancer-Related Fatigue (MCRF) early-phase study. The Model was followed to maintain and assess protocol integrity for the study's manualized Swedish massage therapy (SMT) and light touch (LT) interventions. Methods The Model includes initial rMT training, quarterly retraining sessions, accessible resources (scripts, treatment guides, weekly research personnel meetings), and ongoing monitoring. Model efficacy was assessed by monitoring data collected at retraining sessions, through audio recording review, and through subject and rMT reporting. Results Model application resulted in a high level of intervention consistency throughout the study. Protocol-related session comment rate by subjects was 2.7%. Few study participants reported intra-rMT or inter-rMT treatment delivery differences. Observation during retraining sessions indicated massage therapists continued to adhere to protocols. Importantly rMTs increased their participation beyond core duties, suggesting additional ways to standardize subject treatment experience. Conclusions Through systematic application of the Protocol Training and Assessment Model, continuous and collaborative quality improvement discussions between scientists and research massage therapists resulted in reliable, standardized SMT and LT interventions for the MCRF early-phase study. Future research can apply the Model to support and assess consistent rMT-delivered intervention applications.

Development and validation of a tool to evaluate Inpatient Beliefs, Expectations and Attitudes toward Reflexology (IBEAR-16).

BACKGROUND: The integration of manual therapies, including reflexology, into conventional care settings is growing extensively. Patients' beliefs, attitudes and expectations toward these therapies interact with their outcomes, but currently there are no validated tools to evaluate these factors. We aimed to design and to validate such a tool specifically targeted into reflexology. METHODS: Following input of a multidisciplinary team of experts, the self-administered Inpatient Beliefs, Expectations and Attitudes toward Reflexology (IBEAR) questionnaire was constructed, containing 25 items, 8 referring to demographics and 17 specifically addressing reflexology. Cronbach's alpha was computed to evaluate the questionnaire's internal reliability, and factor analysis was used for further validation (232 patients). Pearson coefficient and Kappa tests were used to test and retest (within 48 hours) the questionnaire on a group of 199 patients, to assure clarity and reliability. RESULTS: For the 232 questionnaires collected, the computed Cronbach's alpha coefficient was 0.716 (acceptable reliability). Factor analysis pointed to two content areas separated into four items addressing attitudes and expectations and five items focusing on beliefs and attitudes. In the test-retest stage, 199 participants filled in the questionnaire for a second time. The Pearson coefficient for all questions ranged between 0.73 and 0.94 (good to excellent correlation) and Kappa scores ranged between 0.66 and 1.0 (moderate to high reliability). Consequently, one of the questions was removed from the IBEAR. CONCLUSIONS: The present study provides evidence that the proposed IBEAR questionnaire with 16 items is a valid and reliable tool for evaluation of inpatients' beliefs, expectations and attitudes toward reflexology.

Medical Pluralism in the Use of Sobadores among Mexican Immigrants to North Carolina.

Mexican immigrants have a rich history of traditional healers. This analysis describes the conditions for which Mexican immigrants seek treatment from sobadores, and delineates factors that influence seeking treatment from a sobador or a biomedical doctor. This systematic qualitative analysis uses interview data collected with 24 adult Mexican immigrants to North Carolina who had been treated by a sobador in the previous 2 years. Immigrants are engaged in medical pluralism, seeking care from sobadores and biomedical doctors based on the complaint and patient's age. Using a hierarchy of resort, adults seek treatment from sobadores for musculoskeletal pain not involving a fracture. Doctors are first consulted when treating children; sobadores are consulted if doctors do not provide culturally appropriate treatment. Mexican immigrants seek care that addresses their culturally determined health concerns. The need to improve access to culturally competent biomedical health care for vulnerable immigrant populations continues.