Value of massage therapy for patients in a breast clinic.

This article examines interest in massage therapy and other forms of complementary and alternative medicine among patients with breast disease. Surveys were mailed to 63 patients who had a breast abnormality or a recent diagnosis of breast cancer and received complimentary massage therapy at Mayo Clinic in Rochester, MN, from February to April 2005. Thirty-five patients responded (56% response rate). All participants felt that massage therapy was effective in helping them relax, and 34 felt that it was very or somewhat effective in reducing muscle tension. More than 75% reported that massage therapy was effective in reducing fatigue, creating a general feeling of wellness, and improving sleep quality and their ability to think clearly. Although this study was small, the findings show that massage therapy may help patients with breast disease relax and feel better overall.

Functional outcomes and quality of life after tumor-related hemipelvectomy.

BACKGROUND AND PURPOSE: Hemipelvectomy is a life-changing treatment for pelvic malignancies. This study compared functional outcomes and quality of life of patients following internal or external hemipelvectomies. SUBJECTS: Ninety-seven patients who underwent tumor-related internal (n=39) or external (n=58) hemipelvectomy surgery between January 1, 1988, and December 31, 2004, participated in the study. METHODS: Using a descriptive retrospective cohort study design, functional status was evaluated with the Barthel Index at 3 time points. Quality-of-life parameters were evaluated at follow-up using the Linear Analog Self-Assessment tool (LASA). RESULTS: Data were collected on all 97 patients at rehabilitation consultation and hospital discharge. Follow-up data were obtained via survey on 44% of the original group at a median of 5.8 years (interquartile range [IRQ]=1.7-10.4) after surgery. Median total Barthel Index scores were similar between the internal and external hemipelvectomy groups at the initial physical medicine and rehabilitation assessment (10 [IQR=10-15] versus 10 [IQR=3.75-15]), at discharge (40 [IQR=30-65] versus 50 [IQR=35-66.25]), and at follow-up (92.5 [IQR=76.25-100] versus 92.5 [IQR=78.75-96.25]). Participants with external hemipelvectomies were less independent in bladder function and experienced greater pain severity at follow-up compared with those with internal hemipelvectomies. Overall quality-of-life parameters were similar between the groups. DISCUSSION AND CONCLUSION: Despite significant differences in surgical procedures, immediate and long-term functional outcomes and quality-of-life parameters were similar among participants with internal and external hemipelvectomies.

Rehabilitation unit staff attitudes toward substance abuse: changes and similarities between 1985 and 2001.

OBJECTIVES: (1) To assess the attitudes of the members of an inpatient rehabilitation unit team toward their unit's substance abuse and tobacco use policies, and (2) to compare the findings with those of a survey 16 years earlier. DESIGN: An anonymous repeated assessment of staff attitudes and behaviors. SETTING: A 47-bed inpatient rehabilitation unit. PARTICIPANTS: Rehabilitation unit nurses, occupational and physical therapists, psychologists, physicians, social workers, and speech pathologists. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Change in response with time. RESULTS: Seventy percent (89/128) of the staff members completed the survey. Seventy-two percent believed that they were "familiar or very familiar" with the unit's substance abuse policy and 51% were "concerned" or "very concerned" about their patients' alcohol and drug use. Nineteen percent reported complaints about the policy from their patients and 8% reported complaints from family members. Support for a uniform substance abuse policy remained high: 96% supported a uniform policy in both 1985 and 2001. However, only 15% believed that staff drug abuse education was adequate and only 45% believed that the current policy was "adequate" or "very adequate." (Corresponding responses in 1985 were 20% and 50%, respectively.) All but 1 respondent considered tobacco use an addiction, but only 48% believed that their patients were routinely assessed for its use. CONCLUSION: Support for a uniform substance abuse policy remains strong. Although most team members support the policy, they believe that their education about substance abuse is inadequate. Staff members almost unanimously accept tobacco use as an addiction, but they believe that assessment and intervention efforts are poor.

Substance abuse attitudes and policies in US rehabilitation training programs: a comparison of 1985 and 2000.

OBJECTIVE: To assess and compare the attitudes, beliefs, and policies of physical medicine and rehabilitation (PM&R) training programs toward substance abuse and tobacco use over the last 15 years. DESIGN: A blinded questionnaire was sent to all US rehabilitation medicine training program directors. Results were compared with a survey conducted in 1985. SETTING: US PM&R residency training programs with inpatient rehabilitation training. PARTICIPANTS: Training directors or their designated agents. INTERVENTION: A 35-item questionnaire was mailed between November 1999 and April 2000 to the 81 US training programs identified by the American Board of Physical Medicine and Rehabilitation as having rehabilitation training programs with inpatient rehabilitation units. Responses were pooled by our Survey Research Center to preserve anonymity. Training programs that did not respond received additional mailings and telephone calls to improve the response rate. MAIN OUTCOME MEASURES: Chi-square analysis to assess changes in responses with time. RESULTS: Forty-six of the 79 (58%) eligible training programs responded (1 program had merged, 1 did not provide inpatient rehabilitation). Programs were located in cities ranging from less than 100,000 (n = 2) to greater than a million inhabitants (n = 18). Eighty percent (37/46) of the respondents were "concerned or very concerned" about their patients' alcohol and drug use, and 69% routinely assessed patients for alcohol and drug use compared with only 25% in 1985 (P <.00001). Almost all respondents (43/46) supported written guidelines to prohibit alcohol and drug use by patients in the rehabilitation unit. Eighty-three percent had a prohibition policy, and 72% had written guidelines. Both of those rates represent increases from the 1985 response rates of 65% and 45%, respectively. Ambivalence persisted about appropriate treatment programs for persons with disabilities: in 1985, 51% of the respondents agreed that a person with a disability could be treated appropriately in a substance abuse program designed for persons without a disability; in 2000, the percentage had increased to 64%. All respondents believed that tobacco use is an addiction, but only 25% of their units offered tobacco cessation services to patients on their rehabilitation unit. CONCLUSION: The survey results are encouraging. Since 1985, not only have substance abuse issues been recognized, but also systemic institutionalized approaches (eg, regular screening, written guidelines) have increased markedly. Tobacco is now uniformly accepted as an addiction, but screening and access to cessation programs are similar to that available for alcohol and drug treatment programs 15 years ago.