Hospital based massage therapy specific competencies.

As massage therapy experiences a resurgence of use for hospitalized patients, it is appropriate to consider the competencies needed by practitioners to practice safely and effectively in the inpatient setting. Hospitals differ vastly from other massage practice locations such as private offices, spas, and sports clubs. The variety of conditions encountered in an acute care setting require the knowledge and ability to adapt massage protocols appropriately. The Academic Collaborative for Integrative Health (ACIH) created the Hospital Based Massage Therapy (HBMT) Task Force to determine if there is a need for HBMT specific competencies and then, if needed, to develop peer reviewed competencies that hospital staff, massage therapy educators, and massage therapists all may find useful. The members of the task force identified massage therapists who worked in hospitals generally, as well as in hospitals known to have HBMT programs. A spreadsheet was created listing the individuals and a survey was distributed to those on the spreadsheet. These individuals were also asked to identify others who might be interested in participating in the project. The purpose of the survey was to assess various elements of HBMT programs such as educational/experience requirements, employment model, orientation, and supervision. 32 out of 37 hospitals (87%) completed the survey. The Task Force considered the high response rate and the extent to which respondents provided in-depth answers to the open-ended questions as evidence of the need for specific competencies for safe and effective massage therapy for hospitalized patients. In addition to the survey, the task force used a Delphi technique to engage survey participants and other experts in the field to shape the initial draft of the competencies. As these competencies are shared with hospitals, massage therapists, and massage educators, the Task Force members expect that additional development of the competencies will take place as various groups implement them.

Process for massage therapy practice and essential assessment.

BACKGROUND: Little evidence exists about processes in massage therapy practice. Investigating current frameworks is warranted. This qualitative study is a secondary data analysis using grounded theory to understand how massage therapy experts describe massage therapy practice. METHODS: 31 massage therapy experts were invited to a 2-day symposium to discuss best practices for the profession. Through qualitative analysis, memoing, and discussion, the data were summarized into themes. RESULTS: Three themes were identified around massage therapy practice: 1) client centered, 2) structure for practice, and 3) influencing factors. Each theme is clarified and expanded. DISCUSSION: Conceptual models were developed for research and clinical practice and a definition for massage therapy practice was identified. Challenges and limitations are discussed. CONCLUSION: The goal of providing these models is to give massage therapists tools to deliver the best possible care. The models need testing to see if they help advance the profession.

A guiding framework to understand relationships within the profession of massage therapy.

An element of professionalization is the development of a body of knowledge and the integration of that knowledge into practice, also known as evidence-informed practice (EIP). EIP was officially adopted in Ontario, Canada, by the massage therapy profession in 2002 when the professional competency document was updated to include competencies related to research literacy (College of Massage Therapists of Ontario, 2002). Despite efforts to increase EIP, there continues to be a research-practice gap in massage therapy. However, there also seems to be interest in finding ways to support the increase massage therapists' capacity to apply research. To support change, it is useful to describe the relationships in the profession that may have an effect on the use of evidence in practice and the development of a broader culture of inquiry. In order to better understand how these relationships may impact on EIP, an ecological model is proposed.

A decade of building massage therapy services at an academic medical center as part of a healing enhancement program.

The use of complementary and integrative medicine therapies is steadily becoming an integral part of health care. Massage therapy is increasingly offered to hospitalized patients for various conditions to assist with the management of common symptoms such as pain, anxiety, and tension. This article summarizes a decade of building the massage therapy service at a large tertiary care medical center, from the early pilot studies and research to the current program offerings, and the hopes and dreams for the future.

Report on a membership audit of the Association of Chartered Physiotherapists in Reflex Therapy (ACPIRT).

Reflex Therapy (RT), akin to reflexology, is a non-invasive physiotherapy modality approved by the UK Chartered Society of Physiotherapists. One hundred members of the Association of Chartered Physiotherapists in Reflex Therapy (ACPIRT) participated in an audit to establish a baseline of practice. Findings indicate that experienced therapists use RT in conjunction with their professional skills to induce relaxation (95%) and reduce pain (86%) for patients with conditions including whiplash injury and chronic pain. According to 68% of respondents, RT is "very good," "good" or "as good as" orthodox physiotherapy practices. Requiring minimal equipment, RT may be as cost effective as orthodox physiotherapy with regards to duration and frequency of treatment.

[Beginning of the institutionalization of physical therapy in a Swiss canton: 1928-1945]. / Débuts de l'institutionnalisation de la physiothérapie vaudoise: 1928-1945.

The institutionalization of physical therapy in Switzerland took place in the inter-war period. This article aims to relate the initiation of this process in the Canton of Vaud, as a specific example that will nevertheless be compared with the Swiss and international contexts. This story occurs around three major events between 1928 and 1945: the massage becomes a regulated profession, followed by the emergence of a professional association and a specialized school. The intention is first to identify the social actors, then the interests, issues, and interactions that have contributed to model the modern physical therapy. Finally, the techniques used by the masseurs--the first professional physical therapists--and their working environment are evoked.

Análise das práticas integrativas em saúde na atenção básica no Distrito Federal / Health Integrative Practices in the Federal District Health Care System

Este é um estudo sobre práticas integrativas em saúde: Homeopatia, Acupuntura e Automassagem no Sistema Único de Saúde do Distrito Federal nas Unidades Básicas de Saúde das Regionais Planaltina, Sobradinho e Paranoá. Tomou-se como referência a base conceitual e diretrizes da Política Nacional das Práticas Integrativas e Complementares no SUS e suas potencialidades e limites. Este estudo qualitativo adotou como critérios de seleção analisar as unidades básicas com alguma das três abordagem das práticas integrativas implantadas há pelo menos um ano. Foram entrevistadas vinte e nove pessoas, entre elas nove gestores, sete profissionais e treze usuários. Os dados foram coletados por meio de instrumento semiestruturado. A análise do material foi realizada por procedimentos de análise de conteúdo, o que possibilitou dar visibilidade a importantes objetivos da pesquisa: protagonismo de profissionais de saúde aliados a alguns gestores mais sensibilizados; fragilidades da sua inserção na rede: desconhecimento dessas práticas no sistema e na sociedade em geral; oferta pouco visível e incipiente. Foi identificado que essas práticas caminham em direção à promoção da saúde e da humanização da atenção, reafirmando os valores, princípios e bases organizativas da Estratégia Saúde da Família. O estudo aponta, sobretudo, para a necessidade de divulgar e informar sobre as PIS junto ao sistema de saúde do Distrito Federal e na sociedade em geral, bem como para a necessidade de sensibilizar gestores e profissionais para a melhoria da infraestrutura e incentivar a formação de profissionais que possam contribuir para a expansão com qualidade das ações e serviços das Práticas Integrativas. (AU)

This is a study on Health Integrative Practices, such as Homeopathy, Acupuncture and Self-massage within the Federal District Health Care System. The primary health clinics from Planaltina, Sobradinho e Paranoá regions where selected as objects. The Integrative and Complementary Practices National Policy was taken as the conceptual framework in observing its potentials and limits within the primary health care set. The study uses a qualitative approach to analyze some units where any of these three integrative approaches exist at least one year. Twenty nine persons were included in the research: nine managers, seven practitioners and thirteen patients. Data was collected by interviews using a semi-structured guideline. Data analysis allowed to illuminate some of the research objectives, such as the pratictioners effectiveness when supported by the managers; the weaknesses of the integrative practices inclusion in the health network and the ignorance of these practices values by the health network and by the majority of the society and the invisibility of its offer as a marginal set in the health system. Positive findings show that the integrative practices under study walk towards health promotion and humanized care, reaffirming the family medicine values, principles and organizational basis. The study points out specially the need to propagate and to inform about the integrative practices in the Federal District health care sets and in the society in order to sensitize managers and pratictioners, to improve infrastructure, and to encourage pratictioners formation aiming to expand quality of integrative health care actions and services.(AU)

Exploring effects of therapeutic massage and patient teaching in the practice of diaphragmatic breathing on blood pressure, stress, and anxiety in hypertensive African-American women: an intervention study.

The problem of hypertension among African-Americans is one of the major areas of health disparities. The American Heart Association (2009) noted that the prevalence of hypertension among African-Americans is perhaps among the highest in the world and this is particularly so among African-American women (44.0%). The purpose of this study was to determine how therapeutic chair massage and patient teaching in diaphragmatic breathing affected African-American women's blood pressure, stress, and anxiety levels over one week or six weeks time periods. A Modified Stress, Coping, and Adaptation Model (Roy, 1976; Lazarus, 1966), Descriptives, T-tests, Pearson Product Moment Correlations, Multivariate analysis of variance (MANOVA), and Multivariate analysis of variance with covariate (MANCOVA) were used. Descriptive statistics indicated a significance for decreased systolic blood pressure levels for the one week post massage intervention measurement with p = .01, diastolic blood pressure level significance for the same group p = .02, significance for this group's State Trait Anxiety Inventory (STAI) Y2 Scale score p = .01, and Roy's Largest Root p = .03.

The effects of employer-provided massage therapy on job satisfaction, workplace stress, and pain and discomfort.

Long-term care staff have high levels of musculoskeletal concerns. This research provided a pilot program to evaluate the efficacy of employer-funded on-site massage therapy on job satisfaction, workplace stress, pain, and discomfort. Twenty-minute massage therapy sessions were provided. Evaluation demonstrated possible improvements in job satisfaction, with initial benefits in pain severity, and the greatest benefit for individuals with preexisting symptoms. A long-term effect was not demonstrated.

Spiritual care as a dimension of holistic care: a relational interpretation.

This article reports on a phenomenological study undertaken to explore the meaning of spiritual care as described by a group of palliative care professionals. The research process was informed by van Manen's (1990) hermeneutic phenomenological approach. Eight palliative care professionals (nurses, complementary therapists and pastoral carers) were recruited from a community palliative care agency in Melbourne, Victoria, which provided home-based palliative care. All participants were female and came from diverse ethnic backgrounds. Data were collected by in-depth conversational interviews and were analyzed thematically. Two themes emerged: 'a living nexus between spiritual care, spirituality and holism' and 'a world of relationships'. The findings of the study point to the need for healthcare professionals to incorporate spiritual care guidelines into practice in order for palliative care to be truly representative of holistic health care.

Policy for therapeutic massage in an academic health center: a model for standard policy development.

CONTEXT: Massage is the most common complementary and alternative medicine (CAM) therapy used in hospitals in the United States. As such, it is often the first CAM therapy to be integrated with conventional medicine. However, few academic medical centers have a written standard policy to guide this integration. This lack of standard policy may impede institutions from offering massage therapy as a clinical service, and may put health care professionals and institutions at risk through a failure to clearly address criteria for practice credentials or malpractice liability. OBJECTIVE: To create a clinical policy for therapeutic massage that may be used as a template for development of policy in academic health centers. RESULTS: We present a clinical policy for therapeutic massage, developed by the University of Michigan Health System, that defines therapeutic massage, provides guidelines for the credentialing and professional conduct of massage therapists, lists indications and contraindications for therapeutic massage, and addresses malpractice in accordance with the specific culture and needs of academic health centers. This policy was created by health care professionals after review of existing evidence and consideration of national criteria for massage therapy. This policy is intended to be used as a template for the development of a standard policy for therapeutic massage by health system administrators, medical directors, and massage professionals, to support the integration of therapeutic massage within their institutions. CONCLUSIONS: With minor modifications of this policy by individual institutions, adoption of this policy may facilitate the thoughtful integration of this CAM therapy into academic health care settings, meeting the unique requirements of academic health care institutions while serving the needs of patients.

The cycle of caring.

This article discusses areas where nurse leaders may make conscious and deliberate efforts to impact the organization's culture for caring. Leaders must first care for caregivers and have a commitment to their well-being. It is essential that we develop and engage in programs and activities that help staff with their personal struggles and propel them forward on the journey to being their best selves. We must seek to give them the skills and competencies necessary to work in a caring environment. Nurse leaders must facilitate the development and implementation of programs that foster a caring and compassionate culture. The author shares 2 programs that nourish the soul during difficult times for patients and their loved ones in the hospital setting-End-of-Life program and Massage Therapy program. Just as we care for those within our walls, we must also plan and deliver programs that promote health and well-being of our community. Such programs are an integral part of fulfilling our organization's mission of caring for the community. New and proven technologies advance our profession and contribute in invaluable ways to a healing environment; however, it is critical that we retain the art of caring, fundamental from the past and that helped to shape the profession of nursing.

Touch Research Institutes: an interview with Dr Tiffany Field (interview by Peter Mackereth).

The following paper reports on a recent visit to the Touch Research Institutes (TRI) based at the University of Miami School of Medicine. The main purpose of making the journey was to participate in a 3-day Research Training Workshop. The paper will first provide a brief overview of the history and work of the TRI. There will then be an interview with Dr Tiffany Field, the TRI founder and Director, and finally accounts of the workshop experience itself and a visit to one of Miami's foremost schools of massage therapy: 'Educating Hands'.