Back massage intervention for improving health and sleep quality among intensive care unit patients.

ABSTRACT

BACKGROUND: A massage may relax muscles, improve blood circulation and reduce pain and anxiety while also improving sleep quality by increasing comfort. However, there is little research on whether a back massage improves sleep quality in intensive care unit (ICU) patients. AIMS AND OBJECTIVES: This study examined the effects of a back massage on improving vital signs, sleep quality, anxiety and depression among ICU patients. DESIGN: Adopting a quasi-experimental design, convenience sampling was used to recruit ICU patients from a medical centre in Southern Taiwan. The experimental group received back massages for three consecutive days (n = 30), while controls received usual care (n = 30). METHODS: The Verran and Snyder-Halpern Scale and the Hospital Anxiety and Depression Scale were used, and subjective and objective sleep time (wrist actigraphy and sleep duration from nurse observations) was recorded. The effect of the intervention was examined using a generalized estimating equation model with a robust standard error and an exchangeable working correlation matrix adjusting for time. RESULTS: The results show that subjective sleep quality scores in ICU patients were low. Mean observed sleep time (measured by nurses) was 3·9 h, but mean sleep time measured using wrist actigraphy was 5·9 h. Back massages improved breathing in patients, increased sleep quality reflected by both subjective and objective data and were associated with a significant change in anxiety. CONCLUSIONS: These findings suggest that a 10-min back massage can improve sleep quality, sleep duration, breathing and anxiety in ICU patients. RELEVANCE TO CLINICAL PRACTICE The implementation of a back massage shows positive improvements in the sleep quality of ICU patients. The training and theory of massage interventions should be further applied when developing courses in critical care nursing.