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Massage Today
April, 2014, Vol. 14, Issue 04

Touch Programs Help Families Bring Cancer Patients Relief

By Massage Therapy Foundation Contributor

Contributed by Jolie Haun, PhD, EdS, LMT, Ruth Werner, Immediate Past President MTF, Beth Barberree, RMT, BA

Effectively addressing the needs of patients with cancer requires a multi-faceted holistic approach in the clinical care and home setting.

Innovative approaches to patient care integrate family members as informal caregivers, to help meet patients'; needs. In this month';s Massage Therapy Foundation research review, we share findings and implications from a randomized controlled trial that evaluated a multimedia instructional program for family caregivers in touch-based techniques to provide comfort to cancer patients at home. The manuscript was published by Supportive Care in Cancer in 2013.

The Proposal

The proposal was to teach loved ones how to massage cancer patients. Massage is a popular palliative modality for symptom relief associated with cancer and associated treatment. Research has demonstrated significant effects for patients with cancer on symptoms such as pain, nausea, stress, anxiety, mood disturbance, fatigue and sleep disturbance. Understanding the need for symptom relief and leveraging the role of informal caregivers, Collinge and colleagues developed a touch-based program for at-home caregivers. The program was designed to empower them with the ability to have an impact on patient well-being through the use of partnered massage. These authors suggest a caregiver-based program such as this can benefit the patient, the partner and the quality of their relationship.

cancer patient - Copyright – Stock Photo / Register Mark Collinge and colleagues developed a multilingual (i.e. English, Spanish, Chinese, Vietnamese) DVD, with an illustrated, spiral bound manual to be used as a home-based instructional tool. (The program is now also available online via streaming video with an ebook manual.) The program, entitled "Touch, Caring and Cancer: Simple Instruction for Family and Friends," addresses, "attitudes and communication about touch in cancer, psychological preparation for giving and receiving touch, safety precautions, massage techniques for comfort and relaxation, acupressure for specific cancer-related symptoms and practice in the home setting." This program offers patients, their family members and loved ones an economical home-based self-paced alternative for symptom relief.

The Experiment

The experiment used was massage for one group and reading aloud for the other. A sample of 97 adult patient and caregiver dyads was randomized to the treatment (DVD massage program) or control groups (reading any literature of the patient';s choice such as poetry, fiction, nonfiction, religious, etc.) for four weeks. Treatment dyads received the program with instructions and were asked to practice at least three times per week. In the control dyads, caregivers were asked to read to their patients for the same frequency. To measure outcomes, self-report instruments assessed change in symptom severity, quality of life, perceived stress and caregiver attitudes.

Results

Results indicate significant reductions in all symptoms for patients in both groups after a 20-minute session of their assigned activity: 12% to 28% reductions after being read to, and 29% to 44% reductions after massage. Though both groups showed improvements, "The average proportion of decreased symptomatology reported from pre- to post-sessions over the four weeks was significantly greater for patients in the massage condition for pain, nausea and other self-reported symptoms (i.e. less common symptoms yet those that were significant to patients)." Significant effects across time were also indicated. Symptom improvement was significantly greater for the treatment group (caregiver massage) than the control group (caregiver reading) for stress and anxiety in weeks two, three and four, pain in weeks three and four and fatigue in weeks one and four.

Massage caregivers in the treatment group reported satisfaction with their ability to help their loved one feel better. They showed significant improvements in confidence, comfort and self-efficacy. There were no significant differences within or between patient groups on the Perceived Stress Scale or the General Functional Assessment of Cancer Therapy-Version 4. However, the authors did note using the specialized statistical method, Classification Tree Analysis, statistically significant associations were found between patients'; diagnostic and massage variables with their Perceived Stress Scale score at follow-up.

No adverse events were reported during the study, which suggests that the massage taught on the DVD appears to be safe for this population.

Conclusions

Collinge and colleagues conclude that, "multimedia instruction in touch and massage methods may offer family members a viable means of enhancing self-efficacy and satisfaction in caregiving while decreasing patient pain, depression and other symptoms. Family members may be able to learn and apply safe and simple methods that increase patient comfort and reduce distress."

Implications

This study has several meaningful implications for the field of massage research and practice. First, these findings support previous research suggesting massage is an effective palliative modality for patients with cancer. Further, these findings indicate that massage, which is typically considered a clinical or spa treatment, may be re-conceptualized as a home-based treatment provided informal caregivers are given proper instruction. Practitioners of Complementary and Alternative Medicine, particularly massage therapists, can consider programs such as Touch, Caring and Cancer as an option to complement other clinical treatments, such as formal massage therapy regimens, to provide patients comfort in the home setting between clinical and massage treatments. This program is one of many that can be created for patients with diverse conditions as an alternative. For example, Collinge and colleagues are currently evaluating a similar home-based integrative therapies program called Mission Reconnect, to promote well-being and relationship resilience in veterans and their partners healing the effects of military deployment. Programs such as these will create a new economical, home-based, self-paced option for diverse patient populations to receive symptom relief at the caring hands of their family members and loved ones.

To learn more about touch and caregiving, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search Pub Med for CAM/CIM cost analysis studies.

Resource:

  • Collinge W, Kahn J, Walton T, Kozak L, Bauer-Wu S, Fletcher K, Yarnold P, Soltysik R. Touch, Caring, and Cancer: randomized controlled trial of a multimedia caregiver education program. Support Care Cancer. 2013 May; 21(5): 1405–1414. Published online 2012 December 21. doi: 10.1007/s00520-012-1682-6. PMCID:PMC3612588.

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