Jan Locke, LMT & Glenda Dennis, RN, CCRN

As the public begins to focus on integrative medicine, many healthcare systems are seeking to incorporate more holistic ways to deliver care. After incorporating massage therapy into the ICU, staff observed increased relaxation in patients and restoration of a degree of tranquility. Patients often encounter many invasive and frightening experiences while in the hospital, including the placement of PICC (Percutaneously Inserted Central Catheters) and Mid-Arm catheters. The goal of this study was to determine the impact of using massage on improving the patient’s physical comfort and reducing stress and anxiety levels during PICC and Mid-Arm catheter insertion. A Likert-scale survey was administered pre-procedure and post-procedure to 21 patients who required PICC/Mid-Arm catheter insertion at McKenzie-Willamette Hospital over a 15-month period of time. Results indicate a 39% improvement in anxiety levels and 23% improvement in physical comfort levels in the group who received massage during the catheter insertion. Those patients who experienced massage as a relaxation technique were also generally easier to cannulate for line placement.

METHODOLOGY:

· Patients were surveyed pre and post procedure using a Likert scale.

· 21 adult patients were surveyed.
9 of the patients received massage during the procedure.
12 patients did NOT receive massage.

· Massage was offered according to the patient’s comfort level. The massage therapist and the patient determined where the patient would feel most comfortable receiving touch during the procedure.

· Generally massage (light effleurage) was provided to the hand, arm (not receiving the catheter), feet, neck or scalp.

· The focus of massage was to redirect the attention of the patient and provide soothing, calming, comforting touch during the procedure.

FINDINGS:

· Those patients receiving massage indicated:
23% improvement in physical comfort levels post procedure.
39% improvement in anxiety levels post procedure.

· Those patients NOT receiving massage indicated:
08% improvement in physical comfort levels post procedure.
29% improvement in anxiety levels post procedure.

· Patients receiving massage demonstrated significant improvement in physical comfort and anxiety levels over those that did not receive massage.

· It was also observed that there was less vascular constriction and a more peaceful recovery among those patients receiving massage during the procedures.

· 77% of patients, when asked if massage affected their physical comfort level indicated, “very much” (the highest score they could give).

· 67% of patients, when asked if massage affected their anxiety levels indicated “very much.”

PATIENT COMMENTS:

· “I think the massage caused a definite improvement in my comfort level. It kept me from focusing on the procedure and relaxed me.”

· “I’m glad that the massage was given. I have had this done three times before without massage. This was the lowest level of anxiety.”

· “Very good to me. Kept my mind off what you’re doing.”

· “Having had two PICC installs without massage, I can say it helped to have it. Thanks!”

RECOMMENDATIONS:

· Highly recommend using massage to reduce anxiety and improve patient comfort during PICC/Mid-Arm catheter placements.

· Highly recommend trying massage to compliment other potentially anxiety or pain producing procedures such as thorocentesis, pre-cardioversion, or with naso-gastric or naso-duodenal feeding tube placement.

OUR PLAN is to modify our survey to include demographics such as gender and age to see if there is any correlation regarding perception of massage or its benefits. We also plan to gather data regarding massage as it affects physical comfort levels and anxiety levels during other invasive procedures in addition to the PICC/Mid-Arm catheter placements.

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