Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montréal, Québec, Canada.
College of Nursing, Florida State University, 104F - Vivian M. Duxbury Hall, Florida, USA.
Pain Med. 2018 Dec 1;19(12):2556-2569. doi: 10.1093/pm/pny055.
To evaluate the effectiveness of hand massage on the pain and anxiety of the cardiac surgery critically ill.
A three-arm randomized controlled trial.
This study was conducted in a medical-surgical intensive care unit in Canada.
Adult patients who underwent elective cardiac surgery, who were able to speak French/English and to self-report symptoms, without a high risk of postoperative complications were eligible.
Patients were randomly allocated to standard care plus either two 20-minute hand massages (experimental), two 20-minute hand holdings (active control), or two 20-minute rest periods (passive control/standard care). Pain intensity, pain unpleasantness, anxiety, muscle tension, and vital signs were evaluated before, after, and 30 minutes later for each intervention.
From the 83 patients recruited, 60 were randomized (20 massage, 19 hand holding, 21 standard care). After controlling for baseline scores, the massage group reported significantly lower pain intensity, pain unpleasantness, and anxiety for the first data collection set compared with both hand holding and standard care (analysis of covariance, P < 0.02), with an average decrease of two points on a 0-10 scale. No statistically significant differences were noted between hand holding and standard care for any of the symptoms. Similar results were observed for the second data collection set (N = 43). Patients had decreased muscle tension post massage. Vital signs did not differ significantly between groups.
Findings suggest that a 20-minute hand massage in addition to routine postoperative pain management can concomitantly reduce pain intensity, pain unpleasantness, and anxiety by two points on average on a 0-10 scale.
评估手部按摩对心脏手术危重症患者疼痛和焦虑的效果。
三臂随机对照试验。
本研究在加拿大的一个内科-外科重症监护病房进行。
接受择期心脏手术、能够讲法语/英语且能够自我报告症状、术后并发症风险低的成年患者符合条件。
患者被随机分配到标准护理加两种 20 分钟的手部按摩（实验组）、两种 20 分钟的手部握持（主动对照组）或两种 20 分钟的休息时间（被动对照组/标准护理）。在每次干预前后和 30 分钟后评估疼痛强度、疼痛不适、焦虑、肌肉紧张和生命体征。
从招募的 83 名患者中，有 60 名被随机分配（20 名按摩、19 名手部握持、21 名标准护理）。在控制基线评分后，与手部握持和标准护理相比，按摩组在第一组数据采集时报告的疼痛强度、疼痛不适和焦虑明显更低（协方差分析，P < 0.02），平均降低了 0-10 分制的 2 分。在手握和标准护理之间，任何症状都没有观察到统计学上的显著差异。在第二组数据采集（N = 43）中也观察到了类似的结果。按摩后患者的肌肉紧张度降低。各组之间的生命体征没有显著差异。
研究结果表明，在常规术后疼痛管理的基础上，进行 20 分钟的手部按摩，平均可降低疼痛强度、疼痛不适和焦虑程度 2 分，得分范围为 0-10。
