Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, Edmonton, Canada.
Nurs Crit Care. 2019 Nov;24(6):414-429. doi: 10.1111/nicc.12417. Epub 2019 Mar 4.
The critical care experience is particularly stressful for patients, which can result in a number of physiological and psychological consequences, including haemodynamic instability, increased pain, agitation and delirium, leading to prolonged mechanical ventilation, length of stay and subsequent complications. Massage therapy encompasses different techniques to promote relaxation and to counter stress, therefore potentially affecting several patients' outcomes.
To systematically review evidence on the effects of massage on outcomes of adult critically ill patients. The outcome measures included pain, vital signs (VS), haemodynamic measurements, level of consciousness, sleep quality, muscle tension, anxiety, feelings of calm and relaxation, coping, arterial blood gases and serum biomarkers.
This was a systematic review based on focused literature searches (PubMed, CINAHL, Scopus, EMBASE-Ovid databases, Google Scholar). The Cochrane Collaboration's tool was used to assess the risk of bias. Eligibility criteria included published experimental and quasi-experimental studies reporting on the physiological and psychological outcomes of critically ill patients.
Based on the selection criteria, 12 studies were included in the review. The main findings are as follows: 8 of 12 studies used randomized control designs with high internal validity, and there was a high level of evidence of favourable effects with respect to improvements in VS and a reduction in pain and anxiety. Outcomes that need to be more rigorously pursued include quality of sleep, analgesic and sedative dosages and level of consciousness.
The results suggest that massage interventions can have positive effects on critically ill patients' outcomes. However, there are several gaps in the literature, along with methodological limitations, that require further consideration in critical care settings.
The results of this systematic review can inform implementation of massage interventions in critical care, which can be challenging as a result of several barriers.
重症监护经历对患者来说尤其有压力，这可能导致许多生理和心理后果，包括血流动力学不稳定、疼痛加剧、躁动和谵妄，从而导致机械通气时间延长、住院时间延长和随后的并发症。按摩疗法包括不同的技术来促进放松和对抗压力，因此可能会影响许多患者的结果。
系统评价按摩对成年重症患者结局的影响。结局指标包括疼痛、生命体征（VS）、血流动力学测量、意识水平、睡眠质量、肌肉紧张、焦虑、平静和放松感、应对、动脉血气和血清生物标志物。
这是一项基于重点文献检索（PubMed、CINAHL、Scopus、EMBASE-Ovid 数据库、Google Scholar）的系统评价。使用 Cochrane 协作工具评估偏倚风险。纳入标准包括发表的报告重症患者生理和心理结局的实验和准实验研究。
根据选择标准，有 12 项研究纳入了综述。主要发现如下：12 项研究中有 8 项采用了具有高内部有效性的随机对照设计，有高度证据表明改善 VS、减轻疼痛和焦虑有良好效果。需要更严格研究的结局包括睡眠质量、镇痛和镇静剂量以及意识水平。
结果表明，按摩干预可能对重症患者的结局产生积极影响。然而，文献中有一些空白，以及方法学上的限制，这些都需要在重症监护环境中进一步考虑。
本系统评价的结果可以为重症监护中实施按摩干预提供信息，但由于存在多种障碍，实施可能具有挑战性。
