Parent and Child Stress Reduction in the Hospital Setting

1
Parent and Child Stress Reduction in the Hospital
Setting Following Two Complementary (CAM)
Interventions New Approach to Family Centered
Care Sheila Wang, PhD, Rosalyn L. Bruyere DDiv,
Ken Weintrub MA, Patricia Megregian MDiv, Suzanne
OBrien, Lynne Morrison, MA,Holly Luenemann LMT,
Richard Kamasinski LMT, Elizabeth Chazen, David
M. Steinhorn MD Judith Nan Joy Integrative
Medicine Initiative, Childrens Memorial
Hospital/ Northwestern University Feinberg
School of Medicine, Chicago, IL
Results
Abstract (APS 2007 Abstract
754498)
Results
Results
Background Hospitalization creates physical and
psychic stress for children and their parents1,2
. Parents may provide comfort or they may create
additional stress if they are anxious or
agitated. While most care and supportive
services are focused on patients, reducing
parental distress may allow them to be more
effective in supporting their hospitalized child
and creating an environment for optimal recovery
to occur. Objective We evaluated whether
Massage Therapy or Touch Healing interventions
would be associated with reduced patient and
parental reports of distress, pain, tension,
discomfort and upset mood. Design/Methods
Patients newly admitted to a general pediatric
ward were offered opportunities to participate in
a study evaluating the impact of Massage Therapy
or Touch Healing on their distress, pain,
tension, discomfort and upset mood. Parents
rated their child in these five areas before and
after the CAM intervention using a 1-5 scale
(least to greatest) adolescents rated
themselves. Parents were also offered the
opportunity to receive Touch Healing or Massage
Therapy and rated their own pre/post distress,
pain, etc. Safety and acceptability of
interventions were also evaluated. Analysis of
pre vs. post-intervention responses was done
using paired t-tests. Results No adverse events
were reported in over 760 interventions.
Ninety-four percent (94) of parents surveyed
were moderately or extremely satisfied and felt
that these modalities should be available to all
patients and parents. One hundred percent (100)
of parents would recommend these modalities to
another patient or parent. In general, parents
rated their own level of distress higher than
their childs. A consistent and very significant
fall in stress ratings was seen in all subjects
following Massage Therapy or Touch Healing
interventions. Conclusions Parents experience
distress in response to their childs
hospitalization which is often perceived to be
greater than their childs distress. Both
parents and children experience a reduction in
stress through Massage Therapy or Touch Healing
interventions. These two CAM modalities may
improve symptom management in hospitalized
children and may enable parents to be more
emotionally available to support their child.
Future studies using suitable control and placebo
interventions are needed.
Parent Feedback Ninety-four percent (94) of
parents who responded to a follow-up survey were
moderately or extremely satisfied and felt that
these modalities should be available to all
patients and parents. One hundred percent (100)
of parent respondents said they would recommend
these modalities to another patient or parent.
Safety No adverse events were reported in over
760 interventions.
Parents Rating Themselves Before and After They
Receive Touch Healing or Massage
Therapy Interestingly, before the interventions,
parents who participated in the study rated
themselves as more distressed, in more pain,
experiencing more tension and discomfort and
being more upset than parents rating their
hospitalized children. Similar to the results
with the patients, highly significant reductions
were found in parents ratings of themselves after
they received Touch Healing (Figure 3) or Massage
Therapy (Figure 4). Figure 3.
Parent Rating of Their Own Level of Distress,
Pain, Tension, Discomfort and Upset Mood Before
and After Receiving Touch Healing Intervention
(Mean SD). For all categories t lt 5.2 , p lt
0.0001. Figure 4. Parent Ratings of
Their Own Level of Distress, Pain, Tension,
Discomfort and Upset Mood Before and After
Receiving Massage Therapy Intervention (Mean
SD). For all categories, t gt 12.1, p lt 1 x
10-22.
Parent Ratings of Their Child Before and After
Their Child Received Touch Healing or Massage
Therapy Highly significant reductions in all
categories of parental ratings of their childs
level of distress, pain, tension, discomfort
upset mood were found after their child received
either Touch Healing (Figure 1) or Massage
Therapy interventions (Figure 2). The magnitude
of the t values and the extremely low probability
values indicate that there was marked consistency
in the direction of the pre to post-intervention
parent ratings. Figure 1. Parent
Ratings of Their Child's Level of Distress, Pain,
Tension, Discomfort and Upset Mood Before and
After Receiving Touch Healing Intervention (Mean
SD). Mean age 7.7 years. For all categories
t gt 12.9, p lt 1 x 10-31. Figure
2. Parent Ratings of Their Child's Level of
Distress, Pain, Tension, Discomfort and Upset
Mood Before and After Receiving Massage Therapy
Intervention (Mean SD). Mean age 13 years.
For all categories t gt 11.1, p lt 1 x 10-20.
Conclusions
N 378 Touch Healing Interventions (147
patients)
N 25 Touch Healing Interventions (19 parents)

• Touch Healing and Massage Therapy interventions
  performed in tertiary care pediatric hospitals by
  trained professionals are safe and well accepted
  by children and their parents.
• Parents experience distress in response to their
  childs hospitalization which is often perceived
  to be greater than their childs distress.
• Both parents and children perceive a significant
  reduction in stress through Massage Therapy or
  Touch Healing interventions.
• Parents are an important part of the healing
  environment for hospitalized children. These two
  CAM modalities may enable parents to be more
  emotionally available to support their child and
  therefore contribute positively to the overall
  healing environment.
• Massage Therapy and Touch Healing may have a
  role to play in improving symptom management in
  hospitalized children.
• Future studies using adequate control and
  placebo interventions are needed.

Methods

• Pediatric Hospital (or Clinic) Patients as
  Participants
• Informed consent obtained
• Parents asked to rate their childs level of
  distress, pain, tension, discomfort and upset
  mood on a scale of 1-5 (e.g. for distress 1
  very calm, 5 very distressed) before and after
  their child received Touch Healing and Massage
  Therapy (though adolescents rated themselves).
• Length of interventions were approximately 15-20
  minutes.
• The interventions took place, for the most part,
  in hospital rooms with patients in their beds or
  in clinic treatment rooms with patients on
  treatment tables.
• Touch Healing was administered by practitioners
  who had completed at least 500 hours of training
  with Rosalyn L. Bruyere in a hands on technique
  that helps to balance and support the bodys
  energy centers. Hand pressure is very light and
  does not involve manipulation of tissues. Hand
  placement is typically on feet, knees, hip,
  abdomen, chest, shoulder, elbow, hand, and head.
  
• Massage Therapy was administered by licensed
  massage therapists with training in pediatric
  massage. Patients were massaged in hospital
  gowns (or fully clothed in clinic) without the
  use of lotions or oils. Common areas massaged
  were hands and feet (85), back (60), shoulders
  (50), and head (50) with very light to moderate
  pressure depending on patient diagnosis, severity
  of illness and tolerance. Light petrissage,
  compression and friction techniques were used.
  Massage Therapists checked in often for feedback
  on patient comfort level during the intervention.
  
• Parents of Hospitalized Children as Participants
• Informed consent obtained
• Parents asked to rate their own level of
  distress, pain, etc., (as above) before and after
  they received Touch Healing or Massage Therapy
  interventions.
• Most interventions took place in hospital rooms
  with the parent seated in a chair and without the
  use of lotions or oils. Shoulders, neck and
  upper back were massaged with moderate pressure
  using petrissage, compression, focused finger
  pressure and friction techniques.

N 233 Massage Therapy Interventions (136
Patients)
N 130 MassageTherapy Interventions (74 parents)





References





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