Is massage a legitimate part of nursing care? A qualitative study

PLOS ONE RESEARCH ARTICLE Is massage a legitimate part of nursing care? A qualitative study Gora Da Rocha Rodrigues ID1,2☯*, Adrien Anex ID2☯, Monique Boegli3‡, Catherine Bollondi Pauly4‡, François Curtin5‡, Christophe Luthy6‡, Jules Desmeules3‡, Christine Cedraschi ID3,6,7☯ a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 OPEN ACCESS Citation: Da Rocha Rodrigues G, Anex A, Boegli M, Bollondi Pauly C, Curtin F, Luthy C, et al. (2023) Is massage a legitimate part of nursing care? A qualitative study. PLoS ONE 18(2): e0281078. https://doi.org/10.1371/journal.pone.0281078 Editor: Nabeel Al-Yateem, University of Sharjah, UNITED ARAB EMIRATES 1 HEdS-School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland, 2 HESAV-School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland, 3 Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, University Hospitals of Geneva, Geneva, Switzerland, 4 Professional Practices Pole, Care Direction, University Hospitals of Geneva, Geneva, Switzerland, 5 University Hospitals, Geneva, Switzerland, 6 Division of General Medical Rehabilitation, University Hospitals of Geneva, Geneva, Switzerland, 7 Geneva Faculty of Medicine, Geneva, Switzerland ☯ These authors contributed equally to this work. ‡ MB, CBP, FC, CL and JD also contributed equally to this work. * Abstract Introduction The use of massage therapy has received increased attention in the treatment of chronic pain. However, barriers can hinder its use in nursing care. This study uses a qualitative methodology to explore professionals’ experiences regarding touch massage (TM) and identify barriers and facilitators for the implementation of this intervention. Received: June 29, 2022 Accepted: January 15, 2023 Materials and methods Published: February 27, 2023 This study is part of a larger research program aimed at investigating the impact of TM on the experiences of patients with chronic pain hospitalized in two units of an internal medicine rehabilitation ward. Health care professionals (HCPs) were trained either to provide TM or to use of a massage-machine device according to their units. At the end of the trial, two focus groups were conducted with HCPs from each unit who took part in the training and agreed to discuss their experience: 10 caregivers from the TM group and 6 from the machine group. The focus group discussions were tape-recorded, transcribed and analyzed using thematic content analysis. Peer Review History: PLOS recognizes the benefits of transparency in the peer review process; therefore, we enable the publication of all of the content of peer review and author responses alongside final, published articles. The editorial history of this article is available here: https://doi.org/10.1371/journal.pone.0281078 Copyright: © 2023 Da Rocha Rodrigues et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Regarding data availability, the data for this study consists of transcripts of two focus groups that contain identifying information. The data cannot be shared Results Five themes emerged from thematic content analysis: perceived impact on patients, HCPs’ affective and cognitive experiences, patient-professionals relationships, organizational tensions, and conceptual tensions. Overall, the HCPs reported better general outcomes with TM than with the machine. They described positive effects on patients, HCPs, and their relationships. Regarding interventions’ implementation, the HCPs reported organizational barriers such as patients’ case complexity, work overload, and lack of time. Conceptual barriers PLOS ONE | https://doi.org/10.1371/journal.pone.0281078 February 27, 2023 1 / 15 PLOS ONE publicly due concerns of healthcare professional confidentiality and ethics requirements. Interviews were confidential to enable freedom of expression by participants, and participants consented to the study with the understanding that only de-identified quotations would be made public, not the entirety of the transcripts. Therefore, only illustrative quotes from the transcripts have been included in this paper. Data access requests may be made to the Regional Ethics committee at . Funding: GDR-JD-CBP-CC: Leenaards Fondation (Grant number 4518.1) https://www.leenaards.ch/ CBP-MB: Fonds de développement de la Direction des soins HUG” https://www.hug.ch/directionmedicale-qualite/recherche-clinique The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Is massage a legitimate part of nursing care? such as ambivalence around the legitimacy of TM in nursing care were reported. TM was often described as a pleasure care that was considered a complementary approach and was overlooked despite its perceived benefits. Conclusion Despite the perceived benefits of TM reported by the HCPs, ambivalence arose around the legitimacy of this intervention. This result emphasizes the importance of changing HCPs’ attitudes regarding a given intervention to facilitate its implementation. 1. Introduction Chronic pain is a major health issue across the world and affects around 20% of the general population [1, 2]. The International Classification of Diseases 11th Revision (ICD-11) defines chronic pain is defined as “persistent or recurrent pain lasting longer than 3 months” [3]. The high prevalence of chronic pain calls for clinicians and finding appropriate treatment to improve life of patients. To this end, the use of massage therapy has increased in chronic pain treatment [1, 4]. Massage therapy has been reported to be effective for reducing delayed onset muscle soreness and postoperative, labor, low back, cancer-related, and musculoskeletal pain, among other types [5]. Furthermore, massage therapy can reduce discomfort from various conditions, such as fibromyalgia [6], chronic low back pain [7, 8], or chronic pain [9]. Aims, intentions, and techniques differ greatly in massage therapy [10], making comparison challenging. However, its effects on pain reduction are low to moderate. In addition to pain reduction, massage therapy has been associated with depressive symptom reduction [6, 11, 12], anxiety reduction [6, 11–14], increased well-being [11, 12], and treatment satisfaction [13, 15]. Overall, the benefits of massage therapy make it a promising complementary or alternative medicine (CAM) treatment for patients with chronic pain. Nonetheless, further research is needed on how to implement such interventions in nursing care. The favorable attitudes of health care professionals (HC (...truncated)