Being in safe hands : the experiences of soft tissue massage as a complement in palliative care : intervention studies concerning patients, relatives and nursing staff

The overall aim of this thesis was to explore how patients, relatives and nursing staff experienced soft tissue massage in palliative care.

In order to explicate the experiences of soft tissue massage two methodological approaches were used. To retrieve information of how soft tissue massage was experienced among patients and relatives, in-depth interviews (59) were used. In order to learn of nursing staffs attitudes towards a one-day course in soft tissue massage, focus group discussions (six discussion groups/ 30 participants) were conducted. Analysis was performed using hermeneutics (22 patients) or content analysis (37 relatives and 30 nursing staff).

In studies I and II patients and relatives in palliative home care were introduced to nine sessions of soft tissue massage over a period of two weeks. The offer of hand or foot massage in their private homes was perceived as luxurious. The experience of receiving soft tissue massage was however, dominated by feelings of retrieving a respite from illness and worrying concerns. The massage sessions were also perceived as generating a sense of own time as well as personal attention, physical nearness and existential meaning in daily life.

In study III soft tissue massage was introduced as an early intervention to bereaved relatives in palliative care. Here, hand and foot massage was offered once a week for eight consecutive weeks following the death of a family member. The main results show that the massage was experienced to facilitate feelings of consolation and help in learning to re-structure their every day life. The results also show that relatives indeed sought early support when offered, as fourteen of eighteen relatives contacted the researcher directly after their loss.

In study IV nursing staff (135) from three large palliative care units were introduced to a one-day introduction course in soft tissue massage involving theory and hands on practise (hand-, foot and back). Following the course 30 nursing staff participated in focus group discussions concerning attitudes and opinions about the actual course. Most staff was overall positive. The teacher s skills and ability to provide relevant information were emphasised as important for learning. Still, some had doubts about the appropriateness of introducing the massage in palliative care.

The result of this thesis illuminates the complexity and power of what physical touch comprises. Even so, a relatively short and simple hand or foot massage proved to be immensely important within a palliative care context.

List of scientific papers

I. Seiger Cronfalk B, Ternestedt BM, Strang P, Friedrichsen M (2008). The existential impact of soft tissue massage in palliative home care. An intervention study. [Submitted]

II. Seiger Cronfalk B, Strang P, Ternestedt BM (2008). Inner power, physical strength and existential well-being in daily life; relatives experiences of receiving soft tissue massage in palliative home care. Journal of Clinical Nursing. [Accepted]
https://pubmed.ncbi.nlm.nih.gov/19583654

III. Seiger Cronfalk B, Strang P, Ternestedt BM (2008). Soft tissue massage- an early intervention to bereaved relatives in palliative cancer care. [Submitted]

IV. Cronfalk BS, Friedrichsen M, Milberg A, Strang P (2008). A one-day education in soft tissue massage: experiences and opinions as evaluated by nursing staff in palliative care. Palliat Support Care. 6(2): 141-8.
https://doi.org/10.1017/S1478951508000229