The Effect of Whole Body Massage on the Process and Physiological Outcome of Trauma ICU Patients: A Double-Blind Randomized Clinical Trial

IntrOductIOnTraumatic patients, who are critically ill and need special care in 24 hour, are hospitalized in the ICU [1].Hospitalization in the ICU, pain, anxiety, stress, long term disability, and fear of death and from an unknown environment can cause haemodynamic instabilities such as increased blood pressure (BP), PR, RR and deterioration of GCS scores [2].Researches indicated that 13.9% ICU mortality rate was due to physiological parameters alteration [1].The ICU environment is a multiple experience for each patient, because anxiety due to the nature of the around and their medical or surgical condition.Patients in ICU and patients undergone heart surgery, such patients are anxious [3,4].Over 70% of ICU patients experience anxiety.In studies of patient experiences in ICU, difficulty sleeping, pain and anxiety were most problems [5].Anxiety in these situations causes agitation, affecting nervous system, catecholamine release, cause dysrhythmias, increased basal metabolic rate, changes in vital signs, myocardial ischemia, detrimental at a psychological level, heart failure, delirium, delay in recovery of injuries and infections, decreases physical well-being and sleep and lead to a prolonged hospitalization of the patient in critical care and finally may leads to death [4,[6][7][8].Today, alternative and complementary therapies such as reflexology, relaxation, herbal medicine, hypnosis, music therapy, guided imagery, therapeutic touch, and therapeutic massage have been used to decrease the mentioned side effects [2].Massage therapy is one of the most common complementary treatment methods [9,10].Previous research reported the effects of massage on reduced anxiety and pain of patients with cardiovascular surgeries, stroke, constipation and hand pain [4,11].Providing health care with high quality for the patients in ICU and care planning by nurses or physicians in these patients is necessary.Therefore, the purpose of this study was to evaluate the effect of massage therapy by patient's relative on physiological outcome (vital signs, GCS and ABG) of ICU patients. MAterIAls And MethOdsThis is an experimental study that was performed at the trauma ICU of the Imam Khomeini Hospital in Ilam University of Medical Sciences (western Iran), during the January to October 2014.The study design was approved by the Institutional Committee of Ethics Practice of our institution, and informed consent was obtained from all samples.The sample size was calculated using a pilot study with 15 patients and 15 patients' relative or family members and the following formula:In a randomized, double-blind trial 54 patients and 54 family members were placed in the experimental group and equal numbers were selected for the control group.Patients were randomly selected by convenience sampling from the record list of the ward at our institution.The inclusion criteria included; length of stay more than 7 days of hospitalization, GCS of 7-12, haemodynamic stability, without mental disorder, without infectious disease or hepatitis, known skin problem, intracranial pressure less than 20 mmHg, and no limitation or contraindication for changes of body position or body massage.The exclusion criteria were the loss of consciousness, having recently cardiac arrest.After training of family members they were allowed to massage the patient.In the intervention group, massage therapy was done by one of the patient's family during a 45 minute session.The control group received the routine care of the unit and no intervention was provided for the control group.

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