Application of Concept Analysis to Clinical Practice
Tammeda Griggs
Grand Canyon University
Nursing 502
04/15/2018

Introduction
With all the different types of pain medication being used in the hospitals today, why is pain management still a problem in the acute care setting? In nursing school, we are taught to assess our patients for pain more ways than one. Every shift, patients are asked about their pain level, if they are unable to verbalize their pain, nurses look for nonverbal ques of pain. Because pain control remains an issue for hospitals today, we must look for other alternatives to control the patients pain. So, what can help with pain management in an acute care setting? How about adding message therapy to the plan of care? Massage therapy was and is being used for many years now in nontraditional medicine, to manage pain.
For this assignment I was asked to find a peer-reviewed concept analysis article of my choice. In my search for an article, I came across this article written in the International Journal of Therapeutic Massage & Bodywork. The title of the article is “The Effects of Massage Therapy on Pain Management in the Acute Care Setting”
The article was written as a study to evaluate the use of massage therapy as a form of pain control on patients in an acute care hospital. This study was done in Flagstaff Medical Center in Arizona on their inpatient population. The requirement for this study, was a group of patients with mild to moderate pain levels. The plan was to assess the patients pain level before and after massage therapy. Pain was assessed using the 0-10 pain sensory scale, quantitative and qualitative methods were also used for analysis of this study.
Method of Analysis
The study was conducted by three females, licensed massage therapists with experience ranging from 2 to 20 years of service. A convenience sample of 65 patients that were admitted between October 1st, 2006, and March 31st, 2007 (Adams, White & Beckett, 2010). The patient samples were picked from the medical, surgical, and obstetrics units.
For the patients to participate in the study, they had to have an order from their physician for message therapy. The patient also had to sign a consent as a willing participant, and give feedback to the hospital after being discharged from the hospital. Each patient received one or more therapy session averaging 30 minutes each at the bedside. The number of sessions received depended on the length of the hospital stay (Adams, White & Beckett, 2010).
There were many types of massage treatments offered during the patient session. Treatments included gentle Swedish effleurage or petrissage, acupressure, craniosacral therapy, or cross-fiber myotherapy with light-pressure effleurage and pressure points being the most commonly used modalities (Adams, White & Beckett, 2010). The areas of treatment included mostly the head, neck, shoulders, back, and feet. The therapist also used lightly scented oils and soft music.
The survey used in this research project (Patient Survey for Massage Therapy Research) was adapted from a survey used by Motsinger in her Capstone Project, titled Development of an Inpatient Massage Therapy Program in an Allopathic Hospital (Adams, White & Beckett, 2010). Demographic Data of Research
Characteristic Value
Participants (n) 65
Mean age (years) 45
Sex % (women/men) 87/13
Ethnicity (%)
White 82
Native American 12
Hispanic 2.3
African American 1
Asian 1
Hospital Unit (%)
Medical 42
Surgical 31
Obstetrics 26
Table 1 (Adams, White & Beckett, 2010)
The steps of process and the results for each step
The first step in the study, is to submit a plan for review to the hospital review board, and get an approval. Next thing is to seek out patients who are willing to sign a consent and participate in the research study. Then you must obtain a physician order for message therapy. Once all paper work is signed off, the patients can now begin the study. After multiple sessions of massage therapy, the study is now completed. The data obtained in survey shows that most participants in the survey received 1 massage (50.8%). Another 40% received 2 – 3 massage sessions, and 6 participants (9.2%) received more than 3 massage sessions. Most sessions (83.9%) lasted 30 minutes, 14 sessions lasted 45 minutes (14.9%), and 1 session lasted 15 minutes. The effects of massage therapy were felt to last 1 – 4 hours by 34 participants (53.1%), and 4 – 8 hours, by 13 participants (20.3%). According to 9 participants (14.1%), the effects lasted 8 – 24 hours, and according to 7 (10.9%), more than 24 hours. One person felt no effect. The response to the question “Do you plan to continue using massage therapy in your healing process?” was yes in an impressive 67.2% of participants. Another 14.1% responded no, and 18.8% didn’t know if they would continue with massage therapy after their hospitalization (Adams, White ; Beckett, 2010).
The finding for the study was reported to be effective overall. Most of the patients reported a decrease in the need for pain medication after receiving massage therapy. They also reported more flexibility to move around with less pain, even sleeping better at night.
Apply the concepts to a practice situation.
As a labor and delivery nurse, I often find that massage therapy is a great way to easy some of the pain the mom is experiencing while laboring. There are many areas you could massage to help ease the pain. Applying a gentle, kneading massage to the lower back in a slow, rhythmic pattern during a contraction, can relieve most of the sharp shooting pain. According to Field (2010), Massage therapy has been demonstrated to be effective during pregnancy. Women who received massage therapy reported decreased depression, anxiety, and leg and back pain. Cortisol levels decreased and, in turn, excessive fetal activity decreased, and the rate of prematurity was lower in the massage group. In a study of labor pain, women who received massage therapy experienced significantly less pain, and their labors were on average 3 h shorter with less need for medication (Field, 2010).
Conclusion
As healthcare providers, continue their search for more effective ways to manage pain, nurses can always implement in their care plan some form of massage therapy. Offering massage therapy in the acute care setting can prevent the need to always treat pain with medication. In my opinion, a lot of our patient become addicted to pain medications, because it seems to be an easy, quick fix to managing pain. If health care facility, added massage therapy as the first form of pain management, we will find that this form of treatment, according to Field (2010), can provide pain relief and relaxation, can support a patient’s emotional well-being and recovery, and can ultimately aid in the healing process for hospitalized patients.
References

Field, T. (2010). Pregnancy and labor massage. Expert Review of Obstetrics & Gynecology, 5(2), 177–181. http://doi.org/10.1586/eog.10.12

Adams, R., White, B., & Beckett, C. (2010). The Effects of Massage Therapy on Pain Management in the Acute Care Setting. International Journal of Therapeutic Massage & Bodywork, 3(1), 4–11.