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Massage and Sleep Patterns in Critically Ill Patients
Critically ill patients are deprived of sleep and its potential healing
qualities, although many receive medications to promote sleep. No one has
adequately evaluated holistic nonpharmacological techniques designed to promote
sleep in critical care practice. This study was conducted to determine the
effects of a 1) back massage and 2) a combination of muscle relaxation, mental
imagery and a music audiotape on the sleep of older men with a cardiovascular
illness who were hospitalized in a critical care unit. Sixty-nine patients were
randomly assigned to one of three groups. A control group received routine
nursing care before bedtime and a six-minute rest period at bedtime. Group two
received a six-minute back massage (effleurage). Group three received a teaching
session on relaxation and a 7.5-minute audiotape at bedtime consisting of
progressive muscle relaxation, mental imagery and relaxing background music.
Because the intervention, if found effective, was to be used by practising
nurses, no special massage training other than basic nursing education was
acquired. Polysomnography was used to measure one night of sleep for each
patient.
Results showed improved quality of sleep among the back massage group.
Descriptive parameters revealed that patients in the back-massage group
experienced higher quality and quantity of sleep than did patients in the
control group. Sleep efficiency index was 14.7% higher in the massage group than
in the control group. The relaxation-audiotape intervention did not have a
statistically significant effect on sleep. This study concludes that the use of
back massage, as an alternative or adjunct to pharmacological treatment, is a
clinically effective nursing intervention for promotion of sleep.
Culpepper-Richards K University of Arkansas College of
Nursing and Veterans Affairs Medical Centre, Little Rock, Arkansas:American
Journal of Critical Care: 7(4):288-299, 1998 July
The Effectiveness of Acupressure in Improving the Quality of Sleep of
Institutionalized Residents
Elderly people often suffer from disturbed sleep. This study tested the
effectiveness of acupressure in enhancing the quality of sleep of
institutionalized residents. The Pittsburgh Sleep Quality Index (PSQI)
questionnaire was used as a screening tool to select 84 subjects with sleep
disturbance.
These subjects were randomly assigned to an acupressure group, a sham
acupressure group and a control group. The same massage routine was used for the
acupressure and sham acupressure groups, with the difference that five acupoints
to enhance sleep were chosen for the acupressure group, while non-acupoints were
used for the sham group. Only conversation was employed in the control group.
Although there were some differences in PSQI scores after intervention
in all three groups, improvements were greatest in the acupressure group, which
experienced a significant reduction in the frequencies of nocturnal awakening
and night wakeful time. The study confirmed the effectiveness of acupressure in
improving the quality of sleep of elderly people and offered a
non-pharmacological therapy method for sleep-disturbed elderly people.
NAMES: Chen ML, Lin LC, Wu SC, Lin JG; Department of Nursing,
National Taipei Nursing College, Taiwan; Journal of Gerontology: MEDICAL
SCIENCES, 1999 Aug, 54:8, M389-94
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