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Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 43 Assessment Scales for Data Collection Four standardized assessment scales were used to collect data for analysis: two scales related to the primary outcomes of interest (caregiver well- being and stress), one to account for potential confounding factors, and one to assess the participants' perceptions and acceptability of the massage intervention. • The Brief Symptom Inventory 18 (BSI 18) 4 produced three symptom scales for depression, anxiety, and somatization, and also provided an overall index of psychological distress. • The Perceived Stress Scale (PSS) 5 was used to quantify the extent to which respondents perceived situations in their lives to be overwhelming, uncontrollable, and unpredictable. • Prior to the intervention, participants completed the Client Expectations of Massage Scale (CEMS) 6 to account for potential confounding aspects of participants' prior experiences and perceptions of massage therapy. • Finally, participants completed an exit survey after they completed study activity, which incorporated Likert- scale questions from the Behavior Intervention Rating Scale (BIRS). 7 The exit interview also included open-ended questions, so participants could provide more detailed responses about what they liked and didn't like about the massage and the program, what they would change, and how they would describe the program to a loved one. including clinicians, support staff, and informal caregivers of admitted patients. The research evidence base is building for anxiety, depression, and stress, which are generally experiences informal caregivers have in abundance. In the health-care environment particularly, informal caregivers tend to suppress their needs while focus is heightened on their loved one who is recovering from a serious illness or injury, or whose health is deteriorating. 2 STUDY DESCRIPTION Recently published research sought to examine massage for informal caregivers in the rehabilitation hospital setting. The article, "Therapeutic Massage to Enhance Family Caregivers' Well-Being in a Rehabilitation Hospital," details a trial in which researchers identified two goals: (1) to understand the impact of massage dosage on the psychological functioning of family caregivers, and (2) to identify implementation barriers and challenges along with caregivers' perceptions of the program. 3 For the study, researchers conducted a trial in which data were gathered through questionnaires and interviews prior to and following completion of the intervention. Caregivers of adult and pediatric patients admitted to the study hospital (with admission expectations of three weeks or more) were invited to participate in the study if they were older than 18 years and did not have a health condition contraindicated for massage. (Patients in the hospital were those with traumatic brain injuries, severe stroke, spinal cord injuries, and complex neurological medical conditions.) Those who enrolled in the study were randomized to receive either one 60-minute massage per week for two weeks or three 60-minute massages per week for two weeks. The massages would take place in a private massage room in or near the hospital by a trained and licensed massage therapist. Massages followed a standardized protocol that allowed for individualization based on each participant's needs, engaged moderate pressure, and addressed the whole body. Study researchers hypothesized that caregivers receiving three massage sessions per week would have better outcomes with regard to their mental well-being and health and indicate more pronounced reductions in their stress. STUDY RESULTS Thirty-eight people enrolled in the study and were randomized to massages either one or three times per week for two weeks. The hour-long massage protocol indicated the body area addressed, order, and time allotment for each portion of the session. Therapists used clinical decision making with regard to muscle address and technique, so participants received individualized care—which is a signature feature of real-world massage. Most of the participants (53 percent) were mothers of patients in the hospital, while another 34 percent were spouses, and almost all participants were white (92 percent). Sixteen percent of participants (n=6) were unable to complete the intervention due to their loved one being discharged earlier than anticipated or feeling too overwhelmed with their loved one's medical condition and treatment/support needs. Most participants had 100 percent compliance (two or six total massages) in the study, but there were several from each group who were unable to complete all of the assigned treatments. Specifically, 79 percent of all planned massages for enrollees were completed, and if only those who finished the data collection are considered, 89 percent of planned treatments were completed. All emotional well-being and perceived stress scores significantly improved from pre- to postintervention for both groups. However, no between-group differences were found. In other words, both groups had less depression, anxiety, somatization, and perceived stress at postintervention

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