Massage & Bodywork

November/December 2012

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DEMOGRAPHICS More than 48 million inpatient surgical procedures are performed annually in the United States.5 This number doesn't account for the less invasive procedures that allow patients to recover at home. Additionally, major surgical interventions are on the rise. Knee replacement surgeries, for example, are expected to increase by nearly 700 percent between 2005 and 2030.6 This increase is anticipated in part due to the fact that people are living 25 percent longer and are more physically active, yet 20 percent heavier than decades ago.7 More than a decade of studies have investigated the use of postoperative massage therapy for a range of surgical interventions. While the surgical procedures and the patient populations vary, the postoperative symptoms are similar and consistently unrelieved through conventional means. Pain and its unpleasantness persist, anxiety is prevalent, and nausea and poor quality sleep are commonplace. The evidence consistently points to the positive effects of massage therapy. THE JOB MARKET Massage therapists currently working in hospital settings are primarily hired and paid through research funding or provide services on a volunteer basis. Publishing positive patient outcomes may encourage full-time positions for massage therapists, particularly if patients demand it.8 Integrative medicine is on the rise, both in the United States and Canada, paving the way for new workplace opportunities for practitioners.9 More cost- effectiveness studies are necessary to dramatically influence the job market for massage in hospital and medical clinic settings; however, change is happening regardless, as health-care reform demands a team approach to wellness, and preventive health care and community education takes center stage over curative medicine. There is much to learn to adapt to the foreign and unpredictable hospital environment. We have little control over the bright lights, beeping and whirring machines, and constant interruptions. There is no autonomy in team medicine. We must learn to communicate up the hierarchical structure using conventional means. Professional boundaries, dress codes, and hygiene requirements are rigid, and rightly so. We must learn a new language, adopt a new uniform, and stretch how we deliver hands-on healing. We are accustomed to maximizing healing by creating beautiful, peaceful spaces. Traditional massage studios are sanctuaries with soft lights, soothing music, water fountains, and colorful art. Additional effort is required to create a safe, healing haven in a hospital room using only our presence and our touch. But we are not alone in this effort to transform hospital settings. The Samueli Institute, a research facility known for its studies on alternative approaches to treating veterans, has implemented a program to help hospitals create "optimal healing environments" that support and stimulate patient healing. One of the Samueli Institute's main goals is to understand what components of a hospital environment contribute to optimal patient recovery and well- being. Another is to evaluate the business impact of optimal healing environments.10 Hospitals are contracting the institute's services to evaluate their current environment and help implement change in hopes of promoting comprehensive approaches to health care. Promoting massage therapy services could be a strategy hospitals adopt to assist them in achieving optimal healing environments. EFFECTIVE MASSAGE STRATEGIES In order to best determine the techniques and modalities to employ when providing postoperative massage, it is important to identify the goals for treatment based on the symptoms and concerns specific to the individual patient's experience. We can look to research protocols and results to help inform our approach to postoperative care. In a study published earlier this year, massage and acupressure were found to relieve symptoms and promote relaxation and sleep among pediatric patients undergoing hematopoietic cell transplant. If the interventions are administered with attention to patients' needs and hospital routines, massage and acupressure may also relieve stress among parents, improve caregiver competence, and enhance the sense of connection between parent and child.11 The massage intervention was a semi- standardized integration of Swedish massage (gentle to moderately firm strokes; light pressure; holding touch to www.abmp.com. See what benefits await you. 53

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