Benefits of massage therapy for hospitalized patients: a descriptive and qualitative evaluation.

CONTEXT: Some acute and long-term care facilities are instituting massage therapy programs to support their patients' health, healing, and quality of life. Evaluation of the impact of these programs from the perspective of patients, providers, and therapists is important for administrative decision making and the design of future outcomes research. OBJECTIVE: To uncover and elucidate a range of patient outcomes of a therapeutic massage program within an acute care setting. DESIGN: Descriptive and qualitative evaluation. Surveys and narrative reports were completed by 70 patients, 14 healthcare providers, and 4 massage therapists. SETTING: A large university hospital. PATIENTS: 113 hospitalized patients received 1 to 4 massages during the course of their hospital stay. INTERVENTION: Massage therapy. MAIN OUTCOME MEASURES: Narrative data were coded into 8 categories (pain, sleep, tension/anxiety, body awareness, physical functioning, psychological support, enhancing healing, and value). Selected patient responses were included to elaborate the meanings of these categories. RESULTS: The most frequently identified outcomes were increased relaxation (98%), a sense of well-being (93%), and positive mood change (88%). More than two thirds of patients attributed enhanced mobility, greater energy, increased participation in treatment, and faster recovery to massage therapy. Thirty-five percent stated that benefits lasted more than 1 day. CONCLUSIONS: The study supported the value of this hospital-based massage therapy program and uncovered a range of benefits of massage therapy for hospitalized patients that should be studied further.

Neuropsychological impairment with schizophrenia vs. acute and chronic cerebral lesions.

Performed detailed neuropsychological evaluations with 25 recently hospitalized schizophrenics in whom systematic neurologic workups had failed to reveal CNS disease. Efforts were made to minimize possible effects of drug-induced extrapyramidal symptoms on test performance. Although the schizophrenics showed some neuropsychological impairment relative to 25 normals, their deficits were not as severe as those of patients known to have either acute or chronic brain disorders (N = 25). The diagnostic accuracy achieved by the tests supports their use in short-term treatment facilities when the differential diagnosis includes schizophrenia and brain disorder, especially acute brain disorder. Schizophrenics' neuropsychological impairment was more correlated with degree of EEG abnormality than with degree of psychosis, which suggests a possible organic basis for the deficits that they showed on testing.

Dopamine excretion and vulnerability to drug-induced Parkinsonism. Schizophrenic patients.

Before and during a standardized course of trifluoperazine therapy, 18 schizophrenic patients underwent repeated examinations for extrapyramidal motor signs, clinical psychopathology, and urinary excretion of free and conjugated forms of dopamine and its metabolites. Patients excreting more free dopamine and metabolites, or showing less complete conjugation, before drug treatment, were much less likely than others to develop parkinsonian akinesia and rigidity during drug treatment. Neither catatonic rigidity nor akinesia before treatment was predictive of a parkinsonian response to trifluoperazine, but pretreatment tremor may have been. The severity of schizophrenic psychopathology was unrelated to dopamine excretion. This study of schizophrenic patients, and our previous research in Parkinson's disease, suggest that urinary dopamine excretion may reflect dopaminergic function of the extrapyramidal motor system in both conditions.

Low urinary dopamine and prediction of phenothiazine-induced Parkinsonism: a preliminary report.

Psychiatric patients who excreted larger amounts of urinary free dopamine before treatment were significantly more likely than patients excreting smaller amounts to develop parkinsonian side effects during moderate-dose trifluoperazine therapy. If this finding is replicated, urinary free dopamine determinations could prove valuable in indicating which patients should receive those antipsychotic drugs least likely to produce extrapyramidal side effects.