Parent and Child Stress Reduction in the Hospital Setting Following Two
Complementary (CAM) Interventions: New Approach to Family Centered Care
Sheila Wang, PhD*, Rosalyn L. Bruyere DDiv, Ken Weintrub MA, Patricia Megregian MDiv, Suzanne O’Brien,
Lynne Morrison, MA,Holly Luenemann LMT, Richard Kamasinski LMT, Elizabeth Chazen, David M. Steinhorn* MD
Judith Nan Joy Integrative Medicine Initiative, Children’s Memorial Hospital/ *Northwestern University Feinberg School of Medicine, Chicago, IL
Abstract
Results
(APS 2007 Abstract # 754498)
Background: Hospitalization creates physical and psychic stress for children and
their parents1,2 . Parents may provide comfort or they may create additional stress
if they are anxious or agitated. While most care and supportive services are
focused on patients, reducing parental distress may allow them to be more
effective in supporting their hospitalized child and creating an environment for
optimal recovery to occur.
Objective: We evaluated whether Massage Therapy or Touch Healing
interventions would be associated with reduced patient and parental reports of
distress, pain, tension, discomfort and upset mood.
Design/Methods: Patients newly admitted to a general pediatric ward were
offered opportunities to participate in a study evaluating the impact of Massage
Therapy or Touch Healing on their distress, pain, tension, discomfort and upset
mood. Parents rated their child in these five areas before and after the CAM
intervention using a 1-5 scale (least to greatest); adolescents rated themselves.
Parents were also offered the opportunity to receive Touch Healing or Massage
Therapy and rated their own pre/post distress, pain, etc. Safety and acceptability
of interventions were also evaluated. Analysis of pre vs. post-intervention
responses was done using paired t-tests.
Parent Ratings of Their Child Before and After
Their Child Received Touch Healing or Massage
Therapy
Highly significant reductions in all categories of parental
ratings of their child’s level of distress, pain, tension,
discomfort upset mood were found after their child received
either Touch Healing (Figure 1) or Massage Therapy
interventions (Figure 2). The magnitude of the t values and
the extremely low probability values indicate that there was
marked consistency in the direction of the pre to postintervention parent ratings.
Conclusions: Parents experience distress in response to their child’s
hospitalization which is often perceived to be greater than their child’s distress.
Both parents and children experience a reduction in stress through Massage
Therapy or Touch Healing interventions. These two CAM modalities may improve
symptom management in hospitalized children and may enable parents to be
more emotionally available to support their child. Future studies using suitable
control and placebo interventions are needed.
Methods
Pediatric Hospital (or Clinic) Patients as Participants
 Informed consent obtained
 Parents asked to rate their child’s level of distress, pain, tension,
discomfort and upset mood on a scale of 1-5 (e.g. for “distress” 1 =
very calm, 5 = very distressed) before and after their child received
Touch Healing and Massage Therapy (though adolescents rated
themselves).
Parents Rating Themselves Before and After
They Receive Touch Healing or Massage Therapy
Interestingly, before the interventions, parents who
participated in the study rated themselves as more
distressed, in more pain, experiencing more tension and
discomfort and being more upset than parents rating their
hospitalized children. Similar to the results with the patients,
highly significant reductions were found in parents ratings of
themselves after they received Touch Healing (Figure 3) or
Massage Therapy (Figure 4).
N = 378 Touch Healing Interventions (147 patients)
Parents of Hospitalized Children as Participants
 Informed consent obtained
 Parents asked to rate their own level of distress, pain, etc., (as
above) before and after they received Touch Healing or Massage
Therapy interventions.
 Most interventions took place in hospital rooms with the parent
seated in a chair and without the use of lotions or oils. Shoulders,
neck and upper back were massaged with moderate pressure using
petrissage, compression, focused finger pressure and friction
techniques.
Safety:
No adverse events were reported in over 760
interventions.
Conclusions
Post
4.50
4.50
Pre
**
Post
**
**
**
**
 Touch Healing and Massage Therapy interventions
performed in tertiary care pediatric hospitals by trained
professionals are safe and well accepted by children
and their parents.
4.00
4.00
****
3.50
****
****
****
****
3.50
3.00
3.00
2.50
2.50
2.00
2.00
1.50
1.50
1.00
1.00
Distress
Pain
Tension
Discomfort
Upset Mood
 Parents experience distress in response to their
child’s hospitalization which is often perceived to be
greater than their child’s distress.
 Both parents and children perceive a significant
reduction in stress through Massage Therapy or Touch
Healing interventions.
Distress
Pain
Tension
Discomfort
Upset Mood
Figure 1. Parent Ratings of Their Child's Level of Distress,
Figure 3. Parent Rating of Their Own Level of Distress,
Pain, Tension, Discomfort and Upset Mood Before and After
Receiving Touch Healing Intervention (Mean + SD). Mean age
= 7.7 years. For all categories t > 12.9, ****p < 1 x 10-31.
Pain, Tension, Discomfort and Upset Mood Before and After
Receiving Touch Healing Intervention (Mean + SD). For all
categories t < 5.2 , **p < 0.0001.
 The interventions took place, for the most part, in hospital rooms
with patients in their beds or in clinic treatment rooms with patients on
treatment tables.
 Massage Therapy was administered by licensed massage
therapists with training in pediatric massage. Patients were
massaged in hospital gowns (or fully clothed in clinic) without the use
of lotions or oils. Common areas massaged were hands and feet
(85%), back (60%), shoulders (50%), and head (50%) with very light
to moderate pressure depending on patient diagnosis, severity of
illness and tolerance. Light petrissage, compression and friction
techniques were used. Massage Therapists checked in often for
feedback on patient comfort level during the intervention.
Ninety-four percent (94%) of parents who responded to a
follow-up survey were moderately or extremely satisfied
and felt that these modalities should be available to all
patients and parents. One hundred percent (100%) of
parent respondents said they would recommend these
modalities to another patient or parent.
Pre
N = 25 Touch Healing Interventions (19 parents)
 Length of interventions were approximately 15-20 minutes.
 Touch Healing was administered by practitioners who had
completed at least 500 hours of training with Rosalyn L. Bruyere in a
“hands on” technique that helps to balance and support the body’s
energy centers. Hand pressure is very light and does not involve
manipulation of tissues. Hand placement is typically on feet, knees,
hip, abdomen, chest, shoulder, elbow, hand, and head.
Parent Feedback:
5.00
5.00
Results: No adverse events were reported in over 760 interventions. Ninety-four
percent (94%) of parents surveyed were moderately or extremely satisfied and felt
that these modalities should be available to all patients and parents. One hundred
percent (100%) of parents would recommend these modalities to another patient
or parent. In general, parents rated their own level of distress higher than their
child’s. A consistent and very significant fall in stress ratings was seen in all
subjects following Massage Therapy or Touch Healing interventions.
Results
Results
5.00
5.00
N = 233 Massage Therapy Interventions (136 Patients)
N = 130 MassageTherapy Interventions (74 parents)
Pre
Post
4.50
4.50
****
Pre
****
****
****
 Parents are an important part of the healing
environment for hospitalized children. These two CAM
modalities may enable parents to be more emotionally
available to support their child and therefore contribute
positively to the overall healing environment.
 Massage Therapy and Touch Healing may have a
role to play in improving symptom management in
hospitalized children.
 Future studies using adequate control and placebo
interventions are needed.
****
References
Post
4.00
4.00
3.50
****
****
****
****
****
3.50
1 Iwasaki,
M (2005) Interventional study on fatigue relief in mothers
caring for hospitalized children-effect of massage incorporating
techniques from Oriental Medicine, Kurume Medical Journal, 52, 19-27.
3.00
3.00
2 Milstein,
J (2005) A paradigm of integrative care: healing with curing
throughout life, “being with” and “doing to”. Journal of Perinatology 25
(9) 563-8.
2.50
2.50
2.00
2.00
1.50
1.50
1.00
1.00
Distress
Pain
Tension
Discomfort
Upset Mood
Distress
Pain
Tension
Discomfort
Upset Mood
Figure 2. Parent Ratings of Their Child's Level of Distress,
Figure 4. Parent Ratings of Their Own Level of Distress,
Pain, Tension, Discomfort and Upset Mood Before and After
Receiving Massage Therapy Intervention (Mean + SD). Mean
age = 13 years. For all categories t > 11.1, ****p < 1 x 10-20.
Pain, Tension, Discomfort and Upset Mood Before and After
Receiving Massage Therapy Intervention (Mean + SD). For
all categories, t > 12.1, ****p < 1 x 10-22.