The attitudes toward massage (ATOM) scale: Reliability, validity, and associated findings

University of Wisconsin-Stout, USA.
Journal of bodywork and movement therapies 02/2009; 13(1):22-33. DOI: 10.1016/j.jbmt.2008.01.002
Source: PubMed

ABSTRACT Despite the key role of attitudes in guiding behavior, no systematic examination of attitudes toward massage has been conducted and no standard assessments have been created. We developed the attitudes toward massage (ATOM) scale, a nine-item measure of an overall attitude toward massage that includes two distinct subscales assessing the attitudes of Massage as Healthful and Massage as Pleasant. These subscales are reliable (alpha>.70 and >.80, respectively), covary with major personality traits and dispositional sensitivities, and are positively correlated with broader attitudes toward complementary and alternative medicine. Clinical evidence suggests that these attitudes change in response to receiving massage, though further research is needed. Supplemental items administered with the ATOM illustrate a general preference for female massage therapists while also showing this preference to be stronger in men. Attitudes pertaining to massage and sexual arousal, which may stand in the way of trying massage for some persons, are also examined. With or without the supplemental items, the ATOM scale is an easily administered measure for assessing attitudes toward massage that can be used in research or practice settings.

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Available from: James Rounds, Sep 26, 2015
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    • "We tested Likert scales reflecting degree of endorsement. Responses included: strongly disagree; moderately disagree; a little disagree; neither agree nor disagree; a little agree; moderately agree; strongly agree (used by [33,34] and more recently by Younger et al. [15]. To test this set of responses, we adapted four items from Mao’s validated “Acupuncture Expectancy Scale” expectations of acupuncture [35,36] (Mao)a: 1) “my pain will improve a lot”; 2) “I will be better able to cope with my pain”; 3) “my pain will go away”; and 4) “my energy level will improve”. "
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    ABSTRACT: No consistent relationship exists between pre-treatment expectations and therapeutic benefit from various complementary and alternative medicine (CAM) therapies in clinical trials. However, many different expectancy measures have been used in those studies, with no validated questionnaires clearly focused on CAM and pain. We undertook cognitive interviews as part of a process to develop and validate such a questionnaire. We reviewed questions about expectations of benefits of acupuncture, chiropractic, massage, or yoga for pain. Components of the questions - verbs, nouns, response options, terms and phrases describing back pain - were identified. Using seven different cognitive interview scripts, we conducted 39 interviews to evaluate how individuals with chronic low back pain understood these individual components in the context of expectancy questions for a therapy they had not yet received. Chosen items were those with the greatest agreement and least confusion among participants, and were closest to the meanings intended by the investigators. The questionnaire drafted for psychometric evaluation had 18 items covering various domains of expectancy. "Back pain" was the most consistently interpreted descriptor for this condition. The most understandable response options were 0-10 scales, a structure used throughout the questionnaire, with 0 always indicating no change, and 10 anchored with an absolute descriptor such as "complete relief". The use of words to describe midpoints was found to be confusing. The word "expect" held different and shifting meanings for participants. Thus paired items comparing "hope" and "realistically expect" were chosen to evaluate 5 different aspects of treatment expectations (back pain; back dysfunction and global effects; impact of back pain on specific areas of life; sleep, mood, and energy; coping). "Impact of back pain" on various areas of life was found to be a consistently meaningful concept, and more global than "interference". Cognitive interviews identified wordings with considerable agreement among both participants and investigators. Some items widely used in clinical studies had different meanings to participants than investigators, or were confusing to participants. The final 18-item questionnaire is undergoing psychometric evaluation with goals of streamlining as well as identifying best items for use when questionnaire length is constrained.
    BMC Complementary and Alternative Medicine 01/2014; 14(1):39. DOI:10.1186/1472-6882-14-39 · 2.02 Impact Factor
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    • "We used ATOM scale to examine the influence of patients' attitude in the effect of massage in our sample of breast cancer survivors. The ATOM-MH scale showed the ability to modify mood changes, such as tension–anxiety, depression–dejection and anger–hostility, confirming the ability of this tool for detecting influences of attitude in massage effects (Moyer & Rounds 2009). Interestingly, current results confirm that breast cancer survivors with a healthful positive attitude towards massage exhibited greater reduction in depression. "
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    ABSTRACT: Our aims were to investigate the immediate effect of myofascial release on heart rate variability and mood state, and the influence of attitude towards massage in breast cancer survivors with cancer-related fatigue. Twenty breast cancer survivors reporting moderate to high cancer-related fatigue participated in this crossover study. All patients presented to the laboratory at the same time of the day on two occasions separated by a 2-week interval. At each session, they received either a massage intervention or control intervention. Holter electrocardiogram recordings and Profile of Mood States questionnaire (six domains: tension-anxiety, depression-dejection, anger-hostility, vigour, fatigue, confusion) were obtained before and immediately after each intervention. The attitude towards massage scale was collected before the first session in all breast cancer survivors. The results showed a significant session × time interaction for standard deviation of the normal-to-normal interval (SDNN) (F= 5.063, P= 0.039), square root of mean squared differences of successive normal-to-normal intervals (RMSSD) (F= 8.273, P= 0.010), high-frequency component (HF) (F= 7.571, P= 0.013), but not for index heart rate variability (F= 3.451, P= 0.080), low-frequency component (LF) (F= 0.014, P= 0.997) and ratio LF/HF (F= 3.680, P= 0.072): significant increases in SDNN, RMSSD and HF domain (P < 0.05) were observed after the manual therapy intervention, with no changes after placebo (P > 0.6). No influence of the attitude scale on heart rate variability results was found. A significant session × time interaction was also found for fatigue (F= 5.101, P= 0.036) and disturbance of mood (F= 6.690, P= 0.018) scales of the Profile of Mood States: patients showed a significant decrease in fatigue and disturbance of mood (P < 0.001) after manual therapy, with no changes after placebo (P > 0.50). A significant influence of the attitude scale was observed in tension-anxiety, depression-dejection and anger-hostility scales. This controlled trial suggests that massage leads to an immediate increase of heart rate variability and an improvement in mood in breast cancer survivors with cancer-related fatigue. Further, the positive impact of massage on cancer-related fatigue is modulated by the attitude of the patient towards massage.
    European Journal of Cancer Care 11/2011; 21(2):233-41. DOI:10.1111/j.1365-2354.2011.01306.x · 1.56 Impact Factor
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    • "Therefore, in addition to conventional health outcome measures that are appropriate to CAM research, a key goal of the Database is to highlight and include outcome measures that are specific to CAM interventions and that are developed to measure concepts that have been identified as important outcomes of CAM interventions, such as transformation and unstuckness. For example, specific to the MT field, Moyer and Rounds developed the Attitudes Towards Massage (ATOM) scale(14). The ATOM scale aims to assess the overall attitude of individuals toward massage based on two key attitudes: massage as “helpful,” and massage as “pleasant.” "
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    ABSTRACT: One of the most commonly used complementary and alternative medicine (CAM) modalities in North America is massage therapy (MT). Research to date indicates many potential health benefits of MT, suggesting that ongoing research efforts to further elucidate and substantiate preliminary findings within the massage profession should be given high priority. Central to the development of a sound evidence base for MT are the use of valid, reliable, and relevant outcome measures in research, and practice in assessing the effectiveness of MT. The purpose of the present article is to introduce MT researchers and massage therapists interested in using outcome measures in research and clinical practice to the IN-CAM Outcomes Database website by describing the Outcomes Database and identifying its utility in MT research and practice. The IN-CAM Outcomes Database is a centralized location where information on outcome measures is collected and made accessible to users. Outcome measures are organized in the database within the Framework of Outcome Domains. The Framework includes health domains relevant to conventional medicine and CAM alike, and health domains that have been identified as important to CAM interventions. Users of the website may search for information on a specific outcome measure, plan research projects, and engage in discussions related to outcomes assessment in the CAM field with other users and with members of the CAM research community. As the MT profession continues to evolve and move toward evidence-informed practice, the IN-CAM Outcomes Database website can be a valuable resource for MT researchers and massage therapists.
    International Journal of Therapeutic Massage & Bodywork Research Education & Practice 03/2009; 2(1):8-16. DOI:10.3822/ijtmb.v2i1.37
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