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The Effects of Employer-Provided Massage Therapy on Job Satisfaction, Workplace Stress, and Pain and Discomfort

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Long-term care staff have high levels of musculoskeletal concerns. This research provided a pilot program to evaluate the efficacy of employer-funded on-site massage therapy on job satisfaction, workplace stress, pain, and discomfort. Twenty-minute massage therapy sessions were provided. Evaluation demonstrated possible improvements in job satisfaction, with initial benefits in pain severity, and the greatest benefit for individuals with preexisting symptoms. A long-term effect was not demonstrated.
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FEATURES
The Effects of Employer-Provided Massage
Therapy on Job Satisfaction, Workplace
Stress, and Pain and Discomfort
Chris Back, BSc, CCPE Helen Tam, BSc (OT) Elaine Lee, BSc (Kin) Bodhi Haraldsson, RMT
Long-term care staff have high levels of musculoskeletal concerns. This research provided a pilot program to
evaluate the efficacy of employer-funded on-site massage therapy on job satisfaction, workplace stress, pain, and
discomfort. Twenty-minute massage therapy sessions were provided. Evaluation demonstrated possible
improvements in job satisfaction, with initial benefits in pain severity, and the greatest benefit for individuals with
preexisting symptoms. A long-term effect was not demonstrated. KEY WORDS: massage therapy,musculoskeletal
injury,workplace stress Holist Nurs Pract 2009;23(1):19–31
THE HEALTHCARE PROFESSION
Healthcare is the second largest industry in Canada1
and has a high incidence of occupational injury and
illness. Although healthcare workers are “committed
to promoting health through treatment and care for the
sick and injured, health care workers, ironically,
confront perhaps a greater range of significant
workplace hazards than workers in any other sector.”2
Healthcare jobs often involve potential exposure to
airborne and blood-borne infectious disease, sharps
injuries,3,and other dangers; many healthcare jobs
can also be physically demanding and mentally
stressful.2Moreover, healthcare workers with
occupational or nonoccupational illness or injury may
face unique challenges because of societal
misperceptions that qualified healthcare providers
must themselves be free from any physical or mental
impairment.4
The quality of health and healthcare services begins
with the frontline healthcare workers—for example, the
Author Affiliations: Occupational Health and Safety Agency for Health-
care in British Columbia (Messrs Back and Lee); Vancouver Coastal Health
(Ms Tam); Massage Therapist Association of British Columbia
(Mr Haraldsson), Vancouver, British Columbia, Canada.
Corresponding Author: Chris Back, BSC, CCPE, Occupational Health
and Safety Agency for Healthcare in British Columbia, 1195 W Broadway,
Vancouver, BC, Canada V6H 3X5 (chrisb@ohsah.bc.ca).
Injuries from needles and other sharp devices used in healthcare and labo-
ratory settings are associated with the occupational transmission of various
pathogens.
nurses, physicians, physiotherapists, laboratory tech-
nicians, nurse aide, or home health worker and so on.
These professionals are often the first and most
frequent point of contact for patients and clients. In
fact, for many patients and clients, the frontline
healthcare worker is the face of the entire organization
for both institutional and community health services.
JOB ACTIVITIES AND WORK DEMANDS
In many respects, the healthcare profession differs
from other types of work. The physical workload, and
especially handling and lifting of patients, often
requires close contact with people in need of medical
and emotional help and support.5,6 In addition,
healthcare work can induce high organizational stress
because healthcare workers often face conflicting
demands from their supervisors and patients.
Additional factors that can lead to stress in healthcare
workers include close contact with human suffering
and death, job role ambiguity, staff shortage, and the
requirements of shift work.
HIGH INCIDENTS OF
MUSCULOSKELETAL INJURY
Healthcare personnel had the highest rate of
back-related worker’s compensation claims according
to WorkSafeBC. Despite several decades of research,
work-related musculoskeletal injuries (MSI) continue
19
20 HOLISTIC NURSING PRACTICE JANUARY/FEBRUARY 2009
to represent an unsolved problem. It is well
established in the existing literature that
musculoskeletal problems have multifactorial
etiology.7Also, there is an extensive body of research
on the work-related physical risk factors such as
working postures and manual lifting and handling, as
well as on the role of nonpsychological individual
factors (age, gender, physical exercise) in
musculoskeletal pain. There is also an increasing body
of evidence that the psychosocial factors play an
important role in the development of MSI.
Musculoskeletal injury (MSI) prevention programs
in healthcare have primarily focused on education,
ergonomic training, and engineering controls.
However, the rate of MSIs in this industry continues to
be of very high incidence. High work demand, small
recovery time, fatigue, and escalated pressure can all
lead to MSI and low job satisfaction.
MASSAGE THERAPY
The art and science of massage has a time-honored
history in western medicine dating back to ancient
Greece.8Although there are different types of
massage, including aromatherapy, reflexology, sports
massage, and shiatsu, Swedish (or classic) massage
remains the most commonly practiced.9Classic types
of massage includes effleurage (stroking), p´etrissage
(compression), tapotement (percussion), vibration,
and friction.9
More and more, massage therapy is being utilized
to relieve health problems.10 In his meta-analysis of
massage therapy effects, Moyer reports that a single
applications of massage therapy reduced state anxiety,
blood pressure, and heart rate but not negative mood,
immediate assessment of pain, and cortisol level.
Multiple applications reduced delayed assessment of
pain. Reductions of trait anxiety and depression were
massage therapy’s largest effects, with a course of
treatment providing benefits similar in magnitude to
those of psychotherapy.
Massage therapy is considered a form of medical
treatment in several countries where it is covered by
national health insurance, including China, Japan,
Russia, and West Germany. On the European
continent, massage has been a routine form of therapy
for acute and chronic lower back pain for many
decades.11 In Canada, massage therapy still is
considered an alternative therapy. Nonetheless, its
popularity seems to be growing.
Massage therapy has been described as having 4
principal goals of treatment: (1) to promote relaxation
and wellness (relaxation massage); (2) to address
clinical concerns (clinical massage); (3) to enhance
posture, movement, and body awareness (movement
reeducation); and (4) to balance and “move” subtle
energy (energy work).12
The College of Massage Therapists of British
Columbia defines the practice of massage therapy as
the assessment of soft tissue and joints of the body and
the treatment and prevention of dysfunction, injury,
pain, and physical disorders of the soft tissues and
joints by manual and physical methods to develop,
maintain, rehabilitate, or augment physical function to
relieve pain and promote health.
Massage therapy has been recommended by many
studies as an effective intervention to combat
work-related anxiety, depression, and musculoskeletal
pain.13–15 Tsao in her systematic review of the massage
therapy literature notes that “existing research
provides fairly robust support for the analgesic effects
of massage for nonspecific low back pain, but only
moderate support for such effects on shoulder pain and
headache pain. There is only modest, preliminary
support for massage in the treatment of fibromyalgia,
mixed chronic pain conditions, neck pain and carpal
tunnel syndrome.16(p165)
Massage therapy has also been attributed with
increasing serotonin and dopamine levels, 2 important
neurotransmitters. Cherkin et al17 reported in their
study that those who received massage therapy had
less severe back pain symptoms than the control group
or those that received acupuncture. In a study by
Brennan and De Bate,14 nurses in the study group
received a 10-minute chair massage while the control
group received a 10-minute break.18 Using the
Perceived Stress Scale, the study group reported
significantly lower stress perception after the chair
massage, whereas the control group reported no
significant changes. In addition to reducing pain and
tension levels, massage therapy has been found to
increase relaxation and improve the overall mood of
patients.19
With past initiatives focusing primarily on physical
factors in the reduction/elimination of musculoskeletal
injuries, this research endeavored to explore the
effects of a wellness intervention program on
psychological well-being, physical health, and safety.
The holistic approach of a wellness intervention
focuses on the promotion or maintenance of good
health rather than correction of poor health.
The Effects of Employer-Provided Massage Therapy 21
Thus, this article presents an examination of the
impact of massage therapy, used as an experimental
intervention, on healthcare workers’ health, especially
from the work-related injury prevention and control
point of view.
MATERIAL AND METHODS
Research design
The evaluation of this project followed a
quasi-experimental time-series design. The
intervention facility was George Pearson Centre
(GPC), a facility with high rates of sick time and MSI.
The GPC is a residential care facility with 200
employees providing care for adults with severe
disabilities in Vancouver, British Columbia, Canada.
The first questionnaire was distributed on February 1,
2005, after ethics approval was received from the
University of British Columbia Behavioral Research
Ethics Board. Figure 1 presents a graphical
representation of the study time frame and
methodology.
Questionnaires
Six matched questionnaires were distributed: 3
preintervention (Q1, Q2, and Q3) and 3
postintervention (Q4, Q5, and Q6) during the period
February 1, 2005, to August 16, 2005. Each participant
was assigned an encrypted identification number for
the entire study. In Q1, 107 participants were asked to
rank a descriptive list of 4 personal wellness programs
(massage therapy, integrative energy healing,
nap/sleep room, and no wellness program) according
to their first and last preference. Massage therapy was
chosen as the most preferred relaxation modality by
94 (88%) of the 107 respondents.
Questionnaires Q1, Q2, Q5, and Q6 were placed in
the facility mailbox of each staff member. Completed
questionnaires were returned to the unit clerk at each
of the 6 wards. The ward that submitted the most
questionnaires during each phase of the evaluation
FIGURE 1. Evaluation methodology. Q =Questionnaire.
received a gift basket. Participants completed Q3 in
conjunction with a medical case history form
immediately before receiving their first massage
therapy session. Q4 was completed by participants
immediately following their final massage therapy
session, or during the week following the massage
program (intervention period) if they did not receive a
massage in the final week of the program. Originally,
this project was intended to evaluate the effects of a
relaxation modality on direct patient care staff only.
Q1 and Q2 reflect this intention. However, after
further consideration of the evaluation, the sample was
expanded to include nondirect patient care staff in Q3,
Q4, Q5, and Q6.
The questionnaires contained questions relating to
“psychological and social factors at work,” as derived
from the constructs developed by the General Nordic
Questionnaire for Psychological and Social Factors at
Work (QPS Nordic),20–24 which referred to
organizational culture, job demands, social interaction,
and control at work. Questionnaires Q3 to Q6 also
included the Brief Pain Inventory (Appendix).25
A total of 107 subjects participated in the Q1 survey
and 81 in Q2. Massage therapy services were offered
to 145 healthcare workers immediately after Q3.
Participants completed questionnaires postintervention
at week 4 (Q4), week 10 (Q5), and week16 (Q6).
Relaxation intervention: Massage
therapy sessions
Massage therapy sessions took place in a designated
room at the GPC with a waiting area and water cooler
adjacent. The treatment room, illuminated by natural
and fluorescent light, was divided into 3 sections with
curtains that could be drawn around each section. Art
decorated the room walls and soft music was played at
all times.
Massage therapy sessions were offered for 4 weeks
at the facility by a Registered Massage Therapist
(RMT), Monday to Friday from 1 to 5 PM. Participants
were allowed to sign up for one 20-minute massage
therapy session each week. The employer allowed
22 HOLISTIC NURSING PRACTICE JANUARY/FEBRUARY 2009
participants to take a paid break from work (in
addition to regular breaks) to attend their session.
Sign-up took place in the cafeteria each prior week.
Four RMTs provided massage therapy. For the 4
weeks, 2 RMTs worked Monday to Friday, 1 worked 4
days (Monday to Wednesday and Friday), and 1
worked Thursdays only. Participants were assigned to
the next available RMT when they arrived for each
session and did not necessarily receive treatment from
the same RMT in all their sessions.
At their first session, participants completed a
medical case history form to identify contraindications
to massage therapy. The massage therapy was
performed with participants fully clothed, sitting
prone on a massage chair. On the basis of
recommendations of the Massage Therapy
Association of British Columbia, the RMTs were
instructed to use only the following treatment
techniques: tapotement (vibration, percussion),
effleurage (glide, touch, or stroke lightly), p´etrissage
(kneading, rolling, wringing), passive stretching,
grade 1 or 2 joint mobilization and traction, as well as
active and passive range of motion. Treatment was
limited to the neck, shoulders, upper back, lower back,
and arms. These treatment techniques reflected
massage therapy for the purposes of general relaxation
rather than specific therapy. Areas treated, treatment
techniques used, and home treatment
recommendations were recorded for each session.
Statistical methods
Standard descriptive statistics (eg, mean, standard
deviation, and percentage) were calculated to
demonstrate the demographics of subjects and
characterize the distribution of variables.
Questionnaires Q1, Q2, and Q3, containing 13 items
derived from QPS Nordic, were used to construct the
domains of the QPS Nordic instrument. An
exploratory factor analysis with rotated component
matrix for each questionnaire (107 subjects from Q1,
81 from Q2, and 145 from Q3) was conducted by
entering all 13 items. The results were consistent
across 3 questionnaires and the confirmed 4 domains
in terms of loading factors (0.50):
Organizational culture (6 items): [The people I work
with encourage each other to work together; consid-
ering all by efforts and achievements, I receive the
respect I deserve at work; I feel that individual differ-
ences (gender, race, education) are respected at work;
I feel that different perspectives are encouraged at
work; I feel that I get appreciated for the work I do; I
am very satisfied with my job],
Job demand (4 items): [I feel that my job is phys-
ically demanding; I feel that my job is emotionally
exhausting; over the past year, my job has become
more demanding; I feel frustrated from my work.],
and
Social interaction (2 items): [I feel that there is a
lack of recognition for good work; I feel that there is a
lack of support from management and control at work
(I have the ability to decide how I do my work)].
Internal consistency of the QPS Nordic instrument
was tested using Cronbach αcoefficient, calculated
for each domain of the QPS Nordic instrument. From
surveys Q1, Q2, and Q3, Cronbach αcoefficients were
.787, .790, and .802 for organizational culture; .703,
.740 and .707 for job demand; and .731, .893, and .821
for social interaction. Cronbach αcoefficients of .70
indicated high internal consistency.8Test-retest
reliability was assessed for the QPS Nordic instrument
by establishing the intraclass correlation coefficients
(ICCs) for Q1 and Q2 responses. The ICC values were
.711, .774, and .789 for organizational culture, job
demand, and social interaction, respectively, each
meeting the recommended threshold for test-retest
reliability (ICCs .70).8Total scores were computed
for each domain of the QPS Nordic instrument in
subjects who answered all of the questions for each
domain. Individual questions, such as control at work,
feeling exhausted, quality of working life,
willingness to recommend the program, and
willingness to participate in the program were
analyzed separately.
According to the scoring booklet for the Brief Pain
Inventory, the mean of pain severity was computed
over 4 severity items; the mean of pain interference
was computed over 7 interference items; and pain
relief was an individual question expressed as a
percentage, with 0% indicating no relief and 100%
representing complete relief. The Friedman test, a
nonparameter method, was used to test differences for
each domain of the QPS Nordic instrument, the
control at work and the individual questions, as well as
the mean pain severity and mean interference across
questionnaires 3, 4, 5, and 6. All tests were 2-sided
significance levels of P.05 estimated from
Statistical Package for the Social Sciences version 14
(Chicago, Illinois). Partially missing values were
automatically excluded from the analyses.
The Effects of Employer-Provided Massage Therapy 23
TABLE 1. Demographic data subjects at baseline
survey
Number of
subjects Mean ±SD Median Min Max
Age 98 46.4 ±8.9 48 25 62
(years)
Number of Percentage (%)
Demographic Subjects of Total
Age group, (y)
21–30 5 5.1
31–40 20 20.4
41–50 37 37.8
51–62 36 4.7
Gender
Male 21 20.2
Female 83 79.8
Job title
RCA 49 52.1
Registered nurse 16 17.0
LPN/LRN 18 19.2
OT/UC/PT/RA 11 11.7
Affiliation
HEU 19 19.6
BCNU 25 25.8
HSA 5 5.2
BCGEU 30 30.0
Other 18 18.6
Job status
Full time 73 68.9
Part time 31 21.2
Casual 2 1.9
Rotating shift
Yes 79 75.2
No 26 24.8
Shift hours
<8 17 16.0
8 78 73.6
>8 3 2.8
<8 to 8 5 4.7
8 to >8 3 2.8
RESULTS
Percentages of questionnaires returned were: 69% for
Q1; 52% for Q2; 100% for both Q3 and Q4; and 53%
for both Q5 and Q6. Table 1 provides demographic
information at baseline for 107 subjects. Mean age
was 46.4 years, with a standard deviation of 8.9 years.
Eighty percent of the participants were women. Most
participants (38%) were aged between 41 and 50 years
or between 31 and 40 years (20%). See Table 1 for
further demographic results.
Number of massage therapy sessions
Participants received up to 4 sessions of massage
therapy over a 4-week period. The average number of
participants receiving massage therapy sessions
increased each week: 17.4% (week 1), 25.7%
(week 2), 19.4% (week 3), and 37.5% (week 4).
Statistical analysis showed that the number of
massages received by a participant did not influence
their perception of psychosocial constructs.
Psychological and social constructs
As shown in Figure 2, work culture showed a
significant decrease from Q3 to Q6 (P=.01) while
massage therapy had no significant impact on job
demands, social interaction, or control at work. Data
showed trends toward improvement of quality of life
associated with the massage intervention, but this
decreased after the intervention period, as indicated by
responses in Q4 (Fig 3). There was no significant
change in staff feeling a lack of recognition in the
workplace (Fig 4) although lack of recognition scores
increased from Q3 to Q6.
Pain severity, pain interference, and pain relief
As seen in Table 2, pain severity showed significantly
different means between Q3 to Q6 (P=.038). Post
hoc analysis showed pain severity decrease
significantly between Q3 and Q4 (P=.013). However,
pain severity showed an increasing trend from Q4 to
Q6. Neither pain interference nor pain relief showed
any significant change. When only Q3 and Q4 were
considered in paired ttest (sample size increased to
n=84) there was still a statistically significant
decrease (4.33 vs 3.96, P=.026) in means between
Q3 and Q4.
Perception of massage therapy
In Q3 to Q6, respondents were asked to indicate their
perception of massage therapy. Positive perception of
massage therapy significantly increased from Q4 to
Q6 using χ2test (P=.002), with 80% of respondents
perceiving that massage therapy was effective in Q6 in
comparison with 79% in Q5 and 59% in Q4.
24 HOLISTIC NURSING PRACTICE JANUARY/FEBRUARY 2009
FIGURE 2. Measurement scores of work culture (WC), quality of work life (QOWL), and recognition at George Pearson
Centre by survey time.
DISCUSSION
In recent years, profound changes have taken place in
the nature of work.26 The most striking development
seems to be its increased psychosocial workload or
work stress. Today for many employees, and in
healthcare in particular, work poses primarily
psychological and emotional demands, instead of
physical demands, and the pace of work is more and
more dictated by patients, clients, and so on.26,27
It is also evident that the consequences of an
increased workload may be expressed in employee
adverse health, such as burnout, psychosomatic health
complaints, absenteeism, and even disability.28
Although high workload is experienced in healthcare
work, there seems to be no adequate compensation in
terms of occupational rewards like salary and
promotion prospects.29
Finally, the main reasons for work disablement are,
among other things, high job demands and poor
occupational rewards. Research has shown that this is
particularly true for work in the healthcare sector.30
Research on the Canadian workforce has
consistently indicated that healthcare workers have a
FIGURE 3. Quality of work life scores (out of 5) at George
Pearson Centre.
greater risk of workplace injuries and more mental
health problems than any other occupational group.
According to Statistics Canada, in 1999 nursing
personnel had a longer duration of time loss and were
more likely to miss work each week due to an illness
or injury than employees in any other sector or in
other types of shift-working occupations.31
Studies with on-site massage therapy programs in
healthcare demonstrate that these programs have a
positive impact on different aspects of the
participants.19
This evaluation endeavored to explore the effects of
a wellness intervention on psychological well-being
and physical health. Results demonstrated initial
benefits in terms of pain severity, with a possible
improvement in job satisfaction and morale. Massage
therapy appears to have a significant effect on pain
severity and, therefore, the greatest benefit on
individuals with preexisting musculoskeletal
symptoms. However, a long-term effect was not
demonstrated. In fact, 6 weeks after the intervention
ceased, pain symptoms became worse and, in addition,
job satisfaction decreased and lower morale was
observed. It is possible that massage therapy sessions
led participants to greater body awareness and pain
FIGURE 4. Recognition scores (out of 10) by survey time.
The Effects of Employer-Provided Massage Therapy 25
TABLE 2. Description and comparison of frontline
workers’ pain severity, pain interference, and pain
relief among Q 3, 4, 5, and 6
NMean (SD) Min Max Pa
Pain severity .038
Q3 25 4.55 (2.08) 0.25 8.50
Q4 25 4.46 (2.13) 0.50 8.00
Q5 25 5.06 (2.21) 0.00 8.25
Q6 25 5.08 (2.33) 0.75 8.00
Pain interference .188
Q3 25 3.53 (2.14) 0.14 7.71
Q4 25 3.82 (2.60) 0.00 8.86
Q5 25 4.33 (2.60) 0.00 9.14
Q6 25 4.41 (2.74) 0.00 9.14
Pain relief .504
Q3 12 42.50 (21.37) 0 80
Q4 12 50.83 (20.65) 20 80
Q5 12 57.50 (22.21) 20 90
Q6 12 53.33 (31.43) 0 90
aPvalues were derived from Friedman Test, a nonparametric test, and
the significant difference is at .05 level.
awareness. The contrast between days when massage
therapy was received with those when it was not may
have become more noticeable.
The perception of massage therapy effectiveness
increased from Q4 to Q6, possibly due to the
decreased number of respondents between Q4 and Q6,
with a higher percentage of massage therapy
“advocates” responding to the final 2 questionnaires.
However, it is also possible that, as time elapsed after
the intervention (Q4 to Q6 was 12 weeks), the
participants’ realization and perception of the benefits
of massage therapy increased.
Clinical implications
The results of this project indicate that targeted
individuals (ie, those with preexisting musculoskeletal
signs and symptoms) are most likely to benefit from a
massage therapy workplace wellness program. The
program must be sustained, as only short-term pain
relief was observed. The short-term effect may be due
to using only treatment techniques for general
relaxation rather than specific therapy. For further
impact, combining a massage therapy program with
other health and safety programs is strongly
recommended. With an aging workforce who may
have chronic conditions, a combination of relaxation
techniques with specific therapy techniques may
produce longer-lasting effects. A recent study of
psychological distress in nurse aides found that work
factors explain only a modest part of psychological
distress.32 Exposure to role conflicts and high
workloads can overcome the benefits of massage
therapy, unless the intervention is continuous.
This study was conducted using a
quasi-experimental time-series methodology, in which
baseline data is established to confirm validity of data
collected before and after the intervention. Although it
is advantageous for identifying systematic patterns
from data collected in equally spaced periods of time,
it lacks the power of a study involving a control group.
A control group was not used in this study because of
the difficulty in finding similar participants to
compliment the staff at this unique facility. Using
different wards at the GPC as a control group for each
other was considered. This idea was rejected because
of the possibility of communication between staff on
these wards influencing the results.
Funding limited the length of time of each massage
therapy session, as well as the number of weeks of
intervention. Longer massage sessions over more
weeks may have impacted the results. The massage
techniques were intentionally limited but may have
influenced the results.
We concluded that healthcare occupations are
exposed to working conditions that result in injuries
and low job satisfaction. Resulting time lost from
work or lowered performance can have detrimental
consequences for both the worker and their patients.
Employers must evaluate methods of lowering work
place injuries, tension, and stress to combat such
health and safety hazards. Massage therapy holds
much potential in benefiting healthcare workers.
Future research that probes the efficacy of this
alternative work injury prevention method can provide
beneficial results for the industry.
REFERENCES
1. Statistics Canada. 2006 Census: labour market activities, industry, occu-
pation, education, language of work, place of work and mode of trans-
portation. http://www.statcan.ca/Daily/English/080304/d080304a.htm.
Published March 4, 2008. Accessed July 3, 2008.
2. Lipscomb J, Borwegen B. Health Care workers. In: Levy B, Wegman D,
eds. Occupational Health: Recognizing and Preventing Work-Related
Disease and Injury. 4th ed. Philadelphia, PA: Lippincott Williams &
Wilkins. 2000:767–778.
3. Overview: risks and prevention of sharps injuries in healthcare per-
sonnel. In: Workbook for Designing, Implementing, and Evaluating a
26 HOLISTIC NURSING PRACTICE JANUARY/FEBRUARY 2009
Sharps Injury Prevention Program. Centers for Disease Control and
Prevention. http://www.cdc.gov/Sharpssafety/. Published February 12,
2004. Accessed March 2007.
4. Bennett J, O’Donovan D. Substance misuse by doctors, nurses and other
healthcare workers. Curr Opin Psychiatry. 2001;14(3):195–199.
5. Coggan C, Norton R, Roberts I, Hope V. Prevalence of back pain among
nurses. N Z Med J. 1994;107:306–308.
6. Elovainio M, Sinervo T. Psychosocial stressors at work, psychological
stress and musculoskeletal symptoms in the care for the elderly. Work
Stress. 1997;11:351–361.
7. Armstrong TJ, Buckle P, Fine LJ, et al. A conceptual model for work-
related neck and upper-limb musculoskeletal disorders. Scand J Work
Environ Health. 1993;19:73–84.
8. Field TM. Massage therapy effects. Am Psychol. 1998;53(12):1270–
1281.
9. Bush E. The use of human touch to improve the well-being of older
adults. A holistic nursing intervention. J Holist Nurs. 2001;19(3):256–
270.
10. Moyer C, Rounds J, Hannum J. A meta-analysis of massage therapy
research. Psychol Bull. 2004;130(1):3–18.
11. Westhof E, Ernst E. Geschichte der Massage [in German]. Dtsch Med
Wschr. 1992;117:150–153.
12. Ernst E. Massage therapy for low back pain: a systematic review. J Pain
Symptom Manage. 1999;17(1):65–69.
13. Corner J, Cawley N, Hildebrand S. An evaluation of the use of massage
and essential oils on the well-being of cancer patients. Int J PalliatNurs.
1995;1(2):67–73.
14. Hernandez-Reif M, Field T, KrasnegorJ, Theakston H. Lower back pain
is reduced and range of motion increased after massage therapy. Int J
Neurosci. 2001;106:131–145.
15. Wilkinson S, Aldridge J, Salmon I, Cain E, Wilson B. An evaluation of
aromatherapy massage in palliative care. Palliat Med. 1999;13(5):409–
417.
16. Tsao JCI. Effectiveness of massage therapy for chronic, non-malignant
pain: a review. Evid Based Complement Alternat Med. 2007;4(2):165–
179.
17. Cherkin DC, Sherman KJ, Deyo RA, Shekelle PG. A review of the
evidence for the effectiveness, safety, and cost of acupuncture, mas-
sage therapy, and spinal manipulation for back pain. Ann Intern Med.
2003;138(11):898–906.
18. Brennan MK, De Bate RD. The effect of chair massage on stress per-
ception of hospital bedside nurses. Massage Ther J. 2004;43(1):76–
89.
19. Katz J, Wowk A, Culp D, Wakeling H. Pain and tension are reduced
among hospital nurses after on-site massage treatments: a pilot study. J
Perianesth Nurs. 1999;14(3):128–133.
20. Lindstr¨om K, Elo A-L, Skogstad A, et al. User’s Guide for the QP-
SNordic: General Nordic Questionnaire for Psychological and Social
Factors at Work.TemaNord. Copenhagen: Nordic Council of Ministers;
2000:603.
21. Dallner M, Elo A-L, Gamberale F,et al. Validation of the General Nordic
Questionnaire (QPSNordic) for Psychological and Social Factors at
Work. Copenhagen: Nordic Council of Ministers; 2000:12.
22. Leboeuf-Yde C, Axen I, Jones JJ, et al. The Nordic back pain subpop-
ulation program: the long-term outcome pattern in patients with low
back pain treated by chiropractors in Sweden. J Manipulative Physiol
Ther. 2005;28(7):472–478.
23. Smith DR, Wei N, Zhao L, Wang RS. Musculoskeletal complaints and
psychosocial risk factors among Chinese hospital nurses. Occup Med.
2004;54(8):579–582.
24. Eriksen W. Service sector and perceived social support at work in Nor-
wegian nurses’ aides. Int Arch Occup Environ Health. 2003;76(7):549–
552. Epub August 5, 2003.
25. Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain
Inventory. Ann Acad Med Singapore. 1994;23(2):129–138.
26. Marmot M, Siegrist J, Theorell T, Feeney A. Health and the psychoso-
cial environment at work. In: Marmot MG, Wilkinson R, eds. Social
Determinants of Health. Oxford: Oxford University Press; 1999:105–
132.
27. de Jonge J, Mulder MJ, Nijhuis FJ. The incorporation of different de-
mand concepts in the job demand—control model: effects on health
care professionals. Soc Sci Med. 1999;48:1149–1160.
28. Schaufeli W, Enzmann D. The Burnout Companion to Study and Prac-
tice: A Critical Analysis. London: Taylor & Francis; 1998.
29. Siegrist J. Occupational health and public health in Germany. In: Le
Blanc PM, Peeters MCW, B¨ussing A, Schaufeli WB, eds. Organiza-
tional Psychology and Health Care: European Contributions. M¨unchen
und Mering: Rainer Hampp Verlag; 1999:35–44.
30. Van der Giezen AM. Women, (Working) Conditions, and Work Disable-
ment [in Dutch]. Amsterdam: LISV; 2000.
31. Akyeampong EB. Missing work in 1998—industry differences.
Statistics Canada Perspectives 1999. http://www.statcan.ca/english/
studies/75-001/archive/1999/pear1999011003s3a04.pdf. Accessed
March 2007.
32. Eriksen W, Tambs K, Knardahl S. Work factors and psychological dis-
tress in nurses’ aides: a prospective cohort study. BMC Public Health.
2006;6:290. http://www.biomedcentral.com/content/pdf/1471-2458-6-
290.pdf. Accessed March 2007.
Appendix
Q1–Q6
For each statement below, circle the number that best describes how you feel. Please circle only one number.
Strongly Strongly
Construct disagree Disagree Neutral Agree agree
Job demands 1. I feel that my job is physically
demanding
1 2 3 4 5
Job demands 2. I feel that my job is emotionally
exhausting
1 2 3 4 5
Control at work 3. I have the ability to decide how I do
my work
1 2. 3 4 5
Org. culture 4. The people I work with encourage
each other to work together
1 2 3 4 5
Job demands 5. Over the past year, my job has
become more demanding
1 2 3 4 5
The Effects of Employer-Provided Massage Therapy 27
Strongly Strongly
Construct disagree Disagree Neutral Agree agree
Org. culture 6. Considering all my efforts and
achievements, I receive the respect I
deserve at work
1 2 3 4 5
Job demands 7. I feel frustrated from my work 1 2 3 4 5
Org. culture 8. I feel that individual differences
(gender, race, education) are
respected at work
1 2 3 4 5
Org. culture 9. I feel that different perspectives are
encouraged at work
1 2 3 4 5
Org. culture 10. I feel that there is a lack of
recognition for good work
1 2 3 4 5
Social interactions 11. I feel that there is a lack of support
from management
1 2 3 4 5
Org. culture 12. I feel that I get appreciated for the
work I do
1 2 3 4 5
Org. culture 13. I am very satisfied with my job 1 2 3 4 5
Q1, Q2, Q4, Q5, Q6
14. In general, I rate my health as...
Please circle only one number where 1 is Poor and 5 is Excellent
Poor Excellent
1 2 3 4 5
Q1
15. After your last workweek, please rank the level of pain you felt in the following body parts (Please rank each
body part from 1 to 5 where 1=minimal pain and 5 =severe pain)
Neck
Shoulder
Upper back
Lower back
Arms
Q1–Q6
16. I feel exhausted at the end of my typical shift?
Please circle only one number where 1 is strongly disagree and 5 is strongly agree
Strongly disagree Disagree Neutral Agree Strongly agree
1 2 3 4 5
17. Overall, I would rate the quality of working life at George Pearson Centre as excellent?
Please circle only one number where 1 is strongly disagree and 5 is strongly agree
Strongly disagree Disagree Neutral Agree Strongly agree
1 2 3 4 5
28 HOLISTIC NURSING PRACTICE JANUARY/FEBRUARY 2009
18. I would strongly recommend this hospital to a friend looking for a job?
Please circle only one number where 1 is strongly disagree and 5 is strongly agree
Strongly disagree Disagree Neutral Agree Strongly agree
1 2 3 4 5
19. I would be willing to participate in a program designed to improve my personal wellness?
Please circle only one number where 1 is strongly disagree and 5 is strongly agree
Strongly disagree Disagree Neutral Agree Strongly agree
1 2 3 4 5
Q1
20. For the list of personal wellness programs below, rank the list from your most preferred (1st) method to your
least preferred (4th) method.
Massage Therapy: The treatment and prevention of injury and pain of muscles and joints by manual
and physical methods to develop, maintain, rehabilitate, or increase physical function to relieve pain
and promote health.
Integrative Energy Healing (IEH): The goal is to support multidimensional, human energy field
repatterning in order to awaken the body’s innate healing potential. The practitioner places his or her
hands directly above the client’s body and moves through the human energy field. Based on this
energetic assessment, the practitioner places their hands directly upon, or above, the client’s body in
order to shift their energy field into a balanced state.
Nap/sleep room: A quiet space will be provided for staff to sleep and rest
Nothing
Q1
21. For the personal wellness program, how often would you like to receive it?
Please check () only one box
!Once per week
!Every other week
!Once per month
Q2
20. The most preferred relaxation modality selected by direct-care workers at George Pearson Centre in Staff
Survey 1 was massage therapy.
How often would you prefer to receive a 20-minute massage therapy session per week?
Please check () only one box.
!Twice per week
!Once per week
Q2
21. How likely is it that you would come to George Pearson Centre to receive a 20-minute massage therapy
session if it was your day off?
The Effects of Employer-Provided Massage Therapy 29
Please circle only one number where 1 is very unlikely and 5 is very likely
Very unlikely Unlikely Neutral Likely Very likely
1 2 3 4 5
If you answered “very unlikely” or “unlikely,” what would be the main reason for your answer?
Q1
Work History
For each statement below, please indicate the answer that best describes you and your work situation.
Age (in years):
Gender: Male/Female
My job title is:
My affiliation is: Manager B.C.N.U. BCGEU
H.E.U. H.S.A Other
Status: Full time Part time Casual
Shift: Less than 8 hours 8 hour shifts More than 8 hours
Rotating shifts: Yes No
Total years working at George Pearson Centre: years
Q3–Q6 Brief Pain Inventory (Short Form)
1. Throughout our lives, most of us have had pain from time to time (such as minor headaches, sprains, and
toothaches). Have you had pain other than these everyday kinds of pain today?
1. Yes 2. No
2. On the diagram, shade in the areas where you feel pain. Put an X on the area that hurts the most.
3. Please rate your pain by circling the one number that best describes your pain at its worst in the last 24 hours.
0 12345678910
No Pain Pain as bad as you can imagine
30 HOLISTIC NURSING PRACTICE JANUARY/FEBRUARY 2009
4. Please rate your pain by circling the one number that best describes your pain at its least in the last 24 hours.
0 12345678910
No Pain Pain as bad as you can imagine
5. Please rate your pain by circling the one number that best describes your pain on the average.
0 12345678910
No Pain Pain as bad as you can imagine
6. Please rate your pain by circling the one number that tells how much pain you have right now.
0 12345678910
No Pain Pain as bad as you can imagine
7. What treatments or medications are you receiving for your pain?
8. In the last 24 hours, how much relief have pain treatments or medications provided? Please circle the one
percentage that most shows how much relief you have received.
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
No relief Complete relier
9. Circle the one number that best describes how, during the past 24 hours, pain has interfered with your:
A. General activity
0 12345678910
Does not interface Completely interfaces
B. Mood
0 12345678910
Does not interface Completely interfaces
C. Walking ability
0 12345678910
Does not interface Completely interfaces
D. Normal work
0 12345678910
Does not interface Completely interfaces
E. Relations with other people
0 12345678910
Does not interface Completely interfaces
F. Sleep
0 12345678910
Does not interface Completely interfaces
G. Enjoyment of life
0 12345678910
Does not interface Completely interfaces
The Effects of Employer-Provided Massage Therapy 31
Q4
How did massage therapy help or not help you complete day-to-day tasks?
Please give specific examples.
Q5
18. Did you participate in the massage therapy program at George Pearson Centre in May and June 2005?
No
Yes
Q5, Q6
19. I would like to see a massage therapy program continue at George Pearson Centre.
Please circle only one number where 1 is strongly disagree and 5 is strongly agree
Strongly disagree Disagree Neutral Agree Strongly agree
1 2 3 4 5
Please provide comments (for example, how long and how often?).
Intake (Q4), Q5, Q6
20. Are you currently receiving massage therapy?
a. No
b. Yes If yes, how long and how often are your sessions?
Q6
21. Were you receiving massage therapy before this study?
a. No
b. Yes If yes, how long and how often were your sessions?
Please comment.
Q5
22. What positive or negative changes did you notice in your life since the completion of the massage therapy
sessions at George Pearson Centre? Please give specific examples.
Q6
23. What positive or negative changes did you notice in your life after the massage therapy program at George
Pearson Centre was finished in June? Please give specific examples.
Intake (Q4), Q5, Q6
18. What is your perception of massage therapy?
It is effective
It is not effective
Don’t know/unsure
Q6
1. Please provide any additional comments about the way this study was run.
... Aromatherapy with lavender essential oil reduced job stress among nurses [24]. Massage therapy led participants to greater body awareness, but no impact on job demands, social interaction, or control at work for long-term care staff [37]. erefore, the cumulative effect of aromatherapy massage with lavender essential oil and a state of rest during interventions could reduce personal burnout and work-related burnout as found in the present study, which were supported by the literature. ...
... Subjects need to return to work after completing the intervention. Exposure to role conflicts and high workloads can overcome the benefits of massage therapy [37]. ese might be the reasons that subjects in the control group reported higher client-related burnout after intervention. ...
Article
Full-text available
Background: Occupational stress is a common issue faced by workers in every discipline. Complementary and alternative medicine (CAM) therapies, such as aromatherapy massage or massage, have antistress effects in the literature. The purpose of this randomized clinical trial with triple blinds is to evaluate the immediate effects of lavender aromatherapy massage for improving work stress, burnout, and HRV parameters of female employees in a university. Methods: A total of 53 subjects in experimental group whereas 57 subjects in control group completed interventions and measurement and led to power of 0.98. Inferential statistics, as independent t-test, paired t-test, and Chi-Square test, were performed to verify the expected relationships. Results: The present study found that subjects in experimental group reported a lower role stress and less inclined to type A personality trait after aromatherapy massage with lavender. For control group, only less inclined to type A personality trait was reported after receiving massage. For burnout, a significant lower personal burnout and work-related burnout were reported after aromatherapy massage whereas only increased client-related burnout was reported in control group. For HRV, both the experimental and control groups reported higher SDNN and RMSSD in time domain after intervention. Contradictory HRT and PSI in time domain were significantly lower after intervention. In frequency domain of HRV, both groups reported significantly higher value in VLF and HF. In addition, the experimental group reported significantly higher value in TP and LF after intervention. Conclusions: Both the lavender aromatherapy massage and massage did show immediate effect on different dimensions of work stress, burnout, and HRV. These two interventions can be applied as routine leisure activities by personal preference to reduce stresses occurring in work environment.
... It is therefore worthwhile to develop preventive methods that could mitigate the workrelated distress. Different massage routines of muscle therapy has hitherto been investigated (Cook et al. 2015;Cheng and Huang 2014;Topolska et al. 2012;Back et al. 2009;Moyer et al. 2004), but the study paradigms are all too often of subjective nature; thus the hard evidence of beneficial effects is hard to come across. One of the more objective methods is a musculoskeletal massage with the use of a specially adapted chair, the so called 'chair massage' taking place directly in the workplace (Cabak et al. 2016;Stephens 2005). ...
... Similar effects have also been noted with 30-min massage sessions in case of sonographers (Engen et al. 2010). Back et al. (2009) have conducted research in a group of 145 healthcare workers with a program consisting of 20-min massage sessions once a week for 4 weeks, performed in a specially prepared room with a relaxing natural light and decor, and soft background music. Those authors pointed to the short-term relaxing effects, suggesting the need for longer and more frequent than once a week sessions. ...
Chapter
Full-text available
People working at computers often suffer from overload-related muscle pain, and physical and mental discomfort. The aim of the study was to evaluate the effectiveness of chair massage, conducted in the workplace among white-collar workers, in relieving symptoms of musculoskeletal strain related to prolonged sitting posture. The study was conducted in 124 white-collar workers, 55 women and 69 men, aged 33.7 ± 7.6 years. Subjects were randomly assigned to three groups: chair massage program, relaxing music sessions, and a control group, each of four-week duration. Each group was evaluated before and after the program completion. Pain perception was assessed algometrically as a threshold for compression pain of neck muscles, measured in kg/cm². The relaxation level was assessed from the heart rate variability. We found that the chair massage increased both the pain threshold in all tested muscles (p < 0.001) and the relaxation level from 31.9% to 41.6% (p < 0.05). In the group with music sessions, muscle pain threshold remained unchanged, except for the trapezoid muscle where it decreased (p < 0.05), while the relaxation level increased from 26.0% to 33.3% (p < 0.05). In both massage and relaxing music groups, there was a significant decrease in muscle tension (p < 0.01). Changes in the control group were inappreciable. We conclude that the chair massage performed in the workplace is an effective method for prevention of musculoskeletal overstrain related to prolonged sitting posture. The program seems worth implementing in various occupational environments.
... (12) Chair massage has demonstrated, in one study, to improve pain severity in patients with pre-existing musculoskeletal discomfort. (13) With ingenuity, most bodily complaints can be addressed with chair massage, making the massage chair ideal for treatment in remote rural areas. ...
... The effectiveness of the treatments was facilitated by the desire of the patient to heal and follow home health care instructions. While this case showed promising results, investigating demonstrates pre-existing musculoskeletal disorders and pain may be eliminated with chair massage, (13) as was seen in this case. Research has demonstrated that massage facilitates a significant increase in ROM, improved function, and decreased pain; (20) MERYANOS: UTILIZING CHAIR MASSAGE IN GHANA (20) Mobilize finger joint with traction, Shear lateral-medial and anterior-posterior And rotate at each joint capsule. ...
Article
Full-text available
Background and Objectives There is limited access to health care in rural Ghana and virtually no rehabilitative services available. This situation presents a unique opportunity to utilize chair massage in addressing women’s health in rural Ghana, particularly when it comes to muscle pain and fatigue from heavy labor. The objective of this case report is to determine the results of chair massage as a strategy to reduce neck, shoulder, and back pain, while increasing range of motion. Case Presentation The patient is a 63-year-old Ghanaian female, who was struck by a public transport van while carrying a 30–50 pound load on her head, two years prior. The accident resulted in a broken right humerus and soft tissue pain. A traditional medicine practitioner set the bone, however there was no post-accident rehabilitation available. At the time of referral, she presented complaints of shoulder, elbow, and wrist pain. In addition, she was unable to raise her right hand to her mouth for food intake. Results The results of this case report include an increase in range of motion, as well as elimination of pain in the right shoulder, elbow, and hand. Visual assessments showed an approximate increase of ROM within the ranges of 45–65 degrees in the right arm, as well as 10–15 degrees in 4th and 5th fingers. There was also a decrease in muscle hypertonicity in the thoracic and cervical areas, and a profound increase in quality of life for the patient. Discussion This case report illustrates how therapeutic chair massage was utilized to address a common health concern for one woman in rural Ghana. It also demonstrates that pre-existing musculoskeletal disorders and pain may be eliminated with massage intervention. Massage therapy may be important to ameliorating certain types of health problems in remote rural villages in low income countries.
... w miej scu pra cy, tam gdzie oso by na ra żo ne są na prze cią że nia na rzą du ru chu, przede wszyst kim okolic krę go słu pa i koń czyn gór nych. Ba da nia na ten temat prze pro wa dzi li już in ni au to rzy, wska zu jąc również na zna cze nie te ra peu tycz ne w aspek cie zdro wia psy cho so ma tycz ne go [13][14][15][16][17][18][19]. ...
... This form of massage is often combined with health education and advice concerning workplace ergonomics and can be performed, for instance, in the workplace, where people are at risk of mus cu loskeletal overload mainly in the region around the spine and in the upper limbs. This issue has already been studied by other authors, who also indicated its therapeutic importance with respect to psychoso matic health [13][14][15][16][17][18][19]. ...
Article
Full-text available
Background: Accumulation of musculoskeletal overload experienced daily over a long period, for months or even years may lead to serious health problems. Simple, quick and easy-to-administer prophylactic and therapeutic interventions not involving complicated medical procedures can bring tangible benefits for sufferers. The aim of the study was to evaluate the efficacy and effects of a massage programme performed during breaks at work among persons exposed to long-term overload of the spinal column and areas around the spine. Material and methods: We studied 50 office workers (20 women and 30 men, mean age 34.04 years). The subjects were randomly divided into an experimental group (massage, 25 people) and a control group (25 people). The study was completed in four weeks, during which 8 massage sessions took place (twice a week for 15 minutes). Subjective assessment tools were used, namely the IPAQ-short version for evaluation of physical activity, Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) for assessment of musculoskeletal pain and a survey to assess the participants' satisfaction with the massage programme. An objective assessment tool was an algometric evaluation of the pain threshold (kg/cm2) in selected muscle trigger points. Statistical significance of differences was set at p <0.05. Results: The level of physical activity was comparable between the groups, with 42% of the experimental group and 40% in the control group declaring a high level of physical activity. According to the CMDQ, the biggest differences after massage were noted with regard to the reduction of pain in the lower and upper spine and the right arm (p <0.001), while slightly smaller improvements were noted in the right shoulder and left forearm (p <0.05). In other parts of the body and in the control group, the changes were not statistically significant. The pain threshold assessed by algometry increased at all points examined in the experimental group, with pain sensitivity decreasing the most in the trapezius and supraspinous muscles on the left side of the spine (p <0.001). In the control group, the changes were not significant. Conclusions: 1. The proposed programme of chair massage in the workplace proved to be effective in relieving musculoskeletal overload and discomfort of the spine and upper limbs. 2. The advantages of this method include its accessibility, cost-effectiveness, ease of administration in different places and short treatment time. It seems advisable to popularise it and increase its use in practice in the prevention of physical and mental work-related overload.
... The proposition investigated using GTM is: workplace health and wellness issues, with many of the researchers recommending that it would be extremely beneficial to employees if these therapies were made available in the workplace (Airosa et al., 2011;Back, Tam, Lee, & Haraldsson, 2009;Bost & Wallis, 2006;Dicker, 2005;Klatt, Buckworth, & Malarkey, 2009;Pipe et al., 2009). ...
... It is important to reflect that for both modalities researchers recommendations are consistently that if incorporated to workplace wellness programs they need to be sustained for comprehensive benefit to employees (Back et al., 2009). ...
Thesis
Full-text available
Concern with employee health and wellbeing and the resulting financial cost of rising healthcare, absenteeism and loss of productivity, has seen the wide-spread incorporation of workplace wellness practice. Wellness has different meanings for different groups. Workplace wellness programs tend to focus on the illness and health related aspects of the workforce and have also been criticized for not incorporating elements for healthy people within the workforce. Redefining wellness and its connection to engagement and the workplace, has been suggested as a new approach for business strategy, and involves thinking outside the realm of health promotion techniques to therapies which have evidence of supporting employee wellness. Traditionally, spas and wellness centers are ideal places for the practice of wellness. Massage and meditation, two modalities offered at spas and wellness centers have been researched in depth and through this literature and practice, significant evidence indicates that they are shown to be effective and have lasting benefits for workers. This study uses the qualitative methodologies of grounded theory and exploratory case study to consider the plausibility of a spa industry and workplace wellness program integration, through the use of spa modalities of massage and meditation, with the purpose of providing more effective wellness outcomes for employees. The grounded theory component succeeds in its aims and determines, through a research synthesis of 25 studies conducted in a workplace environment and three meta-analyses, that both massage and meditation are efficacious therapies for reducing or at least managing stress and anxiety, improving mood, emotions, alertness, attention and self-awareness in employees in the workplace. They are therapies that are easy and cost effective to implement and have high compliance and utilization amongst the workforce. The exploratory case study design, although not yet concluded, proposes to investigate the construct that spas and wellness centers are best placed to provide these therapies, and that integration may better support employee wellness in the workplace. The results of this study may be a catalyst for the development of an integrative model of wellness programs which can be taken into the workplace. It suggests that workplace wellness program design should account for the needs and desires of all employees to attain optimum wellness, regardless of health status. Implementing the strategy has the potential to enable research on a much wider scale with future work involving wellness assessments of employees who use the therapies provided by the proposed integration in order to build empirical evidence and develop best practice for
... Besides, if stress is not adequately addressed and properly managed in the right way, it can lead to many physical and psychological symptoms of EMS staff [19]. Some of such symptoms refer to anxiety [20,21], depression [22], , sleep disorders, fatigue and unsafe behavior [23], gastrointestinal symptoms, backache [24], diminished occupational satisfaction [25], occupational burnout [26], emotional disturbance, and depersonalization [27,28]. ...
Preprint
Full-text available
Background: The Emergency Medical Services (EMS) Center is a community-centric that coordinates with the entire health care system. Employees are the most crucial asset of this medical center. This present study investigates the role of demographic variables associated with 115 disasters and the occupational stress of emergency medical management center personnel in 2019. Methods: This present descriptive study selected a statistical population based on 200 medical personnel associated with disaster and emergency medical management center 115 in Iran, according to inclusion chosen criteria. The review used a scale consisting of two parts, including demographic information and HSE standard questionnaire. The study selected respondents through Cochran's Sample Size Formula using stratified random sampling with a cross-sectional research design for data collection. The study has analyzed received data by using SPSS version 24 and performed the descriptive and inferential statistics (t-test and one-way ANOVA) at a significance level p<0.05. Results: The study results showed the mean score of total occupational stress 3.41±0.26. The results showed the highest (4.34±0.35) and the lowest stress levels (2.72±0.86) related to role dimensions. The study findings revealed a significant relationship between stress level and participants’ age, marital status, educational level, type of base, workplace, and the number of work hours per month. There was no relationship between the type of employment and work experience with stress levels. Conclusion: Emergency medical personnel experience a high level of occupational stress. Senior managers can use similar studies to implement measures to reduce the experience of employees' stress.
... Based on this study results it can be useful to extend the study period. This is also the recommendation from Back and colleagues who highlighted that the number of weeks of intervention can influence the outcome of studies with massage interventions [26]. It also important to increase the number of participants in each study group and the result from the present study can serve as a base when performing power calculations for future studies. ...
Article
Full-text available
Introduction: Inability to relax and recover is suggested to be a key factor for stress-related health problems. This study aimed to investigate possible effects of mechanical massage and mental training, used either separately or in combination during working hours. Methods: Employees were randomly assigned to one of the following groups: i) Mechanical massage combined with mental training (n = 19), ii) Mechanical massage (n = 19), iii) Mental training (n = 19), iv) Pause (n = 19), v) Control (n = 17). The study lasted for eight weeks. Heart rate, blood pressure and fingertip temperature were measured at start, after four and after eight weeks. Results: Between-group analysis showed that heart rate differed significantly between the groups after 4 weeks (p = 0.020) and tended to differ after eight weeks (p = 0.072), with lowest levels displayed in the massage group and the control group. Blood pressure and fingertip temperature did not differ between the groups. Within-group analysis showed that mechanical massage decreased heart rate (p = 0.038) and blood pressure (systolic p = 0.019, diastolic p = 0.026) and increased fingertip temperature (p = 0.035). Mental training programs reduced heart rate (p = 0.036). Combining the two methods increased diastolic blood pressure (p = 0.028) and decreased fingertip temperature (p = 0.031). The control group had a significant decrease in systolic blood pressure during the first four weeks of the study (p = 0.038). . Conclusion: Receiving mechanical massage and listening to mental training programs, either separately or in combination, during working hours had some positive effects on the employees' heart rate, blood pressure and fingertip temperature. The effects were especially strong for employees who received mechanical massage only.
... Based on this study results it can be useful to extend the study period. This is also the recommendation from Back and colleagues who highlighted that the number of weeks of intervention can influence the outcome of studies with massage interventions [26]. It also important to increase the number of participants in each study group and the result from the present study can serve as a base when performing power calculations for future studies. ...
Article
Full-text available
Background: Working people’s reduced ability to recover has been proposed as a key factor behind the increase in stress-related health problems. One not yet evidence-based preventive method designed to help employees keep healthy and be less stressed is an armchair with built-in mechanical massage and mental training programmes, This study aimed to evaluate possible effects on employees’ experience of levels of “Anxiety”, “Stress Susceptibility”, “Detachment” and “Social Desirability” when using mechanical massage and mental training programmes, both separately and in combination, during working hours. Method: Employees from four different workplaces were randomly assigned to one of the following groups: i) Massage and mental training (sitting in the armchair and receiving mechanical massage while listening to the mental training programmes, n=19), ii) Massage (sitting in the armchair and receiving mechanical massage only, n=19), iii) Mental training (sitting in the armchair and listening to the mental training programmes only, n=19), iv) Pause (sitting in the armchair but not receiving mechanical massage or listening to the mental training programmes, n=19), v) Control (not sitting in the armchair at all, n=17). In order to discover how the employees felt about their own health they were asked to respond to statements from the ”Swedish Scale of Personality” (SSP), immediately before the randomisation, after four weeks and after eight weeks (end-of-study). Results: There were no significant differences between the five study groups for any of the traits studied (“Somatic Trait Anxiety”, “Psychic Trait Anxiety”, “Stress Susceptibility”, “Detachment” and “Social Desirability”) at any of the occasions. However, the massage group showed a significant decrease in the subscale “Somatic Trait Anxiety” (p=0.032), during the entire study period. Significant decreases in the same subscale were also observed in the pause group between start and week eight (p=0.040) as well as between week four and week eight (p=0.049) and also in the control group between the second and third data collection (p=0.014). The massage and mental training group showed a significant decrease in “Stress Susceptibility” between week four and week eight (p=0.022). The pause group showed a significant increase in the subscale “Detachment” (p=0.044). Conclusion: There were no significant differences between the five study groups for any of the traits studied. However, when looking at each individual group separately, positive effects in their levels of “Anxiety”, “Stress Susceptibility” and “Detachment” could be seen. Although the results from this pilot study indicate some positive effects, mechanical chair massage and mental training programmes used in order to increase employee’s ability to recover, needs to be evaluated further as tools to increase the employees ability to recover. Australian New Zealand Clinical Trials Registry: ACTRN12615000020583, Date of registration: 15/01/2015.
Article
Full-text available
Background Results of various studies indicate that emergency medical service (EMS) staff suffer from occupational stress that adversely affects their quality of life and their care quality. Purpose This study aimed at determining the effect of massage on occupational stress experienced by emergency medical service staff. Setting Prehospital emergency medical services stations of a city in the southwest of Iran. Participants A total of 58 members of staff of the emergency medical services, working in prehospital emergency medical services stations. Research Design In this randomized controlled trial, a total of 58 EMS staff were selected from prehospital EMS stations, according to inclusion and exclusion criteria, and then assigned in two groups (29 in massage and 29 in control group) randomly by the minimization method. The intervention group received Swedish massage, twice a week for four weeks in the morning after the end of the work shift. Each massage session lasted 20–25 minutes. Subjects in the control group received no intervention. The level of occupational stress of the two groups was measured under the same conditions before and after the intervention by using the expanded nurses’ occupational stress scale (ENSS). Data were analyzed with the SPSS16 software by using the chi-squared test, paired and independent-sample t tests, one-way ANCOVA. P value < .05 was considered as the level of significance. Results The mean and SD of total occupational stress scores in the control group was 114.41±30.11 in pretest and reach to 112.58± 30.62 in posttest stage. Also the mean and SD of total occupational stress scores in the intervention group was 130.20±26.45 in pretest and reach to 110.41±21.75 in posttest stage. A one-way ANCOVA showed that there is a significant effect of massage on EMS staff’s occupational stress level after controlling for pretest score (p = .001). Conclusions The training and the application of massage therapy can serve as an effective method in reducing occupational stress in emergency medical centers.
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Hintergrund Die Prävalenz, Diagnostik und Therapie des Burnout-Syndroms wird in der (Fach)Öffentlichkeit zunehmend diskutiert. Wissenschaftlich wird die unklare Definition und Diagnostik des Burnout-Syndroms kritisiert. Zur Behandlung des Burnout werden verschiedene Therapien mit unklarer Evidenz angeboten. Fragestellungen Der Health Technology Assessment (HTA)-Bericht befasst sich mit der Frage, welche Therapien zur Behandlung des Burnout-Syndroms eingesetzt werden und wie wirksam diese sind. Methodik Die relevante Studienliteratur ist anhand von Schlagworten in 31 Datenbanken (u.a. EMBASE, MEDLINE, PsycINFO) für den Zeitraum 2006 bis 2011 gesucht worden. Wichtige Einschlusskriterien sind Burnout, therapeutische Intervention und Treatment outcome. Ergebnisse 17 Studien erfüllen die Einschlusskriterien und werden für den HTA-Bericht berücksichtigt. Die Studien sind sehr heterogen (Fallzahl, Stichprobe, Intervention, Messverfahren, Evidenzlevel). Sie haben aufgrund ihres Studiendesigns (u.a. vier Reviews, acht randomisierte kontrollierte Studien) eine vergleichsweise hohe Evidenz: dreimal 1A, fünfmal 1B, einmal 2A, zweimal 2B und sechsmal 4. 13 der 17 Studien befassen sich mit der Wirkung von Psychotherapie und psychosozialen Interventionen (teilweise in Kombination mit anderen Techniken) auf die Reduktion von Burnout. Der Einsatz kognitiver Verhaltenstherapie (KVT) führt in der Mehrheit der Studien zu Verbesserungen der emotionalen Erschöpfung. Die Evidenz der Wirkung von Stressmanagementtraining auf die Reduktion des Burnout ist ebenso wie die Wirkung von Musiktherapie uneinheitlich. Zwei Studien zur Wirksamkeit der Qigong-Therapie kommen zu keinem eindeutigen Ergebnis. Durch eine Studie mit dem Evidenzgrad 1B wird die Wirksamkeit von Rhodiola rosea (Rosenwurz) belegt. Physiotherapie wird nur in einer Studie isoliert untersucht und ist dort der Standardtherapie nicht überlegen. Diskussion Trotz einer Reihe von Studien mit hohen Evidenzleveln haben die Aussagen zur Wirksamkeit von Burnout-Therapien vorläufigen Charakter und sind von begrenzter Reichweite. Die Autoren der Studien beklagen die zu geringe Anzahl qualifizierter Studien zur Therapie des Burnout-Syndroms und weisen auf die unzureichende Evaluation von Therapiestudien sowie auf die Notwendigkeit weiterer Forschung hin. Einige Autoren berichten beträchtliche Effekte natürlicher Erholung. Zahlreiche Einschränkungen beeinträchtigen die Qualität der Ergebnisse. Interventionsinhalte und -dauer, Studiendesign und Untersuchungspopulationen sind sehr unterschiedlich und lassen direkte Vergleiche nicht zu. Die Stichproben sind überwiegend klein mit geringer statistischer Power, es fehlen längerfristige Follow-up. Komorbiditäten und parallel in Anspruch genommene Therapien sind unzureichend erfasst bzw. kontrolliert worden. Die weit überwiegende Anzahl der Studien verwendet das Maslach Burnout Inventar, dessen klinische Validität nicht bewiesen ist, als Diagnose- und/oder Outcome-Tool, mit jeweils verschiedenen Cut-off-Werten, zur Bestimmung des (schweren) Burnout. Ethische, soziale und rechtliche Rahmenbedingungen werden in den Studien nicht behandelt. Schlussfolgerung Die Wirkung der Therapien, die zur Behandlung des Burnout-Syndroms eingesetzt werden, ist unzureichend erforscht. Es liegt nur zur Wirkung der KVT eine hinreichend große Anzahl von Studien vor, die die Wirksamkeit der KVT belegen. Es fehlen große langfristig angelegte experimentelle Studien, die die einzelnen Therapien in ihrer Wirkung vergleichen und evidenzbasiert evaluieren. Auch die ohne Einfluss einer bestimmten Therapie erreichte „natürliche“ Erholung ist näher zu untersuchen. Es ist außerdem zu prüfen, inwieweit Therapien und ihre mögliche Wirkung durch die Bedingungen am Arbeitsplatz und die Arbeitsplatzsituation konterkariert werden.
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Burnout is a common metaphor for a state of extreme psychophysical exhaustion, usually work-related. This book provides an overview of the burnout syndrome from its earliest recorded occurrences to current empirical studies. It reviews perceptions that burnout is particularly prevalent among certain professional groups - police officers, social workers, teachers, financial traders - and introduces individual inter- personal, workload, occupational, organizational, social and cultural factors. Burnout deals with occurrence, measurement, assessment as well as intervention and treatment programmes.; This textbook should prove useful to occupational and organizational health and safety researchers and practitioners around the world. It should also be a valuable resource for human resources professional and related management professionals.
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