Effect of massage therapy in reducing signs of stress on premature infants

Abstract

Prematurity is a common health issue worldwide. In Hong Kong, the rate of prematurity is in an increasing trend, from 4.7% in 1999 to 5.1% in 2004 (Tertiary-wide Obstetric & Gynecology Audit Report, 2004). Preterm infants are usually required to hospitalize in neonatal intensive care unit (NICU) which expose them to certain stressors such as noise, caregiver procedure, medical manipulations and pain (Harrison et al., 2003). Stress would lead to certain illnesses likes metabolic and cardiovascular disorders (Caldji, Diorio, & Meaney, 2000). Facing stress of preterm infants not only affects the developmental and neurodevelopment outcome but also increase the morbidity and mortality (Mitchell & Boss, 2002). Preterm birth is a complicated health problem which affects the infant itself and also increase the burden to society as it costs nearly US$26 billion dollars per year for both inpatient and outpatient care (Richard & Adrienne, 2007). Although there were many known benefits of massage therapy in premature infants and the safety of practicing was being acknowledged, massage therapy is still not being practiced in Hong Kong health care settings. Massage therapy was effective in reducing signs of stress on premature infants and could be performed by parents safely as evidenced by six researches (Dieter, Field, Hernandez-Reif, Emory, & Redzepi, 2003; Hernandez-Reif, Diego, & Field, 2007; Lee, 2005; Kuhn, Schanberg, Field, Symanski, Zimmerman, Scafidi, & Roberts, 1991; Smith, Kux, Haley, Beechy, & Moyer-Mileur, 2012; Wheeden, Scafidi, Ironson, Valdeon, & Bandstra, 1993). Based on the evidence, a new evidence-based practice was developed for reducing signs of stress of premature infant by using massage therapy in NICU. Implementation potential was reviewed in relation to target setting, transferability of findings and cost-benefit analysis. Implementation plan was developed. Stakeholders were identified and communication process was discussed in details. Pilot testing would be carried out to assess the feasibility of implementing the guideline. Finally, evaluation on patient, parents and healthcare providers’ outcome were required in implementing this new change smoothly.