The Effect of Hand Massage Before Catara

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Journal of PeriAnesthesia Nursing 35 (2020) 54e59

Contents lists available at ScienceDirect

Journal of PeriAnesthesia Nursing


journal homepage: www.jopan.org

Research

The Effect of Hand Massage Before Cataract Surgery on Patient Anxiety


and Comfort: A Randomized Controlled Study
Ayşe Uyar Çavdar, RN a, Emel Yılmaz, PhD b, *, Hakan Baydur, PhD c
a
Department of Surgical Nursing, Institute of Health Science, Manisa Celal Bayar University, Manisa, Turkey
b
Department of Surgical Nursing, Faculty of Health Science, Manisa Celal Bayar University, Manisa, Turkey
c
Department of Social Work, Faculty of Health Science, Manisa Celal Bayar University, Manisa, Turkey

a b s t r a c t
Keywords: Purpose: This study aimed to determine the effectiveness of hand massage on patient anxiety and
cataract surgery comfort before cataract surgery.
hand massage
Design: A randomized controlled trial.
anxiety
patient comfort
Methods: The 140 patients in this study were assigned to the intervention group (n ¼ 70), which received
a 10-minute hand massage before cataract surgery, and to the control group (n ¼ 70), which received
routine nursing care. The visual analog scale (VAS) and Spielberger State-Trait Anxiety Inventory (STAI)
were used to collect data.
Findings: The median STAI state scores of the intervention and control groups were found to be 46.0
(44.7 to 48.0) and 57.0 (55.75 to 59.00), respectively. The VAS comfort score of the intervention group
after hand massage (4.0 [1.7-5.0]) was lower than that of the control group immediately before surgery
(8.0 [6.0-10.0]) (P < .05). In addition, except oxygen saturation, the remaining vital signs were lower in
the intervention group.
Conclusions: Hand massage reduced the anxiety of patients, positively affected their vital signs, and
increased their comfort.
© 2019 American Society of PeriAnesthesia Nurses. Published by Elsevier, Inc. All rights reserved.

The presence of cataracts is the second cause of blindness in the surgery under local anesthesia may create anxiety because of
world and the cause of moderate and severe visual impairment anesthesia, fear of the operation itself, and worries about the
according to the Global Burden of Disease.1-3 With the aging pop- outcome. Therefore, the patients usually have elevated levels of
ulation, 5-10 million new cases of cataracts occur every year.4 anxiety. Anxiety is a common cause of stress for patients under-
Cataract surgery is one of the most frequently performed opera- going cataract surgery, as the procedure is performed while the
tions in many countries, offering significant increases to the quality patient is awake. Worries related to loss of control and a foreign
of life for patients of all ages.5 environment can create high levels of perioperative anxiety for
In recent years, cataract surgery is generally performed in an these patients. Besides, some patients suffer fear under the drape or
ambulatory setting under local anesthesia to ensure a better pro- experience frightening visual sensations during surgery. Anxiety
cedural safety profile and quicker patient recovery and reduce the activates the stress response, inducing the release of norepineph-
postoperative complications of general anesthesia.6 Cataract rine and epinephrine, which raises heart and respiration rates,
blood pressure, and pupil dilation. Furthermore, the cooperation of
the patient may be compromised during surgery, which results in
involuntary movements and even complications.7-10
This study was accepted in the Master's Program of Celal Bayar University
Institute of Health Science, Department of Surgical Nursing, in Turkey in 2016. It Patient calmness during surgery improves patient comfort,
was also presented at the Second International Congress of Graduate Students held makes it easier for the surgeon to operate, and reduces surgical
on May 12-14, 2017. complications.6,11 Pharmacologic techniques are used to manage
Conflict of interest: None to report. anxiety during operation.11 However, in the recent years, several
* Address correspondence to Emel Yılmaz, Manisa Celal Bayar University, Faculty
of Health Science, Department of Surgical Nursing, Uncubozko €y Sag
lık Yerleşkesi studies were published on nonpharmacologic methods of anxiety
(I_IBF
_ Eski Binası) 45030 Yunusemre, Manisa, Turkey. management because of the side effects of pharmacologic drugs
E-mail address: [email protected] (E. Yılmaz). during local anesthesia.8,12-14 Hand massage, which is one of the

https://doi.org/10.1016/j.jopan.2019.06.012
1089-9472/© 2019 American Society of PeriAnesthesia Nurses. Published by Elsevier, Inc. All rights reserved.
Çavdar et al. / Journal of PeriAnesthesia Nursing 35 (2020) 54e59 55

nonpharmacologic methods, accelerates circulation, relieves mus- instance, phlebitis, inflammation, arthritis, eczema, wound, and
cle spasms, loosens the muscles, and relaxes the patient during the rash; and emergency cases.
perioperative time.15 This method is one of the most common
professional nursing interventions that is easily learned, noninva-
sive, and inexpensive.16-18 A preoperative hand massage improves Data Collection
patient compliance and comfort in the perioperative period by
reducing the anxiety caused by the procedure. In addition, it is also The data were collected using a personal information form, the
easily accepted by patients and increases communication with the visual analog scale (VAS), and the Spielberger State-Trait Anxiety
medical staff, reduces complications, and contributes to the faster Inventory (STAI).
recovery of patients.12,13 Personal information form: This form contained questions
Hand massage was shown to be effective in decreasing anxiety regarding the sociodemographic characteristics of the patients such
during ophthalmology surgery in previous studies.12,13 Oh and as age, gender, education level, duration of cataract diagnosis, and
Park14 assessed the effectiveness of hand massage on anxiety other system diseases. The form was prepared by the researchers
management in patients during local anesthesia. The results indi- according to literature.
cated that the decrease in anxiety level was significant in patients. VAS: This scale was used to quantify the subjective pain and
Similarly, Brand et al19 reported that hand massage decreased the comfort of patients. The VAS is a 10 cm horizontal line anchored by
anxiety of ambulatory surgery patients. In addition, hand massage “0 ¼ no pain ¼ most comfortable” on the left and “10 ¼ extreme
was studied in different populations, including patients awaiting pain ¼ least comfortable” on the right.26
coronary angiography,20 terminally ill patients,21 elderly,22 patients STAI: The scale was developed by Spielberg et al27 and adapted
experiencing hand pain,23 burn patients,24 and intensive care unit €
into Turkish by Oner and Le Compte.28 The STAI is a 40-item scale.
patients,25 and found to have a marked effect in reducing anxiety. This inventory contains two self-report scales. The scale evaluates
However, in Turkey, there are no evidence-based studies evaluating two different dimensions of anxiety: state anxiety (STAI-S) and trait
the effects of preoperative hand massage on cataract surgery pa- anxiety (STAI-T). Each question is rated by a 4-point Likert scale
tients. The purpose of this study was to evaluate the effect of hand scoring from 1 to 4. The scores from the subscales range from 20 to
massage on anxiety and comfort of patients before performing 80. The higher scores define greater levels of anxiety.28
cataract surgery.

The Intervention
Methods
At the beginning of the study, the patients were informed about
Study Design and Setting
the purpose of the study, and their written and verbal consents
were obtained. The personal information form was completed
This study is a parallel-group randomized controlled trial. The
through a face-to-face interview in the patient's room at the
study was conducted between February 2015 and November 2015
ophthalmology clinic. In addition, the anxiety and comfort levels of
in an ophthalmology clinic of a university hospital in the western
the patients were evaluated using STAI and VAS, respectively. The
Turkey. The hospital has a capacity of 610 beds, with 22 being
vital signs of the patients (systolic and diastolic blood pressure,
located in the ophthalmology clinic.
pulse, respiration rate, and oxygen saturation) were measured and
recorded using a noninvasive bedside monitor (Datex Ohmeda, GE
Sample Healthcare, Helsinki, Finland).
Immediately before the operation, the palms, backs of the
The study sample size was determined in the PASS program hands, and fingers of the patients were massaged for 10 minutes
using the Student t test, taking the anxiety values as a reference as with baby oil using patting, kneading, stretching, and circular
stated in the study by Nazari et al.13 The minimum sample size of movements. After the massage, the comfort and anxiety levels of
the study was calculated as 132 (intervention: 66 and control: 66), the patients were reevaluated using the same scales, and the vital
with a power of 80%, 0.05 error, and 95% confidence level. At first, signs were measured and recorded again. When the operation was
150 patients were included in this study, but 6 patients did not completed and the patients returned to their bed, their anxiety and
meet inclusion criteria for the study and 4 patients did not want to comfort levels were evaluated, and the vital signs were measured
participate. The study contained a total of 140 patients scheduled for one last time.
for cataract surgery: 70 patients in the intervention group and 70
patients in the control group. The patients were assigned into two
groups using block randomization. Blinding or masking was not Control Group
performed in this study (Figure 1).
The patients in the control group did not receive hand massage
1. Intervention group: These patients received a 10-minute hand before the surgery. The scales were administered upon admission
massage immediately before surgery. to the hospital, immediately before surgery, and after surgery. The
2. Control group: These patients did not receive any intervention remaining procedures were the same as in the intervention group.
before surgery except for routine nursing care.

The inclusion criteria were patients who consented to partici- Ethical Considerations
pate in the study, a minimum age of 18 years, being scheduled for
cataract surgery under local anesthesia for the first time, being The ethical approval was obtained by the university ethics
conscious, ability to answer questions, and not having any speech committee (reference number: 28/01/2015/20478486-50) and was
problems or hearing loss. Exclusion criteria were hypertension performed in accordance to the principles of the Declaration of
(>160/100 mmHg), diagnoses of psychological diseases or de- Helsinki. The written and verbal consents were provided from all
mentia, damaged tissue and skin on a forearm or hands, for patients.
56 Çavdar et al. / Journal of PeriAnesthesia Nursing 35 (2020) 54e59

Patients undergoing cataract surgery under local


anesthesia who were assessed for eligibility
(N = 150)

Excluded (n = 10)
Did not meet the inclusion criteria (n = 6)
Enrollment
Refused to participate (n = 4)

Randomized = 140
Allocation

Allocated to intervention group Allocated to control group


(Hand massage group) (Received allocated usual care)
n = 70 n = 70

Follow up

Continued participation Continued participation

Analysis

Analyzed (n = 70) Analyzed (n = 70)

Figure 1. CONSORT flow diagram of the progress through phases of the study.

Data Analysis hand massage and surgery were statistically significantly lower in
the intervention group than in the control group (P < .05). The vital
The data were analyzed using the SPSS 15.0 program (SPSS, signs of the patients were positively affected by the hand massage,
Chicago, IL). The Shapiro-Wilk test was used for analyzing and this effect continued in the postoperative period.
normality. The numerical variables were given as mean ± SD, mean Table 3 presents the comparison of the STAI scores of the pa-
rank (median), and median (interquartile range), and the categor- tients in the intervention and control groups. The median STAI-S
ical variables were presented in the format of a number and per- score obtained in the patient's room after the hand massage (46.0
centage. A Mann-Whitney U test and c2 test were used to compare [44.7-48.0]) and postoperative (45.0 [43.0-47.0]) was statistically
the two groups, and the Friedman test was applied to measure the significantly lower than that of the control group (preoperative:
changes over time in the groups. For the post hoc comparisons, the 57.0 [55.75-59.00], postoperative: 50.5 [48.00-53.00]) (P < .05).
Wilcoxon signed-rank test was used. The results were evaluated to This indicates that the patients in the control group had a greater
be in a 95% confidence interval and significant when P < .05. level of anxiety before surgery compared to those in the interven-
tion group. However, for all the measurement times, no statistically
Results significant difference was found between the intervention and
control groups in terms of their STAI-T scores (P > .05) (Table 3).
As shown in Table 1, 44.3% of the patients in the intervention
and control groups were 65 years or younger. The mean age of the
patients was 66.06 ± 10.05 years for the intervention group and
65.83 ± 9.62 years for the control group. Fifty percent of the pa- Table 1
tients in both groups were female. In the intervention group, 64.3% Demographic Characteristics of the Patients

of the patients were literate or elementary school graduates, 55.7% Characteristics Intervention Control P value*
had been previously hospitalized, and 37.1% had undergone surgery Group Group
other than cataract. For the control group patients, these percent- (n ¼ 70), n (%) (n ¼ 70), n (%)

ages were 60.0% for literacy, 57.1% for previous hospitalization, and Age (y)
34.3% for history of other surgery. There was no significant differ- 65  31 (44.3) 31 (44.3) 1.000
66  39 (55.7) 39 (55.7)
ence between the intervention and control groups in terms of age,
Age (mean ± SD) 66.06 ± 10.05 65.83 ± 9.62
gender, education level, previous hospitalization, and history of Gender
surgery (P > .05) (Table 1). Female 35 (50.0) 35 (50.0) 1.000
Table 2 shows the comparative results of the parameters of the Male 35 (50.0) 35 (50.0)
patients measured in the patient's room upon admission, imme- Education level
Literate or elementary 45 (64.3) 42 (60.0) .669
diately before surgery (after hand massage for the intervention school
group), and after surgery. Secondary school 15 (21.4) 14 (20.0)
The median VAS comfort scores of the intervention group after High school and higher 10 (14.3) 14 (20.0)
the hand massage [(4.0 (1.7-5.0)] and after surgery [(1.0 (0.0-2.0)] Previous hospitalization
Yes 39 (55.7) 40 (57.1) .865
were statistically significantly lower compared with the control
No 31 (44.3) 30 (42.9)
group (preoperative: [8.0 {6.0-10.0}] and postoperative: [8.0 {7.0- Surgery history
9.0}]) (P < .05). This shows that the patients in the intervention (noncataract)
group had a greater level of comfort than those in the control group. Yes 26 (37.1) 24 (34.3) .724
The median respiration rate, pulse, and systolic and diastolic blood No 44 (62.9) 46 (65.7)

pressure of the patients measured in the patient room after the *


c2 test.
Çavdar et al. / Journal of PeriAnesthesia Nursing 35 (2020) 54e59 57

Table 2
Comparison of Parameters at Three Measurement Times

Scores Intervention Group (n ¼ 70) Control Group (n ¼ 70) z P*

Mean Rank Median (IQR) Mean Rank Median (IQR)

VAS comfort
Before hand massage 73.96 6.0 (3.0-8.0) 67.04 5.5 (3.0-8.0) d1.017 .309
After hand massage 39.16 4.0 (1.7-5.0) 101.84 8.0 (6.0-10.0) d9.198 .000
Postoperative 35.50 1.0 (0.0-2.0) 105.50 8.0 (7.0-9.0) d10.333 .000
Respiration (min)
Before hand massage 88.26 21.0 (20.0-22.0) 52.74 20.0 (19.0-20.0) d5.342 .000
After hand massage 41.26 20.0 (18.0-20.0) 99.74 22.0 (21.0-22.0) d8.794 .000
Postoperative 62.39 21.5 (20.0-22.0) 78.61 22.0 (21.0-22.0) d2.603 .009
Oxygen saturation (%)
Before hand massage 73.40 98.0 (97.0-98.0) 67.60 98.0 (97.0-98.0) d0.931 .352
After hand massage 74.99 98.0 (98.0-98.0) 66.01 98.0 (97.0-98.0) d1.468 .142
Postoperative 74.67 98.0 (98.0-98.0) 66.33 98.0 (97.0-98.0) d1.371 .170
Pulse rate (min)
Before hand massage 82.96 74.0 (72.0-80.0) 58.04 72.0 (70.0-72.25) d3.681 .000
After hand massage 45.42 70.0 (68.0-76.0) 95.58 78.0 (77.0-80.25) d7.358 .000
Postoperative 60.92 72.0 (70.0-78.0) 80.08 76.0 (72.0-80.0) d3.681 .005
Systolic BP (mm Hg)
Before hand massage 79.68 125.0 (120.0-140.0) 61.32 120.0 (110.0-130.0) d2.779 .005
After hand massage 47.06 110.0 (110.0-120.0) 93.94 130.0 (120.0-140.0) d7.000 .000
Postoperative 58.26 120.0 (120.0-132.5) 82.74 130.0 (120.0-140.0) d3.659 .000
Diastolic BP (mm Hg)
Before hand massage 74.97 80.0 (70.0-80.0) 66.03 80.0 (70.0-80.0) d1.420 .155
After hand massage 44.69 70.0 (60.0-80.0) 96.31 80.0 (80.0-90.0) d8.014 .000
Postoperative 56.79 80.0 (70.0-82.5) 84.21 90.0 (80.0-90.0) 4.274 .000

IQR, interquartile range; BP, blood pressure.


*
Mann-Whitney U test.

Table 4 shows the changes in the VAS comfort scores and vital massage, and the postoperative values were either similar to or
signs of the intervention and control group patients over time. lower than the preoperative values. For the control group patients,
According to the results, for both groups, there was a statistically the vital signs increased immediately before surgery and were
significant difference between the different measurement times in found to be even higher in the postoperative period (P < 0.05)
terms of the VAS comfort scores and all the vital signs except for (Table 4).
oxygen saturation (P < .05). In the intervention group, the VAS
comfort score that was initially high was reduced after the hand
massage and continued to decrease in the postoperative period Discussion
(P < .05).
The patients in the control group had a low VAS comfort score The results indicated that preoperative hand massage has a
when they were hospitalized. This score was observed to increase significant effect on patient-stated anxiety, comfort, and vital signs
immediately before surgery and remained similar in the post- in cataract surgery. This is similar to the findings by Kim et al and
operative period (P < .05). Nazari et al.12,13 Preoperative anxiety is common among patients
In the intervention group, the respiration rate, pulse, and sys- awaiting surgery. In particular, physical changes in body, post-
tolic and diastolic blood pressure were reduced after the hand operative pain, fear of dying, intraoperative awareness, and lack of
autonomy and control are common anxieties in the preoperative
time.29 Cataract surgery is performed under local anesthesia. Pa-
Table 3 tients may be more stressed because they are awake and conscious
Comparison of the STAI Scores of the Intervention and Control Groups at Three during the operation.6 The anxiety leads to sympathetic discharge
Measurement Times
which results in hypertension, tachycardia, hyperventilation, and
Scale Scores Intervention Group Control Group (n ¼ 70) P* acute panic attacks.7-10 Several studies have reported preoperative
(n ¼ 70) anxiety during cataract surgery.7,9,12,13 Therefore, it is important to
Mean Median (IQR) Mean Median (IQR) reduce preoperative anxiety.
Rank Rank In the present study, the anxiety levels of the intervention group
STAI-S patients significantly reduced after hand massage compared with
Before hand 65.55 54.0 (52.0-57.0) 75.45 55.0 (53.00-57.00) .146 the control group patients. Similar to this research, several studies
massage stated that hand massage decreased anxiety before
After hand 35.76 46.0 (44.7-48.0) 105.24 57.0 (55.75-59.00) .000
massage
cataract surgery.12,13 Similarly, Oh and Park14 also reported that
Postoperative 42.70 45.0 (43.0-47.0) 98.30 50.5 (48.00-53.00) .000 hand massage can be considered a complementary method to
STAI-T effectively decrease anxiety during the administration of local
Before hand 67.99 44.0 (42.0-45.0) 73.01 44.0 (42.00-46.00) .461 anesthesia. The study by Brand et al, assessed the effects of hand
massage
massage on patients' anxiety before ambulatory surgery and found
After hand 63. 82 44.0 (42.0-46.0) 77.18 45.0 (43.00-47.00) .050
massage that it reduced patients' anxiety levels.19 Miller et al30 also indi-
Postoperative 65.49 44.0 (43.0-45.0) 75.51 45.0 (43.00-46.00) .139 cated that hand and arm massages were associated with decrease
IQR, interquartile range; STAI-S, Spielberger State Anxiety Inventory; STAI-T,
in anxiety and pain levels for patients who underwent orthopaedic
Spielberger Trait Anxiety Inventory. surgery. In another study evaluating the anxiolytic effect of hand
*
Mann-Whitney U test. massage on patients awaiting coronary angiography, a significant
58 Çavdar et al. / Journal of PeriAnesthesia Nursing 35 (2020) 54e59

Table 4
The Change in the VAS Comfort Scores and Vital Signs of the Intervention and Control Groups Over Time

Scores Intervention Group (n ¼ 70) Control Group (n ¼ 70)

Mean Rank c2 P* Post Hocy Mean Rank c2 P* Post Hocy

VAS Comfort
Before hand massage (a) 2.89 116.988 .000 a>b>c 1.31 61.612 .000 a<b¼c
After hand massage (b) 1.95 2.41
Postoperative (c) 1.16 2.28
Respiration (min)
Before hand massage (a) 2.41 88.525 .000 a¼c>b 1.16 92.496 .000 a<b¼c
After hand massage (b) 1.15 2.44
Postoperative (c) 2.44 2.40
Oxygen saturation (%)
Before hand massage (a) 1.94 3.231 .199 a¼b¼c 2.00 Uncalculated Uncalculated a¼b¼c
After hand massage (b) 2.04 2.00
Postoperative (c) 2.02 2.00
Pulse rate (min)
Before hand massage (a) 2.71 89.253 .000 b<c<a 1.16 90.051 .000 a<c<b
After hand massage (b) 1.19 2.74
Postoperative (c) 2.09 2.10
Systolic BP (mm Hg)
Before hand massage (a) 2.56 76.349 .000 b<c<a 1.31 62.717 .000 a<b<c
After hand massage (b) 1.25 2.28
Postoperative (c) 2.19 2.41
Diastolic BP (mm Hg)
Before hand massage (a) 2.38 62.744 .000 b<c¼a 1.44 51.162 .000 a<c¼b
After hand massage (b) 1.39 2.25
Postoperative (c) 2.24 2.31

BP, blood pressure


*
Friedman test.
y
Wilcoxon signed-rank test.

alleviation in anxiety levels after hand massage was shown.20 In during cataract surgery. The study by Bauer et al. showed that a 20-
addition, hand massage efficacy was studied in several patient minute hand massage could significantly reduce pain intensity,
populations, including in terminally ill patients,21 elderly,22 pa- anxiety, and blood pressure after cardiac surgery.36 In another
tients experiencing hand pain,23 burn patients,24 and intensive care study, Oh and Park also found that hand massage reduced the
unit patients.25 A hand massage relaxes the patient by stimulating systolic blood pressure and pulse rate of patients under local
the tissues through contact. The study results demonstrated that infiltration anesthesia.14 Wang and Keck,37 on the other hand,
hand massage before cataract surgery decreased anxiety levels, and stated that hand and foot massage after surgery could cause the
this effect continued in the postoperative period. The patients were pulse and respiration rate to decrease but did not have a significant
also more comfortable during the perioperative period. In addition, effect on systolic and diastolic blood pressure. In contrast, Nazari
hand massage was easily accepted by patients, and no problem was et al13 stated that hand massage before cataract surgery did not
observed while performing it. significantly change the vital signs of the patients. Similarly, in
The present study shows that hand massage could significantly another study, hand massage before coronary angiography was
increase comfort levels. The comfort levels of the patients in the reported to have no significant effect on blood pressure and pulse of
intervention group significantly increased compared with the the patients.20 Along with other results, our findings show the
control group patients. Kolcaba31 defined comfort as “the imme- effectiveness of hand massage as a nonpharmacologic method to
diate state of being strengthened by having the needs for relief, have a positive effect on patients' vital signs.
ease, and transcendence addressed in the four contexts of holistic
human experience: physical, psychospiritual, sociocultural, and Limitations
environmental”. Nazari et al13 found that hand massage was
significantly associated with the increase in comfort of patients There were some limitations in this study. The sample of the
who had ophthalmology surgery under local anesthesia. Similarly, study consisted of patients hospitalized for cataract surgery in an
the study by Kolcaba et al. assessed the effects of hand massage on ophthalmology clinic of a university hospital in western Turkey.
hospice patients' comfort and found that hand massage improved Although this study indicated that hand massage was associated
patients' comfort levels.16 Previous studies support an association with a decrease in anxiety level and increase in comfort, the results
of hand massage with improved comfort level of nursing home may not be generalizable to all cataract surgery patients. Hand
residents17 and geriatric patients.32,33 In addition, many studies massage was performed at the bedside. Noise and care in-
have shown the effectiveness of back, feet, and hand massages on terruptions of clinical nurses, other hospital staff, or patient rela-
increasing patient comfort.34,35 Hand massage may provide more tives were not checked; therefore, the study results might have
effective comfort when combined with other therapies during the been affected by these. Other limitations of the study include the
perioperative period. multibed rooms and the absence of a separate room to perform the
In the present study, it was further found that performing the massage. These factors may have had an effect on the anxiety and
hand massage resulted in a considerable positive impact on the comfort of the patients. The same researcher who performed the
vital signs (respiration rate, pulse, and systolic and diastolic blood hand massage gathered data during face-to-face interviews with
pressure) of the patients. This effect was observed to continue after the patients without the help of a second observer, which may also
the operation. Similarly, Kim et al12 stated the reduction of systolic be considered as a limitation of this study. Therefore, the reliability
and diastolic blood pressure and pulse rate after hand massaging of the data is limited to the information provided by the patients.
Çavdar et al. / Journal of PeriAnesthesia Nursing 35 (2020) 54e59 59

However, the findings clearly show that a 10-minute hand massage 14. Oh HJ, Park JS. Effects of hand massage and hand holding on the anxiety in
patients with local infiltration anesthesia. Taehan Kanho Hakhoe Chi. 2004;34:
applied by a nurse is a safe, cheap, simple, acceptable, and effective
924e933.
method to improve patient comfort and reduce their anxiety. 15. Jiang PS, Qin Y. Touch therapies for pain relief in adults. Cochrane Database Syst
Rev. 2008;8:1e45.
Conclusion 16. Kolcaba K, Dowd T, Steiner R, Mitzel A. Efficacy of hand massage for enhancing
the comfort of hospice patients. J Hosp Palliat Nurs. 2004;6:91e102.
17. Kolcaba K, Schirm V, Steiner R. Effects of hand massage on comfort of nursing
As a result of the study, it was determined that the hand mas- home residents. Geriatr Nurs. 2006;27:85e91.
sage before cataract surgery reduced patient anxiety and had a 18. Westman KF, Blaisdell C. Many benefits, little risk: the use of massage in
nursing practice. Am J Nurs. 2016;116:34e39.
positive effect on the patients' vital signs (systolic and diastolic 19. Brand LR, Munroe DJ, Gavin J. The effect of hand massage on preoperative
blood pressure, pulse and respiration rates) and increased their anxiety in ambulatory surgery patients. AORN J. 2013;97:708e717.
comfort. It is recommended that hand massage should be offered 20. Mei L, Miao X, Chen H, Huang X, Zheng G. Effectiveness of chinese hand
massage on anxiety among patients awaiting coronary angiography.
preoperatively in cataract surgery by the nurses. J Cardiovasc Nurs. 2017;32:196e203.
21. Osaka I, Kurihara Y, Tanaka K, Nishizaki H, Aoki S, Adachi I. Endocrinological
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22. Remington R. Calming music and hand massage with agitated elderly. Nurs Res.
The authors would like to thank the patients, physicians, and 2002;51:317e323.
nurses of the ophthalmology clinic of Manisa Celal Bayar University 23. Field T, Diego M, Delgado J, Garcia D, Funk CG. Hand pain is reduced by mas-
sage therapy. Complement Ther Clin Pract. 2011;17:226e229.
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