The effect of postoperative back massage on pain, sleep outcomes and serum cortisol after open-heart surgery: A randomized controlled trial

IF 8.7 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2026-04-01 Epub Date: 2026-01-15 DOI:10.1016/j.ijnurstu.2026.105343

Yasemin Özhanlı , Ayşegül Güneş , Nuray Akyüz , Suna Uzun , Müşerref Kurt , Oğuz Omay , Berna Yıldırım Şık , Şükriye Şahin

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引用次数: 0

Abstract

Background

Massage is widely recognized as an effective non-pharmacological intervention for reducing pain and anxiety after cardiac surgery. However, its effects on sleep outcomes and biological stress markers remain underexplored.

Aim

To evaluate the impact of back massage on postoperative pain, subjective and objective sleep outcomes, and serum cortisol levels in patients undergoing open-heart surgery.

Methods

A prospective randomized controlled trial was conducted with 72 patients scheduled for elective open-heart surgery. Participants were randomized (1:1) to an intervention group (back massage) or a control group (routine care with light touch). The intervention consisted of three standardized sessions (15–20 min each) on the first postoperative day. Outcomes included pain (Numeric Rating Scale-Pain), subjective sleep quality (Richard–Campbell Sleep Scale), objective sleep duration (smartwatch measurement), and serum cortisol levels. Data were analyzed using repeated-measures analysis of variance and Brunner–Langer tests in a per-protocol population (n = 64).

Results

Back massage was associated with significantly longer total sleep duration (p = 0.037) and greater reduction in pain scores, with significant group, time, and group × time effects (p = 0.002, p < 0.001, p = 0.048). Cortisol levels decreased over time in both groups (p < 0.001), but without significant between-group differences. Subjective sleep quality improved in both groups, and analgesic use declined, with no significant variation between groups. No adverse events were observed.

Conclusion

This randomized controlled trial demonstrates that back massage is a safe and feasible intervention after open-heart surgery, improving objectively measured sleep duration and reducing pain. By incorporating objective sleep measures and a biological stress marker (serum cortisol), this study provides novel insights that extend beyond the traditionally reported outcomes of pain and anxiety, supporting massage as a complementary strategy within multimodal nursing care.

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术后背部按摩对心内直视手术后疼痛、睡眠结果和血清皮质醇的影响：一项随机对照试验

按摩被广泛认为是减轻心脏手术后疼痛和焦虑的有效非药物干预手段。然而，它对睡眠结果和生物应激标志物的影响仍未得到充分研究。目的评价背部按摩对心内直视手术患者术后疼痛、主客观睡眠结局及血清皮质醇水平的影响。方法对72例择期心内直视手术患者进行前瞻性随机对照试验。参与者被随机（1:1）分为干预组（背部按摩）或对照组（轻触的常规护理）。干预包括术后第一天的三个标准化疗程（每次15-20分钟）。结果包括疼痛（数值评定量表-疼痛）、主观睡眠质量（理查德-坎贝尔睡眠量表）、客观睡眠持续时间（智能手表测量）和血清皮质醇水平。采用重复测量方差分析和每个方案人群（n = 64）的Brunner-Langer检验对数据进行分析。结果背部按摩与总睡眠时间显著延长（p = 0.037）、疼痛评分显著降低相关，组效、时间效应和组×时间效应均显著（p = 0.002, p < 0.001, p = 0.048）。两组皮质醇水平均随时间下降（p < 0.001），但组间无显著差异。两组的主观睡眠质量均有所改善，镇痛药的使用有所减少，两组间无显著差异。未观察到不良事件。结论本随机对照试验表明，背部按摩是一种安全可行的心脏直视手术后干预措施，可改善客观测量的睡眠时间，减轻疼痛。通过结合客观睡眠测量和生物应激标志物（血清皮质醇），本研究提供了超越传统报道的疼痛和焦虑结果的新颖见解，支持按摩作为多模式护理中的补充策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).