NURS 519 Week 6 Research Article Paper on a Nondrug Pain Intervention Example

Hand Massage for Pain in Palliative Oncology: A Research Article Review of a 2026 Randomized Trial and Its Use at the Bedside

The Intervention and Why It Was Chosen

The intervention chosen is massage, specifically gentle hand massage, as a nondrug treatment for pain in patients receiving palliative care for cancer. Matzo and Sherman (2018) present pain management at the end of life as a combination of medications and complementary measures, and massage is one of the measures nurses can deliver themselves without an order for a new drug. The Society for Integrative Oncology and ASCO reached a similar conclusion in their joint guideline, which states that massage may be recommended to patients experiencing pain during palliative or hospice care, while rating the quality of that evidence as low (Mao et al., 2022). Hand massage suits hospice work in particular. It does not require the patient to turn or undress, it can be taught to family members, and it can be offered to patients too weak for other therapies. Those features made it a practical choice for a paper meant to lead to bedside use.

Summary of the Research Article

Koc and Atar (2026) conducted a randomized controlled trial to examine the effect of hand massage on pain, comfort and sleep quality in palliative oncology patients. The setting was the palliative care clinic of a public hospital, where 76 patients were randomly assigned to an experimental group of 38 and a control group of 38. The experimental group received 16 hand massage sessions in total, given twice a day on 2 days each week for 4 weeks, while the control group received no intervention. Pain was measured with a visual analog scale, comfort with the General Comfort Questionnaire, and subjective sleep quality with the Pittsburgh Sleep Quality Index, and a smart wristband recorded objective sleep duration and sleep scores. Measurements were taken before the intervention and at 1, 2 and 4 weeks. The groups did not differ at baseline on demographics, pain, sleep or comfort. From the second week onward, the massage group reported significantly lower pain and greater comfort than the control group, and the wristband showed better sleep in the massage group from the first week. The authors concluded that hand massage is an effective way to reduce pain and improve sleep and comfort in this population.

The timing of these results is worth noticing for practice. Sleep improved first, within a week, while the difference in pain took two weeks to appear, which suggests that the benefit builds with repeated sessions rather than arriving after a single massage. That pattern matters in hospice, where many patients live only weeks after admission; a nurse who offers one massage and sees no change in a pain score may abandon an intervention that needed more time. The trial also measured comfort as its own outcome rather than treating it as a side effect of lower pain, which fits the palliative goal of relieving total suffering, not only a number on a scale. Finally, the intervention was delivered on a fixed schedule rather than on request, so patients did not have to ask for it, a point that matters for older or very ill patients who are reluctant to make demands of busy staff. The trial thus tests a routine, not an occasional kindness, and that is how the findings should be applied.

Strengths and Limitations of the Study

The study's main strengths are its randomized design, its focus on patients already in palliative care rather than on healthier survivors, and its use of an objective sleep measure alongside self-reports, which reduces reliance on patients' recall. The protocol is also simple enough to repeat. Its limitations matter as much. The control group received no intervention at all, so nobody can tell from these data how much of the benefit came from massage itself and how much came from attention, company and touch. A patient who knows a nurse will come twice a day may report less pain for that reason alone. Pain is self-rated, and because massage cannot be hidden from the person receiving it, patients knew their group. The sample of 76 came from a single clinic, and the four-week follow-up says nothing about longer use. These limits are consistent with the wider literature. A 2024 systematic review of nine trials of physiotherapy in palliative oncology found that massage improved quality of life and reduced pain, but it also judged most of the included trials to carry a high risk of bias (Gauchez et al., 2024). The guideline's low rating of the evidence reflects the same problem (Mao et al., 2022). The reasonable conclusion is that hand massage probably helps, with little risk, but its size of effect is uncertain.

Application to Practice

For a nurse in home hospice, the evidence supports offering hand massage alongside the patient's analgesic plan, never in place of it. Consider a composite 81-year-old with metastatic breast cancer whose bone pain is controlled with scheduled opioids but who rates pain at 5 out of 10 each evening and sleeps poorly. The nurse could offer a ten-minute hand massage at evening visits, using unscented lotion and light, slow strokes, and teach the patient's son to give it on the other evenings, so the patient receives some form of massage most days. The patient would rate pain before and 30 minutes after each session in the comfort log already used for breakthrough doses. Safety comes first. The nurse avoids deep pressure, any area with a wound, edema or a vascular access device, and the arm on the side of a past lymph node dissection, and checks recent platelet counts before teaching family members to massage a patient prone to bruising (Matzo & Sherman, 2018). If the log shows no change after two weeks, the team can try a different approach, but even then the patient may value the time of quiet touch, which is a legitimate outcome in palliative care. Teaching the son has a second benefit: family members often feel helpless at the bedside, and a simple, safe task gives him a way to care for his mother that does not involve medicines. The nurse would demonstrate the strokes once, watch the son try them, and leave a one-page handout with the precautions written in plain words.

A Christian Perspective on Healing Touch

Touch has a long place in Christian care for the sick. When a man with leprosy begged for healing, Jesus, "moved with pity, he stretched out his hand and touched him" (English Standard Version Bible, 2001/2016, Mark 1:41), touching a person whom others avoided. A dying patient can feel similarly set apart by illness, equipment and the caution of visitors. Massage offered with care and consent tells that patient they are still a person worth touching. For the Christian nurse, the intervention is therefore not only a technique to lower a pain score but also a way of delivering care with the love of Christ, as the course description puts it. That motivation should still sit alongside the evidence, so the nurse offers massage honestly as a comfort measure with modest proof, never as a cure.

References

English Standard Version Bible. (2016). Crossway. (Original work published 2001)

Gauchez, L., Boyle, S. L. L., Eekman, S. S., Harnie, S., Decoster, L., Van Ginderdeuren, F., De Nys, L., & Adriaenssens, N. (2024). Recommended physiotherapy modalities for oncology patients with palliative needs and its influence on patient-reported outcome measures: A systematic review. Cancers, 16(19), Article 3371. https://doi.org/10.3390/cancers16193371

Koc, M., & Atar, N. Y. (2026). The effect of hand massage on pain, comfort, and sleep quality in palliative care oncology patients. Supportive Care in Cancer, 34(4). https://doi.org/10.1007/s00520-026-10558-5

Mao, J. J., Ismaila, N., Bao, T., Barton, D., Ben-Arye, E., Garland, E. L., Greenlee, H., Leblanc, T., Lee, R. T., Lopez, A. M., Loprinzi, C., Lyman, G. H., MacLeod, J., Master, V. A., Ramchandran, K., Wagner, L. I., Walker, E. M., Bruner, D. W., Witt, C. M., & Bruera, E. (2022). Integrative medicine for pain management in oncology: Society for Integrative Oncology-ASCO guideline. Journal of Clinical Oncology, 40(34), 3998-4024. https://doi.org/10.1200/JCO.22.01357

Matzo, M., & Sherman, D. W. (Eds.). (2018). Palliative care nursing: Quality care to the end of life (5th ed.). Springer Publishing Company.