The Study Question
Massage therapy, along with healthy food, acupuncture, yoga, meditation and other complementary therapies, has demonstrated benefits for patients in medical settings and is considered low-risk and relatively low-cost. A majority of patients self-refer to get access to these therapies when they are offered, and usually pay out of pocket for them. Most complementary therapies are offered in outpatient settings. To what extent do inpatients want to have these therapies available during their hospital stays, and are they willing to pay for them?
The Study Methods
Researchers at the University of California, San Diego, recruited patients from the Family Medicine Inpatient Service over a 10-month period. Inclusion criteria were broad to include a wide variety of patient preferences: over the age of 18, and able to participate in a semi-standardized interview in English. Exclusion criteria included a diagnosis of severe dementia, delirium or other cognitive impairment that would make it difficult for a patient to participate in the interview.
The cross-sectional study used individual interviews to learn about the inpatients’ preferences for complementary therapies. Patients were informed that these services were not currently offered in the hospital, but that the purpose of the study was to learn more about what services, if offered, would be valued by inpatients. The interview also examined patients’ perspectives on how those services could be helpful and whether they would be willing to pay for those services if they were offered in the hospital.
During each interview, a researcher described 11 commonly provided complementary therapies. The list was generated by a previous needs assessment conducted a year earlier. A standard description was given for each therapy to make sure each patient had the same level of understanding of the therapy. As each therapy was described, the inpatient was asked, ‘‘Do you think [this therapy] would be helpful to you during your hospital stay?’’ (yes or no). If yes, the inpatient was asked, ‘‘Would you be willing to pay for these services yourself?’’ (yes or no). Inpatients were also asked to state whether they believed each therapy could: (1) help them relax, (2) help them recover more quickly, (3) help them cope with being in the hospital, (4) decrease their pain, (5) decrease emotional difficulties, (6) increase their sense of well-being and (7) increase their overall satisfaction with the hospitalization (yes or no). Each interview lasted an average of 30 minutes and was conducted at the inpatient’s bedside.
One hundred inpatients, ranging in age from 19 to 95, agreed to participate in the interviews. The average age was 53, with a standard deviation of 19.2 years. Fifty-nine were female (38 male) and 82 were non-Hispanic (14 Hispanic). The average length of stay was six days, with 75 inpatients having a length of stay from one to seven days. The majority (77 percent) of inpatients were admitted to the hospital from the emergency room; only 19 percent were admitted as part of a planned visit.
Inpatients most commonly reported that healthy food (85 percent), massage therapy (82 percent) and humor therapy (70 percent) would be helpful during their hospital stay. Additionally, inpatients indicated they would be most willing to pay for healthy food (71 percent), massage therapy (70 percent) and stress management (48 percent). Overwhelmingly, inpatients indicated that complementary therapies could help them relax (88 percent), increase their well-being (86 percent), increase their overall satisfaction with the hospitalization (85 percent), help them cope (84 percent), speed recovery (82 percent), decrease pain (80 percent) and decrease emotional difficulties (76 percent).
Limitations of the Study
This study used a convenience sample of inpatients in one Southern California hospital, and the generalizability of the findings to other geographic regions is not clear. And while inpatients reported that they would be willing to pay for therapies such as massage, these services were not currently offered in the hospital. So, it’s hard to tell if the inpatients would actually submit payment when billed, and whether it would be feasible for the hospital to charge a separate fee for complementary therapies offered to inpatients. It’s also difficult to say how much the inpatients would be willing to pay for each service because the researchers did not indicate a suggested dollar amount for the price of each therapy when the therapy was described to study inpatients during the interviews.
Implications for Evidence-Informed Practice
Despite its limitations, this study provides highly useful information regarding hospitalized patients’ beliefs and preferences regarding the desirability of having massage therapy available to them during their stay. Massage therapists who are interested in establishing an inpatient massage service will want to include the findings of this study in any proposal developed for hospital administrators and board members.
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Singer J, Adams J. "Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers." BMC Complement Altern Med. 2014 May 22;14:167.
Dion LJ, Cutshall SM, Rodgers NJ, Hauschulz JL, Dreyer NE, Thomley BS, Bauer B. "Development of a hospital-based massage therapy course at an academic medical center." Int J Ther Massage Bodywork. 2015 Mar 1;8(1):25-30.