There is a rapid increase in cancer incidence and mortality worldwide. The International
Agency for Research on Cancer (IARC) 2018 found that 18.1 million individuals were
diagnosed with cancer worldwide. Individuals diagnosed with cancer experience many
symptoms during the disease process, during the treatment phase, and in the terminal
period. In most patients, many symptoms such as pain, insomnia, nausea and vomiting,
anorexia, shortness of breath and fatigue are frequently observed, depending on the type
and stage of cancer, treatments applied and accompanying diseases. Failure to control
these symptoms affects the treatment process and may cause patients and family members to
experience difficulties in the fight against cancer. During this period, the most
effective way to meet all the needs of the patient and his family is to receive
palliative care services. Palliative care is the key to individualized and holistic care.
The scope of palliative care includes defining goals of care based on the patient's
values and beliefs and addressing patients' physical, emotional, spiritual, and social
problems. Palliative care is a multidisciplinary approach in which appropriate health
care is provided for oncology patients, who have a wide range of medical, functional,
social and emotional needs. Pharmacological approaches are generally used in symptom
management of palliative care patients. In addition to pharmacological approaches,
non-pharmacological approaches are also preferred. Practices such as reflexology, music
therapy, acupuncture, aromatherapy, pet therapy, therapeutic touch, reiki, massage, hand
massage therapy are non-pharmacological applications that can be used in palliative care
oncology patients.
Massage is a preferred intervention among professional nursing practices because it is
reliable, has no side effects, has a direct effect on patients, and is easy to apply.
Massage is the stimulation of the skin, subcutaneous tissue, muscles, internal organs,
metabolism, circulation and lymph systems for therapeutic purposes through mechanical and
neural means . The presence of sufficient mechanoreceptors in the hands, which stimulate
painless nerve endings, shows that the hands should be chosen as the appropriate area for
massage. Hand massage application changes the sensation of pain in the neuromatrix. It
increases the stimulation of large nerve fibers on the small C nerve fiber in the
spinothalamic system through the spinal cord and reduces the sensation and transmission
of pain by increasing blood flow to the hands. With the application of hand massage,
sensory information is transferred from the hands to the spinothalamic pathway via the
thalamus and somatosensory cortex via the spinal cord. While sensory information changes
within the neuromatrix structure, it also reduces chronic pain. The scope of hand massage
is limited, but it is a more accessible area. In addition, it can be applied more easily
and conveniently than whole body massage due to its pain-reducing and comfort-increasing
effect Among the effects of hand massage: ensuring the regeneration of cells,
facilitating the elimination of accumulated toxins, providing relaxation, helping to
reduce pain by facilitating the release of endorphins, helping to increase circulation,
regulating respiratory functions, providing stress and anxiety control, creating a state
of well-being, strengthening the immune system, increasing general comfort, improving
sleep quality. Studies in the literature show that hand massage reduces anxiety levels,
pain levels, stress and agitation levels; It has been stated that it is effective in
increasing the level of comfort and sleep quality.
As seen in the literature, the effectiveness of hand massage applied to different sample
groups on anxiety, stress, agitation, pain, comfort and sleep parameters was evaluated.
There are very few studies evaluating the effectiveness of hand massage applied to
oncology patients. In addition, no study has been found that evaluated the effects of
hand massage on pain, comfort and sleep in palliative oncology patients, who constitute
the majority of palliative care patients. Hand massage, which is a practical, safe and
cost-free method in symptom management, which forms the basis of palliative care and has
an important place in the treatment of oncology patients, should be used by evaluating
its effectiveness.
