A 10-minute massage for pediatric palliative care patients, as well as family caregivers, resulted in less pain for the patients and less distress for the caregivers, according to recent research.

The study, “Impact of a Massage Therapy Intervention for Pediatric Palliative Care Patients and Their Family Caregivers,” involved 53 pediatric palliative care patients with “complex, chronic medical conditions” and 112 family caregivers. The mean age of the patients was 46 months.

Study Design

Each family selected a 30-minute scheduled time for the massage intervention, which took place in the patient’s hospital room.

Among the 53 children who received a massage, the mean duration of massage was 10.5 minutes.

Among the 112 caregivers who received a massage, the mean duration of massage was 10.3 minutes.

Prior to the start of the massage, the caregiver and, whenever possible, the child, were encouraged to share an intention, such as “I want to feel better” or “I want to relax.”

Certified, pediatric-trained massage therapists performed each massage, with a focus on the hands, feet, arms, scalp, head and shoulders. In order to reduce the background noise of the hospital, soft music was played throughout the intervention.

During the patient’s massage, family caregivers were encouraged to make note of the “calming touch techniques that could be used by the family.”

Outcome Measures

The main outcome measures in this study were symptom severity and the number of times each patient needed to use medication for nausea or pain. Symptom severity was measured before and after massage primarily via the Face, Legs, Activity, Cry, Consolability (FLACC) scale, designed to assess pain in young children.

To measure medication usage, the researchers checked each patient’s chart in the 24 hours before and after the massage.

Other outcome measures were caregiver distress and nurse perception of massage therapy for patients and caregivers.

Caregiver distress was measured five minutes before and after massage using the National Comprehensive Cancer Network (NCCN) Distress Thermometer Scale. To determine nurse perception of the massage intervention, the researchers asked the nurses to complete a short written survey.


Results of the research showed a reduced FLACC score for the majority of the pediatric palliative care patients, as well as a statistically significant reduction in the use of medication for pain in the 24 hours after massage.

In addition, caregiver distress decreased after the intervention, and the nurses responded positively to the use of massage therapy for the patients and caregivers.

“Massage therapy is noted in this pilot investigation to be feasible for children and family caregivers and acceptable for bedside nursing staff,” state the study’s authors.

“Based off the FLACC scores in children and NCCN Distress Thermometer Scale ratings for caregivers, massage has the potential to serve as a caring intervention in the pediatric palliative care setting.”

Authors: Taelyr Weekly, Beverly Riley, Christopher Wichman, Melissa Tibbits and Meaghann Weaver. Sources: Nebraska Medical Center, University of Nebraska Medical Center, Omaha, Nebraska; and Division of Pediatric Palliative Care, Children’s Hospital and Medical Center, Omaha, Nebraska. Originally published online in November 2018 in the Journal of Palliative Care.