title: Comparing the effect of whole body massage by a specialist nurse and patients' relatives on blood cortisol level in coronary patients.
abstract: BACKGROUND
  Cardiovascular diseases such as acute coronary syndrome and myocardial infarction are often accompanied by severe anxiety over the likelihood of death. Cortisol has been known as a stress hormone. However, there are controversies about the effect of massage therapy on blood cortisol level. Furthermore, no study is available on the difference between massage applied by a nurse specialist or by patients' relatives on blood cortisol level. This study was aimed to compare the effect of massage applied by a nurse specialist and patients' relatives on blood cortisol level among the patients admitted in coronary care unit (CCU).
  
  
  METHODS
  In a randomized controlled trial, ninety patients hospitalized at CCU were randomly placed in three groups: massage by a nurse; massage by patients' relatives and control group. The two massage groups received a session of whole body massage. The control group received the routine care. Data were analyzed using analysis of variance, chi-square and Fischer exact tests, Kruskal-Wallis and Wilcoxon Signed Ranks tests.
  
  
  RESULTS
  The mean age of participants was 58.43 ± 14.23 years. None of the participants had the history of massage therapy. In the group massaged by a nurse, the median blood cortisol level was 281.90 nanomoles, which were decreased to 197.00 after the intervention (P < 0.007). The median blood cortisol level in the group massaged by the patients' relatives and the control group did not affect significantly.
  
  
  CONCLUSIONS
  Massage therapy decreased the blood cortisol level in the group that received massage by a specialist nurse. It can be recommended that massage therapy be used in patients admitted in CCU.
authors.affiliation: Professor, Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Adib-Hajbaghery
authors.affiliation: Department of Nursing, Dehdash Imam Khomeini Hospital, Yasouj University of Medical Sciences, Yasouj, Iran.
authors.forename: Rahman
authors.initials: R
authors.lastname: Rajabi-Beheshtabad
authors.affiliation: Assistant Professor, Physiology Research Center, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Abolfazl
authors.initials: A
authors.lastname: Ardjmand
keywords: Acute Coronary Syndrome; Cortisol; Massage Therapy; Myocardial Infarction; Nurses; Relatives