Akademik Veri Yönetim Sistemi
International Journal of Nursing Studies, cilt.176, 2026 (SCI-Expanded, SSCI, Scopus)
Background: Massage is widely recognized as an effective non-pharmacological intervention for reducing pain and anxiety after cardiac surgery. However, its effects on sleep outcomes and biological stress markers remain underexplored. Aim: To evaluate the impact of back massage on postoperative pain, subjective and objective sleep outcomes, and serum cortisol levels in patients undergoing open-heart surgery. Methods: A prospective randomized controlled trial was conducted with 72 patients scheduled for elective open-heart surgery. Participants were randomized (1:1) to an intervention group (back massage) or a control group (routine care with light touch). The intervention consisted of three standardized sessions (15–20 min each) on the first postoperative day. Outcomes included pain (Numeric Rating Scale-Pain), subjective sleep quality (Richard–Campbell Sleep Scale), objective sleep duration (smartwatch measurement), and serum cortisol levels. Data were analyzed using repeated-measures analysis of variance and Brunner–Langer tests in a per-protocol population (n = 64). Results: Back massage was associated with significantly longer total sleep duration (p = 0.037) and greater reduction in pain scores, with significant group, time, and group × time effects (p = 0.002, p < 0.001, p = 0.048). Cortisol levels decreased over time in both groups (p < 0.001), but without significant between-group differences. Subjective sleep quality improved in both groups, and analgesic use declined, with no significant variation between groups. No adverse events were observed. Conclusion: This randomized controlled trial demonstrates that back massage is a safe and feasible intervention after open-heart surgery, improving objectively measured sleep duration and reducing pain. By incorporating objective sleep measures and a biological stress marker (serum cortisol), this study provides novel insights that extend beyond the traditionally reported outcomes of pain and anxiety, supporting massage as a complementary strategy within multimodal nursing care.