mary kay keller, phd critical review
TRANSCRIPT
Infant massage benefits for infants and parents/caregivers: A critical review
M. Kay Keller, MPA, PhD FLORIDA STATE UNIVERSITY
COLLEGE OF HUMAN SCIENCES
Copyright 2010 by M Kay Keller
Objective
Report whether or not results were dependable and if implications could be legitimately derived from results to determine if there are specific benefits of providing infant massage as an intervention to infants receiving massage and to the persons providing the massage.
Statement of the Problem• A wide range of social and health problems are attributed to adverse
childhood experiences (Centers for Disease Control and Prevention, 1998).
• Research indicates a lack of nurturing emotional and physical experiences resulting in an inter-generational cycle of child abuse and neglect, substance abuse, domestic violence, and health related disorders (Center for Disease Control and Prevention, 1998).
• The longer an infant is deprived of nurturance the more severe the attachment disorder (O’Conner & Rutter, 2000).
• In so far as, parental competence contributes to increased outcomes of child well-being (Coren, 2005) and can increase the well-being of both parents or caregivers and children (Coren, 2005), this review focused on one type of parenting intervention, infant massage.
Historically
Previous Research indicated benefits for infants including:• infants exposed to substances in utero• infants at risk of child abuse and neglect• infants experiencing developmental delays• infants of teen parents• infants born prematurely• and infants of fathers
Field, 1995; Field & Diego, 2008; Field & Hernandez-Reif, 2001; Field et al., 1996; Mendes & Procianoy, 2008; O’Higgins et al., 2008; Pelaez-Nogueras et al., 1996; Scafidi et al., 1996
Research Question
This critical review aimed to evaluate experimental and quasi-experimental research previously published which focused on answering the question:
“Does providing infant massage benefit the infant and the parents or caregivers?”
Critical Review Process
This critical review process was achieved by a determined plan to complete a rigorous review.
Methods
Sample
The articles selected for this critical review were published research studies targeting parents or caregivers who massaged infants.
Samples in these research studies were further reviewed to determine if there was a description of any confounding variables such as whether or not an infant developmental and/or physical disability was diagnosed.
Methods
Inclusion/Exclusion Criteria
Only peer reviewed journal articles on Infant Massage, printed in English on Infant Massage were included in this review from the earliest date to 2009.
All located studies were reviewed for adherence to rigorous standards as accepted by the social sciences professional community and general accepted practices in the field of social science..
Selection criteria to determine which articles had independent findings were articles whose objective was to research infant massage as an intervention provided by caregivers or parents with measured outcomes for the infant and/or parent/caregiver.
Methods
The articles identified by the inclusion and exclusion criteria were critically reviewed to determine the rigor, relevance and robustness of reliability coefficients and validation studies based upon the appropriateness of the statistical measurements selected for the methodological design of each article.
In addition, criteria as described by Gibbs (2003) and Isaac & Michael (1995) was applied to experimental and quasi-experimental designs.
Potentially relevant studies identified and screened for retrieval(n=201)
Ineligible studies excluded not an infant massage intervention, participants not parents or caregivers or duplicate articles(n= 157)
Abstracts of studies retrieved(n=44)
Studies excluded if not an intervention study or not measuring health outcome(n=6)
Potentially appropriate studies for review. Studies evaluated in detail to determine relevance to inclusion criteria (n=38)
Studies excluded from review if results presented did not relate outcomes to the benefit of parents/caregivers & infant (n=7)
Studies with usable information by outcome (n=31)
Quorum Flowchart
Methods
Qualitative research was not reviewed as experimental and quasi-experimental designed studies provide the appropriate methodology to address the outcomes and results of this research question.
Qualitative methodological designs address formative evaluation, the processes by which the intervention is applied, and are not appropriate for determining the outcome or results of this research question (Issac & Micheal, 1995).
Part I
The first part of the review provides a description of the systematically identified research literature from diverse fields of study.
MethodsResearch Description - Location
Country Author Country Author
Australia Scholz & Samuels, 1992 Japan Fujita et al., 2006; Ohgi, 2004
Brazil Mendes & Procianoy, 2008 Mexico Gonzales et al., 2009
Canada Elliot et al., 2002 Russia Kelmanson & Adulas, 2005
Ecuador Jump et al., 2006 S. Korea Kim et al., 2003
Finland Huhtula et al., 2000 Turkey Arikan et al., 2007
India Arora et al., 2005; Mathai et al., 2003; Sankaranarayanan et al, 2005
United Kingdom Gitu et al., 2002; Glover et al., 2002; O’Higgins, 2008; Onozawa, 2001
Israel Ferber et al., 2005; Ferber et al., 2002; Ferber et al., 2002
USA Cullen et al., 2000; Diego et al., 2007; Feij’o et al., 2006; Field et al., 1996; Field et al., 1996; Field et al., 1998; Massaro et al., 2009; Pelaez-Nogueras 1996; Scafidi & Field, 1995; Teti et al., 2009
MethodsResearch Description - Setting
Setting AuthorChildcare Center Field et al., 1998; Field et al., 1996
Home Arikan et al., 2007; Cullen et al., 2000; Elliot et al., 2002; Huhtula et al., 2000; Ferber et al., 2002; Fujita et al., 2006; O’Higgins, 2008; Onozawa, 2001
Hospital Feij’o et al., 2006; Ferber et al., 2002; Field et al., 1996; Gitu et al., 2002; Glover et al., 2002; Kelmanson & Adulas, 2005; Mendes & Procianoy, 2008; Ohgi, 2004; Scafidi & Field, 1995; Scholz & Samuels, 1992
NICU Arora et al., 2005; Diego et al., 2007; Ferber et al., 2005; Gonzales et al., 2009; Massaro et al., 2009; Mathai et al., 2003; Sankaranarayanan et al, 2005; Teti et al., 2009
Observation room Pelaez-Nogueras, 1996
Orphanage Jump et al., 2006; Kim et al., 2003
MethodsInfant Participants Descriptions
Experience Author
Born Premature Arora et al, 2005; Diego et al., 2007; Feij’o et al., 2006; Ferber et al., 2005; Ferber et al., 2002; Gitu et al., 2002; Gonzales et al., 2009; Kelmanson & Adulas, 2005; Massaro et al., 2009; Mathai et al., 2003; Mendes & Procianoy, 2008; Sankaranarayanan et al, 2005; Teti et al., 2009
Cerebral Insults Ohgi, 2004
Colic Arikan et al., 2007; Huhtala et al., 2000; Elliot et al., 2002
Healthy Arikan et al., 2007; Cullen et al., 2000; Elliot et al., 2002; Ferber et al., 2002; Field et al., 1996; Field et al., 1996; Field et al., 1998; Fujita. et al., 2006; Glover et al., 2002; Huhtala et al., 2000; Onozawa, 2001; Pelaez-Nogueras, 1996; Scholz & Samuels, 1992
Infant Diarrhea Jump et al., 2006; Kim et al., 2003
Maternal HIV Scafidi & Field, 1995
Maternal Depression Feij’o et al., 2006; Field et al., 1996; Fujita. et al., 2006 ; O’Higgins, 2008; Onozawa, 2001; Pelaez-Nogueras, 1996
MethodsParticipants Descriptions
Massager Author
Elder Field et al., 1996
Father Cullen et al., 2000; Scholz & Samuels, 1992
Mother Arikan et al., 2007; Arora et al, 2005; Feij’o et al., 2006; Ferber et al., 2002; Ferber et al., 2002; Fujita. et al., 2006; Glover et al., 2002; Mendes & Procianoy, 2008; Ohgi, 2004; O’Higgins, 2008; Onozawa, 2001; Pelaez-Nogueras, 1996; Teti et al., 2009
Mothers watchedWhile staff provided
Field et al., 1996
Parents Elliot et al., 2002; Gonzales et al., 2009; Huhtala et al., 2000
Professional Staff Diego et al., 2007; Ferber et al., 2005; Field et al., 1996; Field et al., 1996; Gitu et al., 2002; Jump et al., 2006; Kelmanson & Adulas, 2005; Kim et al., 2003; Massaro et al., 2009; ; Mathai et al., 2003; Sankaranarayanan et al, 2005; Scafidi & Field, 1995
Part II
The second part of the review provides an integration of the identified research literature and critically reviews the theoretical framework and the rigor of the identified research design.
Methods
Author Measurement Design Analysis strategy
Reliability & Validity Citations
Multiple Post-tests
Detailed description of Infant Massage
Description of Instructor’s credentials
Arikan et al., 2007
Physical (crying) Experimental Intention to Treat
Reliability Coefficient Citations
Arora et al, 2005 Physical Experimental Attrition Rates X X
Cullen et al., 2000
Interaction Experimental Validity Citation References
X X
Diego et al., 2007
Physical Experimental X X
Elliot et al., 2002 Physical & Interaction
Experimental Reliability Coefficient Citations/ Validity Citation References
X
Feij’o et al., 2006
Interaction Experimental
Methods
Author Measurement Design Analysis strategy
Reliability & Validity Citations
Multiple Post-tests
Detailed description of Infant Massage
Description of Instructor’s credentials
Field et al., 1998 Interaction Quasi Intention to Treat
X X
Field et al., 1996 Physical Experimental
Field et al., 1996 Interaction Experimental Reliability Coefficient Citations
X
Ferber et al., 2005
Interaction Experimental Attrition Rates
Ferber et al. 2002
Physical Experimental Intention to Treat
X
Ferber et al., 2002
Physical Experimental X
Fujita et al., 2006
Interaction Experimental Intention to Treat
X
Methods
Author Measurement Design Analysis strategy
Reliability & Validity Citations
Multiple Post-tests
Detailed description of Infant Massage
Description of Instructor’s credentials
Gitu et al., 2002 Physical Quasi
Glover et al., 2002
Both Quasi X
Gonzales et al., 2009
Physical Experimental Attrition Rates Reliability Coefficient Citations
X
Huhtula et al., 2000
Physical (crying) Experimental X
Jump et al., 2006 Physical Experimental Intention to Treat/ Attrition Rates
X X
Kelmanson & Adulas, 2005
Physical Quasi
Methods
Author Measurement Design Analysis strategy
Reliability & Validity Citations
Multiple Post-tests
Detailed description of Infant Massage
Description of Instructor’s credentials
Kim et al., 2003 PhysicalExperimental
Reliability Coefficient Citations/ Validity Citation References
X X
Massaro et al., 2009
Physical Experimental Attrition Rates X X
Mathai et al., (2003)
Physical Experimental X
Mendes & Procianoy, 2008 Physical
Experimental Attrition Rates X
O’Higgins, 2008
Interaction Experimental X X
Ohgi, 2004 Physical Experimental
Methods
Author Measurement Design Analysis strategy
Reliability & Validity Citations
Multiple Post-tests
Detailed description of Infant Massage
Description of Instructor’s credentials
Onozawa, 2001 Interaction Experimental Intention to Treat
Reliability Coefficient Citations
X X
Pelaez-Nogueras 1996
Interaction Experimental Reliability Coefficient Citations/ Validity Citation References
X X
Sankaranarayanan et al, 2005
Physical Experimental Attrition Rates Validity Citation References
X X
Scafidi & Field, 1996
Physical Experimental Validity Citation References
X
Scholz & Samuels, 1992
Interaction Experimental Reliability Coefficient Citations
X X
Teti et al., 2009 Interaction Experimental Intention to Treat
X
MethodsLimitations
No theoretical premise
Threats to Validity• Homogeneity of participants characteristics• However, no study described generational or immigrant status, disability status, sexual orientation, gender identity,
or language preferences.• Limited sample sizes (No power analysis to determine, 21 studies) • Furthermore, studies not conducted over a longer period, such as 12 weeks, are not considered longitudinal
studies and limit generalizability. • Sixteen studies did not address intention to treat and/or attrition rates.• Healthy infants generalizable to health infants• 4 did not randomly assigned and 24 did not blindly assign participants• Did not address limitations of designs or ecological validity• No hypothesis, did not explicitly identify the Dependent or Independent Variable• No operational definitions of the terms• No reliability coefficients or validity citations for the measurement tools • No justification of appropriateness of statistical analysis• Infant Massage protocol not described• Pre-, Post, Multiple Measurements testing interaction
Part III
Finally, a summary of the conclusions is reported (Rothman, Damron-Rodiques, Shenassa, 1994).
MethodsParticipants Outcomes
Infant Outcome Parent/Caregiver Outcome
Decrease in crying/colic Decreased symptoms of stress, anxiety & depression
Decrease in length of hospital stayIncreased caregiving activities
Decrease in DiarrheaIncreased interaction
Increased Interaction (Engagement & Entrainment Behavior)
Improvements in Lifestyles
Increase in Physical GrowthIncreased Self Efficacy
Increased Sleep Time Parent/Caregiver Outcome
Implications for Future Research
• Infants initiating engagement behaviors
• Fathers increasing quality of interaction with infants
• Mothers reporting less symptoms of depression after massaging or watching infants be massaged
• Volunteers reported increased social satisfaction after massaging infants.
Research
Additionally, numerous research studies showed positive outcomes for infants of mothers experiencing depression. These Outcomes included: – engagement– interaction– relaxation – relief from stress – and stimulation of the physiological systems – and increased sleep by infants who were massaged
Field, 1995; Field & Diego, 2008; Field & Hernandez-Reif, 2001; Field et al., 1996; Mendes & Procianoy, 2008; O’Higgins et al., 2008; Pelaez-Nogueras et al., 1996; Scafidi et al., 1996
Research
Infant massage was indicated to increase the frequency and quality of engagement of fathers and mothers with their infants
Cullen et al., 2000; Ferber et al., 2005; Field et al., 1996; Onozawa et al., 2001; Pardew, 1996; Scholz & Samuels, 1992
Research
Furthermore, mothers experiencing depression showed less depression after massaging their infants or watching their infants massaged by another caregiver
Feijo, Hernandez-Reif, Field, Burns, Valley-Gray & Simco, 2006
Even volunteers who massaged infants showed an increase in their quality of lifestyle
Feijo et al., 2006
Parentbenefits
Baby receivesmassage
Baby benefits
Parent massages
infant
ResearchIn summary, research on infant massage has previously reported primary
parents/caregiver outcomes as increased sense of parental competency and positive infant care behaviors.
• For the infant, primary outcomes reported include increased sleep time, relaxation, and relief from stress.
• Secondary outcomes reported include increased engagement cues and increased interaction between the parent/caregiver and the infant who received the massage for both the infant and the parent/caregiver.
• Secondary outcomes also included increased engagement and interaction behaviors with the adult
Field, 1995; Field & Diego, 2008; Field & Hernandez-Reif, 2001; Field et al., 1996; Mendes & Procianoy, 2008; O’Higgins et., 2008; Pelaez-Nogueras et al., 1996; Scafidi et al., 1996
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