Finding the value in oncology massage : a mixed-method study of cancer services and survivors in Australia

Objectives: This study aimed to quantify massage service provision by Australian cancer services and explore providers' and survivors' views about massage services. Design: A mixed-method study design combined data from a national cross-sectional survey of cancer services, an on-line survey of cancer survivors, and focus group or individual interviews with cancer survivors. Methods: Quantitative and qualitative analyses of the data were merged using the principles of triangulation analysis for a thematic analysis. Results: Three meta-themes were identified: 1) an under provision of high-quality massage services; 2) the perceived benefits of massage extend beyond symptomatic relief; and 3) the interrelated barriers to massage service provision and access reflect different values. Response rate for the national cancer services survey was 93.2% (n = 275/295), of which 18.1% (n = 50/275) provided massage. Service provision was not evenly distributed across the country with gaps in many regions. The 121 survivors who answered the online survey and 31 survivors who participated in the interviews affirmed this finding. Quality control was an important reason why survivors wanted cancer services to offer massage. Survivors reported numerous benefits from massage and valued the 'human touch'. Overwhelmingly, finance was the greatest barrier that was interrelated with other barriers such as finding suitably qualified massage therapists and various information, evidence and logistical constraints. Conflicting findings included survivors stating the unavailability of massage services was an important barrier, whereas services reported low patient demand as a reason for not providing massage. An explanation given for not funding or using massage was the tendency to downplay the value of massage as a non-essential service; an attitude that was strongly refuted by some. Conclusions: Massage is yet to be firmly established in cancer care across Australia. Balancing different views about the value of massage in supportive cancer care will be key to informing appropriate funding and service delivery.