Abstract
Background
The use of massage therapy, a complementary and alternative medicine modality, is widespread and growing. However, little is known about why consumers choose and continue to use massage therapy, in most cases at their own expense. In addition, the characteristics of the therapeutic encounter and outcomes that provide satisfaction to the client, and encourage them to return for further treatment are unknown.
Aims and objectives
The purpose of this thesis was to determine why repeat users of massage therapy use and choose massage therapy, and investigate what they value in the therapeutic interaction and outcomes to return to massage therapy. The primary aim was to investigate: (1) the elements of the therapeutic encounter that are valued by clients and therapists; the importance and influence of comfort, contact, connection, and caring within a massage therapy session; and the importance of health outcomes for massage therapy clients; and (2) explore the drivers for why people continue to seek or reinitiate massage therapy. As a precursor to this, the utilisation and practice patterns of massage therapy in New Zealand by qualified massage therapists were investigated.
Methods
A two-phase, sequential mixed methods approach was adopted. Initially, a qualitative approach was used. Two telephone focus groups (n = 16) were conducted with providers (massage therapists) and three telephone focus groups (n = 19) were conducted with repeat users (clients) of either relaxation, remedial or sports massage services. Subsequently, themes were used to develop two specifically designed questionnaires. Practising members of Massage New Zealand (MNZ) (massage therapists: n = 66) and their clients (n = 646) were sampled.
Results
Focus group findings identified six valued elements of the culture of massage therapy care as well as four key drivers for repeat use of massage therapy. The survey response rate was 71.7% (n = 92) for massage therapists and 57.4% (646/1125) for massage clients. The survey of therapists highlighted a number of practice patterns: most therapists are female, NZ European, and hold a massage diploma; and massage therapy was both a full and part time occupation. The majority of massage therapists practised solo but used a wide and active referral network, and commonly used therapeutic / remedial / deep tissue, relaxation, neuromuscular therapy, and sports massage techniques. Common issues or conditions for which massage therapy was used by clients were neck / shoulder pain/problem, relaxation and stress reduction, back pain/problem, and regular recovery or maintenance massage. The essence of massage therapy involved a client-centred partnership approach to massage care, modulated by comfort, contact, connection, and caring. Drivers for returning to, or continuing with massage therapy were a regular appointment, positive expectation, positive experience and positive outcome. Data were used to build a descriptive model of the valued elements of massage therapy encounter: purposeful, participatory, process factors, person centered partnership, and product categories were highlighted.
Conclusions
This thesis provides an informative insight into the practice and repeat utilisation of massage therapy by MNZ therapists and their clients. Furthermore, the description of and insight into the massage therapy encounter highlights elements of process, product, and the therapeutic relationship in massage therapy. These make an original contribution to the literature on massage therapy and provide the foundation and direction for subsequent studies.