Abstract
BACKGROUND: Nurses face demanding work linked to poor mental and physical health. Evidence for Swedish classic massage in this context is limited to short-term trials with passive comparators. Before a randomised controlled trial, feasibility should be evaluated. Guided by Bowen’s feasibility framework, we examined a 12-month, monthly Swedish classic massage programme for nurses, focusing on limited efficacy (stress, mental health, sleep, physical activity, HR-QoL, pain, work ability) and acceptability (recruitment, adherence, satisfaction). METHODS: An embedded mixed-methods, one-group pre–post design was used. Quantitative outcomes were assessed at baseline, 6 months, and 12 months. Limited efficacy was defined as ≥ 3 target domains with effect sizes ≥ 0.20 at 6 or 12 months. Acceptability was appraised using predefined traffic light criteria (Green, Amber, Red) for recruitment, adherence, and satisfaction. Qualitative data from open-ended questions at 12 months explored participants’ experiences. RESULTS: Twenty-five nurses participated (84% completed follow-up). Recruitment reached 50% of the target (Amber), while adherence and satisfaction met Green thresholds. According to predefined criteria, limited efficacy was achieved, with ≥ 3 target domains exceeding the 0.20 threshold at both 6 and 12 months. Domains contributing to this signal included stress, HR-QoL, work ability, and mental health, with many changes evident by 6 months. Depressive symptoms and exhaustion continued to improve to 12 months, while sleep and sustained pain relief contributed only partially to the limited efficacy signal. Integration of quantitative and qualitative data indicated that perceived reductions in stress, increased emotional balance, and greater capacity to manage work demands aligned with measured outcomes. CONCLUSION: This feasibility study met predefined acceptability and limited efficacy criteria, except for recruitment. Progression to a larger trial in this format is not warranted; however, modifications such as extended recruitment, repeated invitations, and preference-based designs may improve feasibility. Domains with weaker or inconsistent change may require targeted co-interventions in a future evaluation. TRIAL REGISTRATION: ClinicalTrials.gov NCT05555082