Abstract
BACKGROUND: Enteral nutrition helps maintain nutritional status and sustain quality of life in palliative care patients. In this context, enteral nutrition supports nutritional intake, while nursing care aims to enhance comfort and prevent related complications. OBJECTIVES: This study aimed to evaluate the effects of abdominal massage and in-bed exercise on gastrointestinal complications, pain and comfort in enterally fed palliative care patients. METHODS: A randomised controlled trial was conducted at a palliative care centre with 105 patients assigned to three groups: abdominal massage, in-bed exercise, and control (n = 35 each). In the abdominal massage intervention, superficial and deep effleurage, petrissage, vibration and repeated superficial effleurage manoeuvres were applied sequentially. The in-bed exercise intervention consisted of passive exercises designed to maintain the range of motion of the upper and lower extremity joints. Interventions were administered twice daily for 3 days, with 15-min sessions. Data were collected using the Patient Information Form, Comfort Behaviours Checklist, Wong-Baker Faces Pain Rating Scale, and Gastrointestinal Complication Form. RESULTS: In the abdominal massage group, constipation and abdominal distension significantly decreased over time (p < 0.05). In the in-bed exercise group, constipation, nausea, vomiting, and distension significantly decreased (p < 0.05). Pain scores were significantly lower in both the abdominal massage (1.97 ± 0.70) and in-bed exercise (2.05 ± 0.80) groups compared to the control group (p < 0.001). Comfort scores were significantly higher in both intervention groups (71.60 ± 7.89 and 71.25 ± 10.05, respectively) than in the control group (p < 0.001). CONCLUSIONS: Abdominal massage and in-bed exercise are effective, safe, and independent nursing interventions that reduce gastrointestinal complications and pain, while improving comfort in palliative care patients receiving enteral nutrition. TRIAL REGISTRATION: ClinicalTrials.gov: NCT07125482.