The effect of abdominal massage on nutrition intolerance and blood sugar levels in intensive care patients with continuous enteral feeding and diabetes

Non-pharmacological methods, such as abdominal massage, have been reported to benefit the management of complications that may develop in patients receiving enteral nutrition. This study aimed to evaluate the impact of abdominal massage on feeding intolerance and blood sugar levels in hospitalised intensive care unit patients with diabetes who were receiving continuous enteral nutrition. The sample of the study, which was conducted as a randomised controlled experimental study between 12.06.2023-24.06.2024, consisted of 64 patients, 32 intervention and 32 control, who were hospitalised in intensive care units, were over 18 years of age, had a diagnosis of diabetes, had just started continuous enteral nutrition with nasogastric catheter, and had a Glasgow Coma Scale >3. The data were collected by the researcher in the intensive care units of a state hospital. Consent was obtained from the patients who could give consent to participate in the study and from the first-degree relatives of those who could not give consent. The patients in the abdominal massage group received abdominal massage twice a day for 15 minutes in the morning and evening for five days. Personal Information Form, Patient Parameters Monitoring Form in which the changes occurring during the continuous enteral nutrition process and nutritional intolerance were recorded and Bristol Stool Scale in which stool classification was performed were used for data collection. Abdominal distension, abdominal circumference, blood glucose levels, gastric residual volume 4 times a day, gastric residual volume 5 times a day, type and frequency of defecation twice a day, nutritional solution and water infusion rate were evaluated daily. Consort flow chart was adhered to during the study and enrolment was made in the clinical trials database (NCT06075121). It was found that gastric residual volume scores and the amounts of nutritional solution and water in the patients in the abdominal massage and control groups did not differ significantly between the groups (p>0.05). It was found that the presence of abdominal distension was significantly lower in the abdominal massage group on the 3rd day compared to the control group (p<0.05). It was found that the rate of diarrhoea was significantly higher in the abdominal massage group compared to the control group on the 4th day (p<0.05). In the 1st, 2nd, 3rd and 4th measurements of blood glucose values in the abdominal massage and control groups, it was found that the intra-group/repeated measurement mean differences were not statistically significant (p>0.05). In this study, abdominal massage was found to reduce abdominal distension. Integration of abdominal massage into nursing care practices and further studies in this field are recommended.