Aims
Palliative care services are increasingly utilising complementary interventions to improve symptom management and quality of life for patients with end-stage illnesses. However, the clinical evidence for complementary interventions in palliative care populations remains limited. Clinical studies evaluating spa therapy with other patient populations suggest this intervention reduces pain severity and anxiety. The aim of this research was to conduct a pilot study to evaluate the use of spa therapy in a palliative care setting with a group of palliative cancer patients to investigate the impact of spa sessions on their perceptions of pain and emotional distress.

Methods
The planned accrual target for this pilot study is 30 participants. To date, six patients with a palliative diagnosis admitted to hospice for symptom management consented to participate. These participants completed 20 minute spa sessions once every two days over a period of two weeks utilising a therapeutic spa system. Participants’ perceptions of psychological distress and pain are assessed prior to and following each spa therapy session. Patients are followed up weekly to assess quality of life utilising the McGill QOL scale.

Results
Results will be analysed using a repeated measures analysis of variance. To detect differences in perceived levels of psychopathology and pain and minimise multiple comparisons the means from the post treatment sessions for each scale will be calculated to create a summary score. The significance of the variability of changes will also be analysed.

Conclusions
It is hypothesised that spa therapy sessions decrease subjective reports of pain and distress and improve subjective perceptions of QOL. The prospective nature of this study will allow an assessment of perceptions of pain and distress following a non pharmacological intervention. Amelioration of psychological and physical symptoms is key to assist patients to improve quality of life during end-stage cancer. If therapeutic spas reduce pain and improve psychological well being, non pharmacological intervention has the potential to enhance the effectiveness of pharmacological treatments for pain and distress whilst easily being integrated into standard clinical palliative care practice. Consistently offering a non pharmacological intervention such as spa therapy may also improve the quality of the palliative care experience for patients, carers and staff.

Acknowledgement of funding – Calvary Centre for Palliative Care Research