The Development and Validation of the Client Expectations of Massage Scale

Abstract

Research Design: A practice-based research methodology was used to collect data from two samples of massage therapy clients. For Sample 1, 21 volunteer massage therapists collected data from their clients before the massage. Factor analysis was conducted to test construct validity and coefficient alpha was used to assess reliability. Correlational analyses with the CEMS, previous measures of client expectations, and the Life Orientation Test-Revised were examined to test the convergent and discriminant validity of the CEMS. For Sample 2, 24 massage therapists distributed study materials for clients to complete before and after a massage therapy session. Structural equation modeling was used to assess the construct, discriminant, and predictive validity of the CEMS.Participants: Sample 1 involved 320 and Sample 2 involved 321 adult massage clients.Intervention: Standard care provided by licensed massage therapists. Main Outcomes: Numeric Rating Scale for pain and Positive and Negative Affect ScheduleRevised (including the Serenity subscale).Results: The CEMS demonstrated good construct, convergent, discriminant and predictive validity, and adequate reliability. Client expectations were generally positive toward massage and their massage therapists. Positive outcome expectations had a positive effect on clients' changes in pain and serenity. High interpersonal expectations had a negative effect on clients' changes in serenity.Conclusions: Client expectations contribute to the nonspecific effects of massage therapy.KEYWORDS: massage therapy, validity, practicebased research, pain, affect introduCtion Although massage therapy is a popular form of complementary and alternative medicine (1) , and evidence for its effectiveness is increasing (2-3) , little is known of the mechanisms by which massage therapy achieves its effects. There is both theoretical (4)(5) and empirical (6)(7)(8) support for the importance of studying the relationships between the expected benefits of health behavior and outcomes of care. As no validated measures of client expectations of massage exist, the purpose of this study was to develop and validate a scale to assess client expectations of massage therapy and massage therapists.