<![CDATA[Post-surgical sleep disturbance is a common problem with a prevalence of 64.9%, while pre-operative anxiety is also frequently experienced by almost all patients undergoing surgery. Pharmacological interventions such as sedatives and analgesics often carry side effects such as dependence and over-sedation. Slow Stroke Back Massage (SSBM) and Hot Stone Massage (HSM) have emerged as promising non-pharmacological alternatives, but scientific evidence regarding the effectiveness of these two techniques in the orthopedic surgical population is still limited. This literature review aims to examine the effectiveness of Slow Stroke Back Massage (SSBM) and Hot Stone Massage (HSM) in reducing anxiety and improving sleep quality in orthopedic surgery patients. This study used a literature review method based on the PICOT approach. Articles were searched systematically through the PubMed, ProQuest, Cochrane Library, and Google Scholar databases with keywords: "slow stroke back massage", "hot stone massage", "anxiety", "sleep quality", "orthopedic surgery", and "postoperative". Inclusion criteria included full-text articles, orthopedic surgery patient population, SSBM or HSM intervention, anxiety and/or sleep quality outcomes, and publications between 2013 and 2026. Of the 2,222 identified articles, 6 articles met the inclusion criteria for review. The six articles reviewed consisted of 4 Randomized Controlled Trial (RCT) studies and 2 Quasi-Experiment studies. The results showed that SSBM and HSM significantly reduced postoperative anxiety levels with a p value <0.001 and improved sleep quality in orthopedic surgery patients with a p value <0.001. The duration of the intervention varied between 5 to 15 minutes, with a frequency of 1-2 times a day. Both massage techniques showed better effectiveness than routine care without massage. Non-pharmacological interventions in the form of SSBM and HSM were proven to be significantly effective in reducing anxiety and improving sleep quality in post-orthopedic surgery patients. Both massage techniques are considered safe, economical, and can be implemented independently by nurses. However, study limitations such as small sample sizes, protocol heterogeneity, and lack of control for additional medications emphasize the need for large-scale randomized controlled clinical trials to strengthen the existing evidence.]]>
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