Pilot Study to Test the Effectiveness of Healing Touch on Agitation in People With Dementia

Mind-body practices for people living with dementia and their family carers: a systematic review

INTRODUCTION

People with dementia and their family carers may benefit from non-pharmacological interventions, including mind-body (MB-) practices, which can improve physical and mental health by inducing relaxation. This systematic review provides an overview of availability and effects of MB-practices.

CONTENT

The authors performed a systematic search in PubMed, Embase, Emcare, Web of Science, Cochrane Library, PsycINFO, China National Knowledge Infrastructure and Academic Search Premier on February 1, 2024. Research papers on MB-practices for people with dementia and/or their family carers in English, Chinese, Japanese, German, French and Dutch were included if a full text was available. Selection of included articles, data extraction and methodological quality assessments were conducted by two researchers.

SUMMARY

Of the 130 included studies, 100 (77 %) were of high quality. Traditional Chinese Medicine (TCM) and touch interventions for people with dementia, and meditations for family carers resulted in improvements in respectively cognition and neuropsychiatric symptoms, and mental health. Lack of evidence for other MB-practices is related to small numbers of studies, fragmented use of outcome measures and mixed findings.

OUTLOOK

MB-practices showed promising results. We recommend implementation and further research of TCM- and touch interventions for people with dementia as well as meditations for family carers. We suggest a cross-over of the promising results of one group to be studied in the other group.

Effect of Therapeutic Touch on Sleep Quality in Elders Living at Nursing Homes

This study was carried out to investigate the effect of therapeutic touch on sleep quality in the elderly people living in the nursing homes. The study is a randomized controlled experimental study (pretest-posttest control group). The sample of the research consisted of 25 elderly people. As a result of the study, although there was a significant increase (p < 0.05) in the sleep quality of each group, no significant difference was found between the groups (p > 0.05). Therapeutic touch is an effective method of improving the sleep quality of the elders living at a nursing home.

Mind-Body Therapies in Individuals With Dementia: An Integrative Review

Mind-body therapies frequently derive from Eastern philosophies and are becoming increasingly popular. These therapies, such as meditation, yoga, tai chi, qigong, biofield therapies, and guided imagery, have many reported benefits for improving symptoms and physiological measures associated with various chronic diseases. However, clinical research data concerning the effectiveness of these practices in individuals with dementia have not been evaluated using a synthesis approach. Thus, an integrative review was conducted to evaluate studies examining the efficacy of mind-body therapies as supportive care modalities for management of symptoms experienced by individuals with dementia. Findings from the studies reviewed support the clinical efficacy of mind-body practices in improving behavioral and psychological symptoms exhibited by individuals with dementia. [Res Gerontol Nurs. 2017; 10(6):288-296.].

Mental Health Wellness and Biofield Therapies: An Integrative Review

Biofield therapies such as Healing Touch and Reiki increase relaxation, decrease anxiety and stress, and improve mood. Understanding the efficacy of these therapies in terms of mental health wellness is important for nurses interested in complementary and integrative care. The goal of the present integrative review was to investigate the state of knowledge regarding biofield therapies and the impact on anxiety, mood, and mental health wellness. Electronic databases were searched for articles available in English and published from 2014 to 2016. Biofield therapies show safety and promise in reducing anxiety, improving mood, and cultivating mental health and wellness.

Complementary medicine for treatment of agitation and delirium in older persons: a systematic review and narrative synthesis

BACKGROUND

Agitation and delirium frequently occur in cognitively impaired older people. We conducted a systematic review with narrative synthesis of the literature aiming to assess effectiveness of complementary and alternative medicine (CAM) modalities to address these conditions.

METHODS

Following preliminary search, we included 40 original researches on CAM treatment of delirium and agitation in older persons. Then, the quality of these studies was assessed using the Downs and Black Checklist and Quality Assessment Tool for Studies with Diverse Designs, and the effect sizes were calculated. We subsequently conducted a narrative synthesis of the main findings, including theory development, preliminary synthesis, exploration of relationships within and between studies, and assessment of synthesis robustness.

RESULTS

Forty articles that met the inclusion criteria were analyzed. Sixteen of these were randomized controlled trials. One article specifically addressed CAM treatment of delirium in patients without dementia, and the remaining 39 articles described treatments of agitated older persons with dementia. Thirty-five of the 40 included studies suggested that the investigated CAM therapies may ameliorate the severity of agitation and delirium. The physiological surrogates of agitation assessed in these studies included cortisol level, chromogranin A level, and heart rate variability. Very few of the studies systematically assessed safety issues, although no major adverse effects were reported.

CONCLUSION

Overall, the systematic review of the literature suggests that several CAM modalities are potentially beneficial in the treatment of agitation and delirium among older persons. We suggest that promising CAM modalities should be further explored through large-scale randomized controlled trials in different clinical settings. Copyright © 2017 John Wiley & Sons, Ltd.

Bio-Energy during Finals: Stress Reduction for a University Community

To re-examine the effectiveness of a bio-energy intervention on self-reported stress for a convenience sample of university students during dead week, a quasi-experimental, single-group pretest-posttest design was used. Thirty-three students participated, serving as their own controls. After participants had consented, a 15-min Healing Touch intervention followed enrollment. Self-reported stress was significantly reduced after the bio-energy (Healing Touch) intervention. Bio-energy therapy has shown to be beneficial in reducing stress for students during dead week, the week before final examinations. Further research is needed.

A Pilot Study

AIM

To examine the effectiveness of a bio-energy intervention on self-reported stress for a convenience sample of University students, faculty, and staff during finals week. We hypothesized that participants would report a decrease in stress after a 20 minute bio-energy intervention.

STUDY DESIGN

A quasi-experimental, single-group, pretest-posttest design was used.

METHOD

Thirty-nine faculty, staff, and students participated. Participants served as their own controls. A specific technique was provided by each bio-energy practitioner for 20 minutes after participants had completed a visual analogue scale identifying level of stress and listing two positive and negative behaviors they were currently using in response to stress.

RESULTS

A one-sample t test indicates that bio-energy therapy significantly reduces stress, t(35) = 7.74, p < .0001. A multiple regression analysis further indicates that the decrease in stress levels is significantly greater for higher initial stress levels, t(31) = 4.748, p < .0001); decreases in stress are significantly greater for faculty and staff compared to students, t(31) = -2.223, p = .034; and decreases in stress levels are marginally significantly higher for older participants, t(31) =1.946, p = .061.

CONCLUSION

Bio-energy therapy may have benefit in reducing stress for faculty, staff, and students during final examination week. Further research is needed.

An Initial Study Using Healing Touch for Women Undergoing a Breast Biopsy

AIM

To determine if a noninvasive complementary therapy, Healing Touch, would benefit women undergoing diagnostic procedures for the determination of breast cancer. Women often experience high levels of fear and anxiety during this diagnostic period.

STUDY DESIGN

A randomized controlled pilot study.

METHOD

An out-patient clinic specializing in breast care management was used. Seventy-three women age 18 to 85 years old participated, with 31 in the control group of standard care and 42 in the intervention group receiving Healing Touch, a noninvasive energy therapy. A specific technique, magnetic clearing, was provided by a practitioner for 15 minutes prior to the biopsy procedure. Both the State-Trait Anxiety Inventory and the Coping Resources Inventory were used preprocedurally and the following day to assess changes.

RESULTS

A mixed analysis of variance indicated that State Anxiety for the Healing Touch group showed a statistically significant reduction of anxiety that was sustained into the following day, F(2, 142) = 10.94, p < .001. For Trait Anxiety, there was a significant change pre-and postintervention to the day after, F(2, 142) = 5.15, p < .007. The Coping Resources Inventory had significant changes in two subcategories, Emotional, F(2, 142) = 6.10, p = .003, and the Spiritual/Philosophical, F(2, 142) = 6.10, p < .001, in the Healing Touch group.

CONCLUSION

Healing Touch may have benefit in reducing anxiety from diagnostic breast procedures.

A systematic scoping review of complementary and alternative medicine mind and body practices to improve the health of veterans and military personnel

BACKGROUND

Meditation, imagery, acupuncture, and yoga are the most frequently offered mind and body practices in the Department of Veterans Affairs. Yet, the research on mind and body practices has been critiqued as being too limited in evidence and scope to inform clinical treatment.

OBJECTIVES

We conducted a systematic scoping review of mind and body practices used with veterans or active duty military personnel to identify gaps in the literature and make recommendations for future primary research.

RESEARCH DESIGN

Following systematic literature review methodology, we searched 5 databases using 27 different National Center for Complementary and Alternative Medicine-defined mind and body practices as text words, keywords, and MeSH terms through June 30, 2014. We also conducted handsearches of 4 previous reviews.

SUBJECTS

Active duty military members or veterans 18 years or older participating in mind and body practice interventions globally.

MEASURES

Data were extracted from studies meeting 5 inclusion criteria. The quality of randomized controlled trials (RCTs) was assessed using an existing checklist.

RESULTS

Of 1819 studies identified, 89 interventions (50 RCTs) published between 1976 and 2014, conducted in 9 countries, using 152 different measures to assess 65 health and well-being outcomes met our inclusion criteria. Most interventions took place in the United States (n=78). Meditation practices (n=25), relaxation techniques including imagery (n=20), spinal manipulation including physical therapy (n=16), and acupuncture (n=11) were the most frequently studied practices. Methodological quality of most RCTs was rated poorly.

CONCLUSIONS

Meditation and acupuncture practices are among the most frequently offered and studied mind and body practices. Future research should include yoga as it is currently understudied among veterans and military personnel. A repository of mind and body intervention outcome measures may further future research efforts, as would conducting pragmatic trials and more robust RCTs.

Using an experimental model for the study of therapeutic touch

OBJECTIVE

to verify whether the Paw Edema Model can be used in investigations about the effects of Therapeutic Touch on inflammation by measuring the variables pain, edema and neutrophil migration.

METHOD

this is a pilot and experimental study, involving ten male mice of the same genetic strain and divided into experimental and control group, submitted to the chemical induction of local inflammation in the right back paw. The experimental group received a daily administration of Therapeutic Touch for 15 minutes during three days.

RESULTS

the data showed statistically significant differences in the nociceptive threshold and in the paw circumference of the animals from the experimental group on the second day of the experiment.

CONCLUSION

the experiment model involving animals can contribute to study the effects of Therapeutic Touch on inflammation, and adjustments are suggested in the treatment duration, number of sessions and experiment duration.

WITHDRAWN: Touch therapies for pain relief in adults

This review is out of date and has been withdrawn. The content of the review may be of historical interest to readers.

The editorial group responsible for this previously published document have withdrawn it from publication.

Healing touch for older adults with persistent pain

The purpose of this report was to provide an in-depth review of responses from older adults residing in long-term care facilities receiving Healing Touch (HT) for pain management. Persistent pain is common in this population and, while the mainstay for pain management is analgesics, HT may provide supportive therapy. Twenty older adults from 5 facilities in the southwestern United States participated in the study, with 12 receiving the active intervention of HT and 8 receiving the control of presence care. A convergent mixed-methods approach was used in this secondary report, using the providers' descriptions of 84 HT sessions and quantitative findings to provide an in-depth within-case analysis. Outcome measures included quantitative measures of pain, daily living, and quality of life, as well as qualitative descriptors of the HT sessions. The findings suggest that the experience is highly varied and on a continuum from no perceived or noticeable benefit to a decrease in pain and improvement in other physiological and psychosocial symptoms. Therefore, HT may be beneficial for some older adults within long-term care facilities as an adjunct for chronic pain.

Biofield therapies and cancer pain

The public and healthcare professionals have become increasingly aware and accepting of the benefit in physical, psychological, social, and spiritual support for patients with cancer. Patients with cancer often seek nonpharmacologic interventions to complement conventional care and decrease the pain associated with cancer and its treatment. Most often referred to as complementary and alternative medicine (CAM), these supportive therapies consist of a heterogeneous group of modalities used as adjuncts to allopathic health care. Biofield therapies are CAM modalities that involve the direction of healing energy through the hands to facilitate well-being by modifying the energy field of the body. This critical review of studies of biofield therapies emphasizes research using these modalities to decrease pain in patients with cancer. Although the therapies have demonstrated clinical efficacy, additional research is warranted. Oncology nurses should familiarize themselves with biofield therapies so they can offer informed recommendations to patients with cancer experiencing pain.

Biofield therapies in cardiovascular disease management: a brief review

Though there have been advances over the last 30 years in the therapeutic approaches to cardiovascular disease (CVD), heart disease and stroke remain the leading cause of mortality and morbidity worldwide. Many medical therapies for CVD are associated with a number of side effects, often leading patients to seek non-pharmacological treatments to complement standard care. Referred to as complementary and alternative medicine (CAM), these therapies consist of a heterogeneous group of modalities used in addition to conventional health care. Biofield therapies exist within this CAM domain and involve the direction of healing energy to facilitate general health and well-being by modifying the energy field. What follows is a brief overview of three biofield therapies developed or used within the field of nursing (Therapeutic Touch, Reiki, and Healing Touch), surveying the use of these interventions for individuals with CVD, and outcomes that may impact CVD risk factors and health-related quality of life.

Effects of healing touch in clinical practice: a systematic review of randomized clinical trials

Hands-on healing and energy-based interventions have been found in cultures throughout history around the world. These complementary therapies, rooted in ancient Eastern healing practices, are becoming mainstream. Healing Touch, a biofield therapy that arose in the nursing field in the late 1980s, is used in a variety of settings (i.e., pain centers, surgical settings, and private practices) with reported benefits (i.e., decreased anxiety, pain, and depressive behaviors; increased relaxation and a sense of well-being). However, clinical trial data concerning the effectiveness of Healing Touch have not been evaluated using a systematic, evidence-based approach. Thus, this systematic review is aimed at critically evaluating the data from randomized clinical trials examining the clinical efficacy of Healing Touch as a supportive care modality for any medical condition.

Anxiety and related symptoms in older persons with dementia: directions for practice

Anxiety disorders and related symptoms commonly occur in older people with cognitive impairment or dementia, significantly worsening functioning and reducing quality of life. This review of the literature outlines the extent of the problem, and focuses on current best practices in psychosocial interventions anxiety in persons with dementia. Discussion follows on promising nonpharmacological interventions that are recommended for further consideration and future research.

Improving the well-being of nursing leaders through healing touch training

INTRODUCTION

Chronic stress adversely affects performance. We evaluated the effect of Healing Touch training on subjective and objective measures of stress in nursing leaders in an academic health center.

MATERIALS AND METHODS

In this quasi-experimental single group pretest-post-test study, we recruited nursing leaders at an academic health center and provided 17.5 hours of Healing Touch training over 2 days. We measured subjective measures of stress using visual analog scales as well as heart rate variability 1-2 weeks before and 4 weeks after the training.

RESULTS

Target enrollment was exceeded within 2 weeks; all participants were women and the mean age was 47 years. Of the 26 enrollees, 24 completed training, and 20 (77%) completed all pre- and post-training measures. There was significant improvement in self-reported stress, depression, anxiety, relaxation, well-being, and sleep. Heart rate variability changes were also significant for total power, high- and low-frequency power, and coherence, suggesting improved autonomic function consistent with greater well-being.

CONCLUSIONS

Training nurse leaders in an academic health center in Healing Touch is associated with significant improvements in subjective and objective measures of stress. Additional studies are needed to compare the impact of this training versus stress management training on the nurses themselves and on the quality of care.

Touch therapies for pain relief in adults

BACKGROUND

Pain is a global public health problem affecting the lives of large numbers of patients and their families. Touch therapies (Healing Touch (HT), Therapeutic Touch (TT) and Reiki) have been found to relieve pain, but some reviews have suggested there is insufficient evidence to support their use.

OBJECTIVES

To evaluate the effectiveness of touch therapies (including HT, TT, and Reiki) on relieving both acute and chronic pain; to determine any adverse effect of touch therapies.

SEARCH STRATEGY

Various electronic databases, including The Cochrane Library, MEDLINE, EMBASE, CINAHL, AMED and others from their inception to June 2008 were searched. Reference lists and bibliographies of relevant articles and organizations were checked. Experts in touch therapies were contacted.

SELECTION CRITERIA

Randomized Controlled Trials (RCTs) or Controlled Clinical Trials (CCTs) evaluating the effect of touch on any type of pain were included. Similarly, only studies using a sham placebo or a 'no treatment' control was included.

DATA COLLECTION AND ANALYSIS

Data was extracted and quality assessment was conducted by two independent review authors. The mean pain intensity for completing all treatment sessions was extracted. Pain intensity from different pain measurement scales were standardized into a single scale. Comparisons between the effects of treatment groups and that of control groups were made.

MAIN RESULTS

Twenty four studies involving 1153 participants met the inclusion criteria. There were five, sixteen and three studies on HT, TT and Reiki respectively. Participants exposed to touch had on average of 0.83 units (on a 0 to ten scale) lower pain intensity than unexposed participants (95% Confidence Interval: -1.16 to -0.50). Results of trials conducted by more experienced practitioners appeared to yield greater effects in pain reduction. It is also apparent that these trials yielding greater effects were from the Reiki studies. Whether more experienced practitioners or certain types of touch therapy brought better pain reduction should be further investigated. Two of the five studies evaluating analgesic usage supported the claim that touch therapies minimized analgesic usage. The placebo effect was also explored. No statistically significant (P = 0.29) placebo effect was identified.

AUTHORS' CONCLUSIONS

Touch therapies may have a modest effect in pain relief. More studies on HT and Reiki in relieving pain are needed. More studies including children are also required to evaluate the effect of touch on children.

Energy-based modalities

Research on touch therapies is still in the early stages of development. Studies of Therapeutic Touch, Healing Touch, and Reiki are quite promising; however, at this point, they can only suggest that these healing modalities have efficacy in reducing anxiety; improving muscle relaxation; aiding in stress reduction, relaxation, and sense of well-being; promoting wound healing; and reducing pain. The multidimensional aspects of healing inherent in patient care continue to be expanded and facilitated by our understanding and application of energy therapies.