Therapeutic touch and post-Hurricane Hugo stress

Effects of Intentional Touch on Complicated Grief of Bereaved Mothers

Loss of one's child represents one of the most traumatic events a human may endure. Few effective interventions have been documented. The purpose of this research was to determine the effect of touch therapy on grieving mothers. Bereavement responses of mothers who had lost a child in the previous 6–60 months ( n 31, intervention group; n 34, comparison group) were evaluated for significant differences between intervention (touch therapy) and comparison groups, measured by the Grief Experience Inventory (GEI). Analysis of the nine clinical scales of the GEI demonstrated statistically significant differences for the intervention group on the following scales: despair ( F 8.290, p .006), depersonalization ( F 4.904, p .031), and somatization ( F 6.833, p .012). Significance of findings as they relate to treatment of complicated grief is discussed.

Pandimensional Field Pattern Changes in Healers and Healees

Rogers's Science of Unitary Human Beings framed this study of pandimensional pattern changes in healers and healees paired for an 8-week series of Therapeutic Touch (TT) sessions. Comparison of healee patterns before and after 141 TT sessions supported the hypotheses that healees would manifest decreased pulse and blood pressure, and reduced pain and stress ( p < .05). Duration of TT sessions was not preset but determined by healers according to energy cues. TT time was not related to pattern changes, consistent with the clinical practice of TT and the atemporal nature of Rogers's conceptual framework. Healers and healees showed parallel changes after the TT series. Participants manifested greater spirituality ( p <.05). Although increases in three of the four dimensions of power were significant ( p <.05), changes in power measured as a whole were not. Contrary to expectations, manifestations of diversity were decreased in healers and healees.

The implementation and evaluation of therapeutic touch in burn patients: an instructive experience of conducting a scientific study within a non-academic nursing setting

OBJECTIVE

Evaluation of therapeutic touch (TT) in the nursing of burn patients; post hoc evaluation of the research process in a non-academic nursing setting.

METHODS

38 burn patients received either TT or nursing presence. On admission, days 2, 5 and 10 of hospitalization, data were collected on anxiety for pain, salivary cortisol, and pain medication. Interviews with nurses were held concerning research in a non-academic setting.

RESULTS

Anxiety for pain was more reduced on day 10 in the TT-group. The TT-group was prescribed less morphine on day 1 and 2. On day 2 cortisol level before dressing changes was higher in the TT-group. The situational challenges of this study led to inconsistencies in data collection and a high patient attrition rate, weakening its statistical power.

CONCLUSION

Conducting an effect study within daily nursing practice should not be done with a nursing staff inexperienced in research. Analysis of the remaining data justifies further research on TT for burn patients with pain, anxiety for pain, and cortisol levels as outcomes.

PRACTICE IMPLICATIONS

Administering and evaluating TT during daily care requires nurses experienced both in TT and research, thus leading to less attrition and missing data, increasing the power of future studies.

The Internal Process of Therapeutic Touch

Therapeutic Touch (TT) is a complementary healing modality used by health care providers to reduce anxiety, accelerate relaxation, decrease pain, and enhance immunity. Research studies report outcomes of TT treatments, but few describe the specific process. This qualitative research study was conducted to describe the nature of the core process of TT in adults and full term infants as practiced by five professional nurses, each treating one adult and one infant. Analysis of data obtained from interviews and focused participant observations was conducted. Findings provide empirical data to depict an overall process divided into three phases: (a) preparation, (b) treatment, and (c) termination, that adheres to the standard process as described by Krieger. It expands on the description of each phase, including two new subcomponents, orienting and disengagement, not previously seen in the literature. Lastly, the study describes the modification of the TT process with infants compared to adults.

Therapeutic touch for anxiety disorders

BACKGROUND

Anxiety disorders are a common occurrence in today's society. There is interest from the community in the use of complementary therapies for anxiety disorders. This review examined the currently available evidence supporting the use of therapeutic touch in treating anxiety disorders.

OBJECTIVES

To examine the efficacy and adverse effects of therapeutic touch for anxiety disorders.

SEARCH STRATEGY

We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (CCDANCTR-Studies and CCDANCTR-References) (search date 13/01/06), the Controlled Trials website and Dissertation Abstracts International. Searches of reference lists of retrieved papers were also carried out and experts in the field were contacted.

SELECTION CRITERIA

Inclusion criteria included all published and unpublished randomised and quasi-randomised controlled trials comparing therapeutic touch with sham (mimic) TT, pharmacological therapy, psychological treatment, other treatment or no treatment /waiting list. The participants included adults with an anxiety disorder defined by the Diagnostic and Statistical Manual (DSM-IV),the International Classification of Diseases (ICD-10), validated diagnostic instruments, or other validated clinician or self-report instruments.

DATA COLLECTION AND ANALYSIS

Two review authors independently applied inclusion criteria. Further information was sought from trialists where papers contained insufficient information to make a decision about eligibility.

MAIN RESULTS

No randomised or quasi-randomised controlled trials of therapeutic touch for anxiety disorders were identified.

AUTHORS' CONCLUSIONS

Given the high prevalence of anxiety disorders and the current paucity of evidence on therapeutic touch in this population, there is a need for well conducted randomised controlled trials to examine the effectiveness of therapeutic touch for anxiety disorders.

Influences of a Relaxation Intervention on Perceived Stress and Power Spectral Analysis of Heart Rate Variability

This study was designed to determine whether power spectral analysis (PSA) of heart rate variability (HRV) can detect change in autonomic tone following a relaxation intervention called therapeutic touch (TT). Thirty healthy subjects underwent TT by one of three TT practitioners using the steps developed by Krieger and Kunz (The Therapeutic Touch, Prentice-Hall, 1979). Both subjects and TT practitioners were monitored by continuous electrocardiographic monitoring (Holter) before (15 minutes), during, and after (15 minutes) TT was administered. Subjects and TT practitioners completed a visual analogue scale (VAS) of perceived stress before and after TT. Change scores for VAS and PSA of high-frequency/low-frequency (HF/LF) ratios were compared for the 2-minute interval before TT began and the end of TT and the end of the recovery period, using t tests. VAS scores decreased (less stress) from before to after TT for both subjects (p < 0.0005) and TT practitioners (p < 0.0005). Mean HF/LF ratios increased significantly to reflect greater parasympathetic dominance from before TT to the end of treatment for subjects (p = 0.006), but not for TT practitioners. However, further analysis revealed that this change was due to an exaggerated HF/LF response from four outliers (p < 0.0005). Data collected in this study did not reveal differences between these four subjects and the rest of the sample. There were no significant changes in HF/LF ratios from the end of TT to end of recovery for either group. Further research is needed to determine why some subjects may have greater change in autonomic tone in response to relaxation in order to be able to predict who will demonstrate physiologic response to relaxation interventions.

Touch the pain away: new research on therapeutic touch and persons with fibromyalgia syndrome

This pilot study tested the effectiveness of 6 therapeutic touch treatments on the experience of pain and quality of life for persons with fibromyalgia syndrome. Its findings support that subjects who received therapeutic touch had a statistically significant decrease in pain for each pretherapeutic to posttherapeutic touch treatment, as well as significant improvement in quality of life from pre-first to pre-sixth treatment. Therapeutic touch may be an effective treatment for relieving pain and improving quality of life in this specific population of persons with fibromyalgia syndrome.

Therapeutic caring: a learning disability experience

This paper is a reflective account of our experiences of giving Therapeutic Touch (TT), for the first time within a learning disability setting, to a client who has profound learning disabilities. Using a case study approach, we share our story of this pathfinder journey of discovery and show how the process of reflection was instrumental in enabling us to gain insight on the unfolding therapeutic and caring relationship which we developed with this client. Issues relating to informed consent were addressed, however these were complex and needed special consideration. As client consent could not be achieved through verbal means we needed to draw on our senses and use intuitive skills together with team involvement. IntroducingTT into a learning disability setting was breaking new ground, and as this case study has shown it does appear to have the potential to enhance therapeutic caring.

Biological correlates of Reiki Touch(sm) healing

BACKGROUND

Despite the popularity of touch therapies, theoretical understanding of the mechanisms of effect is not well developed and there is limited research measuring biological outcomes.

AIMS

The aim of this study was to test a framework of relaxation or stress reduction as a mechanism of touch therapy.

METHODS

The study was conducted in 1996 and involved the examination of select physiological and biochemical effects and the experience of 30 minutes of Reiki, a form of touch therapy. A single group repeated measure design was used to study Reiki Touch'ssm effects with a convenience sample of 23 essentially healthy subjects. Biological markers related to stress-reduction response included state anxiety, salivary IgA and cortisol, blood pressure, galvanic skin response (GSR), muscle tension and skin temperature. Data were collected before, during and immediately after the session.

RESULTS

Comparing before and after measures, anxiety was significantly reduced, t(22)=2.45, P=0.02. Salivary IgA levels rose significantly, t(19)=2.33, P=0.03, however, salivary cortisol was not statistically significant. There was a significant drop in systolic blood pressure (SBP), F(2, 44)=6.60, P < 0.01. Skin temperature increased and electromyograph (EMG) decreased during the treatment, but before and after differences were not significant.

CONCLUSIONS

These findings suggest both biochemical and physiological changes in the direction of relaxation. The salivary IgA findings warrant further study to explore the effects of human TT and humeral immune function.

The experience of therapeutic touch from a nursing perspective

This article describes the phenomenon of therapeutic touch (TT). Similarities and differences in the experience of the phenomenon from the perspective of a novice practitioner and healthy volunteers are highlighted. A qualitative analysis of findings indicates that the experiences of giving and receiving TT can be classified within two categories: the cognitive (knowing in the widest sense); and conative (instinct and feeling). The key constructs which emerged in this study are associated with feelings such as tingling, warmth, coolness, comfort, peace, calm and security. Formulation of the two main categories, cognitive and conative, emphasize the relationship associated with what is known by the mind and instinctively felt by the body. The holistic aspects associated with the phenomenon of TT are confirmed in the therapeutic relationship which can be formed between the practitioner and recipient during the administration of TT. It is suggested that TT, when provided by the nurse in the clinical setting, can promote feelings of comfort, peace, calm and security among patients.

Physiologic and psychodynamic responses to the administration of therapeutic touch in critical care

Recent publications have questioned the efficacy of therapeutic touch (TT). The focus of attention has been on substantiating the existence of the recipient's energy field rather than on the physiologic and psychodynamic responses to TT. In this article the physiologic and psychodynamic responses during and following the administration of TT is described. The project involved the implementation of a time series design in which the physiologic and psychodynamic responses were measured. It is acknowledged that critical care environments are stressful for patients in terms of invasive medical and nursing procedures. Continuous bright lighting, and excessive noise prohibits the potential for relaxation and sleep. Within this context, the control of confounding variables was not possible, and therefore not an object of concern in the study. Rather the responses to TT in the natural setting were of importance to discern. Statistical repeated measures analysis of variance (one way) indicated there was no significant difference between pre-, during and post-physiologic variables in response to TT. However psychodynamic responses demonstrated significant correlation's in terms of relaxation and sleep. The non significance of physiologic change in variables pre-, during and post-administration of TT indicates critically ill patients remained physiologically stable. Significant correlations of psychodynamic responses demonstrated it is possible for critically ill patients to experience periods of relaxation and sleep in an otherwise stressful environment. TT was found to be a useful therapy to enhance relaxation and sleep in critically ill patients.

The efficacy of therapeutic touch for improving functional ability in elders with degenerative arthritis

The purpose of this Rogerian study was to determine whether therapeutic touch improved functional ability in elders with arthritis as compared to routine treatment and progressive muscle relaxation. Eighty-two non-institutionalized elders were randomly assigned to therapeutic touch or progressive muscle relaxation treatments. Subjects served as their own control for 4 weeks, then received six treatments at 1-week intervals. Pain, tension, mood, and satisfaction improved after therapeutic touch and progressive muscle relaxation. Hand function improved after therapeutic touch; walking and bending improved after progressive muscle relaxation. Functional ability was significantly different between the two groups for mobility and hand function. Lower scores (indicating better function) were attained by the therapeutic touch group.

The effectiveness of therapeutic touch: a meta-analytic review

The purpose of this article is to explore the adequacy of published scientific evidence supporting therapeutic touch as a nursing intervention. Meta-analytic techniques were used to integrate the research-based literature published in the past decade. The results seem to indicate that therapeutic touch has a positive, medium effect on physiological and psychological variables. It is impossible to make any substantive claims at this time because there is limited published research and because many of the studies had significant methodological issues that could seriously bias the reported results. Resolving these methodological issues is imperative for therapeutic touch research to move forward.

Experiences of administering and receiving therapeutic touch in intensive care

This article describes the experiences of a practitioner who administered therapeutic touch (TT) to two patients in an intensive care unit and the experiences of the two patients who received TT. The experiences are presented as two case studies. Each of the patients presented in the case studies received either five or ten treatments of TT lasting five minutes each. Following each administration of TT the practitioner described what she sensed verbally and in writing. However, owing to the medical conditions of the patients, only brief interviews were conducted in which the patients were asked to describe their experiences of receiving TT. The experiences, which have been reflected in the case studies, indicate TT assists patients to relax, brings comfort and a sense of peace. Much like meditation, TT helps patients become more in touch with themselves. They come to understand more about themselves and reality. TT is recommended as a practice which could contribute to the psychological well-being of patients in intensive care as it promotes relaxation, comfort and a sense of peace.

Effect of therapeutic touch on the well-being of persons with terminal cancer

The purpose of this study was to examine the effect of three Therapeutic Touch treatments on the well-being of 20 persons with terminal cancer in palliative care. Participants in the experimental group (n = 10) received three noncontact Therapeutic Touch treatments, the duration of which varied between 15 to 20 minutes. Participants in the control group (n = 10) participated in three rest periods. Well-being was measured at preintervention time and immediately postintervention time using the Well-Being Scale, a visual analogue scale measuring pain, nausea, depression, anxiety, shortness of breath, activity, appetite, relaxation, and inner peace. The results of the study support the hypothesis that three noncontact Therapeutic Touch treatments increase sensation of well-being in persons with terminal cancer.

Therapeutic touch as a nursing intervention

Therapeutic Touch (TT) is being proposed as a nursing intervention. Its proponents claim that it is integral to the art of nursing practice and can facilitate comfort and healing in a wide range of patients. However, the practice of TT is also controversial, primarily because it does not usually involve physical contact and is based on energy field theoretical frameworks. The development of TT and its conceptualization as an energy field interaction are reviewed, and points of controversy discussed. The method of practice is described. Review of controlled efficacy studies indicates limited and inconclusive scientific support for its proposed effects. The intrinsic relationship between TT and the placebo phenomenon is discussed. The potential of TT to enhance the placebo effect requires further exploration but should not be discounted in seeking to relieve discomfort and distress and facilitate healing. For some patients, TT may serve as a beneficial adjuvant nursing intervention.

Therapeutic touch with HIV-infected children: a pilot study

In this pilot study, 20 HIV-infected children, 6 to 12 years of age, were randomly assigned into therapeutic touch (TT) and mimic TT groups. The effectiveness of TT in reducing anxiety was evaluated. The self-report measure, the A-State Anxiety subscale of the Spielberger State-Trait Anxiety Inventory For Children, was administered before and immediately after interventions. As predicted, the TT intervention resulted in lower overall mean anxiety scores, whereas the mimic TT did not. These findings provide preliminary support for the use of TT in reducing the state anxiety of children with HIV infection.

Reflection of a therapeutic touch experience: case study 2

The purpose of this case study was to explore the experience of both giving and receiving Therapeutic Touch. A subjective account of the Therapeutic Touch experience is given in an attempt to throw light on its unique creative and therapeutic qualities. In most instances it was shown that the experience of both giving and receiving Therapeutic Touch was a parallel experience. This case study explores the effects of Therapeutic Touch on a client experiencing pain and associated anxiety. Whilst a response to treatment was observed, the need for further case studies and research studies in this area was identified.

Quantitative research on therapeutic touch. An integrative review of the literature 1985-1995

Quantitative research on Therapeutic Touch (TT), published in referred nursing journals from 1985 to 1995, is reviewed. Therapeutic Touch is defined by Dolores Krieger, the founder of this nursing intervention. The authors of this Integrative Review examine what is known and not known to date in order to facilitate appropriate application of this modality in practice, and to offer recommendations for future research. Critical characteristics of eleven quantitative studies are identified and analyzed. These characteristics include: author/year/journal/title; study purpose (hypotheses); background/literature review/conceptual citations; sample selection method; study design/random assignment; independent variable/length of treatment/control and confounders; dependent variables/measurements; outcomes; study limitations; and implications for future research. After reviewing the studies, it is concluded that there is evidence to support the practice of Therapeutic Touch for the reduction of pain or anxiety. There is clearly a lack of congruity between the research statement, conceptual framework, operational definition of TT and the findings. This incongruity is discussed and incorporated in the recommendations for future research including outcome, theory-generating and theory-testing research.

The state of research on the effects of therapeutic touch

Therapeutic Touch is investigated using an integrative review of the literature. Using Ganong's (1987) methodology, the article explores the research question, What is the state of development of research regarding Therapeutic Touch? by analyzing primary research reports from 23 articles in 14 referred journals. The findings of the review indicate positive regard for the use of Therapeutic Touch. All research points to the need for further study in this area. Research methods used are satisfactory, but more rigorous methodologies would promote a more scientific contribution to the body of literature on Therapeutic Touch.

The effectiveness of therapeutic touch for decreasing pain in elders with degenerative arthritis

The purpose of this study was to determine if Therapeutic Touch (TT) decreased pain in elders with degenerative arthritis, compared with routine treatment and progressive muscle relaxation (PMR). Eighty-two noninstitutionalized subjects, age 55 or older, were randomly assigned to TT or PMR treatments. Subjects served as their own controls for 4 weeks and then received six treatments at 1-week intervals. Visual analogue scales (VAS) for pain intensity and distress were used. Significant differences from baseline to postsixth treatment were found within groups. TT decreased pain (t(46) = 7.60, p = < .001) and distress (t(44) = 7.08, p = < .001). PMR decreased pain (t(36) = 6.58, p = .005) and distress (t(36) = 6.90, p = < .001). Differences in effectiveness existed between the TT and PMR groups; the pain and distress scores were lower in the PMR group. The differences approached significance for pain, F(2, 76) = 2.8, p = .06, and were significant for distress, F(2, 75) = 5.6, p = .005.

Therapeutic touch with adolescent psychiatric patients

Seven hospitalized, adolescent psychiatric patients who received a total of 31 Therapeutic Touch treatments over two 2-week periods were interviewed about their experience. Findings from the interviews were categorized within 2 overarching themes-the therapeutic relationship and the body/mind connection. The study participants enjoyed the Therapeutic Touch, and in fact, they wanted more of it. This research shows the possibility of Therapeutic Touch as a nursing intervention with adolescent psychiatric patients if all care is taken to obtain their consent and to provide them with a safe environment for touch therapy.

Anxiety and therapeutic touch

This four-group, repeated-measures experimental design divided 40 healthy professional caregivers/students into high- and low-anxiety groups and further into "therapeutic touch" and comparison groups. The effectiveness of the use of therapeutic touch in reducing anxiety was evaluated, as were the methodologies used. Three self-report measures of anxiety (Profile of Mood States, Spielberger's State/Trait Anxiety Inventory, and visual analogue scales) were evaluated for equivalence and concurrent validity to determine their potential for use in future studies. The correlations among these instruments were highly significant. The small sample size prevented differences between groups from reaching statistical significance, but the reduction of anxiety in the high-anxiety group was greater for those who had received therapeutic touch than for those who did not. Using variability data, the sample size necessary to find statistically significant differences between those who had therapeutic touch and those who did not was determined.

Healing touch as a nursing intervention: wound infection following cesarean birth--an anecdotal case study

From the context of postoperative wound infection care, this article describes the clinical use of Healing Touch, an integrated system of energetic healing techniques now being taught nationwide in cooperation with the American Holistic Nurses' Association. The author documents the progress of a patient with a significant wound infection as a consequence of cesarean birth. Along with standard medical care, the patient received Healing Touch treatments. This is an anecdotal report and is not intended to replace a structured study on wound healing.