Does the Use of Healing Touch Decrease
Anxiety, Decrease Emergence
Delirium/Emergence Agitation and
Decrease Length of Stay in Preschool
Tonsillectomy & Adenoidectomy (T&A)
Patients in the Post Operative Anesthesia
Care Unit? (PACU)
Wendy Grace Rolf
RN, MSN, CHTP, AHN-BC
What Is “Energy Medicine”
“Biofield Medicine” ?
Healing Touch
Healing Touch is a biofield therapy
that is an energy-based approach to
health and healing. It uses touch to
influence the human energy system.
• The energy system
– energy centers,
– the fields that surround the body,
– the meridians.
Goal of Healing Touch
• Goal restore harmony and balance
• Healing Touch complements conventional
health care
PICO Question:
P (population) Pediatric Post Operative T&A Patients
ages 3 - 6
I (intervention) Healing Touch
C (comparison) No Healing Touch
O (outcome)
Decrease post op anxiety
Decrease emergence delirium/emergence agitation
Decrease time to meet PACU discharge criteria
Outcomes
• Anxiety- Patient’s & Family’s
• Ease of Wake Up--Emergence Delirium/Emergence
Agitation
• Patient Flow- Earlier Discharge to home
• Increase Patient And Family Satisfaction
CCHMC Vision & Mission
2010
Cincinnati Children’s Hospital Medical Center is committed to
improving children’s health and CCHMC values the patient’s
and family’s positive experience and quality of life.
Arrive in PACU after T&A Surgery Complete
Healing Touch Done
Improved Ease of Wake
Up
Less Emergence Delirium &
Agitation
Less Anxiety
Earlier
Discharge to
Home
Parents
More
Satisfied
Review of Literature
Weight of the Evidence
•
CINAHL, MEDLINE, Cochrane, EBSCO, PUBMED, OVID, Centre for Reviews &
Dissemination, Healing Touch International, Healing Touch Program, Dissertations, &
NACHRI
•
•
1960-PRESENT
TERMS:
–
–
–
–
–
–
–
–
–
–
–
–
–
–
Healing touch
Reiki
Bioenergy
Energy medicine
Energy therapies
Energy healing
Children
Anxiety
Anxiety in hospitalized children
Relaxation
Pain
Surgery
Emergence delirium
Length of stay
Findings:
62 articles reviewed
10 most recent & highest level that addressed PICO question
• 3 Meta-analysis or SR
• 3 RCTs
• 3 descriptive studies
• 1 Qualitative
•
•
3 CCHMC PACU staff surveys
1 CCHMC Retrospective Study (Unpublished)
•
2 NACHRI Responses
Synthesis of Evidence
•
High grade of evidence to support the safety of Healing Touch with
adults and children (Jain,2010 [1a]; Lee, (2008) [1a]; So, 2008 [1a];
Whitley, 2008 [1a]).
•
High grade of evidence to support Healing Touch for pain and anxiety
with adults (Jain,2010 [1a]; Lee, 2008 [1a]; So, 2008 [1a]).
•
High grade of evidence to support the use of HT to decrease stress
with premature infants (Hanley, 2008 [2a]; Im, 2009[2b]; Whitley, 2008
[2a]).
•
Moderate evidence that Healing Touch may decrease the length of
stay (MacIntyre, 2008 [2a]).
•
Moderate evidence to support the use of Healing Touch with
children’s stress & anxiety (Kramer, 1990 [4b]; Kemper, 2009 [4a];
Zimmer, 2008 [Unpublished]).
Evidence Summary
Healing Touch may decrease the child’s anxiety and
support the ease of wake up from anesthesia which
may lead to earlier discharge to home.
There is evidence that supports the use of Healing
Touch and other biofield therapies with adults but
little research has been done with children. To date,
there has been no published research with HT and
post operative pediatric patients (Healing Touch
International Research Survey 2010).
Recommendations
Research is needed to answer clinical question
Submit research proposal to IRB for a a prospective, repeated measures
randomly controlled trial to compare two groups of pediatric T&A
patients. One group will receive Healing Touch post operative, while
the control group will receive the usual standard of care.
Research Questions
1. Does Healing Touch decrease stress in post operative pediatric
patients ages 3-6?
2. Does Healing Touch decrease emergence delirium/ emergence
agitation?
3. Does Healing Touch decrease the time it takes to meet discharge
criteria?
Next Steps
• Research & evaluate outcomes
• Share outcomes
– Posters & podium presentations
– Manuscripts
• Teach nurses Healing Touch to support their patients.
• Guide staff in Evidence-Based Practice initiatives at the
unit level
Bibliography
•Barnes PM, Powell-Griner E, McFann K, Nahin Rl. Complementary and alternative medicine use among
adults: United States, 2002. Adv Data. 2004; 343:1-19.
•Hanley, M (2008) Therapeutic touch with preterm infants: composing a treatment. Explore. July/August Vol. 4,
No. 4 249-258.
•Im, H, Eunjung, K Effect of Yakson and Gentle Human Touch versus usual care on urine stress hormones
and behaviors in preterm infants: A quasi –experimental study. International Journal of Nursing Studies 46
(2009) 450-458.
•Jain, S & Mills, P (2010) Biofield Therapies: Helpful or Full of Hype? A best evidence Synthesis. Int. J.
Behav. Med. 17:1-16
•Kemper K, Flecher, N, Hamilton, C, McLean, T. (2009) The Impact of Healing Touch on Pediatric Oncology
Outpatients: Pilot Study. Journal of Society for Integrative Oncology, Vol 7, No 1 (Winter),:12-18
Kramer, N (1990) Comparison of Therapeutic Touch and casual touch in stress reduction of hospitalized children.
Pediatric Nursing. September-October Vol.16/no.5.483-485.
•Lee, MS, Pittler, MH, Ernst, E. (2008) Effects of Reike in clinical practice: a systematic review of randomized
clinical trials. International Journal of Clinical Practice Volume 62, Issue 6, pages 947-954
•MacIntyre, B, Hamilton, J, Fricke, T, Ma, W Mehle, S Michel, M (2008). The efficacy of Healing Touch in coronary
artery bypass surgery recovery: A randomized clinical trial. Alternative Therapies Jul/Aug 2008. Vol 14. No 4
•Maville, J, Bowen, J, Benham, G. (2008) Holistic Nursing Practice, March/April:103-110.
•So, PS, Jiang Y, Qin Y. Touch therapies for pain relief in adults. Cochrane Database of Systematic
Reviews 2008. Issue 4. Art. No.: CD006535. DOI: 10.1002//14651858. CD006535. pub2.
•Whitley, J, Rich, B. (2008) A double-blind randomized controlled pilot trial examining the safety and efficacy of
Therapeutic Touch in premature infants. Advances in Neonatal Care, Vol.8, No.6: 315-33