January 10th, 2018
Efficacy of Therapeutic Touch and Effects of Study Designs
The studies evaluated render support for the effectiveness of the use of therapeutic touch in driving better outcomes under widespread conditions. Out of the eleven studies only one suggested the effect of therapeutic touch to no differ significantly between the test (treated appropriately) and the placebo group – given a sham treatment (Frank, et al., 2007). The remainder of studies that conducted a research study (had sample and analysis) have suggested positive outcomes of therapeutic touch in such aspects as improving well being in dementia settings (Doherty, Wright, Aveyard, Sykes, 2006; Gleeson & Higgins, 2009; Gregory &Verdouw, 2005; Jackson, et al., 2008; MacIntyre, et al., 2008; Salzmann-Erikson & Erikson, 2005). Conceptual studies have also argued for the use of therapeutic touch in various settings (Eschiti, 2007; Leder & Krucoff, 2007; Vickens, 2008).
The study findings may have been influenced by various methodological aspects. First of these is the use of small sample sizes in studies that used an exploratory design. One study for instance based its touch meanings evaluation on a sample of 4 participants with an initial sample size target having been seven (Salzmann-Erikson & Erikson, 2005). Such low sample size could affect applicability of findings in widespread settings that therapeutic touch use is suggested to be essential. Second , the limitations to the study involve the use of self-reported measures to evaluate outco9mes. Unless for a study that used a single-blind for the patients (Frank, et al., 2007) the knowledge of participants of the group that are placed in the control or test group could result in bias thus affect validity and reliability of the results (Yu, 2010).
Similar tools of research have been found to be applied in the studies evaluated. For exploratory studies, interviews and questionnaires were main methods used to identify themes according to which analysis was based. Such studies have also been limited by the sample size used. For experimental studies the tolls used to assess aspects such as pain have been found to be similar (e.g. visual analogue scale). Differences in the study tools in the studies evaluated thus arise out of the study design used with similar designs using tools that have a high degree of similarity.
Tools used in the studies evaluated could affect the reliability and validity of the results. The use of self-reported efficacy measures could for instance affect the rating of efficacy especially where the study subjects were the in the know-how of the treatment they received (Yu, 2010).
Evidence Summary and Recommendations
Effects of therapeutic touch under various conditions according to the reviewed literature can be summarized in the table below.
|Outcome Measures||Example Conditions Needing Care||Studies Supporting Positive Effects of Therapy||Studies Finding a Negligible Effects of Therapy|
|Pain, fatigue, anxiety, length of stay, use of antiemetic medication, well being, edema.||Cancer, Surgery, Dementia, other critical illnesses.||5||1|
|Perception meanings||Psychiatric disorders||4||0|
The evidence of effectiveness of therapeutic touch in reviewed studies was evaluated based on outcome measures of associated conditions. Studies on mental health were evaluated in a single group since they used a similar study design (exploratory) that aimed to identify meanings of touch with regards to care giver and recipient. The remaining studies were grouped together with their study designs being different ranging from experimental designs to literature review.
Based on the reviewed literature therapeutic touch (TT) seems to better care outcomes for clients in different conditions. Such evidence reinforces the case for increased entrenchment of TT practice within nursing practice. Adoption of TT within specific care environments however need to be well further evaluated to identify implications of its use under such environments. Limitations of studies reviewed mainly presented by the study designs used call for more research to delineate the usefulness of touch under different conditions. The strategy for nursing with respect to TT should thus be cautious introduction in areas such as psychiatric nursing where its perceived benefits are not broadly acknowledged.