The Effect of Therapeutic Touch on Pain and Infection in Burn Patients

The purpose of this randomized clinical trial was to determine whether Therapeutic Touch (TT) versus sham TT treatment could produce greater pain relief, reduce anxiety, and lower the rate of nosocomial infection (NI) among burn and/or trauma patients (n = 115). Participants in this study received either TT or sham TT treatment as an adjunct to routinely administered analgesic, sleep, and anti-anxiety medications. The study was conceptually based on Rogers' (1970) theory of unitary human beings.

Data were gathered between November 1995 and June 1996, from the burn unit in a teaching hospital located in the southeastern United States. No significant differences in participants' demographic or study characteristics were found between the experimental (n = 69) and control groups (n = 46).

Data were collected using the McGill Pain Questionnaire, a Visual Analogue Scale for Pain, a Visual Analogue Scale for Anxiety, a Credibility of Treatment Form (CTF), a Visual Analogue Scale for Satisfaction with Therapy, and an Effectiveness of Therapy Form (ETF). Blood was also collected from a subset of participants on days 1 and 6 for lymphocyte analysis. Medication usage in mean morphine equivalents and mean doses per day of sleep, anxiety, and antidepressant medications was recorded for each participant remaining in the study through Day 6.

Of the 69 participants in the experimental group, 77% (n = 53) completed all pain and anxiety assessments in the study, compared to 74% (n = 34) of the 46 participants in the control group (sham TT treatment). Assessments taken at baseline and day 3 on participants lost to the study before day 6 were used in the analysis. Using regression analysis with multiple covariables, including baseline score, age, race, gender, CTF score, days from injury to Day 1, and whether or not pain, sleep, or anti-anxiety medication had been administered within 4 hours of measurement, participants in the TT group were found to have less pain and/or anxiety after treatment than those receiving sham treatment. This difference was statistically significant at alpha = .1 for some, but not other measurements. Usable blood samples on days 1 and 6 were obtained for 12 participants. Those who received TT exhibited 7.8% more CD4+ cells on Day 6 than those who received sham TT treatments [one-tailed t(9) = -1.64, p = .68]. Scores on two of the four items in the ETF indicated that experimental participants had significantly more satisfaction than participants receiving sham treatments.

Of the 88 participants who remained in the study through day 6, only 3 had evidence of an NI during or after participation in the study. The low number of participants with documented infections did not allow for statistical comparisons. No significant differences were found between groups in morphine equivalents or mean doses of sleep, anti-anxiety, or anti-depressant medication.

The investigators concluded that using TT as a nursing treatment was effective in reducing perceived pain and anxiety in this study population. They recommended that a largerscale clinical trial be undertaken with a randomly assigned TT group, sham treatment group, and pure control group. The exceptionally low NI rate documented in this study is believed to have resulted from the unique medical and nursing management strategies employed at the study site. In the interest of decreasing morbidity, mortality, and costs associated with NI, these strategies should be further studied and described.

Final Report available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2007107...