The Effect of Healing Touch on Anxiety, Stress, Pain, Pain Medication Usage, and Physiological Measures in Hospitalized Sickle Cell Disease Adults Experiencing Vaso-Occlusive Pain Episodes

Presented by Linda Thomas, PhD, RN-BC, CCRN, CHTP

Introduction: Sickle cell disease (SCD), a common genetic blood disorder affecting primarily African-Americans causes a vaso-occlusive pain episode (VOPE) affecting both men and women across their life span. Both physical and psychological stress has been reported to precipitate aVOPE placing them at risk for early death. In fact, 78% of the patients who die from SCD do so during a VOPE.

Purpose: Healing Touch (HT), a complementary therapy, has been shown to decrease anxiety, stress, and pain in other patient populations such as cancer, orthopedic, and post-cardiac surgery patients, but sickle cell pain has not been studied. The purpose of this parallel-group randomized control trial (RCT) was to determine the effectiveness of Healing Touch on anxiety, stress, pain, pain medication usage, and selected physiological measures of hospitalized SCD adults experiencing a VOPE.

Methods: The outcome variables were measured, while controlling for the music and presence. The study sample was 24 participants who ranged in age from 22 to 49 years with an average age of 31.4 years. The participants were allocated to a treatment (HTM) or control (ACM) group by using a permuted block randomization scheme to ensure an equal number of patients in each group. Healing Touch sessions were administered for 30 minutes on four consecutive days, and the self-reported data on anxiety, stress, pain, and the selected physiological data were collected.

Results: The results on the 16 patients who completed the study were not statistically significant across the two groups due to the small sample size. Overall, there were no statistically significant changes in any between group comparisons, except for present pain on day 4 for the Attention Control with Music (ACM) group. For both Healing Touch with Music (HTM) and the ACM, the within groups comparison showed a reduction in physiological parameters, but was not statistically significant. For anxiety, the within groups comparison showed a statistically significant reduction for the ACM group (p=.01). For stress, the ACM group reached a statistically significant reduction (p=.03), after day 4, however the HTM group also reached statistical significance after day 2 (p=.02) and again after day 4 (p=01), consistent with the findings from previous studies in HT. The pre- to post-intervention reductions in present pain were greater in the HTM group than the ACM group across all 4 days. The only statistically significant within groups findings for present pain reduction were in the HTM group (p<.01) on day 1, consistent with other studies done with HT.

Implications: Integrative therapies are becoming more common in healthcare as patients begin to seek out other option outside of conventional medicine. The trends identified in this study using one of those integrative therapies, Healing Touch, warrant further research on its effect on anxiety, stress and pain as a possible adjunct in the treatment of vaso-occlusive pain in the SCD patient.