Woods Diana Lynn, Beck Cornelia, Sinha Karabi
School of Nursing, University of California Los Angeles, CA 90095-6919, USA.
Forsch Komplementmed. 2009 Jun;16(3):181-9. doi: 10.1159/000220479. Epub 2009 Jun 5.
Between 75-90% of nursing home (NH) residents with dementia develop behavioral symptoms (BSD) which may be associated with a stress response. Therapeutic touch has been shown to decrease restlessness in NH residents, however the mechanism is unknown. The purpose of this randomized controlled trial (RCT) was to examine the effect of therapeutic touch on BSD and basal cortisol levels among NH residents with dementia.
Using a double blind experimental interrupted time series ABAB design, 65 participants were assigned to one of three groups. The experimental group received therapeutic touch with contact on the neck and shoulders delivered twice daily for 3 days (administered over 2 separate treatment periods); the placebo group received a mimic treatment identical in appearance, and the control group received routine care. Study outcomes were BSD, measured by the modified Agitated Behavior Rating Scale (mABRS), and salivary cortisol levels, measured by enzyme-linked immunosorbent assay (ELISA).
64 residents, aged 67-93 years (M = 85.5, SD = 5.50), completed the study. Restlessness was significantly reduced in the experimental group compared to the control group (p = 0.03). There was a significant difference in morning cortisol variability among groups across time periods (<0.0001). Findings suggest that therapeutic touch may be effective for management of symptoms like restlessness coupled with stress reduction. At a time when cost containment is a consideration in health care, therapeutic touch is an intervention that is non-invasive, readily learned, and can provide a non-pharmacologic alternative for selected persons with BSD.
75%至90%的患有痴呆症的养老院居民会出现行为症状（BSD），这可能与应激反应有关。治疗性触摸已被证明可减少养老院居民的躁动，但机制尚不清楚。这项随机对照试验（RCT）的目的是研究治疗性触摸对患有痴呆症的养老院居民的BSD和基础皮质醇水平的影响。
采用双盲实验性中断时间序列ABAB设计，65名参与者被分配到三组中的一组。实验组接受颈部和肩部接触的治疗性触摸，每天两次，持续3天（在两个单独的治疗期内进行）；安慰剂组接受外观相同的模拟治疗，对照组接受常规护理。研究结果包括通过改良的激越行为评定量表（mABRS）测量的BSD和通过酶联免疫吸附测定（ELISA）测量的唾液皮质醇水平。
64名年龄在67至93岁之间（M = 85.5，SD = 5.50）的居民完成了研究。与对照组相比，实验组的躁动明显减少（p = 0.03）。各时间段内各组间早晨皮质醇变异性存在显著差异（<0.0001）。研究结果表明，治疗性触摸可能对管理躁动等症状以及减轻压力有效。在医疗保健中考虑成本控制的当下，治疗性触摸是一种非侵入性、易于学习且可为选定的BSD患者提供非药物替代方案的干预措施。
