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治疗性触摸对烧伤患者疼痛和焦虑的影响。

The effect of therapeutic touch on pain and anxiety in burn patients.

作者信息

Turner J G, Clark A J, Gauthier D K, Williams M

机构信息

University of Alabama School of Nursing, University of Alabama at Birmingham, 35294-1210, USA.

出版信息

J Adv Nurs. 1998 Jul;28(1):10-20. doi: 10.1046/j.1365-2648.1998.00770.x.

Abstract

The purpose of this single-blinded randomized clinical trial was to determine whether therapeutic touch (TT) versus sham TT could produce greater pain relief as an adjunct to narcotic analgesia, a greater reduction in anxiety, and alterations in plasma T-lymphocyte concentrations among burn patients. Therapeutic touch is an intervention in which human energies are therapeutically manipulated, a practice conceptually supported by Rogers' (1970) theory of unitary human beings. Data were collected at a university burn centre in the south-eastern United States. The subjects were 99 men and women between the ages of 15 and 68 hospitalized for severe burns, and they received either TT or sham TT once a day for 5 days. Baseline data were collected on day 1, data were collected before and after treatment on day 3, and post-intervention data were collected on day 6. Instruments included the McGill Pain Questionnaire, Visual Analogue Scales for Pain, Anxiety and Satisfaction with Therapy, and an Effectiveness of Therapy Form. Blood was drawn on days 1 and 6 for lymphocyte subset analysis. Medication usage for pain in mean morphine equivalents, and mean doses per day of sleep, anxiety and antidepressant medications were recorded. Subjects who received TT reported significantly greater reduction in pain on the McGill Pain Questionnaire Pain Rating Index and Number of Words Chosen and greater reduction in anxiety on the Visual Analogue Scale for Anxiety than did those who received sham TT. Lymphocyte subset analyses on blood from 11 subjects showed a decreasing total CD8 + lymphocyte concentration for the TT group. There was no statistically significant difference between groups on medication usage.

摘要

这项单盲随机临床试验的目的是确定,对于烧伤患者,治疗性触摸(TT)与假治疗性触摸相比,作为麻醉性镇痛的辅助手段,是否能带来更大程度的疼痛缓解、更大程度地减轻焦虑以及引起血浆T淋巴细胞浓度的变化。治疗性触摸是一种对人体能量进行治疗性操控的干预措施,罗杰斯(1970年)的整体人类理论在概念上支持了这一做法。数据收集于美国东南部的一家大学烧伤中心。研究对象为99名年龄在15至68岁之间因严重烧伤住院的男性和女性,他们每天接受一次TT或假TT治疗,持续5天。第1天收集基线数据,第3天在治疗前后收集数据,第6天收集干预后的数据。使用的工具包括麦吉尔疼痛问卷、疼痛视觉模拟量表、焦虑视觉模拟量表、治疗满意度量表以及治疗效果表格。在第1天和第6天采集血液进行淋巴细胞亚群分析。记录以平均吗啡当量计算的疼痛用药量,以及睡眠、焦虑和抗抑郁药物的日均剂量。接受TT治疗的受试者在麦吉尔疼痛问卷疼痛评分指数和所选词汇数量上的疼痛减轻程度,以及在焦虑视觉模拟量表上的焦虑减轻程度,均显著高于接受假TT治疗的受试者。对11名受试者血液进行的淋巴细胞亚群分析显示,TT组的总CD8 +淋巴细胞浓度降低。两组在用药方面无统计学显著差异。

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