It is therefore believed that the drop in vital signs after the therapeutic touch session may be related to tactile and kinesthetic stimulation of the baby. A Brazilian study with 30 elderly patients that had the objective of evaluating the effect of therapeutic touch in chronic pain, in self-rating depression and sleep, also demonstrated significant reduction in pain These data reinforce the ones found in the present study, in which the pain score presented by the NBs was also reduced after the use of this strategy, like other vital signs.
During data collection, the researchers of this study noted that the use of therapeutic touch in the NB also contributed to calm down the mothers, by noticing their children more relaxed after the application of the technique, especially after suffering a painful procedure. At the end of the session, the NB was really more relaxed, with calm face, sleeping for 1 or 2 hours, remaining calm after waking up.
The stimuli related to maternal care and from the environment are the mediators of the continuous neurobiological development of the NB and, above all, they determine the organization of the functioning neural networks, besides regulating the responses to the situations of pleasure and frustration The results reinforce, once again, the importance of therapeutic touch as an effective strategy to render comfort to the NB, and at the same time, tranquility to the mothers, enabling them to more effectively participate in the child's care, since they also interact with their babies during the therapy.
This study corroborates the result of another research that used a technique with similar principles of placing hands and energy channeling - Reiki. This research verified that biological changes may be generated within a limited time frame, demonstrating the potential of this resource to improve clinically factors relevant to health status of the individuals Although the results demonstrated effectiveness of therapeutic touch in decreasing vital signs, further studies with larger samples are needed to validate these findings.
There were significant changes in all vital signs after the therapeutic touch, especially in pain score. The study demonstrated the effectiveness of therapeutic touch in the babies' relaxation and pain reduction. Therapeutic touch is, therefore, a powerful humanizing strategy, since besides relieving pain and providing comfort to the NB, it fosters closer affective bonds between the child and their family members.
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Conclusion: The results showed that therapeutic touch promotes relaxation of the baby, favoring reduction in vital signs and, consequently in the basal metabolism rate. Table 1 Vital signs presented by the newborns before and after therapeutic touch. Open in a separate window. HR: heart rate; RR: respiratory rate. Figure 1. Percentage decrease in mean vital signs after therapeutic touch. Moreira ME. Costenaro RG. Souza D, Silva MJ.
Rev Latinoam Enferm. The results showed that therapeutic touch promotes relaxation of the baby, favoring reduction in vital signs and, consequently in the basal metabolism rate. Admission to the neonatal intensive care unit NICU places the newborn NB in a restricted environment, where he she is exposed to unpleasant stimuli, such as stress and pain.
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Noise, intense light, and the clinical and invasive procedures are constant, generating significant changes in the NB's vital signs 1 — 3. It is important to emphasize the need to provide assistance with a holistic approach, in such a way that care contributes to reducing the deleterious effects caused by hospitalization, both for NB as well as their family members 4 — 6. The use of alternative measures, such as therapeutic touch, used to reestablish and rebalance body energy, can be very effective 7 — 9.
Therapeutic touch is a healing method in which, by the use of hands, energy, warmth and love are transferred from a donor to the body of a recipient.
This method guides the practitioner on how to proceed to concentrate and focus attention, a crucial part of every healing process 9 , The practitioner then enters in harmony with the universal field, by means of a conscious interaction, so that they can guide the patient's vital energy in such a way as to reestablish their vitality 5. Besides the exchange of energy established between therapist and patient, the therapeutic touch, as well as other types of massage, also produces mechanic stimulation of the tissues, by means of applying pressure and elongation, compressing and putting tension in the soft tissues, and, as a consequence, stimulating the receptor nerve terminals It is important to mention that skin pressure of different intensity gives origin to tactile stimuli, thus activating nerve receptors.
This stimulus is converted into electrochemical reactions, which are sent to the posterior horn of the spinal cord and from there to the hypothalamus Since the tactile fibers are more myelinated than the nervous ones thick fibers , the tactile stimulus reaches the cord faster, inhibiting the thin fibers, which carry the painful stimulus. Besides that, when the hypothalamus is stimulated, endorphins and enkephalins are released and they have an action similar to morphine, acting over pain and generating a feeling of pleasure Since the hypothalamus is the mediator system for emotions and regulates visceral functions, tactile stimulus may act over the autonomous system, relieving stress and anxiety However, touching does not encompass only the physical aspect, but also an affective experience.
This is due to the fact that nervous receptors, which are touch sensory elements, induce neurologic, glandular, muscle, and mental changes, which combined may produce or trigger emotions Therapeutic touch is recognized as a nursing complementary practice by the Federal Board of Nursing CFE, acronym in Portuguese , according to the COFEN resolution , of March 19, , and it is allowed to be used in patient's care Like other complementary therapies, the therapeutic touch is an auxiliary treatment, not replacing conventional treatment, and should be done in parallel to the treatment plan proposed by the health professional team A study using complementary application of therapeutic touch in women with breast cancer on chemotherapy demonstrated a reduction in side effects of the medication, such as nausea, vomiting, mucositis, anorexia, abdominal pain, esophagitis, diarrhea, and bowel constipation.
This practice represented, therefore, an important tool to plan and implement nursing care to be dlivered by the nursing team to oncologic patients under chemotherapy Another study addressed the use of massage as a means to grant comfort to women during labor, and demonstrated the therapeutic value of this procedure in promoting relaxation and relieving pain in that moment It also led to improvement in arterial blood pressure and in the quality of sleep and rest Considering the benefits reported in the literature in regard to the use of therapeutic touch, this study proposes to investigate its use as a way to give relief to stress experienced by neonates admitted to the NICU.
To compare vital signs of newborns admitted to neonatal intensive care before and after the application of therapeutic touch.
Wilson, David August [WorldCat Identities]
In the present study there was manipulation of variables, in this case the use of therapeutic touch independent variable , and vital signs dependent variable. The same group of NBs was assessed in regard to vital signs before control group and after experimental group the application of the therapeutic touch. Nevertheless, this choice was on purpose, since the first NBs admitted to the NICU during the data collection period were included in the sample. The sample consisted of 40 NBs admitted to the NICU during October , having their legal guardians agreed to their participation in the research, and signing the Informed Consent Form.
To collect the data, an instrument was designed encompassing information on the epidemiologic profile of the NBs and the vital signs before and after the application of therapeutic touch: temperature, heart and respiratory rates, and pain intensity. It consists of five behavioral parameters and one physiological indicator evaluated before, during and after acute invasive procedures. Therapeutic touch was applied soon after painful procedures in the NB, and before starting it, a warm, well-ventilated and relaxing environment was provided, using reassuring background music at low volume The steps of the technique in NB are herein described: the baby was positioned comfortably while the investigator stood behind and to its side, maintaining the position of the hands in each region of the body for 3 minutes, in many parts, such as head, anterior and posterior chest, one at a time.
Sessions lasted from 20 to 30 minutes, and further attention was dedicated to the ill parts of the body 19 , The relationship between humor and pain was studied with 80 participants, aged 18—44 years. On top of the water there was an arm resting place on which the participant held the left arm. Participants were divided into four groups of Group 1 watched a humorous film, Group 2 watched a repulsive film, Group 3 watched a neutral film, and Group 4 had no film to watch.
State-Trait Anxiety Inventory, Humor Questionnaire, measurement items for self-efficacy for pain control, visual analog scale for anxiety, and a post-experiment questionnaire were used. Pain tolerance significantly increased with humor. In addition to the behavioral and physiological effects, the benefits of interacting with clowns are not restricted to patients; family and professionals seem to also benefit.
Interaction with clowns interferes in a whole context in which the child is placed. An example of this was found in a study performed in Germany, in which one of the objectives was to evaluate the performance of clowns by the parents of hospitalized children and by the hospital staff.
The study included 37 parents and 43 staff, and a satisfaction scale and monitoring at the acting field were applied. Both the parents and the staff reported that they and patients benefit from the intervention. The results show a strong relationship of empathy and complicity between the Clown Doctors and the children, as well as a strong sense of belonging, on the part of artists, to the hospital community, visible in the relationship established with professionals and in delivering a quality care that provides well-being and joy.
This sense of sharing and creating ties extends also to the children's relatives, who act as channels of communication between the relationship Clown Doctor and the child. To show that the changes are not perceived only by those attending the presentation, a study investigated something different in this regard. Data revealed a wide opening to the presence of artists, pointing them as potential minimizers of the hospitalization and treatment emotional impact and highlighted their contribution to the humanization of care and demystification of health professionals.
However, the reported disadvantages were panic or fear of clown by some children, little receptivity due to suffering, and resistance to the presence of clowns by adolescents due to the childishness involved. Finally, the survey of this intervention disadvantages 22 brings to discussion the recognition of limitations regarding the playful interaction with clowns, such as the fear of clown arising mainly from fantasies, which makes it essential that professionals involved in playful activities with clowns show sensitivity, common sense, and respect for children and their negative reactions crying, screaming, refusal to play with clown in order to be really beneficial and therapeutic..
Despite its limitations, such as observational bias a single observer assessed the behavior and applied the non-verbal behavior scale , option for the application of a non-validated instrument, and measurement bias lack of vital signs continuous measurement , the study has outcomes indicating that the playful interaction with clowns can be a therapeutic resource to minimize the effects of the stressor environment during the intervention, improve the emotional status of children, and reduce pain perception..
The authors declare no conflicts of interest.. Inicio Revista Paulista de Pediatria English Edition Effect of interaction with clowns on vital signs and non-verbal communication of ISSN: Effect of interaction with clowns on vital signs and non-verbal communication of hospitalized children.
Descargar PDF. Autor para correspondencia. Under a Creative Commons license. Table 1. Table 2. Table 3. Table 4. Objective Compare the non-verbal communication of children before and during interaction with clowns and compare their vital signs before and after this interaction. Methods Uncontrolled, intervention, cross-sectional, quantitative study with children admitted to a public university hospital.
Non-verbal communication was observed before and during the interaction using the Non-Verbal Communication Template Chart, a tool in which non-verbal behaviors are assessed as effective or ineffective in the interactions.
Results The sample consisted of 41 children with a mean age of 7. Systolic and diastolic blood pressure increased and pain scales showed decreased scores. Conclusions The playful interaction with clowns can be a therapeutic resource to minimize the effects of the stressing environment during the intervention, improve the children's emotional state and reduce the perception of pain.oxonoqyx.gq
Wong´s Fundamentos Enfermagem Pediátrica (Portuguese Edition)
Non-verbal communication. Texto completo. Introduction The joy therapy, also called laughter therapy or humor therapy, is a known therapeutic method since the s. This study was done in order to better understand the effects of playful interaction of clowns in non-verbal communication and the physiological parameters of hospitalized children. Method This is an uncontrolled, cross-sectional, interventional study, investigating quantitative variables, with vital signs and non-verbal communication as dependent variables. Children with intellectual and visual impairments that prevent them from identifying the design of faces pain scale or interact with the clowns were excluded.
A previous observation of non-verbal communication was carried out at this time.
The intervention time lasted 20min.
Related Wong´s Fundamentos Enfermagem Pediátrica (Portuguese Edition)
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