Therapeutic Touch in the hämato-oncological care

Transcription

1 Therapeutic Touch in the hämato-oncological care 22./23 March 2010 Andrea F. Watzl, DGKS, Director of the European Therapeutic Touch Institut, Vienna Gabriele Kerbler, DKKS, TT-Projektleader

2 Various health professionals practice TT since approx. 40 years worldwide in over 80 countries Standards developt for practicing TT in hospitals, clinics and in practice Krieger, Dolores: PhD, RN, Prof. for nursing Uni NY, she started teaching TT 1974 at the University Kunz, Dora Officially practiced in the health care system in Austria since 1998 Evidence based more than 600 studies and publications abstracts (german): download

3 Therapeutic Touch integrated in health care system in Austria Curriculum Nursing School, 3 rd. Year, Pflegeprinzipien und Handlungsschemata Objective/qualification: describing a standardised nursing concept and argumenting the relevance Positionspapier der Pflegenden des KAV 1 st. Okt. 2000, individual and general nursing concept, state of the art, sole responsible field of practice GAMED Integrative Health Care Lehrgang CAM- categories USA/Europe/Austria

4 Nursing Concept according to M. Rogers Nurse diagnosis (n) Energetic field disturbance (NANDA 1994) Standardised steps Standardised documentation Standardised education Evidence based - Benefits well documented/ studies

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7 TT is a natural human potential Aktivated by learning and doing lernabel teachable a holistic nursing intervention a Complementary method practiced additional to medical therapies

8 Laying on of hands although it derives from this Faith healing Psychic healing Analternative treatment instead medical treatment

9 TT is safe has a sientific basis developes creative and intuitive skills state of the art energy medicine/care

10 Therapeutic Touch the steps Centering Assessment and documentation Balancing/ treatment Clearing/unruffling Evaluation and documentation

11 Diagnosis: Energetic field disturbance NANDA 1994 Definition: Disturbance of the energy flow surrounding a person, with the result of a disharmony of body, soul and or mind. Handbook Nurse diagnosis, Marjory Gordon Deutsche Ausgabe Herausgegeben von Jürgen Georg Ullstein, 1998 POP: Energetic field, affected

12 Diagnosis: Energy field disturbance NANDA 1994 Characteristics: (TT-Assessment) Change in temperature (heat, cold) Visual change (appearance, skin colour,...) discontinuity of the field (emptiness, congestion, stagnation...) Movement (tingling, compression/pressure,...) sounds (tones, words,...)

13 .. is the well-being, health and the harmonious structure of the client s energetic field M. Rogers Patient related: Feeling of relaxation Decrease in pain (VAS) Breath is calm and deep Stefan, Allmer, Eberl

14 Therapeutic Touch Basic level lessons Degree: Basic level certificate (=level1,2,3) nursing school -students Therapeutic Touch Practitionerapprox. 1 ½ years, degree: certificate Therapeutic Touch Tutor approx. 3-5 years

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16 Projects with questioning of oncological patients Median 5 VAS TT - Spitalsgesamtprojek Befindlichkeitsveränderung N = 599 5,5 vorher 8,2 nachher TT-Spitalsgesamtprojekt Behandlungsziele N = 223 Psychische Stabilisierung 37 = 13% Subjektive Befindlichkeitsverbesserung 22 = 8% Schmerz 22 = 8% Anderes 9 = 3% Vitalisierung 65 = 22% Entspannung 55 = 19% Symptome 81 = 27%

17 TT before heart transplantation at the New Yorker Columbian Presbytarian Hospital

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20 Therapeutic Touch for a hospice team in Minsk, Belarus The first mobile hospice for adults and geriatric people in Belarus was established with the support of Hilfswerk Austria and the European Commission TACIS. A Therapeutic Touch Basic Course is integrated into the schooling of specialists in the fields of palliative medicine und care.

21 Studies pain Effects of TT on the overall wellbeing of patients with terminal cancer Glasson M., et.al. (1998), N=20 Journal of Holistic Nursing, 16(3):383ff 3 treatments/15-20 minutes VAS for parameters such as pain, fear, nausea, mood, actvity, inner peace, relaxation Effects of TT on pain and fatigue Nahid Aghabati, et.al. (2008) N=90 ecam Advanced Access Feb treatments /30 minutes Pain and und exhaustion by means of scales

22 Elke Uresch, Martina Spalt Feedback of patients: more relaxed, more vital, less stressed,.. Some patients fell asleep during the treatments Feedback of colleagues improved well-being, improved vital energy

23 Therapeutic Touch with adolescent Project for health promotion since Sept in a Viennese School Exam. anxiety abdominal pain headaches neck and shoulder tension Relaxation vitalisation concentration motivation

24 Benefits of Therapeutic Touch As additional and supporting care intervention for hämato-oncological patients Reduction of symptoms through physiological relaxation (pain, sleeping disorders, fatigue, wound healing blockage, affected orientation, ) Reduction of anxiety (fear, anxiousness) improvement of overall wellbeing improvement of vitality

25 TT in the haematology nursing/caring in-patient and out patient care During periods of anxiety/fear Before and after transplantation and examinations Follow- up care additional to pain treatment additional to chemo and radio therapy periods without therapy - follow-up care blockage in the healing of wounds in palliativ care Rehabilitation -post rehabilitation support health care health promotion

26 Practioning care person Balance Care SelfCare Centering, emotional stabilisation Job contentment, job residence time evaluation continuous /nursing schoolstudents, practitioner clients/ patients Touch engraves the development of human beings

27 Chinesisches Sprichwort

28 Contact: European Therapeutic Touch Institute Schmalzhofgasse 6/ Wien Thank you for your attention!

29 TT Benefit for users / team Evaluation continuous/intermediate data Improvement of stress management realisation of own resources Cognition of other people 84% Selfcare 72% Body perception 92% Body posture 88% Breath 92% Sleep 60%

30 Basic Certificate for health care professions Objective: learning of simple applications to integrate into the daily routine. Experience with interactions people and environment Learning and practising of basic techniques Body and centering exercises, SelfCare Standardised steps, documentation Course of treatment, short treatments Focus lies on human beings and touch Duration: 40 units + 20 units documented treatments in 2 or 3 blocks

31 Quelle: Ergebnisbericht 2007 der 3. nationalen Gesundheitswirtschaftskonferenz Deutschlands [1]

32 Complementary methods CAM categories Complementary and Alternative Therapies 1. Alternative Medical Systems (TCM, Homöopathie,..) 2. Mind-Body Interventions (meditation, prayer, music, dance,..) 3. Biologically Based Therapies (herbs, food, vitamins, dietary supplements,..) 4. Manipulative and Body-Based Methods (ostheopathie, chiropractic, massage,..) 5. Energy Therapies - Biofield Therapies (qi gong, Therapeutic Touch,..) - Bioeletromagnetic-based Therapies (magnetic fields,..)

33 a) Care intervention TT for care people nursing, geriatric care and health care,.. b) TT as a complementary method Accompanying medical therapies Health care profession, physiotherapist, Logotherapist, assistant medical technician massage therapist, psychologists, health practitioner,... Doctors, holistic health practitioner, TCM-doctors Health facilitation Health trainer, healing, educator,... c) Hausapotheke (Medicine Chest)??? - family, friends, TT is executed on a multi disciplinary level in hospitals and in practices

34 The care person/nurse should be able to regulate the structures of the energetic fields of human beings and their environment in such way, that the highest potential for the health of human beings can be obtained. Therapeutic Touch, love, hope, humour, music, colours, dance, optimistic attitude, art, movement, nutritional counselling, poetry, nature