Reiki

Reiki

PEP Topic 
Chronic Pain
Description 

Reiki (pronounced "RAY-kee") is a form of energy healing that uses vibration drawn through the practitioner into the recipient, in accordance with the recipient’s need. Proponents hypothesize that Reiki reestablishes the energy balance in areas of the body associated with discomfort, thus promoting healing and increasing quality of life. Researchers have evaluated Reiki in patients with cancer for its impact on anxiety, depression, pain, and fatigue.

Effectiveness Not Established

Research Evidence Summaries

Birocco, N., Guillame, C., Storto, S., Ritorto, G., Catino, C., Gir, N., . . . Ciuffreda, L. (2012). The effects of Reiki therapy on pain and anxiety in patients attending a day oncology and infusion services unit. American Journal of Hospice and Palliative Care, 29, 290–294.

doi: 10.1177/1049909111420859
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Study Purpose:

To examine the effects of Reiki on pain, anxiety, and global wellness among patients with cancer who are receiving chemotherapy

Intervention Characteristics/Basic Study Process:

Reiki sessions were offered to patients in a day oncology and infusion services unit that provided chemotherapy. Patients sat in a chair or lay on a bed during Reiki sessions. Each session lasted approximately 30 minutes. Each patient received a maximum of four Reiki sessions. Prior to each session, Reiki practitioners assessed levels of anxiety and pain according to a numeric scale. After each session, levels of pain and anxiety were recorded on a visual analog scale. The study was done over three years.

Sample Characteristics:

  • The study reported on a sample of 118 patients, but only 22 completed all sessions.
  • Mean patient age was 55 years, with a range of 33–77 years.
  • The sample was 57% male and 43% female.
  • Patients had various types of cancer, and all were receiving chemotherapy.

Setting:

  • Single site
  • Outpatient setting
  • Italy

Phase of Care and Clinical Applications:

Patients were receiving active antitumor treatment.

Study Design:

A prospective pre/post-test design was used.

Measurement Instruments/Methods:

  • Numeric rating scale
  • Visual analog scale (VAS)

Results:

Only 48% of patients had more than one Reiki session, and only 22 patients (17%) completed four sessions and were included in statistical analysis. From session 1 to session 4, mean anxiety scores post-Reiki session declined, but scores immediately after each time point were higher than those reported immediately prior to the session.

Conclusions:

Findings of this study do not support the effectiveness of Reiki. The study included numerous limitations in study design and methods.

Limitations:

  • The study had a small sample size, with fewer than 30 participants.
  • The study had risk of bias due to no control group, no blinding, and no random assignment.
  • Measurement validity/reliability was questionable.
  • The intervention was expensive, impractical, or presented training needs.
  • The study reported that pre-session measures, on a numeric scale, were collected by Reiki providers and that post-session measures, per a VAS, were collected by the practitioner. These are two different scales that cannot be directly compared. The study does not make clear what the actual data scale was or the size of the VAS, for interpretation of data.
  • Scoring was done by the Reiki practitioners, which could introduce bias. Reiki practitioners required two years of training, one year of additional workshops, and one year of in-hospital practice with tutors.

Nursing Implications:

 This study does not support the effectiveness of Reiki. The study and methods were not well designed or reported.

Rosenbaum, M.S., & Velde, J. (2016). The effects of yoga, massage, and reiki on patient well-being at a cancer resource center [Online exclusive]. Clinical Journal of Oncology Nursing, 20, E77–E81. 

doi: 10.1188/16.CJON.E77-E81
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Study Purpose:

To evaluate the effects of yoga, massage, and Reiki therapies on stress, pain, anxiety, mood, overall health, and quality of life (QOL)

Intervention Characteristics/Basic Study Process:

Data were collected from patients who self-enrolled in yoga, Reiki, and massage services during a six-month period. Patients completed study questionnaires before and after participating in one of these services, within one to three minutes before and after participation.

Sample Characteristics:

  • N = 150   
  • AGE = Not provided
  • MALES: 9%, FEMALES: 91%
  • CURRENT TREATMENT: Chemotherapy, radiation therapy, other
  • KEY DISEASE CHARACTERISTICS: Patients involved were at varied points in the care trajectory, and 75% were either newly diagnosed or had completed initial treatment. Disease types were not reported.

Setting:

  • SITE: Single site   
  • SETTING TYPE: Other    
  • LOCATION: Community center in Illinois

Phase of Care and Clinical Applications:

  • PHASE OF CARE: Multiple phases of care
  • APPLICATIONS: Palliative care 

Study Design:

  • Quasi-experimental

Measurement Instruments/Methods:

  • 10-point rating scales for all outcome measures

Results:

The time patients had been participating in the service ranges from one month to more than three years. Significant changes in pain levels pre- and postservice provision were reported (p < 0.001). Individuals receiving Reiki had higher preservice pain levels. Center staff encouraged patients with pain to enroll in Reiki. No significant postservice differences in pain across the intervention types were reported. All patients reported lower anxiety scores after receiving the service (p < 0.001) with no differences between groups.

Conclusions:

Integrative therapies such as Reiki, massage, and yoga may be helpful for management of symptoms such as pain and anxiety.

Limitations:

  • Risk of bias (no control group)
  • Risk of bias (no blinding)
  • Risk of bias (no random assignment) 
  • Risk of bias (no appropriate attentional control condition)  
  • Risk of bias (sample characteristics)
  • Measurement/methods not well described
  • Measurement validity/reliability questionable
  • Author states that this was a repeated measures design and used repeated measures ANOVA, but description of methods looks as if each patient completed study assessment only immediately pre and post a single service. 
  • Measurements were at a time point immediately before and after a service—it is unclear how meaningful this timing is in terms of looking at ongoing symptom management.
  • Validity of the instrument for measurement and interpretation of anxiety and mood is questionable.
  • Pain levels overall were low,suggesting potential floor effects in measurement in non-Reiki patients.
  • No information is provided about chronicity, type, etc., for pain, or any other interventions being used for pain.

Nursing Implications:

This study has numerous limitations and high risk of bias, so no firm conclusions can be drawn about the actual efficacy of the interventions being evaluated.

Systematic Review/Meta-Analysis

Gonella, S., Garrino, L., & Dimonte, V. (2014). Biofield therapies and cancer-related symptoms: A review. Clinical Journal of Oncology Nursing, 18, 568–576. 

doi: 10.1188/14.CJON.568-576
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Purpose:

STUDY PURPOSE: To review the evidence regarding the effects of biofield therapies for relief of cancer-related symptoms
 
TYPE OF STUDY: Systematic review

Search Strategy:

DATABASES USED: PubMed, CINAHL, PsycINFO, Trip database, and Cochrane Collaboration
 
KEYWORDS: Not provided 
 
INCLUSION CRITERIA: Cancer diagnosis; age > 18 years old; undergoing biofield therapies (BT) to relieve cancer-related pain, anxiety, and fatigue, or to increase well-being and quality of life
 
EXCLUSION CRITERIA: Studies related to surgical pain were excluded

Literature Evaluated:

TOTAL REFERENCES RETRIEVED: 121
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Not stated

Sample Characteristics:

  • FINAL NUMBER STUDIES INCLUDED = 13 
  • TOTAL PATIENTS INCLUDED IN REVIEW = 1,003
  • SAMPLE RANGE ACROSS STUDIES = 16–230 patients
  • KEY SAMPLE CHARACTERISTICS: Various tumor types, patients in active treatment undergoing chemotherapy or radiation therapy

Phase of Care and Clinical Applications:

PHASE OF CARE: Active antitumor treatment
 
APPLICATIONS: Palliative care 

Results:

Interventions considered to be BT were healing touch, Reiki, and therapeutic touch. The effect on pain was examined in seven studies. There were some mixed findings, but most showed a reduction in pain over short time periods. Fatigue was assessed in five studies. These demonstrated fatigue reduction post-treatment, but data were conflicting over a longer period of four to eight weeks. Anxiety and depression were examined in seven studies. All but one found a significant reduction in mood disorders, but a study comparing Reiki, sham Reiki, and usual care found no difference between the sham and actual Reiki groups. Most studies were of descriptive or quasi-experimental design; potential confounding variables were not examined, and placebo effects could not be ruled out.

Conclusions:

Studies using biofield therapies for relief of pain, anxiety, fatigue, and depression generally showed benefit; however, the evidence is not strong due to the limitations of the studies included.

Limitations:

Low-quality design studies and the short duration of study follow-up

Nursing Implications:

BT therapies have not demonstrated effectiveness in well-designed clinical studies; however, though it is weak, evidence suggests potential benefit. There were no adverse effects of these interventions reported. Biofield therapies are not expensive and are low-risk, so they can be considered in the management of cancer-related symptoms. Well-designed clinical trials are needed to establish efficacy.

Thrane, S., & Cohen, S.M. (2014). Effect of reiki therapy on pain and anxiety in adults: An in-depth literature review of randomized trials with effect size calculations. Pain Management Nursing, 15, 897–908. 

doi: 10.1016/j.pmn.2013.07.008
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Purpose:

STUDY PURPOSE: To summarize evidence and quantify the effects of reiki on pain and anxiety

TYPE OF STUDY: Systematic review

Search Strategy:

DATABASES USED: PubMed, PROQUEST,CINAHL, MEDLINE, Cochrane, PsychInfo, Web of Science, Global Health, and the Center for Reiki Research
 
KEYWORDS: Pain, anxiety, and reiki
 
INCLUSION CRITERIA: Used reiki in one arm versus a control or usual care group; randomized design; measured either pain or anxiety
 
EXCLUSION CRITERIA: Not specified

Literature Evaluated:

TOTAL REFERENCES RETRIEVED: 55
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: No study quality evaluation described

Sample Characteristics:

  • FINAL NUMBER STUDIES INCLUDED = 7
  • TOTAL PATIENTS INCLUDED IN REVIEW = 328
  • SAMPLE RANGE ACROSS STUDIES: 16–60 patients
  • KEY SAMPLE CHARACTERISTICS: 48% women; mean age 63 years; three studies were in patients with cancer; two studies tested the intervention in a surgical setting; two studies used reiki in community-dwelling adults

Results:

The effects sized for within-group differences ranged from d = 0.24 for decreased anxiety in women undergoing breast biopsy to d = 2.08 for decreased pain in community-dwelling adults. For reiki versus a rest intervention in patients with cancer, the effect for a decrease in pain was d = 0.032, and the effect in community-dwelling adults was d = 0.45. A detailed discussion of individual studies showed some mixed findings, particularly for one study in which reiki was compared to both sham reiki and usual-care groups. The median number of study participants was 24. It was noted that it took more than a year to recruit a small number of subjects in some trials. The timing, number of sessions, and specific applications of reiki varied.

Conclusions:

Data were insufficient to draw any generalizations regarding the effects of reiki on anxiety or pain. The magnitude of the effect sizes calculated suggests Reiki may be helpful, but more rigorous trials with larger samples are needed to fully evaluate its efficacy.

Limitations:

  • Limited number of studies with only three in patients with cancer
  • Sample sizes were small
  • No quality evaluation of studies was include
  • Timing and length of the intervention varied substantially, and most were for very short durations with few reiki sessions

Nursing Implications:

This review did not demonstrate clear efficacy of reiki for pain or anxiety. However, the effect sizes shown here suggest that additional, wel- designed research is warranted. The authors made a note of the difficulty in recruiting patients to these trials and high attrition rates, particularly in the control groups. They suggested that the of a crossover design would be helpful to address these problems. The timing and length of treatment needs to be considered based on the desired effects and context of the patient situation. As much as possible, the standardization of the reiki intervention and the use of a sham control would be helpful to evaluate potential placebo effects.

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