Jackson, E., Kelley, M., McNeil, P., Meyer, E., Schlegel, L., & Eaton, M. (2008). Does therapeutic touch help reduce pain and anxiety in patients with cancer? Clinical Journal of Oncology Nursing, 12, 113–120.

To examine research about the effectiveness of therapeutic touch in decreasing the pain and anxiety of patients with cancer

• Databases searched were PubMed, CINAHL, and the Cochrane Library.
• Search keywords were healing touch, therapeutic touch, cancer, and pain and anxiety.
• Studies were included if they
  • Researched the use of therapeutic touch in the context of any type of cancer.
  • Used therapeutic touch as the independent variable and pain or anxiety as the dependent variable.
• Exclusion criteria were not cited.
• Although the initial search strategy did not include the search keywords healing touch or Reike, these terms were included later.

• The study does not cite the number of studies retrieved or how authors assessed the studies for inclusion.
• Studies were organized, according to the quality of the evidence, by using the seven-level rating system that Melnyk proposed.

• Authors included 12 studies in the analysis.
• Sample size across all 12 studies was 6,066 patients. The range of sample sizes was 9–5,457.

• Authors identified only one study as a level 1 study. This study, a systematic review of 18 studies, concluded that, though evidence showed therapeutic touch to be a promising intervention, the evidence to support recommending therapeutic touch was inadequate.
• Three studies reported positive results, demonstrating that therapeutic touch was associated with significant improvement in physical and psychological health.
• The analysis yielded no results regarding the direct effect of therapeutic touch on pain or anxiety. Studies in this regard, three cohort or case control studies, were of low quality. Authors assessed them as level 3 nonrandomized controlled trials. One of these trials reported significant reduction (p = 0.03) of measured anxiety during the perioperative period.

The authors report that research relating to therapeutic touch indicates that the therapy helps to reduce pain and anxiety; however, the evidence that the research provides is very weak. Few studies showed statistically significant results, and several studies did not directly measure either variable. The rating scale used does not take sample size into account. As a result, a study rated level II included only 20 patients. Even with this rating scale, most studies analyzed were of low quality. Although the purpose of this study was to summarize the research, the authors incorporated opinion and review articles that were in support of therapeutic touch.

The evidence to support the efficacy of therapeutic touch, as a means of reducing the pain and anxiety of patients with cancer, is weak because the research about this topic is of low quality. Many investigators believe that therapeutic touch and related interventions are promising for patients with cancer and that the interventions pose little risk. Delivering these interventions requires training, however. Some authors have noted that, compared to inexperienced practitioners, experienced practitioners achieve more significant results. Therapeutic touch is something to consider as an adjunctive treatment for the pain and anxiety of patients with cancer. However, therapeutic touch must be administered by a trained and experienced practitioner. Well-designed and appropriately powered research of the efficacy of therapeutic touch is warranted.