Effectiveness Not Established

Reiki

for Fatigue

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 Reike re-establishes the energy balance in areas of the body associated with discomfort, thus promoting healing and increasing quality of life. Researchers have evaluated Reike in patients with cancer for its impact on anxiety, depression, pain, and fatigue.

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. 

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.

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Research Evidence Summaries

Tsang, K. L., Carlson, L. E., & Olson, K. (2007). Pilot crossover trial of Reiki versus rest for treating cancer-related fatigue. Integrative Cancer Therapies, 6, 25–35.

Intervention Characteristics/Basic Study Process

The study used the Usui method, which is the most common form of Reiki. Time varied but averaged about 45 minutes. The study used a randomized order:  Reiki for five consecutive sessions, a one-week washout, and two days of Reiki versus rest for five days with a one-week washout, and then one week of no treatment. The intervention was administered by a Reiki master.

Sample Characteristics

  • The study included 16 participants, including 13 women and 12 Caucasians, all with varying cancer types and times since chemotherapy.
  • Median age was 59 years (range 33–84 years). 
  • Patients were included if they had fatigue greater than 3 on 0-to-10 scale, understood English, and were living at home.
  • Patients were undergoing long-term follow-up, but it was unclear how long it had been since chemotherapy was completed.

Setting

The study was conducted at an unspecified setting in Canada.

Study Design

The study was a counterbalanced crossover, with eight participants randomized to each order.

Measurement Instruments/Methods

  • Functional Assessment of Cancer Therapy–Fatigue (FACT-F)
  • FACT-General (FACT-G), before and after each period (Reiki or rest) 
  • Edmonton Symptom Assessment Scale (ESAS), daily before and after treatment

Results

About 88% of the participants completed all seven treatments. The effect was 0.56 (Reiki) versus 0.02 (rest) on the FACT-F and 0.27 (Reiki) versus 0.08 (rest) on the FACT-G. The paired t-test for the FACT-F was not significant (p = 0.24). Tiredness decreased daily over time.

Limitations

  • No analysis of order effect was conducted.
  • The study had a small sample size.
  • Multiple diagnoses, stages, and treatments were included.
  • Analysis did not look at interaction effect.
  • There was a problem with the inclusion criteria:  the range of time from diagnosis was 3 days to 3.79 years.
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