Examination Date
8-2021
Degree
Dissertation
Degree Program
Nursing (PhD)
Examination Committee
Gloria Giarratano, PhD, APRN, CNS, FAAN; Susan Orlando, DNS, APRN, NNP-BC, CNS; Jane Sumner, PhD, RN, PHCNS, BC, ANEF; Deidre Devier, PhD; Lee S. McDaniel, PhD; Diane Wind Wardell, PhD, RN, WHNP-BC, AHN-BC
Abstract
Nurses experience high levels of occupational stress related to the nature of their work in fast-paced acute healthcare environments. Occupational stress has long-lasting effects on nurses' health including higher morbidity and mortality rates (Aiken et al., 2001; Hasan et al., 2018; Peipins et al., 1997). Nurses' increased stress correlates with poor patient health outcomes, decreased quality of patient care and financial loss for healthcare institutions (Duffield et al., 2016; Jones, 2005; Letvak & Ruhm, 2012; Roberts et al., 2012; Vasconcelos et al., 2016). The Centers for Disease Control and Prevention (CDC) with the National Institute of Occupational Safety and Health (NIOSH) made recommendations directed toward improving the workplace environment, and teaching nurses to improve self-care (Gerschon et al., 2007; Poghosyan et al., 2010). The American Nurses Association (ANA) extended self-care to include holistic complementary and integrative modalities to reduce stress perception (American Nurses Association [ANA], 2018).
Healing Touch (HT) is a safe, low cost, and effective biofield energy modality with statistically significant evidence for reducing stress and anxiety in a variety of sample populations (Foley-Haslauden et al., 2016; Goldberg et al., 2016; Mangione et al., 2017); however, there is a paucity of research documenting HT administered to nurses for stress reduction and self-care. The studies focusing on nurses learning or administering Healing Touch indicate that the experience of HT provides stress reduction benefits for both the nurse and the patient receiving the treatment creating a healthier environment (Anderson et al., 2016).
The primary purpose of this study was to assess whether or not HT was an effective modality for reducing nurses' perceptions of workplace stress. Specifically, the purpose of the study was to determine whether administering HT to nurses during a shift was more effective
than deep breathing techniques offered in many stress reduction programs (ANA, 2018). The secondary exploratory descriptive component investigated nurses' perceptions about HT and their potential use of this modality. One-hundred and fifty registered nurses in one acute care urban pediatric hospital were recruited and randomly assigned in matched pairs. The HT (n=75) and the DB (n=75) interventions were delivered by two different investigators. Pre and immediate post-intervention heart rate (HR), blood pressure (BP), and respiratory rate (RR) (physiological) and VASS (stress) measures were collected, followed by one-to-four-hour post intervention follow-up assessment of VASS, HR, BP, and RR. Open ended questions followed the study to determine the nurses' perception of receiving either HT or DB, to identify facilitators or barriers to future use, and assess their knowledge about the use of HT in nursing practice.
The General Estimating Equation 1 (GEEl) compared the measures to determine if there was a significant difference in change over time between the HT intervention and DB comparison groups for both the physiological and psychological variables (Fain, 2017). Mean comparisons were also conducted for the individual dependent variables with significant change noted in the GEEl. The open ended questions were analyzed through thematic analysis and tallying of common descriptions.
The GEEl comparisons found that nurses in the HT intervention, had significantly lower VASS stress scores at post treatment (-0.95,p = .0002) and at follow-up (-0.73,p = 0.0144) than the DB group, and the RR rate differences were nearly significant at post intervention and significant at follow up, respectively (1.36,p = .0.0568 and -2.28,p = 0.0011), indicating lower RR after HT. Analysis of themes from the opened ended questions revealed an over-arching theme of relaxation since nurses from both groups expressed relaxation following the respective intervention. Nurses in the HT intervention, however, used more profound descriptions of the experience stating they felt as stress was effortlessly lifted from them. In contrast the DB group stated that with effort, they were more relaxed. The majority of participants expressed the need for more education about HT and that they were not aware that HT was within their nursing scope of practice.
This study further confirms the positive impact of both HT and DB interventions as immediate stress reduction modalities in the workplace. Nurses need to be educated to seek and use stress reduction modalities for their self-care and care of patients. Education needs to begin in pre licensure education to prepare nurses to enter the workforce with increased knowledge of stress management and use of complementary holistic and integrative therapies. Likewise, healthcare institutions need to implement system strategies to reduce nurse stress during a workshift and promote self-care. Nurse leaders need to advocate for policy changes at state and national levels that promote healthy work environments aimed at reduction of stress in the workplace. Lastly, future research recommendations include more RCTs to investigate stress relief strategies in the workplace, followed by comparative effectiveness studies for best practice and qualitative inquiries to elucidate evolving perceptions of stress.
Recommended Citation
Rosamond, Randy L., "HEALING TOUCH: A STRATEGY FOR ACUTE CARE NURSES' STRESS REDUCTION" (2021). School of Nursing. 15.
https://digitalscholar.lsuhsc.edu/etd_son/15
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