title: The effect of therapeutic touch on behavioral symptoms and cortisol in persons with dementia.
abstract: BACKGROUND
  Between 75-90% of nursing home (NH) residents with dementia develop behavioral symptoms (BSD) which may be associated with a stress response. Therapeutic touch has been shown to decrease restlessness in NH residents, however the mechanism is unknown. The purpose of this randomized controlled trial (RCT) was to examine the effect of therapeutic touch on BSD and basal cortisol levels among NH residents with dementia.
  
  
  METHODS
  Using a double blind experimental interrupted time series ABAB design, 65 participants were assigned to one of three groups. The experimental group received therapeutic touch with contact on the neck and shoulders delivered twice daily for 3 days (administered over 2 separate treatment periods); the placebo group received a mimic treatment identical in appearance, and the control group received routine care. Study outcomes were BSD, measured by the modified Agitated Behavior Rating Scale (mABRS), and salivary cortisol levels, measured by enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  64 residents, aged 67-93 years (M = 85.5, SD = 5.50), completed the study. Restlessness was significantly reduced in the experimental group compared to the control group (p = 0.03). There was a significant difference in morning cortisol variability among groups across time periods (<0.0001). Findings suggest that therapeutic touch may be effective for management of symptoms like restlessness coupled with stress reduction. At a time when cost containment is a consideration in health care, therapeutic touch is an intervention that is non-invasive, readily learned, and can provide a non-pharmacologic alternative for selected persons with BSD.
authors: School of Nursing, University of California Los Angeles, CA 90095-6919, USA. lwoods@sonnet.ucla.edu
authors: Diana Lynn
authors: DL
authors: Woods
authors: Cornelia
authors: C
authors: Beck
authors: Karabi
authors: K
authors: Sinha
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000097:blood / Q000523:psychology / Q000628:therapy*; D002940:Circadian Rhythm / Q000502:physiology; D004311:Double-Blind Method; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008297:Male; D009735:Nursing Homes; D011595:Psychomotor Agitation / Q000097:blood / Q000523:psychology / Q000628:therapy*; D019124:Therapeutic Touch
chemical_list: D006854:Hydrocortisone