title: Nursing intervention using healing touch in bilateral total knee arthroplasty.
abstract: OBJECTIVE
  Healing touch (HT), a nurse-initiated modality, has potential to improve postoperative pain control and restore balance to a patient's energy field to facilitate self-healing. We hypothesized that addition of HT to standard pharmacologic intervention would reduce pain, anxiety, and opioid consumption, and would improve ambulation distance, knee flexion, and patient satisfaction with quality of care in bilateral total knee arthroplasty.
  
  
  METHODS
  Forty-one patients were prospectively randomized to an HT group (n = 20) or a standard treatment (ST) group (n = 21).
  
  
  METHODS
  For the HT group, HT was administered once daily between 2 daily physical therapy sessions. Pain was assessed using a visual analog scale (VAS) before surgery, before and after HT daily (HT group), or between physical therapy sessions daily (ST group). Anxiety was measured using State-Trait Anxiety Inventory (STAI). Opioid analgesic consumption was converted into dose equivalents (DE; 10 mg morphine intravenous = 1 DE). Satisfaction was assessed at the 1-month postoperative visit.
  
  
  RESULTS
  Demographics were similar. Pain VAS was lower in the HT group than in the ST group but was not significant. Within the HT group, pain VAS after the HT treatment was significantly diminished compared with pre-HT pain VAS (p < .05) except on postoperative Day 1. State anxiety was lower in the HT group but reached significance (p = .046) only on postoperative Day 2. Total opioid DE was lower in the ST group by 0.5 DE. Twenty percent more in the ST group reported overall pain as moderate/severe. One month after surgery, 95% of the HT group, compared with 87% of the ST group, felt that their pain was adequately controlled during the hospital stay.
  
  
  CONCLUSIONS
  Healing touch provides another tool that nurses can use to decrease pain in patients undergoing postoperative bilateral total knee arthroplasty.
authors.affiliation: Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, CA, USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Hardwick
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Pulido
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Adelson
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D008297:Male; D009729:Nursing; D011446:Prospective Studies; D014110:Touch