ICU Management & Practice, Volume 16 - Issue 3, 2016

Touch Creates a Healing Bond in Healthcare

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In contemporary healthcare, touch— ‏contact between a doctor’s hand and a ‏patient—appears to be on its way out. ‏The expanding role of CT and MRI imaging ‏is decreasing reliance on touch as a way of ‏making diagnoses. Pressures to move patients ‏through the system more quickly leave health ‏professionals with fewer opportunities to make ‏contact. Our experience suggests that when ‏doctors spend fewer minutes with patients, ‏less time is available for touch (Rabin 2014).

 

Yet despite the rise of scanners, robots and ‏other new medical technologies, the physician’s ‏hand remains one of medicine’s most valuable ‏diagnostic tools. Touch creates a human bond ‏that is particularly needed in this increasingly ‏hands-off, impersonal age. Medical practice is ‏replete with situations where touch does more ‏than any words to comfort and reassure.

 

The USC psychologist Leo Buscaglia, whose ‏habit of hugging those he met soon earned ‏him the sobriquet “Doctor Love,” bemoaned ‏our neglect of touch in his book, “Love,” in ‏these terms:

Too often we underestimate the power of a touch, a smile, ‏a kind word, a listening ear, an honest compliment, or ‏the smallest act of caring, all of which have the potential ‏to turn a life around (Buscaglia 1985).

 

For thousands of years, touch has been recognised ‏as an essential part of the healing arts. ‏Native American healers (Cohen 1994) relied ‏on touch to draw out sickness, and kings and ‏queens were long believed to possess the “Royal ‏Touch," through which the mere laying on of ‏hands could heal (Science Museum n.d.). The ‏Bible contains numerous stories of the healing ‏power of touch.

 

Touch is an Essential Part of our Wellbeing

 

An indication of our need for touch can be found ‏among our primate relatives. Psychologists have ‏observed that many such species spend upwards ‏of five hours of each day touching one another, ‏partly through grooming (Keltner 2010). For ‏many human beings, however, the daily dose ‏of touching would be measured not in hours ‏but minutes, perhaps even seconds.

 

Lack of touch can be hazardous to health. ‏In experiments with primates some 60 years ‏ago, researcher Harry Harlow demonstrated that ‏young monkeys deprived of touch did not grow ‏and develop normally (Smuts 2003). Mere food, ‏water and shelter are not sufficient—to thrive, ‏such creatures need to touch and be touched.

 

The same can be said for human beings. ‏During the 20th century, wars landed many ‏babies in orphanages, where their caretakers ‏observed that no matter how well the infants ‏were fed, they would fail to thrive unless they ‏were held and cuddled on a frequent basis ‏(Rothman 1962). Touch offers no vitamins or ‏calories, yet it plays a vital role in sustaining life.

 

More recent studies have corroborated these ‏findings. “Kangaroo care,” using papoose-like ‏garments to keep babies close to their mothers, ‏decreases the rate at which they develop ‏blood infections (Larimer 1999). Touching ‏also improves weight gain and decreases the ‏amount of time that newborns need to remain ‏in the hospital.


See Also:
Music Therapy Can Comfort Premature Infants

 

Touch Creates a Bond Between Doctor and Patient

 

Novelist and physician Abraham Verghese has ‏argued that touching is one of the most important ‏features of the patient-physician interaction. ‏When he examines a patient, he is not merely ‏collecting information with which to formulate ‏a diagnosis, but also establishing a bond that ‏provides comfort and reassurance.

 

The notion that touch can reassure and ‏comfort has a scientific basis. Ten years ago ‏researchers used MRI scans to look at the ‏brains of women undergoing painful stimuli ‏(Coan et al. 2006). When subjects experience ‏pain, certain areas of the brain tend to “light ‏up.” The researchers studied subjects when ‏they were alone, when they were holding a ‏stranger’s hand, and when they were holding ‏their husband’s hand.

 

They found the highest levels of pain activation ‏when the women were alone. When ‏they were holding a stranger’s hand, the pain ‏response was decreased. And levels of activation ‏were lowest of all when they were holding ‏their husband’s hand. Interesting, the higher ‏the quality of subjects’ marriages, the more ‏pain responses were blunted.

 

Touch From Parents Helps Kids in Intensive Care

 

We have been studying this phenomenon in ‏our own institution, looking at the effect of ‏touch not only on patients but on the parents ‏of patients admitted to the pediatric intensive ‏care unit.

 

The project, called ROSE (Reach Out, Soothe, ‏and Embrace), sought to determine whether ‏increasing opportunities to touch patients could ‏promote parent well-being without compromising ‏patient safety (LeLand 2016).

 

Instead of merely determining whether ‏patients could be taken off the ventilator or ‏fed, we also identified patients who could be ‏safely touched and even held in their parents’ ‏arms. When a patient was deemed safe to hold, a ‏magnet bearing the image of a red rose embraced ‏by two hands was placed on the door to the ‏patient’s room.

 

While we are still analysing the results and ‏further study is needed to fully delineate the ‏health benefits of touch, several findings are ‏already clear.

 

First, increasing opportunities for touch ‏does not compromise patient safety. Second, ‏the subjective wellbeing of family members is ‏enhanced when touching is encouraged. Third, promoting touch empowers family members ‏to become more involved in their child’s care. ‏To be sure, inappropriate and unsafe touching ‏can be harmful. But when touch is encouraged in ‏the right ways and for the right reasons, it is good ‏for patients, family, friends and health professionals ‏alike. Touch is one of the most fundamental ‏and effective ways to create a sense of connection ‏and community among human beings.

 

In the words of the 20th-century theologian ‏Henri Nouwen, who wrote in his book, “Out ‏of Solitude”: ‏

When we honestly ask ourselves which person in our lives ‏means the most to us, we often find that it is those who, ‏instead of giving advice, solutions, or cures, have chosen ‏rather to share our pain and touch our wounds with a ‏warm and tender hand (Nouwen 2004).

 

So next time you find yourself confronted ‏by a person in distress, remember the power of ‏touch. Medicines and words both have healing ‏power, but so does touch, and it is perhaps the ‏most widely available, financially responsible and ‏safest tool in the healing arts. When we touch, ‏we connect, and when we connect, we create ‏a healing bond for which there is simply no ‏substitute.

 

Conflict of Interest

 

Brian LeLand receives funding from Indiana ‏University Health Values Grant Board. 2 year ‏grant awarded through IU Health of $50,000 ‏per year. Grant awarded in 2014. ‏     

 

Reprinted from The Conversation (conversation.‏com) under Creative Commons CC BY-ND ‏4.0(creativecommons.org/licenses/by-nd/4.0).


References:

Rabin RC (2014) 15-minute visits take a toll on the doctor-patient relationship. KHN: Kaiser Health News, 21 April. [Accessed: 19 September 2016] Available from khn.org/news/15-minute-doctor-visits

 

Buscaglia LF (1985) Love: what life is all about. New York: Ballantine.

 

Coan JA, Schaefer HS, Davidson RJ (2006) Lending a hand: social regulation of the neural response to threat. Psychol Sci, 17(12):1032-9.

PubMed

 

Cohen K (1994) Native American healing touch. Bridges, 5(1):  5-7.

Article

 

Keltner D (2010) Hands on research: the science of touch. Greater Good, 29 September. [Accessed: 19 September 2016] Available from: greatergood.berkeley.edu/article/item/hands_on_research

 

Larimer K (1999) Kangaroo care benefits. [Accessed: 19 September 2016] Available from prematurity.org/baby/kangaroo.html

 

LeLand B (2016) Fairbanks Ethics Lecture-Project ROSE: Reach Out, Soothe, and Embrace. A focus on caregiver spiritual wellbeing [videorecording]. Vimeo.com. [Accessed: 19 September 2016] Available from vimeo.com/155025967

 

Nouwen HJM (2004) Out of solitude: three meditations on the Christian Life. Notre Dame, Indiana: Ave Maria Press.

 

Rothman PE (1962) A note on hospitalism. Pediatrics, 30(6): 995-9.

PubMed

 

Science Museum (n.d.) King’s evil and the royal touch. [Accessed: 19 September 2016] Available from sciencemuseum.org.uk/broughttolife/techniques/kingsevil

 

Smuts B (2003) No more wire mothers, ever. New York Times, 2 February. [Accessed: 19 September 2016] Available from nytimes.com/2003/02/02/books/no-more-wire-mothers-ever.html




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