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Intersensory conflict between vision and touch: the response modality dominates when precise, attention-riveting judgments are required.

In four experiments, reducing lenses were used to minify vision and generate intersensory size conflicts between vision and touch. Subjects made size judgments, using either visual matching or haptic matching. In visual matching, the subjects chose from a set of visible squares that progressively increased in size. In haptic matching, the subjects selected matches from an array of tangible wooden squares. In Experiment 1, it was found that neither sense dominated when subjects exposed to an intersensory discrepancy made their size estimates by using either visual matching or haptic matching. Size judgments were nearly indentical for conflict subjects making visual or haptic matches. Thus, matching modality did not matter in Experiment 1. In Experiment 2, it was found that subjects were influenced by the sight of their hands, which led to increases in the magnitude of their size judgments. Sight of the hands produced more accurate judgments, with subjects being better able to compensate for the illusory effects of the reducing lens. In two additional experiments, it was found that when more precise judgments were required and subjects had to generate their own size estimates, the response modality dominated. Thus, vision dominated in Experiment 3, where size judgments derived from viewing a metric ruler, whereas touch dominated in Experiment 4, where subjects made size estimates with a pincers posture of their hands. It is suggested that matching procedures are inadequate for assessing intersensory dominance relations. These results qualify the position (Hershberger & Misceo, 1996) that the modality of size estimates influences the resolution of intersensory conflicts. Only when required to self-generate more precise judgments did subjects rely on one sense, either vision or touch. Thus, task and attentional requirements influence dominance relations, and vision does not invariably prevail over touch.

Adult↗

Visual-touch perceptual equivalence for shape information in children and adults.

Although there has been substantial developmental research which has compared shape information processing performance under visual and touch conditions, there has been little work that bears on the shape attributes that are routinely employed, or on the similarity between shape attributes employed by adults and those employed by children. The present research was carried out to investigate the visual-touch perceptual equivalence of young children, using multidimensional scaling techniques, and to compare the visual and touch perceptual structures of this age group with those of adults. The results provide evidence for adult-like perceptions of shape among 6-year-olds, in terms of both the patterns of interstimulus similarities and the shape attributes attended to by children using each modality. In addition, it was found that children have somewhat more visual-touch perceptual equivalence than adults do.

Attention↗

Complementary therapy. The use of touch in nursing practice.

Touching patients seems a natural and integral part of nursing care, but do nurses really understand the potential benefits and potential harm touch can cause patients? The authors look at the importance of touch in nursing care, and suggest that greater awareness of how touch affects patients would be of benefit to nurses.

Complementary Therapies↗

[Therapeutic touch].

In the advanced stages of dementia of the Alzheimer's type (DAT), affected persons present body language and various behaviours expressing discomfort: shouting, agitation, irritability, aggressiveness, tense movements. Nursing, up until now, has had few available means to ease this discomfort. The authors of the following article have conducted an experimental study measuring the alleviating effects of therapeutic touch on the discomfort of persons in the advanced stages of DAT. Experimental group subjects (n = 16) received 5 sessions of therapeutic touch lasting 12.4 minutes. Control group subjects (n = 11) received 5 sessions of simple presence lasting 10.3 minutes. The authors measured subject discomfort levels using the Discomfort Scale for Dementias of the Alzheimer's Type (DS-DAT). Results show that discomfort levels of persons in the advanced stages of DAT decreased significantly after 5 therapeutic touch sessions, becoming significantly lower than levels in the control group. If care was focused on the whole person and his or her comfort, tools like therapeutic touch would become available to nurses, allowing them to enhance the quality of life of the people in their care.

Aged↗

Keep it simple! A touch technique peritoneal dialysis procedure for the blind and visually impaired.

Diabetes is the main cause of blindness in patients with end stage renal disease (ESRD). The number of diabetic patients who require dialysis has increased from 16% in 1981 to 30% in 1999 (CIHI, 1999). Therefore, it is important for blind individuals to find a peritoneal dialysis (PD) technique that will ensure their independence and prevent peritonitis. In July 2000, the home peritoneal dialysis unit (HPDU), Toronto Western Hospital (TWH), University Health Network, successfully developed and implemented a "touch technique" connection procedure for the blind and visually impaired. The procedure involved is a touch technique connection utilizing the Fresenius Premier Plus Double Bag system. Three blind patients on the UV Flash peritoneal dialysis system were retrained in the touch technique on a one-to-one basis for an average of four days. Additionally, they were each given a procedural audiotape or CD for reference at home. This simple touch technique has enabled these three patients the freedom of a relatively independent lifestyle. They have been peritonitis-free since implementation, for 19, 15 and four months respectively. This technique allows blind and visually-impaired ESRD patients to perform peritoneal dialysis in their homes and, thus, maintain independence.

Adult↗

Outcomes of touch therapies during bone marrow transplant.

CONTEXT: The integration of complementary modalities into mainstream healthcare is gaining increasing emphasis. It is important, therefore, to document the effects of these interventions on patient outcomes. OBJECTIVE: To investigate the effects of Therapeutic Touch and massage therapy on the outcomes of engraftment time, complications, and perceived benefits of therapy during bone marrow transplant. DESIGN: Randomized clinical trial. PARTICIPANTS/SETTING: Subjects were adult patients on the bone marrow transplant unit of a large urban tertiary care center. INTERVENTIONS: Subjects were randomly assigned to 1 of 3 treatment groups: Therapeutic Touch (TT), massage therapy (MT), and a control group called the friendly visit (FV). Subjects (N = 88) were stratified by type of transplant (allogeneic or autologous). Twenty-seven subjects received MT; 31 received TT; and 30 received FV. Nurses with expertise in the 2 touch therapies administered them. The interventions of MT, TT, and FV were administered according to standarized protocols every third day beginning the day chemotherapy began until discharge from the program. OUTCOME MEASURES: Time for engraftment, complications, and patient perceptions of benefits of therapy were the main outcome measures. Analysis of variance and analysis of covariance were used to determine significant differences among the 3 groups with respect to time of engraftment. RESULTS: A significantly lower score for central nervous system or neurological complications was noted for subjects who received MT comppared with the control group; however, no differences were found among the 3 groups with respect to the other 10 complication categories or in the total mean score for complications. Patients' perception of the benefits of therapy (total score) was significantly higher for those who received MT compared with the FV control group. The mean scores on the comfort subscale were significantly higher for patients receiving both MT and TT compared with the FV control group. CONCLUSIONS: Massage therapy may be effective in altering the psychological and neurological complications associated with chemotherapy during bone marrow transplant. Both massage and Therapeutic Touch provide comfort to patients undergoing this challenging process.

Adult↗

Testing a family intervention hypothesis: the contribution of mother-infant skin-to-skin contact (kangaroo care) to family interaction, proximity, and touch.

The provision of maternal-infant body contact during a period of maternal separation was examined for its effects on parent-infant and triadic interactions. Participants were 146 three-month-old preterm infants and their parents, half of whom received skin-to-skin contact, or kangaroo care (KC), in the neonatal nursery. Global relational style and micro-patterns of proximity and touch were coded. Following KC, mothers and fathers were more sensitive and less intrusive, infants showed less negative affect, and family style was more cohesive. Among KC families, maternal and paternal affectionate touch of infant and spouse was more frequent, spouses remained in closer proximity, and infant proximity position was conducive to mutual gaze and touch during triadic play. The role of touch as a constituent of the co-regulatory parent-infant and triadic systems and the effects of maternal contact on mothering, co-parenting, and family processes are discussed.

Adult↗

[Affective touch and self esteem in the elderly].

The hospital is an environment which accomodates the elderly persons and in which these last have to make trainings at one time when they are not in full possession with all their physical, psychological and cognitive capacities. They can then live there humiliating situations which generate feelings of discomfort, embarrassment and shame. The presence of interveners not very warm, lacking compassion lack and impressed negative prejudices towards the elderly patients, is another factor which is added to lead them not to feel at ease, involving, inter alia, consequences a fall of their self-esteem. However the affective touch is a strategy which would have the potential to act on the personal value of the elderly patients and to thus improve their self-esteem. It is with a view to popularize the use of the affective touch in practice nurse that a study was carried out in order to check its effects on the self-esteem of the elderly patients. The results confirm that the emotional touch influences positively the self-esteem of the elderly patients. The authors of the study thus recommend the systematization of the affective touch in nursing practice.

Affect↗

The effect of touch on patients' estimates of time in the waiting and examination rooms.

This study examined the accuracy of patient estimates of time spent in the waiting room, examining room, and with the physician. In addition, the impact of physician touch (such as a handshake in greeting) upon those estimates was determined. Patients were noted to be quite accurate in estimates of waiting room time. Examining room waiting time tended to be markedly underestimated, while physician contact time was markedly overestimated. The overestimation of physician contact time was positively related to the number of interruptions requiring the physician to leave the examining room. Minimal touch in greeting had no effect on estimates of waiting room time but did significantly magnify the underestimation of examining room waiting time. Patients who were touched did, on an average, overestimate physician contact time to a greater extent than those who were not touched; however, this difference did not reach statistical significance.

Appointments and Schedules↗

An attempt to reduce the loss of pain and touch sensations in leprosy patients.

An attempt was made to improve the perception of pain and touch sensations at the leprosy lesions. The loss of pain and touch sensations in a lesion was graded using Pain/Touch-Sensation-Testing-and-Grading devices. Application of a solution containing 1 mg of histamine per ml of DMSO, at the affected area decreased the grades of the loss of pain sensation in 11 (31.4%) patients and of touch sensation in 8 (22.8%) patients, out of the 35 patients tested, indicating an improvement in the perception at the lesion. This effect, however, did not persist even for 5 minutes. A higher concentration (2 mg/ml) of histamine produced reduction in the sensory loss in a larger percentage (47% for pain and 35.3% for touch) of patients, though the duration of this effect was still not prolonged.

Adolescent↗

Therapeutic touch: is there a scientific basis for the practice?

The research-related literature on the topic of therapeutic touch is critically reviewed. The purpose of the review is to explore the current scientific basis for the teaching and practice of therapeutic touch as a treatment modality. An examination of published research literature indicates that empirical support for the practice of therapeutic touch is, at best, weak. The results of well-designed, double-blind studies have been transient, of no significance, or are in need of independent replication. Current practice of therapeutic touch is empirically little more than practice of placebo. Considerations for further nursing research are also presented.

Animals↗

Teaching touch at medical school.

The association between touch and healing is ancient and worldwide. Skilled hands are among the physician's most important diagnostic and therapeutic tools. Yet a survey of medical schools in the English-speaking world revealed that most offer no touch training in their curricula. Of 169 medical schools, only 12 give any formal instruction in the uses and meaning of therapeutic touch in medicine. The teaching modes of these 12 schools are discussed, and the program of the most touch-conscious school, the University of Otago, is described.

Behavioral Sciences↗

Meaning of touch to hospitalized Puerto Ricans with cancer.

This ethnographic study was undertaken to elicit the meaning of nurse's touch for hospitalized Puerto Rican patients with cancer. The key informants were eight cancer patients at a tertiary 12-bed oncology research unit in Puerto Rico. Data gathering methods included participant observation and several ethnographic interviews during a month period. Content analysis was used to identify pattern of behavior and meaning. Analysis of the field notes and interviews was done to search for domains. Theme analysis was used in the search for the relationship among domains. In the analysis of the patient interviews, two types of touch were identified: procedural and affective touch. The predominant theme about perception of nurse's touch was that of conveying confidence. Confidence was related to the patient's increase in positive expectation as much as the possibility of recovery from the cancer illness. The confidence theme was represented by two domains: the enhancement of the abilities of the patient for coping and through the acceptance of the patient as a person during their illness experience.

Adaptation, Psychological↗

The use of touch in nursing practice.

This paper examines the types of touch used in nursing practice and the effects of touch on the body and mind. The effects of two types of touch, therapeutic touch and massage, are evaluated by reviewing research studies conducted by nurses.

Humans↗

Neonatal deprivation of maternal touch may suppress ornithine decarboxylase via downregulation of the proto-oncogenes c-myc and max.

Previously, we have shown that short-term (1 hr) separation of neonatal rats from their mother (MS) suppresses basal ornithine decarboxylase (ODC) synthesis and tissue ODC response to trophic factors. This effect in the pup is caused by absence of maternal tactile stimulation (touch) but not from lack of maternal nutrients (food). This study was performed to examine in 10-d-old rats whether maternal touch deprivation affects expression of certain hepatic proto-oncogenes, the protein products of which are known to interact with the regulatory region of the ODC gene. Prolactin (PRL) injected subcutaneously increased hepatic ODC activity as well as mRNA levels of ODC and the proto-oncogenes c-fos, c-jun, junB, junD, c-myc, and max. MS significantly suppressed PRL-induced increases in ODC enzyme activity and c-myc, max, and ODC mRNAs but had little effect on expression of the other proto-oncogenes. PRL-induced stimulation of ODC, c-myc, and max mRNAs also was depressed in neonates placed with an anesthetized lactating dam (touch-deprived) but not in pups placed with nipple-ligated dams (food-deprived). Furthermore, unlike its effect on preweanling-age pups (< 20 d old), MS did not alter expression of either ODC or c-myc mRNAs in 25-d-old pups acutely separated from their mother. These findings indicate that suppression of ODC gene transcription in the neonatal pup during MS may be mediated by downregulation of the ODC gene transactivator proto-oncogenes c-myc and max. They are also consistent with our previous observation that lack of maternal touch, but not maternal milk, initiates the physiological alterations induced by MS.

Analysis of Variance↗

Stress-induced immunosuppression and therapeutic touch.

OBJECTIVE: The specific aim of this study was to evaluate the effectiveness of therapeutic touch in reducing the adverse immunological effects of stress in a sample of highly stressed students. Long-term goals are to develop methods by which a variety of stress-reduction techniques can be tested for efficacy. DESIGN: Experimental. SETTING: A large urban medical university in a southern coastal city. SUBJECTS: Healthy medical and nursing students who are taking professional board examinations. INTERVENTION: Therapeutic touch. MAIN OUTCOME MEASURES: T-lymphocyte function (CD25) and immunoglobulin levels. RESULTS: Subjects who received therapeutic touch and subjects who did not had significantly different levels of IgA and IgM; CD25 (mitogen-stimulated T-lymphocyte function) and IgG levels differed in the expected direction between the two groups, but the differences were not statistically significant. Apoptosis (programmed cell death) was significantly different between the two groups. CONCLUSIONS: The small sample size requires cautious interpretation of the results. This is a pilot study designed to provide evidence to show that further study of therapeutic touch as an intervention that may be useful in reducing the adverse immunologic consequences of anxiety related to stress in otherwise healthy students is warranted. Change in immune function related to anxiety and the relief of anxiety can be measured. Subsequent power analysis suggests sample sizes of 90 subjects per group are required to confirm the conclusions.

Adult↗

Cross infection in the high-touch areas of dental radiology clinics.

Disinfection and sterilization have received considerable attention due to the spread of AIDS and HIV. Several infections hazards to the patient and personnel of dental surgery have been identified from blood, saliva and water of dental unit. The high touch areas of dental x-ray equipment is a potential source of infection. The present study was undertaken to determine the extent of cross-infection present in the dental radiology clinics with and without the use of surface disinfectants. Swabs taken from high touch areas of the x-ray equipment in 15 different sessions with in one month were cultured in three different media. The study revealed, almost all high touch areas in dental radiology clinic had bacterial contamination in the absence of surface disinfection. "Webcol" and "Superficid" disinfectants showed minimum or no contamination. To remove risk of cross-infection, disinfection of high-touch areas of dental x-ray equipment is mandatory.

Cross Infection↗

The effects of therapeutic touch on patients with osteoarthritis of the knee.

BACKGROUND: The purpose of this study was to determine if therapeutic touch, an alternative medicine modality, is effective in the treatment of osteoarthritis of the knee. METHODS: A single-blinded randomized control trial was conducted in a family practice center of a community hospital family practice residency program in Pennsylvania. The patients were between the ages of 40 and 80, had been given a diagnosis of osteoarthritis of at least one knee, had not had knee replacement, and had no other connective tissue disease. The patients were randomized to therapeutic touch, mock therapeutic touch, or standard care. The main outcome measures were pain and its impact, general well-being, and health status measured by standardized, validated instruments, as well as the qualitative measurement of a Depth interview. RESULTS: Twenty-five patients completed the study. The treatment group had significantly decreased pain and improved function as compared with the placebo and control groups. The qualitative Depth interview confirmed this result. CONCLUSION: Despite the small numbers, significant differences were found in improvement in function and pain for patients receiving therapeutic touch. A larger study is needed to confirm these results. Alternative therapies can neither be accepted nor rejected without being subjected to the scientific method.

Activities of Daily Living↗