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PubMed1999

Passive, active and intra-active (self) touch.

A series of experiments are described in which magnitude estimates of the perceived size of steel balls were made when the balls were actively rolled between the fingertip and several other body sites (thumb, thenar eminence, forearm). This movement, called scripting, involves actively-moving an object by a touching surface over another surface of the body which is passively being touched. We define this active/passive activity as "intra-active touch" and the results show that the perceptual size of the balls is dependent upon the body part passively being activated. An additional series of experiments decoupled the actively generated and passively received tactile information by having subjects either perform the scripting on another individual's body site or by having the other individual roll the balls on the subject's various sites. The latter experiments showed that the passive body can contribute to the overall impression of the size of the balls, but only when the intra-active touching involved the glabrous skin of the hands. Intra-active touch between the active finger and the passively touched hairy skin of the forearm showed no effect of the touched surface on the perceived size of the balls. The results suggest that the mechanisms of intra-active touch are different when glabrous skin activates glabrous skin than when glabrous skin activates hairy skin.

Adult↗
PubMedDate not supplied

Effect of therapeutic touch on anxiety level of hospitalized patients.

Effect of therapeutic touch on the anxiety of 90 volunteer male and female subjects between the ages of 21 and 65, hospitalized in a cardiovascular unit of a large medical center in New York City, was examined. The dependent variable, state anxiety, was defined as a transitory emotional state of the individual at a particular point and was measured by the Self-Evaluation Questionnaire x-1, developed by Spielberger, Gorsuch, and Lushene. Subjects were administered this tool pre- and postintervention. Three matched intervention groups were formed; each subject received an individual five-minute period of intervention by therapeutic touch, casual touch, or no touch. Subjects who received intervention by therapeutic touch experienced a highly significant (p < .001) reduction in state anxiety, according to a comparison of preposttest means on A-state anxiety using a correlated t ratio. Subjects who received intervention by therapeutic touch had a significantly (p < .01) greater reduction in posttest anxiety scores than subjects who received intervention by causal touch or no touch.

Adult↗
PubMed2004

The use of touch to enhance nursing care of older person in long-term mental health care facilities.

The self-care deficits experienced by older clients in long-term mental health settings, because of cognitive impairment, are likely to impact upon the clients' higher-order needs. The practice of nursing the elderly involves a lot of personal contact, during the delivery of fundamental physical care. While physiological and safety needs are crucial to clients in long-term settings, higher-order needs need also to be addressed. From the clients' perspective nurse's use of touch provides comfort, warmth and security, although there is a dearth of empirical evidence of these benefits. This paper explores the nurse's use of touch, the impact of touch and the experiences of touch on the older person in long-term settings. Because of the dearth of research in the use of touch with elderly clients in long-term care mental health facilities, a review of the literature was performed on the topic. This revealed that touch by nurses is frequently associated with routine tasks within nursing, and is less likely to be a caring touch intervention. Recommendations include further research on the topic and caution with widespread adoption of caring touch as an intervention.

Aged↗
PubMed1990

Dopamine neurons of the monkey midbrain: contingencies of responses to active touch during self-initiated arm movements.

1. Previous studies have shown that midbrain dopamine (DA) neurons in monkeys respond to external stimuli that are used to initiate behavioral reactions. In the present study, we investigated to what extent changes in neuronal activity would occur when behavioral acts are generated internally or whether they would depend solely on external stimuli. 2. Monkeys performed self-initiated arm movements from a resting key into a covered, food-containing box at a self-chosen moment and without external preparatory or triggering signals. In a second task, the arm movement was triggered by rapid opening of the door of the food box. This stimulus was either audible and visible or only audible to the animal. Impulses of DA neurons were recorded with movable microelectrodes from the pars compacta of substantia nigra (area A9) and areas A8 and A10 and were discriminated from those of other neurons by their long duration (1.5-5.0 ms) and low spontaneous frequency (0.5-8.5 imp/s). 3. The activity of 12% of 104 DA neurons increased slowly and moderately up to 1,500 ms before the onset of individual self-initiated arm movements. Median increases amounted to 91% over background discharge rate. A further 16% of DA neurons were activated together with the onset of muscle activity and during the movement. 4. During self-initiated movements, a nonhabituating, phasic burst of impulses occurred when the monkey's hand touched a morsel of food inside the box. This response was seen in 84% of 154 neurons on the contralateral side, with median onset latency of 65 ms and duration of 160 ms. A comparable percentage of neurons responded to ipsilateral touch with similar latency and duration. 5. The touch response during self-initiated movements was absent, both on the contra- and ipsilateral sides, when the animal's hand touched the bare wire normally holding the food, when touching nonfood objects, or during tactile exploration of the empty interior of the food box. Thus responses appeared to be related to the appetitive properties of the object being touched rather than the object itself. 6. In the task employing stimulus-triggered movements, 77% of 86 DA neurons discharged a burst of impulses in response to door opening but entirely failed to respond to the touch of food in the box. The response to door opening in this task was similar to the touch response during self-initiated movements in the same neurons in terms of latency, duration, and magnitude.(ABSTRACT TRUNCATED AT 400 WORDS)

Action Potentials↗
PubMed1976

Interpersonal touch in high school relative to sex and race.

Previous studies have indicated that interpersonal touch decreases from kindergarten through junior high. In the present study 1154 pairs of high school students were observed in school cafeteria queues. Instances of touch were recorded along with body parts used to touch and touched. High school students were observed to segregate themselves by race and sex as did the primary and junior high students in the earlier studies. Touch was not less probable than that observed in younger students. Cross-sex touch was not more frequent as had been predicted. Touch was highest among black students. An increase in aggressive touch seen in female junior high students was not observed in the present study.

Adolescent↗
PubMed2000

External motivators of self-touching behavior.

Previous research has shown that nonverbal self-touching behaviors can be induced by external motivators such as videos and literary passages about insects. This study investigated whether the number of self-touching behaviors differed between presentation of what was assumed to be an anxiety-inducing stimulus (listening to the reading of a passage about leeches and answering questions) or a nonanxiety-inducing stimulus (a passage about canaries). It also investigated whether there was a difference in frequency of self-touching when subjects were passively listening to passages or actively answering questions. The difference in frequency of self-touching between men and women was also observed. Over-all, subjects did not perform significantly more self-touching gestures during the anxiety-inducing stimulus than during the nonanxiety-inducing, as previous research had indicated. Subjects did touch themselves significantly more, however, while answering questions than while listening to the passage. Over-all, men performed significantly more self-touching behaviors than women. And, women touched themselves significantly more during the active anxiety-inducing cell than in any other condition.

Adolescent↗
PubMed1999

An integrative review and meta-analysis of therapeutic touch research.

OBJECTIVE: To perform an integrative research review and meta-analysis of therapeutic touch research. DATA SOURCES: Bibliography maintained by the Nurse Healers-Professional Associates International; MEDLINE, CINAHL, and Psylit databases; dissertations and master's theses. STUDY SELECTION: Thirty-eight research articles were included in the analysis. All dissertations and research articles were analyzed. DATA EXTRACTION: Data on 32 substantive characteristics of the sample, the therapeutic touch procedure, and the article/dissertation were extracted following Moody's method for an integrative research review. The meta-analysis used studies that reported means and standard deviations of the treatment and control groups. DATA SYNTHESIS: The research questions were as follows: (1) What are the substantive characteristics of the sample, the therapeutic touch practice, and the article/dissertation in research studies from 1975 to 1997? (2) What does the research demonstrate regarding the efficacy of therapeutic touch as an intervention? (3) Based on the results of the review and meta-analysis, what are the gaps, trends, and outcomes of the therapeutic touch research studies? CONCLUSIONS: The review demonstrated that there are many approaches to therapeutic touch research, samples are described incompletely, and the therapeutic touch practices vary in the studies. Most of the studies supported hypotheses regarding the efficacy of therapeutic touch, though a number had mixed or negative results. A meta-analysis was performed on 13 studies. The average effect size in these studies was .39, which is described as moderate. Gaps, trends, and outcomes were identified and discussed.

Adult↗
PubMed2003

Touch during childbirth: yesterday and today.

Birth helpers touch the parturient woman in many ways. They make physical contact to diagnose difficulties and manipulate safe delivery. They may also touch the woman in non-physical ways, with special words, as they help a woman to give birth. Some hope also for a divine touch, as Jewish tradition teaches that God is a partner in the birth process. This paper takes a historical look at the different forms of touch used by birth attendants to ease the safe arrival of a healthy infant. We hope that this short retrospective will encourage today's birth helpers, especially doctors and midwives, to notice how they themselves touch birthing women. We hope to promote awareness of the verbal and non-verbal language of touch and to encourage the use of the art of touch among medical staff who are now more skilled than ever before in applying scientific touch to patients.

Female↗
PubMed1991

Conduction velocities and nerve fibre diameters of touch, pain, urinary bladder and anal canal afferents and alpha and gamma-motoneurons in human dorsal sacral roots.

1. Single action potentials were recorded extracellularly at 2 sites from human sacral dorsal nerve roots, and their conduction time measured. Conduction velocity frequency distribution histograms were constructed from afferent and efferent nerve fibres. Conduction velocity distribution peaks could be identified from afferents of mechanoreceptors of the skin, the bladder, the anal canal, of stretch and flow receptors of the urinary bladder, from spindle afferents and from the 3 alpha (extrafusal) and 3 gamma-motoneuron (intrafusal) classes. The electrophysiologically measured roots were removed and morphometrically analysed. Nerve fibre diameter frequency distribution histograms were constructed with respect to 3 myelin sheath thickness ranges. Nerve fibre diameter distribution peaks could partly be correlated to the corresponding conduction velocity distribution peaks. 2. Identified nerve fibre classes, characterized by their group peak values of conduction velocity and fibre diameter were at about 36 degrees C (age 30 years): Spindle afferents: SP1 (60 msec-1/13.2 microns) SP2 (50/12.0?); touch afferents: TO (49 msec-1/13.0 microns), T1 (44/11.2), T2 (39/10.1), T3 (31/9.1), T4 (20/8.3); pain afferents: P (13 msec-1/?); mucosa touch afferents from bladder and anal canal: M (12.5 msec-1/?); bladder afferents from stretch receptors measuring probably mural tension: S1 (42.5 msec-1/?), ST (38/?) and from flow receptors: S2 (12.5/?); alpha-motoneurons: alpha 1 (60 msec-1/13.1 microns) [FF], alpha 11 (?/12.0) [F (int)], alpha 2 (50/10.2) [FR], alpha 3 (37/8.3) [S]; gamma-motoneurons: gamma beta (27 msec-1/7.2 microns), gamma 1 (20/6.7), gamma 2 (15/6.2). 3. Because of the strong temperature dependence of the conduction velocities a calibration of the structure of the velocities, which was almost independent of temperature, is defined by the condition that the alpha 2-motoneurons have the same peak conduction velocity then the secondary spindle afferents (SP2); the T1 touch afferents have about 10% lower velocity values. 4. Touch afferents and alpha-motoneurons had a different velocity-diameter relation, which indicated differences in the myelin sheath thickness and/or membrane properties. The conduction velocities of the touch afferents were more temperature-dependent than those of the alpha-motoneurons. Within the classes of touch afferents and alpha-motoneurons the temperature dependence increased towards smaller class peak values. 5. Through the use of action potential wave form comparisons it was possible to identify action potentials from single nerve fibres in each class of touch afferents (T0 to T4). Activity patterns of single touch units could partly be analysed.(ABSTRACT TRUNCATED AT 400 WORDS)

Action Potentials↗
PubMed1989

Touch: a nursing strategy in the intensive care unit.

In this article findings are reported from a qualitative study that examined touch from the perspective of intensive care (ICU) nurses. In-depth interviews with eight experienced ICU nurses and participant observation were used to collect data. Three distinct kinds of touch were identified, as well as normative patterns of touch among ICU nurses. The findings indicate that an understanding of touch is predicated on knowledge about the structural components of touch and the contextual variables and conditions that determine norms of touching. Touch is described as a multipurpose nursing strategy in the ICU. A need was identified to study a wider range of potential therapeutic and nontherapeutic touch meanings for nurses and patients than has previously been reported.

Critical Care↗
PubMed2005

Design and evaluation approach for increasing stability and performance of touch pens in screen handwriting tasks.

Touch pens allow user to write directly on a computer screen. An ergonomically designed touch pen can improve user performance and reduce musculoskeletal injuries. This study investigates the touch pen use in three sections. First, observations of users' handwriting during three screen tasks: writing, pointing-and-clicking and drawing. Second, examinations of the design and development of touch pens based on observed results and related design theory. Third, this study compares the five-point grip pen (FPGP) with the common touch pen. Study conclusions are as follows: (1) The gesture of gripping a common touch pen for on-screen handwriting is unnatural; that is, users tend to use the wrist, elbow or little finger for support. A user's hand and fingers are in a more natural position when using an FPGP. (2) User performance with the FPGP is superior to that with the common touch pen during three screen tasks. (3) The advantages of the FPGP include: increased hand stability, reduced hand fatigue, enhanced performance, and provided adjustability. (4) This study proposed an FPGP whereby a brace was added to a touch pen to increase the stability during screen-based tasks. The idea of adding a brace can be applied to those tasks requiring higher accuracy or continuous freehand without other limb support tasks, such as wall-painting, surgery operation, and other aiming tasks.

Adult↗
PubMed2005

A 'touch' of the White platelet syndrome.

Investigations into structural defects in platelets from a large family with the White platelet syndrome (WPS) separated the members into three groups. The first group of 22 members was the subject of our first report (White JG, Key NS, King RA, Vercellotti GM. The white platelet syndrome: A new autosomal dominant platelet disorder. Platelets 2004;15:173-184). A third group of 13 members had no abnormalities of platelet ultrastructure. The second group of 17 members, the focus of the present study, had a 'touch' of the WPS. Platelet counts, mean platelet volumes (MPVs) and platelet responses to aggregating agents were normal in 'touch' patients in contrast to platelets of those with the full WPS in whom these parameters were abnormal. Up to 13% of the full WPS platelets contained large, fully developed Golgi complexes, up to seven in number, extruding innumerable vesicles from the trans-Golgi face and filling the cytoplasm of many platelets. Many Golgi complexes had centrioles associated with them. 'Touch' platelets had one or two Golgi complexes of intermediate size in 3-5% of their platelets. Golgi vesicles were uncommon and centrioles absent. Gray platelets and hypogranular cells were infrequent in patients with a 'touch' of the WPS, whereas up to 44% of the platelets from those with the WPS were gray or hypogranular. Elements of the dense tubular system were prominent in full WPS platelets, together with their formation into areas of cytoplasmic sequestration and autodigestion. These features were absent in 'touch' platelets. As commonly observed in full WPS platelets, mitochondria were larger and more numerous than alpha granules in some 'touch' cells. Both 'touch' and full WPS platelets frequently contained giant and rod-shaped granules. Dense bodies, however, were normal in size and number in 'touch' platelets, and half normal size in full WPS platelets. The separation of ultrastructural abnormalities in the two varieties of the WPS suggests that genetic defects involve more than a single gene and the genes are variable in their penetrance. Genetic studies to determine if this is the case are currently in progress.

Blood Coagulation Disorders, Inherited↗
PubMed2005

Touch-screen computer systems in the rheumatology clinic offer a reliable and user-friendly means of collecting quality-of-life and outcome data from patients with rheumatoid arthritis.

OBJECTIVES: To investigate the feasibility of collecting rheumatoid arthritis (RA) patient self-administered outcome data using touch-screen computers in a routine out-patient clinic. METHODS: Forty patients with RA completed the touch-screen and paper Rheumatoid Arthritis Quality of Life Questionnaire (RAQol) in the clinic and rated ease of use and preference. Forty-five others completed the Stanford Health Assessment Questionnaire (HAQ) and visual analogue scales (VASs) for pain, fatigue and global arthritis activity on touch screen and paper and a joint assessment on touch screen. They rated ease of use and willingness to complete the assessment again. Joints were independently assessed, and completion times and technical problems recorded. RESULTS: No technical problems were encountered. The touch-screen RAQol took no longer to complete, was preferred by 64% (33% had no preference) and was rated significantly higher for ease of use (two-tailed P=0.003, n=40) even by computer naïve patients (two-tailed P=0.031, n=24). Intraclass correlation coefficients between methods were high for RAQol (0.986) and tender joint counts (0.918), and as high for the pain, fatigue and global activity (0.855, 0.741, 0.881) as for test-retest of the paper versions (0.865, 0.746, 0.863). Ninety-eight per cent rated the touch screen very/quite easy for HAQ and VAS, and 90% for joint assessment. Ninety-six per cent stated a willingness to complete the touch-screen assessment in clinic again. CONCLUSIONS: Touch-screen questionnaires in the clinic can produce comparable results to paper, eliminate the need for data entry and afford immediate access to results. It is an acceptable, and in many cases a preferable, option to paper, regardless of age and previous experience of computers.

Adult↗
PubMed2005

Outpatient hysteroscopy: traditional versus the 'no-touch' technique.

OBJECTIVE: To assess whether outpatient hysteroscopy using the 'no-touch' technique confers any advantages in terms of patient discomfort over the traditional technique. DESIGN: Prospective randomised controlled study. SETTING: Outpatient hysteroscopy clinic in a large university undergraduate teaching hospital. POPULATION: All women referred for outpatient hysteroscopy in a 12-month period. INTERVENTIONS: Women were randomised to undergo either traditional saline hysteroscopy requiring the use of a speculum and tenaculum, or a 'no-touch' vaginoscopic hysteroscopy which does not require a speculum or tenaculum. Each group was further subdivided to have hysteroscopy with either a 2.9-mm or 4-mm hysteroscope. Patients were asked to complete pre- and postprocedure questionnaires ranking pain scores. MAIN OUTCOME MEASURES: The relative success of each of these techniques, requirement for local anaesthetic and pain scores at different times during the hysteroscopy were recorded at the end of the procedure. The time taken to carry out each procedure was also measured. RESULTS: One hundred and twenty women were recruited in this study: 60 were randomised to traditional hysteroscopy and 60 to 'no-touch' hysteroscopy. The overall success rate for hysteroscopy was 99%. There was no significant difference in the requirement for local anaesthetic between the two groups, but those who underwent 'no-touch' hysteroscopy with a 2.9-mm hysteroscope had the lowest requirement of local anaesthetic (10% compared with 27% in the no-touch hysteroscopy with a 4-mm hysteroscope group). The time taken to perform hysteroscopy and biopsy was significantly shorter with 'no-touch' hysteroscopy (5.9 vs 7.8 min; difference 1.9, 95% CI 0.7-3.1). There were no differences in pain scores between the groups at different times during hysteroscopy. CONCLUSIONS: 'No-touch' or vaginoscopic hysteroscopy is significantly faster to perform than the traditional technique. Although there was no difference in pain scores between the two techniques, local anaesthetic requirements were least in those who underwent 'no-touch' hysteroscopy with a narrow bore hysteroscope.

Adult↗
PubMed2005

Pancreatectomy using the no-touch isolation technique followed by extensive intraoperative peritoneal lavage to prevent cancer cell dissemination: a pilot study.

CONTEXT: In pancreatic cancer, even for patients who have undergone curative resection (R0), survival analysis has revealed a poor survival rate due to cancer recurrence. Because the operation itself might have caused the dissemination of these cancer cells, the no-touch isolation technique and extensive intraoperative peritoneal lavage may be a potential operative procedure for improving the outcome. PATIENTS: Eight patients treated by the no-touch isolation technique were compared with 10 patients treated using conventional techniques. MAIN OUTCOME MEASURES: Cancer cell detection rates in the portal venous blood, frequency of recurrence, and survival rate. We also analyzed the lymphatic fluid squeezed from the resected cancerous pancreatic tissue. RESULTS: In 5 out of 10 cases (50%) in the conventional procedure group, CEA mRNA was identified in the portal blood after tumor manipulation, while only 1 out of 8 cases (13%) in the no-touch isolation technique group was positive for portal CEA mRNA. All lymphatic fluid samples squeezed from the resected cancerous pancreatic tissue were positive (8/8) for CEA mRNA. The recurrence rate was 90% (9/10) in the conventional procedure group, and 38% (3/8) in the no-touch isolation technique group (P=0.043). In the conventional procedure group, hepatic metastasis, local recurrence, peritoneal dissemination, and extraabdominal recurrence were identified in 6 (60%), 4 (40%), 4 (40%), and 2 patients (20%), respectively. On the other hand, among the no-touch isolation technique group, recurrence was identified in 1 (13%), 1 (13%), 0 (0%), and 1 patient (13%), respectively. There was no peritoneal dissemination along with the decreased hepatic recurrence rate. Mean (+/-SEM) survival time was 21.2+/-5.8 months for the conventional procedure group and 41.5+/-5.6 months for the no-touch isolation technique group (P=0.018). The 3-year survival rate was 12.5+/-11.5% for the conventional procedure group and 75.0+/-21.7% for the no-touch isolation technique group. CONCLUSION: This study presented the potential of cancer dissemination during the intraoperative manipulation of tumors and its contribution to cancer recurrence, as well as the significance of the no-touch isolation technique and extensive intraoperative peritoneal lavage for pancreatic cancer surgery.

Carcinoembryonic Antigen↗
PubMed2005

Selective use of intraoperative touch prep analysis of sentinel nodes in breast cancer.

Imprint cytology (touch prep) is often used for intraoperative examination of sentinel nodes in breast cancer. This allows axillary lymph node dissection (ALND) to be performed immediately for tumor-positive nodes. We evaluated the accuracy of touch prep examination of sentinel nodes and its role in the surgical treatment of breast cancer. We analyzed 169 breast cancer patients who underwent 170 lymphatic mapping procedures with intraoperative touch prep examination. Results from the touch prep were correlated with histopathology and clinical variables. There were 115 true-negative, 35 true-positive, 15 false-negative, and 5 false-positive results. Touch prep had a sensitivity of 70 per cent and specificity of 96 per cent. Positive predictive value, negative predictive value, and diagnostic accuracy were all 88 per cent. The false-negative rate was 30 per cent and correlated with the size of the nodal metastasis and number of involved nodes, but not other patient factors. Touch prep is useful for the evaluation of sentinel nodes in breast cancer, but it has a lower sensitivity than initially reported, particularly in patients with micrometastases. False positive results occur, although they may be reduced after experience with the technique. We recommend that suspicious findings on touch prep should be confirmed by frozen section and that ALND only be performed for histologically documented metastases. We currently perform touch prep only in patients who are at high risk of nodal metastasis or will undergo mastectomy. This improves operative efficiency and limits the impact of false positive and negative results without dramatically increasing the number of patients who require a second surgical procedure.

Adult↗
PubMed1986

The development of an observation schedule for measuring nurse-patient touch, using an ergonomic approach.

An observation schedule for recording nurse-patient touch was developed, using an ergonomic approach to design. A preliminary study using video-tape analysis and a ward survey indicated that 'instrumental touch' was more frequently employed by nursing staff than 'expressive touch'. Three levels of relevant information relating to touch were recorded: General circumstances (the type of hospital, etc.); Demographic variables (relating to participants in the touch episode); Events specifically relating to the touch episode. The third section of the schedule was tested in an acute geriatric ward, using inter-observer reliability techniques. Reliability was found to be acceptable for those where the criteria for categorization were reasonably objective. It was concluded that an instrument for recording nurse-patient touch has useful applications for both ergonomic and nursing research.

Adult↗
PubMed1985

Self-touching as an indicator of underlying affect and language processes.

In this study of 28 physicians and their patients during the medical interview, information is presented on a class of nonverbal behavior, self-touching, thought to represent states of negative affect. A more recent perspective suggests that self-touching is associated with cognitive processing. The results of the present study focused on differences in types of self-touching by patients and physicians, semantic content of utterances when self-touching was displayed, and temporal location of self-touching within the speech stream. These are considered with respect to affective and psycholinguistic theories of self-touching. The results lend support to the notion that self-touching is exhibited in relation to information processing and production, in addition to negative affect.

Affect↗