Reiki Therapy in Primary Care for Cancer Pain

REIKI THERAPY AS ADJUNCTIVE TREATMENT IN CANCER PATIENTS WITHIN PRIMARY CARE SETTING JOYCE VALENCIA GNRS 597 COMPREHENSIVE EXAMS July 26, 2016

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BACKGROUNDStatistics2012: 14 million new cancer cases2016: leading estimated deaths in USLung cancer: 158, 080 deathsColorectal cancer: 49, 190 deathsPancreatic cancer: 41, 780 deaths(ACS, 2016)2006-2012: 66.9% 5+ year survival(ACS, 2016)

External factorsTobaccoAlcohol consumptionInfectious pathogensPhysical inactivityInternal FactorsGenetic mutationsHormonesDysfunction of immune system(American Cancer Society, 2014)

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CANCERSigns and SymptomsFatigueNauseaStressFearAnxietyDepressionRestlessnessDiminished Quality of LifePain(Henneghan & Schnyer, 2013)

Cancer PainDisease processInvasive treatmentsSide effects of treatments(Running & Turnbeaugh, 2011)

Poor Management80% of the population is inadequately controlled(Aghabati, Mohammadi, & Esmaiel, 2010)

PROBLEM OF INTEREST

CANCERPharmacological treatmentMisconceptionsTolerancePhysical dependencePsychological addiction(Aghabati et al., 2010)

Pain is not being well communicatedPain is not being treated wellPatients are going elsewhere for management5

CANCER PAINPredictors of CAMGenderMarital statusCancer stageTreatment# severe symptoms (Fouladbakhsh, Stomell, Given, & Given, 2005)

73% of radiation oncology patients did not report use of CAM to providers.6

COMPLEMENTARY AND ALTERNATIVE MEDICINECenters for Disease Control and PreventionNational Center for Health Statistics$33.9 billion spent on CAM1.2 million visits to energy healers(Nahin, Barnes, Stussman, & Bloom, 2009)

ENERGY MEDICINENational Institutes of HealthNational Center for Complementary and Integrative Health (NCCIH)Energy MedicineSubtle energy modalitiesReiki therapyHealing TouchTherapeutic Touch(Rindfleisch, 2010)

REIKI THERAPYReikiJapanese origins (1922)Levels of experienceReiki Level IReiki Level IIReiki MasterPromotes positive energyExtracts negative energy(Rand, 1991)

ENERGY THERAPY1st Law of ThermodynamicsEnergy can neither be created nor destroyed(Keyes, 2012)

Biophysical DomainElectromagnetic fieldsElectrocardiogramElectroencephalogram(Henneghan & Schnyer, 2013)MRI (Rindfleisch, 2010)

This expands the biochemical and molecular components of biology to a dynamic biophysical domain composed of electromagnetic fields.Examples: spraining ankle and negative perceptions of an individual.10

REVIEW OF LITERATURESearch MethodologyCochrane LibraryPubMedCINAHLMedLine

Scholarly Articles3 randomized controlled trials3 prospective nonrandomized studies1 prospective cohort study2 literature reviews of energy medicine in cancerKeywordsReikiReiki therapyComplementary and alternative medicineEnergy medicineCancer painOncology

REVIEW OF LITERATURELiterature reviews

Healing Touch (n=5)Therapeutic Touch (n=6)Reiki Therapy (n=11) anxiety relaxation, mood QOL pain relief relaxation, comfort, awareness pain relief, relationships well-being mood pain scores, fatigue preoperative anxiety cognition postoperative pain BP, IgA, muscle tension, temperature Preoperative relaxation pain, depression, anxietySelf-care intervention VAS by 1.2 points

(Coakley & Barron, 2012)

These studies help to emphasize that subtle energy modalities as a whole seem to have a positive impact on recipients.12

REVIEW OF LITERATUREGeneralized Cancer PopulationExpansive inclusion criteriaUtilized different measuring toolsGeneral painCancer-related painComparisons in cancer treatmentsOpioid analgesicsChemotherapyRadiation therapyUnique research methodologies

REVIEW OF LITERATUREPain measurementBirocco et al. (2012)Visual Analog ScaleChemotherapy 1-2 pointsOlson, Hanson & Michaud (2003)Edmonton Staging SystemVital signsOpioids

(Birocco et al., 2012)

(Olson, Hanson, & Michaud, 2003)

Birocco et al (2012): mean pain reduction 4.4 to 2.32 in 118 subjects receiving chemotherapy for 30 minutes by volunteers.Olson, Hanson & Michaud (2003): 24 subjects in 2 groups. (1) opioids + rest (2) opioids + 1.5 hrs Reiki by a Reiki Master.14

REVIEW OF LITERATUREBest PracticesOverall duration of treatment20-75 minutesDifferent Reiki PractitionersReiki MastersReiki volunteersNo mentionConclusionReiki Master for 30 minutes

- Marcus, Blazek-ONeill, & Kopar (2012): additional factors with marked improvements: relaxation, anxiety, mood and sleep. 145 subjects15

GAPS IN LITERATURENo mechanism of actionLimited studies in the basic sciencesSchumann theory(Baldwin, Rand, & Schwartz, 2013)Qualitative data desired(Miles & True, 2003)Small subject poolsHighest: n=360Lowest: n=16Difficulties in sham placebo groups(Catlin & Taylor-Ford, 2011)

SCIENCE OF UNITARY HUMAN BEINGS: REIKI THERAPY

reiki energy

integrality

patient

practitioner

environment

openness

pain

pain relief

helicy

pandimensionality

energy fields

clinical exam room

patterns

resonancy

MARTHA ROGERS: SCIENCE OF UNITARY HUMAN BEINGSFour ElementsEnergy fieldsOpen systemsPatternsPandimensionality(Polit & Beck, 2012)

BIOETHICAL CONCEPTSPaternalismMedical expertiseBeneficence(Mitchell et al., 2012)AutonomyExpressed interest in CAMUtilitarianismMaximize well-being(Maclean, 1993)

APRN ROLEPractice holistic care in medical modelMindBodySpiritAssess for painPromote patient education and interaction

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PROPOSED INTERVENTIONCommunity partnershipsSan Diego Reiki CorpsAmerican Holistic Nurses AssociationTrainingWeekend workshop$50-200Self-treat for 21 days(Rand, 1991)

PROPOSED INTERVENTIONPre- and Post-measurementsVASVital signsMYMOP Questionnaire(Siegel et al., 2016)Treatment sessions30 minutesDocumentationSOAPDuration of treatmentTotal # treatmentsOutcome of treatments(Shepherd-Gentle, 2016)

ReimbursementCPT code 99215NANDA 1.8 (?)(OMalley, 2011)

REFERENCESAghabati, N., Mohammadi, E., & Esmaiel, Z. P. (2010). The effect of therapeutic touch on pain and fatigue on cancer patients undergoing chemotherapy. Evidence-Based Complementary and Alternative Medicine, 7(3), 375-381.American Cancer Society. (2016). Estimated deaths, 2016. Retrieved from https://cancerstatisticscenter.cancer.org/#/data-analysis/module/yg6E0ZLc?type=barGraphBaldwin, A. L., Rand, W. L., & Schwartz, G. E. (2013). Practicing reiki does not appear to routinely produce high-intensity electromagnetic fields from the heart or hands of reiki practitioners. The Journal of Alternative and Complementary Medicine, 19(6), 518-526. doi: 10.1089/acm.2012.0136Birocco, N., Guillame, C., Storto, S., Ritorto, G., Catino, C., Gir, N., Balestra, L., Tealdi, G., Orecchia, C., De Vito, G., Giaretto, L., Donadio, M., Bertetto, O., Schena, M., & Ciuffreda, L. (2012). The effects of reiki therapy on pain and anxiety in patients attending a day oncology and infusion services unit. American Journal of Hospice and Palliative Medicine, 29(4), 290-294. doi: 10.1177/1049909111420859Catlin, A., & Taylor-Ford, R. L. (2011). Investigation of standard care versus sham reiki placebo versus actual reiki therapy to enhance comfort and well-being in a chemotherapy infusion center. Oncology Nursing Forum, 38(3), 212-220. doi: 10.1188/11.ONF.E212-E220Coakley, A. B., & Barron, A. (2012). Energy therapies in oncology nursing. Seminars in Oncology Nursing, 28(1), 55-63. doi: 10.1016/j.soncn.2011.11.006Fouladbakhsh, J. M., Stommel, M., Given, B. A., & Given, C. W. (2005). Predictors of use of complementary and alternative therapies among patients with cancer. Oncology Nursing Forum, 32 (6), 1115-1122.Henneghan, A. M. & Schnyer, R. N. (2013). Biofield therapies for symptom management in palliative and end-of-life care. American Journal of Hospice and Palliative Medicine, 0, 1-11. doi:10.1177/1049909113509400

REFERENCES CONTKeyes, R. (2012). The healing power of reiki: A modern masters approach to emotional, spiritual & physical wellness. Woodbury, MN: Llewellyn Publications.Maclean, A. (1993). The elimination of morality: Reflections on utilitarianism and bioethics. New York, NY: Routledge.Miles, P., & True, G. (2003). Reiki review of a biofield therapy history, theory, practice, and research. Alternative Therapies, 9(2), 62-72.Mitchell, P. H., Wynia, M. K., Golden, R., & McNellis, B., Okun, S., Webb, C. E., Von Kohorn, I. (2012). Core principles & values of effective team-based health care. Institute of Medicine, 1-30.Nahin, R. L., Barnes, P. M., Stussman, B. K., & Bloom, B. (2009). Costs of complementary and alternative medicine and frequency of visits to cam practitioners: United States, 2007. National Center for Health Statistics, 18, 1-15.Olson, K., Hanson, J., & Michard, M. (2003). A phase II trial of reiki for the management of pain in advanced cancer patients. Journal of Pain and Symptom Management, 26(5), 990-997. Doi:10.1016/S0885-3924(03)00334-8Polit, D. F., & Beck, C. T. (2012) Nursing research: Generating and assessing evidence for nursing practice (9th ed.). China: Wolters Kluwer Health. Rand, W. L. (1991). Reiki the healing touch: First and second degree manual. Southfield, MI: Vision Publications.Rindfleisch, J. A. (2010). Biofield therapies: Energy medicine and primary care. Primary Care: Clinics in Office Practice, 47 (1), 165-179.Running, A., & Turnbeaugh, E. (2011). Oncology pain and complementary therapy: A review of the literature. Clinical Journal of Oncology Nursing, 14(4), 374-379.Siegel, P., da Motta, P. M., da Silva, L. G., Stephan, C., Lima, C. S., de Barros, N. F. (2016). Reiki for cancer patients undergoing chemotherapy in a brazilian hospital. Holistic Nursing Practice, 30(3), 174-182.

QUESTIONS?

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