Efficacy of Facilitated Tucking Position and Reiki Given to Preterm Infants During Orogastric Tube Insertion: A Randomised Controlled Trial

Abstract

We accept that Reiki [1], which is grouped as Energy therapies and other complementary therapies among Complementary and Alternative Medicine (CAM) practices, includes healing approaches that are not included in Western medicine. Although experimental medicine/mainstream science are evidence-based practices with scientific foundations, CAMs have proven benefits. Although some complementary practices have been found to have statistically significant positive results in pain and symptom management, clear evidence has not yet been established to show how their mechanisms of action work. However, it is clear that many researchers are turning to such practices as part of the treatment process [2-5].

Reiki is one of the methods that can be used in conjunction with standard medical treatment, but is not considered a treatment on its own. Reiki is a healing therapy defined by Dr. Usui in the 19th century. Reiki progresses sequentially from Level 1. The person who practices (depending on their level) can apply Reiki by actively using the touch method or without touching. In our study, a Level 1 Reiki application was performed. During the OGT procedure, after the hands were washed and cleaned, superficial contact was made alternately to the soles of the feet, head, and abdomen without grasping the extremities, after waiting for them to reach natural body temperature. A cold and irritating palm may have possible negative neurological effects on the infants based on an individualised developmental care approach. Therefore, this way of doing the application is also based on the basis of eliminating this. Thus, the baby's normal body reactions were not prevented during the OGT insertion. Therapeutic touch in infants is a method that has been used for many years to calm babies and its effectiveness has been tried to be demonstrated with different studies [6-8]. We think that Reiki also creates a kind of therapeutic touch effect in babies. We stated that this study is remarkable in terms of revealing the first findings showing the effect of Reiki intervention on physiological parameters, stress, and pain during OGT placement in premature babies. We also emphasised that more studies should be conducted on the subject as a result of the study.

We have stated in the limitations of this study that the fact that two researchers actively took part in managing the data collection process for physiological parameters, pain, and stress scores may have caused variability. In addition, since the sample size was small, it is possible that the results are sample-specific, which is also stated in the limitations. We also acknowledge that infants cannot be blinded by nature and that the researchers who administered the intervention cannot, unfortunately, be excluded. An independent clinical nurse and independent statistician were used in the assessment to some extent to control bias in the assessment process.

You stated that there may be a subjective interpretation for pain and stress scores, but physiological parameters are quite objective results. They are objective health outcomes that will support the change in pain and stress scores.

It is seen in the historical process that some nursing theorists have drawn attention to the human’ energy field and spiritual aspect, which are included in basic nursing practices. The energy field, spiritual aspect and spiritual needs were added to nursing care many years ago. For example, we notice that Florence Nightingale addresses the soul and body as a whole. Rogers' Unitary Human Model, Watson's Human Care Model and Levine's Protection Model draw attention to the energy aspect of the human [9, 10]. The North American Nursing Diagnosis Association (NANDA) has also included a nursing diagnosis classification for human's energy aspect. When looking at the international literature, it is seen that studies on the use of energy therapies are old and the fact that nurses can contribute to healing by incorporating these applications into care should not be ignored.

Although the mechanism of action has not been proven, there are no studies that emphasise that there is a negative effect in case of use. It is also a limitation that some phenomena are interpreted as unnecessary or absurd because they cannot be explained by mainstream science (god, power, goodness, faith, energy field, … etc.).

Despite the heterogeneity in study results, Liu et al. emphasise that overall Reiki therapy is a safe and effective complementary intervention for alleviating negative states such as anxiety, stress and pain [11] However, we also recognise the need for further high-quality randomised controlled trials (RCTs) to explore the efficacy of Reiki in interventional applications and to investigate its physiological mechanisms.

The authors declare no conflicts of interest.