anyone do a PICO paper about Reiki?

[amboyacres]

I am starting a EBP paper for graduate project and I am trying to come up with topics. I was thinking along the lines of Reiki and pain relief. Just wondering if anyone has any good info. reiki seems to becoming popular in hospitals, my hospital actually has reiki practitioners know. Does anyone work at a hospital that has published research?

Thanks,

Megan

[Double-Helix, BSN, RN]

A classmate of mine wrote a paper about it, so I know there is research available. However, you need to do the research for your paper, not use someone else's. You should not be looking for hospitals that have done studies, but looking for peer-reviewed nursing or medical journals. Start by searching databases like ebsco host, cochrane and med line. That should give you a lot of articles to choose from.

Remember that PICO questions should be specific. So your topic should not be to research reiki or even reiki and pain relief. Choose a specific population that you want to investigate, such as children, patients with cancer, post operative patients, hospice patients, laboring mothers, etc.

[onedayitllbeme]

I am pre-nursing student, what does PICO stand for? I can't imagine writing a paper about it unless it was to argue any use of it should be with disclaimers about the fact science has never backed it up. I read a lot of peer-reviewed studies and I have never seen one that showed Reiki was any better than placebo. Is it really common in hospitals now? I really hope that isn't true.

Here is an example of a typical study I see, I hope at some point the money goes into researching something else:

https://www.ncbi.nlm.nih.gov/pubmed/21531671

[Scarlette Wings]

Sounds like your hospital is proactive and willing to use alternative treatments to help the patients. You are indeed blessed to work in a place like that.

To answer your question I do not have literature but I have a roommate who is a reiki practitioner level 2 and she is a licensed professional counselor working in private practice and as an eap for the postal service. She would be a great resource to interview and has numerous texts that she could recommend.

If you would like to ask her some questions you can write her, she used to help administrate the old nursing boards and is great at answering stuff. I can send you her email if you'd like or you can send them to me and I will give them to her.

[Hospice Nurse LPN, BSN, RN]

onedayitllbeme said:

I am pre-nursing student, what does PICO stand for? I can't imagine writing a paper about it unless it was to argue any use of it should be with disclaimers about the fact science has never backed it up.

A PICO is an evidenced based paper. You'll be doing one sometime during your studies. We did ours in Nursing Research.

P-problem or population

I-intervention

C-comparison

O-outcome

Most people use online resources such as PubMed. Many of the online resources are free, whereas others require a subscription fee. These resources include: systematic reviews and critically appraised topics; clinical practice guidelines and protocols; article reviews; and drug databases.

One of the free resources is PubMed.

[Double-Helix, BSN, RN]

onedayitllbeme said:

I am pre-nursing student, what does PICO stand for? I can't imagine writing a paper about it unless it was to argue any use of it should be with disclaimers about the fact science has never backed it up. I read a lot of peer-reviewed studies and I have never seen one that showed Reiki was any better than placebo. Is it really common in hospitals now? I really hope that isn't true.

Here is an example of a typical study I see, I hope at some point the money goes into researching something else:

https://www.ncbi.nlm.nih.gov/pubmed/21531671

Hi,

Reiki is a form of complementary or alternative medicine (CAM). Meaning that it can be used in conjunction with, or in place of other more traditional western medicine. It is often practiced by those of foreign cultures and those who believe in a more holistic approach to health. No, it is not widely used by hospitals, but many do have Reiki practicioners available for those who wish to utilize them. Why would it need a disclaimer? I'm sure you know that there are also western medical techniques that do not work for every patient. Some patient have pain that is not relieved by morphine, but it is relieved by another medication. I don't offer my patient's morphine with a written disclaimer that it might not work for them. Reiki is in no way a dangerous or risky therapy. If a patient wants to try it, they should be supported, not criticized because it isn't "science based" or told that it's no better than a sugar pill.

There are studies available that show that Reiki can be effective at reducing pain or anxiety in certain populations. There are also people that swear by it. As nurses, we do follow evidence based practice for most of our interventions, but there are times when alternative interventions are actually more effective, especially if the patient requests those interventions.

I can see that, as a pre-nursing student, you don't have a lot of experience with alternative therapies and, like many Americans, believe that western medicine is superior. In nursing school, you will learn about a lot of different CAMs, such as accupressure, imagery, herbs, chinese medicine, etc. You will also care for people from a variety of cultures who might not have the same beliefs about medicine that you do. I'm sure that after you attend school, you'll have more respect for these alternative therapies and the people that practice them.

[onedayitllbeme]

Yes, I am science-centric. Is it true that nursing school turns people away from science!?

it cannot be compared to the fact that sometimes certain people do not react the same way to a medication that another does. Morphine has been shown in double blind studies to have a real effect. If you can post any of the studies you mention about Reiki I would more than willingly read them. I have heard CAM has infiltrated some schools and hospitals, but I really hope that only encompasses some of the alternative medicine that has show to actually work better than placebo.

I refuse to believe I am in the minority in nursing students that are skeptical of a modality that can't be shown with science.. even in my prereqs such as nutrition they teach you had to be very critical of anything that hasn't been backed by peer-reviewed studies.

[Double-Helix, BSN, RN]

onedayitllbeme said:

Yes, I am science-centric. Is it true that nursing school turns people away from science!?

it cannot be compared to the fact that sometimes certain people do not react the same way to a medication that another does. Morphine has been shown in double blind studies to have a real effect. If you can post any of the studies you mention about Reiki I would more than willingly read them. I have heard CAM has infiltrated some schools and hospitals, but I really hope that only encompasses some of the alternative medicine that has show to actually work better than placebo.

I refuse to believe I am in the minority in nursing students that are skeptical of a modality that can't be shown with science.. even in my prereqs such as nutrition they teach you had to be very critical of anything that hasn't been backed by peer-reviewed studies.

Nursing school does not turn people away from science. Most of what you learn will be traditional western medicine. However, it does give you a greater appreciation and respect for alternative therapies.

• Richeson, N., Spross, J., Lutz, K., & Peng, C. (2010). Effects of Reiki on anxiety, depression, pain, and physiological factors in community-dwelling older adults. Research in gerontological nursing, 3(3), 187-199. Retrieved from EBSCOhost. This article details significant improvement in pain, depression and anxiety on older adults after reiki therapy.

That's just one. I'm sure there are others, but I have to go to work for the day.

You seem to be rather offended by the thought that other CAMs that are not well proven are being used in hospitals. With the large variety of cultures treated in American hospitals, why should it be any other way? Should our hospitals be a place where we use western medicine, period, because we know it works and forget about any other remedies that our patients want? Why does it bother you that reiki is being used in hospitals? While it might not be proven as effective as morphine, it's not dangerous in any way. If a patient would rather use Reiki than take a narcotic, isn't that the patient's right? Reiki has far fewer side effects than morphine, or an antidepressant medication.

Prayer and spiritual support is used by a great percentage of patients. Prayer is a CAM and I haven't yet found a study that proved prayer increased health outcomes. So should we fire our pastoral staff at the hospitals because their work isn't science-based?

I use CAMs almost every day, in one form or another. When I give a scared child his favorite blanket for security, when I talk to and hold the hand of my intubated and sedated patients, when I call in the chaplain to speak to a family, when I offer hot water instead of cold water to an Asain mother who has a new baby, and the list goes on. None of those interventions are science-based. But all of them help my patients to feel more secure and comfortable.

[pmiles]

How wonderful that you are looking at how Reiki can help patients in conventional medical settings. I have been pioneering the use of Reiki in health care for 20 years, and you'll find papers on my website published in peer-reviewed journals that will give you a good start, and save you from sorting through a lot of papers that are not solid research

https://reikiinmedicine.org/medical-papers/

Although there is not yet much good research on how Reiki can help patients, a number of studies have shown it can help reduce pain. And there is much unpublished data. For example, in a program evaluation for a 3 year funded program I had at an out-patient cancer center in NYC, 97% of the people who reported pain and/or anxiety before their Reiki treatment, reported feeling relief after their treatment. Most of the participants were patients, but also some family and staff, and the treatments lasted between 10 and 50 minutes. We started very low key, but soon the nurses were referring patients for Reiki treatment, or asking that I send the practitioner into the chemo room, because they saw how much even a brief Reiki treatment did to make the patients more comfortable and the nurses' work easier. All the hospitals where I've set up Reiki programs have had similar experiences.

Reiki treatment is increasingly offered to patients in hospital, including many prestigious hospitals such as Memorial Sloan Kettering, Yale-New Haven, Dana Farber/Harvard, M. D. Anderson, and California Pacific Medical Center, despite the lack of research because it is widely recognized that Reiki is low-risk (unlike morphine) and the anecdotal evidence is compelling, and growing.

[onedayitllbeme]

I read the conclusions of the study you listed. It isn't testing whether Reiki actually exists. Meaning it isn't comparing Reiki delivered by a energy healer versus a non energy healer (double blind). All studies that have done that have shown no difference. I do believe that some people would have a positive anxiety reducing experience and if this satisfies them in terms of pain alleviation etc. I have no problem with it, but sometimes CAM in place of evidenced based medicine can be harmful. Think of the case where someone wants the most effective treatment to get rid of a tumor and they are told by a Reiki healer that this can help them and they don't question it. They are wasting precious time, and they might just not understand that the treatment they are being given has never been shown to be better than doing nothing at all.

My concerns with it really come from a very good place. I just want people to understand what they are choosing, and if they do I have no problem with it. I think all your examples such as giving a mother a different temp water are not the same thing at all. If there is no medical benefit to one temp versus another than of course you would do what made your patient feel more comfortable. If there was a medical benefit I think it should be your duty to tell them what risk they are taking by choosing the different temp water. I don't think taking a very specific concern I have about Reiki and translating it to this is fair. That isn't what I was saying at all. actually I never heard that type of things that you mentioned described as CAM.

Lastly, I believe in medicine. And many alternative medicines that were shown with science to be safe and effective are now just considered medicine or a valid treatment. An example is honey and lemon for a cough. It has been shown to be more effective than cough medicine. As such, I know that giving my children this when they are uncomfortable might have a positive effect. Since they love honey, even if it hadn't been proven effective I might try it anyway. I agree there is nothing wrong with it. Here is the difference with a patient. Now that it has been shown to be safe and effective I would think it would make sense for a doctor to recommend it for cough alleviation. If it hadn't shown to be effective I wouldn't expect a doctor to suggest it, but I would expect that if a patient requested it and it was cleared by the doctor that they should be able to have it.

Does that make sense? I am very open to understanding how to help my patients and know I will see many cultures with many different beliefs and as long as they are not hurting themselves without realizing it I will fight for what they want, but that doesn't mean I think there should be doctors in a hospital prescribing a reiki treatment. I also support people's belief in god of course and there request to have a chaplain or anything else of that order. I even support someone's desire to not get life saving treatment if they don't want it. I just think people should be informed even with morphine the risks versus benefits.

Ashley, PICU RN said:

Nursing school does not turn people away from science. Most of what you learn will be traditional western medicine. However, it does give you a greater appreciation and respect for alternative therapies.

• Richeson, N., Spross, J., Lutz, K., & Peng, C. (2010). Effects of Reiki on anxiety, depression, pain, and physiological factors in community-dwelling older adults. Research in gerontological nursing, 3(3), 187-199. Retrieved from EBSCOhost. This article details significant improvement in pain, depression and anxiety on older adults after reiki therapy.

That's just one. I'm sure there are others, but I have to go to work for the day.

You seem to be rather offended by the thought that other CAMs that are not well proven are being used in hospitals. With the large variety of cultures treated in American hospitals, why should it be any other way? Should our hospitals be a place where we use western medicine, period, because we know it works and forget about any other remedies that our patients want? Why does it bother you that reiki is being used in hospitals? While it might not be proven as effective as morphine, it's not dangerous in any way. If a patient would rather use Reiki than take a narcotic, isn't that the patient's right? Reiki has far fewer side effects than morphine, or an antidepressant medication.

Prayer and spiritual support is used by a great percentage of patients. Prayer is a CAM and I haven't yet found a study that proved prayer increased health outcomes. So should we fire our pastoral staff at the hospitals because their work isn't science-based?

I use CAMs almost every day, in one form or another. When I give a scared child his favorite blanket for security, when I talk to and hold the hand of my intubated and sedated patients, when I call in the chaplain to speak to a family, when I offer hot water instead of cold water to an Asain mother who has a new baby, and the list goes on. None of those interventions are science-based. But all of them help my patients to feel more secure and comfortable.

[pmiles]

Reiki is a healing practice. There is no reason to study whether or not the practice exists, just as there is no need to do research to find out whether meditation or yoga exist. The point is to study the impact of the practice on the human system, and although research into the effects of Reiki is just beginning, there are many small studies in which there are significant improvements in both physiologic and self-report measures. A study I participated in at Yale was written up in the well respected conventional peer-reviewed Journal of the American College of Cardiology. Twenty-minute Reiki treatments given to patients within 72 hours after a heart attack improved heart rate variability as effectively as beta-blockers. You can read more here

https://reikiinmedicine.org/clinical-practice/reiki-heart-attack-reik/

With all respect, you don't seem to be in touch with how complementary therapies are currently being used in hospitals to support patients, families, and staff. No one is suggesting that patients receive a Reiki treatment instead of conventional care.

[onedayitllbeme]

pmiles said:

With all respect, you don't seem to be in touch with how complementary therapies are currently being used in hospitals to support patients, families, and staff. No one is suggesting that patients receive a Reiki treatment instead of conventional care.

Quite possible since I don't work in a hospital .. yet. I just know that all the double blind studies have shown having a reiki treatment has the same benefit whether or not a person who knows anything about Reiki does it. that's all I meant. Before I learned what these alternative treatments were, I had my fair share of them , for example acupuncture and homeopathy.. when I noticed they didn't work for me, I looked into them and realized there was actually no reason they should work. I didn't become more fertile with acupuncture and my kids cried just as much with teething when I gave them homeopathic teething tablets (though man did they love the taste of sugar). fertility doctor helped with the infertility and tylenol helped with the teething pain. (and I sometimes wish I had put that money towards my kids college funds especially since some of the teething tablets were recalled, at least with reiki there is no dangerous substances you are putting in your body)