Nursing diagnosis "altered energy field"

Nurses General Nursing

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"Altered energy diagnosis"

Do you support this NANDA diagnosis? Or do you feel that this diagnosis threatens the legitamacy of our profession? Nanda still stands behind it. What are your thoughts?

paphgrl

Energy field disturbance was included due to a very vocal minority insisting on it. The majority caved in to this head strong bunch. It is obviously meaningless as it cannot be seen, touched, measured, or even described adequately. Listed symptoms, treatments and outcomes all have legitimate models that have nothing to do with energy fields. IMHO

It seemed like this very vocal minority decided to make TT "legit" through political means instead of through running high quality scientific research.

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I used that example to cite the healthy skepticism of a young teen, as a contrast to the unquestioning faith many adults have in unproven treatment modalities.

We can both locate research of varying quality to support our arguments. What I have yet to see is proof that an energy field exists.

Until that proof is presented, let us call TT what it is: time spent one on one with a patient. We all know that is beneficial.

May I ask a question of all those who cast disdain upon TT? Do you believe in the use of biofeedback? Do you believe it is just one of those alternative treatment modalities, without a scientific bases? Do you believe it does not or does have a place in our current nursing treatments?

Grannynurse

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... The NIH even studies "alternative" medicine. Basically if you have trouble with this concept, and the field of Quantum Physics, you need to throw your cell phone away and please don't send patients to get an MRI because they can't possibly exist!

Let's take a look at NIH on energy, it is quite interesting.

http://nccam.nih.gov/health/backgrounds/energymed.htm

What NIH is trying to do is to be evidence base with minimum hype which is good. The topic under discussion is "putative" energy in the NIH. It also talks about TT toward the bottom (have to scroll way down).

Here are a few interesting quotes.

"In the aggregate, these approaches are among the most controversial of CAM practices because neither the external energy fields nor their therapeutic effects have been demonstrated convincingly by any biophysical means. Yet, energy medicine is gaining popularity in the American marketplace and has become a subject of investigations at some academic medical centers..."

The "approaches" in the context is different energy medicines.

"Many small studies of Therapeutic Touch have suggested its effectiveness in a wide variety of conditions, including wound healing, osteoarthritis, migraine headaches, and anxiety in burn patients. In a recent meta-analysis of 11 controlled Therapeutic Touch studies, 7 controlled studies had positive outcomes, and 3 showed no effect; in one study, the control group healed faster than the Therapeutic Touch group. Similarly, Reiki and Johrei practitioners claim that the therapies boost the body's immune system, enhance the body's ability to heal itself, and are beneficial for a wide range of problems, such as stress-related conditions, allergies, heart conditions, high blood pressure, and chronic pain. However, there has been little rigorous scientific research. Overall, these therapies have impressive anecdotal evidence, but none has been proven scientifically to be effective."

So there are some studies of possible effectiveness for TT and some do not. We do not know the quality of these studies from this quote however.

So nurses who are trained in the evidence base approach and learn to think critically, why should we rush into puting up another new nursing diagnosis which has really not been scientifically proven to be effective (base on ALL the studies, one that supports it and that do not) yet? Shouldn't the nursing profession wait till there are more high quality evidence coming in and have it settle before the new diagnosis be created? As the NIH mentioned already, energy medicine is one of the most controversial CAM pratices, so why should we put such a controversial CAM pratice into nursing diagnosis? Given it is controversial, emotion will run high, objectiveness goes out the window lots of time for people who are really hard core energy practitioner and people who thinks it is just quakery. I think it would be wise to take out this nursing diagnosis and wait till things settle down and we know one way or another from an evidence base approach.

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i'm not getting the impression that tt and energy fields are synonymous.

as for the nsg dx re alt energy fields, i do believe that to be targeted more to the holistic nurses who are experienced in alternative therapies.

as for the success of tt, that too is subjective but believe is quantifiable.

some people love being touched, others do not.

i have given back rubs and noticed a decrease in vitals, less tension and the pt statement of feeling so much better.

a friendly rub on the head can work wonders; a pat on the hand/leg; holding their hand; it doesn't take much to make that 'connection' and i find it therapeutic to most.

just as 'pet therapy' is known to assist in those who are depressed- it's the concept of touch and response that makes me a firm believer in tt.

but again, alt energy field is out of our expertise, unless one has been specifically trained, therefore would never use it in my care plan.

leslie

Leslie, have you ever observed a patient using biofeedback? Or acupuncture? Both are known to have positive effects but the base of their treatment cannot be proven scientifically. I have used biofeedback for 15 years to help control my chronic pain. Sometimes it helps and sometimes it does not. The only means of measuring its impact is monitoring my pulse, respirations and blood pressure, all of which drop as I go farther back in my relation period. You might say that the only proof it is effective is my own subjective response. The same goes for acupuncture. It too cannot be proven scientifically. I grues all those who subscribe to such practices are either being duped or have a few nuts and bolts loose.

Grannynurse:balloons:

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Biofeedback was consider to be "alternative". So is something like Cognitive Therapy a while back. The difference is that both of these have become mainstream because they take the scientific route of running good studies. TT as far as I can tell is not at that state yet. Maybe 5 years from now, or maybe never.

Let me clarify one thing about the studies, I am not talking about the scientific bases of biofeeback or CBT. I am refering to studies that are done on what areas they are effective in and what areas they are not effective in.

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Leslie, have you ever observed a patient using biofeedback? Or acupuncture? Both are known to have positive effects but the base of their treatment cannot be proven scientifically. I have used biofeedback for 15 years to help control my chronic pain. Sometimes it helps and sometimes it does not. The only means of measuring its impact is monitoring my pulse, respirations and blood pressure, all of which drop as I go farther back in my relation period. You might say that the only proof it is effective is my own subjective response. The same goes for acupuncture. It too cannot be proven scientifically. I grues all those who subscribe to such practices are either being duped or have a few nuts and bolts loose.

Grannynurse:balloons:

Looks like the discussion is taking off in a different direction. If I understood it right, the original discussion was whether the energy field diagnosis should be included in the new nursing diagnosis, not whether TT is effective for anyone.

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Leslie, have you ever observed a patient using biofeedback? Or acupuncture? Both are known to have positive effects but the base of their treatment cannot be proven scientifically.

Grannynurse:balloons:

I think the problem with TT at this moment is not whether the base of the treatment can be proven scientifically. The problem is whether it is even effective. As quoted from the NIH, it is questionable with the current evidence that we have.

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I think the problem with TT at this moment is not whether the base of the treatment can be proven scientifically. The problem is whether it is even effective. As quoted from the NIH, it is questionable with the current evidence that we have.

Tell me, does everything in nursing have to be proven scientifically? If it does, I can think of a number of areas that cannot be, therefore they have no place in nursing. I can also think of several things that could not be proven scientifically, initially but were later after tools were developed to measure them scientifically. To you catch my drift. And because one group of researchers says its effectiveness cannot be proven, does that mean we drop it? Or do we do more studying? Do we attempt to develop tools by which to measure it.

Grannynurse:balloons:

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Looks like the discussion is taking off in a different direction. If I understood it right, the original discussion was whether the energy field diagnosis should be included in the new nursing diagnosis, not whether TT is effective for anyone.

I didn't think it was a new diagnosis. Hasn't it been in for years? If we want to advance nursing with other sciences, then it makes sense that it should be included.

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Tell me, does everything in nursing have to be proven scientifically? If it does, I can think of a number of areas that cannot be, therefore they have no place in nursing. I can also think of several things that could not be proven scientifically, initially but were later after tools were developed to measure them scientifically. To you catch my drift. And because one group of researchers says its effectiveness cannot be proven, does that mean we drop it? Or do we do more studying? Do we attempt to develop tools by which to measure it.

Grannynurse:balloons:

No, because there is an art side to nursing. But when we are dealing with nursing diagnosis, I do think the more scientific backing one has, the better.

Given the current state of TT in terms of scientific understanding, it is at a state of requiring more studies because there are lots of strong anedotal evidence (according to NIH). And as you suggest, develope tools if possible to do the studies. But from a scientific point of view, anedotal evidence (no matter how strong), cannot be used. It can be used, however, to set a direction for studies and let the scientific process to prove it or disprove it.

The thing is with the cases of TT being effective, we have to ask is there another explaination? If so, is this alternative explanation(s) as good as the TT explaination or better? For example, could TT be effective in some cases has nothing to do with manipulation of energy fields? Could it be just the theraputic alliance that is set up between the nurse and the patient instead? There are many interesting things one can do in terms of looking at the effectiveness of TT. One I could think of is to have the practioner do the TT with different distances (according to the nursing diagnosis, you are suppose to do it between 2 to 3 inches). Say we do one with about 1 inch, 2 inches, 3 inches, 4 inches, 5 inches, and 6 inches. Are there any statistical significance differences with the result? Now you do have the potential problem of unconscious bias if the practioner is convinced that 2-3 inches is the "correct" distance. Maybe one can teach new TT practioner, keep everything the same, except the distance, then see if there are any differences. I mean you have to be fairly creative here in coming with something that meet the rigor of scientific research (hard to do, but I think it can be done).

What else, there are so many questions. Would the believe of the patient make a difference in the results. Do it on patients who believe TT 200%; do it on patients who is absolutely sure TT is quackery; do it on patient who has no opinion; do it on patients who are not sure.

What is the claim of TT (I did not look at some of the links references in this thread in detail)? Does it claim it can cure cancer or does it just claim it can alleviate anxiety or certain kind of physical pain? The claims dictates where the research is going.

Assuming there is such a thing as the kind of energy field TT claim (and most Eastern medical/spiritual/marital art system claim), it should be able to develop some kind of equipment to measure it eventually. Once that equipment is in place, now you can ask another question like can a person actually manipulate energy field? We got the machine, let's actually measure whether a TT practioner is affecting the energy field. If it turned out the tT practioner is not affecting the energy field and the patient got better... well, it is something else that is going on.

Let's see... TT claim that lots of our illness is because our energy field is misaligned or out of balance (as lots of other energy medicine claim also)... a question could be what cause those out of balance or misalignment in the first place? Could it be our unhealthy life style? Our fast-pace high stress environment? Polutions? If it is because of these mentioned factor, then balancing the energy field is just treating the symptoms just like TT in the nursing diagnosis charge against Western medicine. The root causes are these factors.

What else... how about having a double blind study where 1/2 the patients are really perfectly healthy and the other half all have illness that TT claim they can treat (they may have done this already, don't know)?

Well, I digress big time...

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I didn't think it was a new diagnosis. Hasn't it been in for years? If we want to advance nursing with other sciences, then it makes sense that it should be included.

It is not a new diagnosis? I thought it was... I could be wrong.

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The same goes for acupuncture. It too cannot be proven scientifically. I grues all those who subscribe to such practices are either being duped or have a few nuts and bolts loose.

Grannynurse:balloons:

I consider myself pretty smart, especially to see that Western medicine has many limitations. Apparently many others do as more out of pocket dollars and visits are made to "alternative" practitioners than primary care physicians.

There are studies from the 50's (a vet no less) showing the effectiveness of acupuncture. There have also been recent MRI studies. You must realize that you won't see these studies published in the mainstream medical journals...although JAMA did publish a few a few years ago. (The JAMA TT study was so flawed that it became an embarrassment to JAMA). Even a skeptical society wrote that if you wanted to debunk something at least do it right!

I've taught many Zen Shiatsu students (in an acupuncture school) to feel energy in just a few minutes. Once you can do this you realize that it is there...just like the wind or electricity, even though you can't see it. It's interesting that many of the students were engineers from the computer industry. They had no trouble with the concept of energy.

It really helps to be up on what's happening before you debate it...unless you just want to throw out an opinion.

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