Nursing diagnosis "altered energy field"

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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

What? Please explain a bit more. If it was tried and it was statistically insignificant, how would that deemed it invalid? What was deemed statistically insignificant?

A pool of numbers is what is known a the source of statistical information. Using a pool of less then 100 subjects, which is what the study used, is considered, by reputable researchers, as being insignificant because the source is not large enough to draw any valid inferences from(N. Burns,PhD, S. Grove, PhD, The Pratice of Nursing Research,2001). The fact that the study was deemed statistically insignificant, not only by me but two other nursing researchers who challenged the study.

Grannynurse:balloons:

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thought I'd look for studies. It was hard to find many, these are what I came up with.

The purpose of this study was to examine the effect of three Therapeutic Touch treatments on the well-being of 20 persons with terminal cancer in palliative care. http://jhn.sagepub.com/cgi/content/abstract/16/3/383

The Surgical Significance of THerapeutic touch: http://www.findarticles.com/p/articles/mi_m0FSL/is_2_69/ai_53893763

I went to your first site and came up with 52 articles. Unless you have access to first search or medline, full text articles are difficult for the average person to access on-line.

Grannynurse:balloons:

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The purpose of this study was to examine the effect of three Therapeutic Touch treatments on the well-being of 20 persons with terminal cancer in palliative care. http://jhn.sagepub.com/cgi/content/abstract/16/3/383

Since this is an abstract, I just looked at it and here are my thoughts.

This appears in the Holistic Nursing. So one question is if one do a search in this journal that deals with TT, are they ALL positivie or there are studies that are negative?

First the sample size is really small. 10 person receive TT and 10 for control. Usually in statistics, you prefer something bigger, at least 30. With 10, there are some ways still to measure things, but a bigger size is better.

Second is that the control group seemed to recieve nothing, just rest period while the experimental group received 3 sessions of TT ranging 15 to 20 minutes. Using the Well-Being-Scale (this is good as it define exactly what is being measure so other people can try to duplicate it), the TT group score higher than the control group.

What I would like to look for if I have access to the full article is to see the actual scores between the groups. Does the article conclude the TT group sccore better just because it is higher (or lower, I don't know which way it goes) or did they run some statistical stuff over it (which I would like to see).

Assuming there is a statistical significance between the result, the next question is - how do we know it is not due to placebo effect? This is a valid question is scientific studies especially when the control group is receiving nothing but rest while the TT group is receiving lots of attention (3 sessions of 15-20 minutes of attention). Do the practioners also talk to the patients during the session. Could the act of talking have the same effect?

So with this study, if you stay scientifically grounded, you would not conclude anything. What this study does is to spurs the next round of studies with better design. A better design would be a few things. One I could think of is instead of rest for the control group, have the Chaplain in the hospital to come in and talk with the patients for 3 sesssions of 15-20 minutes each (we would have to filter out the patients who do not want to see a Chaplain). Or maybe instead of a Chaplain, have a social worker or a non-TT nurse to do the same.

Second is to increase the sample size to at least 30 patients for TT and 30 patients for control. The more the better.

That is all I got, I am sure I missed something. What are your thoughts as we are all taught to think critically. If you are anti-TT, what are your critiques? If your are pro-TT, how would you improve the next round of studies so that it will be more convincing to the people who are on the fence? If you are on the fence, what would make you swing one way or another in the next rounds of studies?

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A pool of numbers is what is known a the source of statistical information. Using a pool of less then 100 subjects, which is what the study used, is considered, by reputable researchers, as being insignificant because the source is not large enough to draw any valid inferences from(N. Burns,PhD, S. Grove, PhD, The Pratice of Nursing Research,2001). The fact that the study was deemed statistically insignificant, not only by me but two other nursing researchers who challenged the study.

Grannynurse:balloons:

I think I am not understanding you at all... we are cross-wireing each other.

Where do these PhDs get their statistical training? To be able to calculate something that is statistical significant, you need at least 30 samples, not a 100. Actually you can do it with less than 30 but the way to do it is quite different. That is basic statistics. Are you sure your understanding of the book is correct.

But anyway, if you need at least a 100, then the article "Effect of Therapeutic Touch on the Well-Being of Persons with Terminal Cancer" in the Holistic Journal is also invalid. I also will wonder how many of the many TT studies you mentioned do fit this criteria?

If it is not too much trouble, can you give me the actual source on this study that did what I suggested already. Also I would like the page reference to the textbook "The Pratice of Nursing Research" since I find it hard to believe and I want to check the source myself.

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...The fact that the study was deemed statistically insignificant, not only by me but two other nursing researchers who challenged the study.

Grannynurse:balloons:

These other nursing researchers are all very pro-TT, I take it?

It seemed like the term "statistically insignificant" is used in a very unconventional way. For example, the "Effect of Therapeutic Touch on the Well-Being of Persons with Terminal Cancer", I may disagree with it but I would not be able to say that it is "statistically insignificant". I may say the design is invalid or it has serious methodology problems, but I can't say this study is "statistically insignificant". "Statistically Insignificant" is something the studies conclude. Now I may look and disagree with the way "statistically insignificance" is calculated but I would not say the study itself is "statistically insignificant".

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Specializes in Nursing assistant.
These other nursing researchers are all very pro-TT, I take it?

It seemed like the term "statistically insignificant" is used in a very unconventional way. For example, the "Effect of Therapeutic Touch on the Well-Being of Persons with Terminal Cancer", I may disagree with it but I would not be able to say that it is "statistically insignificant". I may say the design is invalid or it has serious methodology problems, but I can't say this study is "statistically insignificant". "Statistically Insignificant" is something the studies conclude. Now I may look and disagree with the way "statistically insignificance" is calculated but I would not say the study itself is "statistically insignificant".

Ah! Now you are confusing us with the facts!;) Wink, wink, nod, nod :clown:

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I think the concept of "Nursing Diagnosis" was a well intentioned attempt to describe what we do in language that would make us sound more professional to doctors and administrators. Unfortunately, like most things built by committee, it has spiraled out of control into a useless ungainly beast. Many times I have heard MD's laughing among themselves about the ridiculous NANDA language. Diagnosis like "potential for energy field disturbance" does not help!

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Specializes in Med-Surg.
I think the concept of "Nursing Diagnosis" was a well intentioned attempt to describe what we do in language that would make us sound more professional to doctors and administrators. Unfortunately, like most things built by committee, it has spiraled out of control into a useless ungainly beast. Many times I have heard MD's laughing among themselves about the ridiculous NANDA language. Diagnosis like "potential for energy field disturbance" does not help!

I've never heard an MD talk about NANDA Diagnosises, but I've heard many a nurse ridicule them. Probably my included. They have virtually no support in the lay community actually doing bedside nursing.

I would much rather see something like: He's what you do from a nursing standpoint with an anxious person...................rather than "Potential for energy field disturbance"

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These other nursing researchers are all very pro-TT, I take it?

It seemed like the term "statistically insignificant" is used in a very unconventional way. For example, the "Effect of Therapeutic Touch on the Well-Being of Persons with Terminal Cancer", I may disagree with it but I would not be able to say that it is "statistically insignificant". I may say the design is invalid or it has serious methodology problems, but I can't say this study is "statistically insignificant". "Statistically Insignificant" is something the studies conclude. Now I may look and disagree with the way "statistically insignificance" is calculated but I would not say the study itself is "statistically insignificant".

Actually, I do not believe they were. They were just analying the research. There are researchers who do nothing but that, without ever taking a position on the subject of the research.

Grannynurse:balloons:

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A pool of numbers is what is known a the source of statistical information. Using a pool of less then 100 subjects, which is what the study used, is considered, by reputable researchers, as being insignificant because the source is not large enough to draw any valid inferences from(N. Burns,PhD, S. Grove, PhD, The Pratice of Nursing Research,2001). The fact that the study was deemed statistically insignificant, not only by me but two other nursing researchers who challenged the study.

Grannynurse:balloons:

Ok,I got a hold of "The Practice of Nursing Research - Conduct, Critique, & Utilization" 4th ed by Nancy Burns and Susan K. Grove in the library.

If you have the time, could you give me the page reference? I can't find it in the book, but I am not family with it as your are. If you are too busy, then don't worry about it as there are other more important things to worry about (like studying).

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Specializes in Nursing assistant.
Ok,I got a hold of "The Practice of Nursing Research - Conduct, Critique, & Utilization" 4th ed by Nancy Burns and Susan K. Grove in the library.

If you have the time, could you give me the page reference? I can't find it in the book, but I am not family with it as your are. If you are too busy, then don't worry about it as there are other more important things to worry about (like studying).

Interesting. The page reference would be nice!

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Ok,I got a hold of "The Practice of Nursing Research - Conduct, Critique, & Utilization" 4th ed by Nancy Burns and Susan K. Grove in the library.

If you have the time, could you give me the page reference? I can't find it in the book, but I am not family with it as your are. If you are too busy, then don't worry about it as there are other more important things to worry about (like studying).

Suggest you read Chapters 18 thru 22. And Chapters 15 thru 16 might be helpful as well. I have two other sources of statistical analysis as well but I wouldn't want to burden you with those.

Grannynurse

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