Energy therapies consist of interventions that are designed to interact with the biofield of a person. The concept of the biofield is based on the assumption that all living things have a natural flow of energy that is integral to their basic composition.[1–4] This principle stems from the interchangeability of energy and matter (E = mc2). The biofield of a person is part of the body, and it extends beyond the physical body in the form of energy. The concept of energy flowing through and around the physical body has a long-standing history and is the basis for various ancient healing practices and many complementary and alternative therapies.[1–4]
The biofield is often referred to, both historically and in the current literature, as chi, ki, qi, aura, prana, mana, and human energy field, among other terms.[1,3,6–9 ] Ki-energy, or the biofield, is described as “invisible psychophysical energy” and “energy, force, vitality, and strength.” The biofield is noted to be an integral part of human beings and nature. Healthcare modalities commonly utilized in Asian countries often interact with the biofield,[6,10] as the biofield is believed to influence both physical and mental health.[3,6,7,10] In Eastern tradition, the biofield is viewed from a holistic perspective rather than the mind–body dichotomy of Western tradition.[7,10]
Energy therapies/interventions are common practice for many cultural groups, including, but not limited to, Africans, Chinese,[10,12] Japanese, Koreans, Vietnamese, and Native Americans. Integration of energy therapies with other complementary therapies is increasing in Western cultures as well.[15–19] Complementary and alternative therapies that interact with the biofield include Healing Touch, Therapeutic Touch, Reiki, qi gong, acupuncture, acupressure, and others.
HOW DO THEY WORK?
The energy therapies are based on the assumption that physical, mental, emotional, and/or spiritual illness or injury will manifest in both the physical body and the biofield. The intent of energy therapies is to restore the balance of energy to the biofield, thus promoting health, healing, and general well-being. Energy therapies such as Healing Touch, Reiki, and Therapeutic Touch are practitioner-dependent. The therapist seeks to restore balance to the biofield by using his or her hands, with or without light touch on/over the body, to clear disturbances and facilitate a natural flow of energy. The facilitation of a balanced biofield is thought to optimize the body’s own ability to heal.[3,20]
HOW ARE THEY CURRENTLY USED?
The use of energy therapies potentially has very broad application, from promotion of relaxation, general health, and well-being, to treatment for symptoms of chronic conditions. The National Center for Complementary and Alternative Medicine (NCCAM) identifies anecdotal evidence supporting the efficacy of biofield therapies for a wide variety of health problems, such as asthma, hypertension, arthritis, acute pain, chronic pain, wound healing, stress, and anxiety. Many nurses trained in energy modalities will incorporate the practice as part of routine nursing care, such as directing or sending energy to a patient during a procedure or while assisting with activities of daily living, such as bathing.
Education and training in energy therapies are varied and usually involve multiple levels of classes and practice. For example, Healing Touch certification is offered through Healing Touch International, (a program endorsed by the American Holistic Nurses Association) or the Healing Touch Program, and it involves a rigorous program of study over a period of 2 years or more, as well as working with a mentor for at least 1 year, in addition to other requirements.
WHAT IS THE EVIDENCE RELATED TO ENERGY THERAPIES AND CANCER?
Energy therapies remain one of the most challenging and controversial areas of CAM therapies, as there is no accepted proof or biologic measure of the biofield. Several studies have been published evaluating various energy therapies. Unfortunately, many of the studies lack rigor. Therefore, there is a paucity of well-designed research evaluating energy therapies.
Case reports and pilot-level data have been published supporting the benefit of energy therapies in cancer care for palliation of cancer symptoms and treatment-related side effects. Areas that have shown promise include: Reiki for cancer-related fatigue, anxiety, overall improvement in quality of life, and decreased pain[23,24]; Therapeutic Touch for anxiety; and Healing Touch for mood disturbance, fatigue,[27–30] nausea, pain,[26,27] side-effect bother, vitality, and physical functioning and well-being.[27,30]
Jain and Mills recently published a “best evidence” synthesis in which they reviewed 66 published research studies on various energy therapies. Their review identifies evidence to support use of energy therapies in cancer patients for acute pain, but it found conflicting evidence for use in cancer patients in regard to fatigue, quality of life, nonacute pain, and physiologic response of relaxation. Overall, many of the studies evaluating energy therapies are methodologically weak. While a number of randomized placebo-controlled studies are being completed, additional large, randomized, placebo-controlled trials are still needed.
Findings from two small randomized, placebo controlled studies of Healing Touch in women with cancer who were receiving radiation therapy showed similar outcomes in terms of impact on health-related quality of life. The first study, by Cook et al, evaluated Healing Touch in 62 women with breast and gynecological cancers, using the Short Form-36 health-related quality-of-life tool as an outcome measure. Healing Touch was given once weekly over a 4-week period, with a subsequent treatment 4 weeks later. There were significant improvements within both groups for various subscales, but the Healing Touch group had statistically greater improvement than the placebo group (P < .05) in the areas of physical functioning, pain, and vitality.
In the second study, Schnepper and colleagues evaluated Healing Touch in 40 women receiving radiation therapy for early-stage breast cancer, using outcome measures from the Functional Assessment of Cancer Therapy–Breast (FACT-B). Participants were randomized to Healing Touch or a placebo treatment, given once per week over a period of 4 to 6 weeks. Over the course of the study, women who received Healing Touch had significant improvement on the FACT-B, compared with those randomized to placebo treatment (P < .038). The Healing Touch Group had greater improvement on all subscales of the FACT-B vs the placebo group,
with significance on the physical-well-being subscale
(P < .020). The Healing Touch group also experienced less fatigue and less treatment-side-effect bother.
WHAT ARE THE POTENTIAL RISKS?
Energy therapies have no known appreciable risks. Persons receiving an energy therapy sometimes report an increase in energy levels. Theoretically it is possible to overexert oneself after receiving an intervention, which may result in increased fatigue later. This has not been reported in any research findings, however.
WHAT IS THE BOTTOM LINE MESSAGE?
With the upsurge in public demand for complementary approaches to health and illness,[17,32] there is growing concern about the value, safety, and efficacy, of many integrative therapies. Definitive research into the benefits of energy therapies and biofield interventions is not yet available. Nevertheless, preliminary data suggest a high safety profile and potential symptom improvement. Energy therapies fit within the body of nursing knowledge and philosophy, because they have a focus of care that incorporates body, mind, and spirit. Thus, as more evidence becomes available, nurses should be poised to integrate energy therapies into patient care.
About Our Guest Editors
Debra Barton, PhD, RN, AOCN, FAAN, is chair of the Education Committee for the Society of Integrative Oncology (SIO) and a board member of SIO.
At the Mayo Clinic in Rochester, Minnesota, her program of research includes clinical trials with herbal and dietary supplements as well as mind-body therapies for symptom management in cancer survivors.
Susan Bauer-Wu, PhD, RN, FAAN, a highly regarded expert in mind-body medicine and psychoneuroimmunology, serves on the board of directors for SIO.
Her research and teaching interests at Emory University include mindfulness meditation and other bio-behavioral approaches for alleviation of symptoms and stress in the context of palliative care and in family and professional caregivers.
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