Influência do toque terapêutico na pessoa com risco para integridade tissular : um ensaio clínico randomizado

Abstract

Diabetes mellitus is a chronic disease that leads to a high risk for the development of skin lesions. In the prevention of common complications in the disease, the participation of nurses through health intervention strategies is crucial. In this context, therapeutic touch emerges in order to promote energy balance and help sick people in recovery and / or curing process. The purpose of this study was to evaluate the influence of therapeutic touch in the tissue integrity risk of the feet of people with diabetes mellitus type 2. This study is a clinical trial, randomized, masked, held between March and June 2014 with approval of The Ethics Committee of the Federal University of Alfenas - UNIFAL-MG, under General Certificate of Appreciation for Ethics - CAAE: 20758513.7.0000.5142 and registry in Brazilian Registry of Clinical Trials portal - REBEC: RBR-45rdh2. The final sample consisted of 48 people with diabetes type 2 were divided into two groups: Control Group (n = 23), who received one home visit per week, with an average duration of 15 minutes for a period of 30 days; and Treated Group (n = 25) who were laid under 12 sessions of therapeutic touch through Krieger_Kunz method, it was held three times a week, on an average duration of 20 minutes for a period of 30 days. The experimental groups were evaluated on three distinct occasions: first evaluation (before the start of interventions); second evaluation (at the end of interventions); third evaluation (15 days after the last appraisal). The evaluations consisted in checking the blood glucose; measuring the tissue temperature of the feet and the plantar pressure and eventually the score of compromising of feet through a scale of specific usage in diabetes mellitus. The results were analyzed using the Chi-square test or Exact of Fisher; of the Analysis of Variance with Repeated Measures (ANOVA) and of the Statistical Power through Piface Application Selector software, version 1.76. This study confirms the alternative hypothesis about the influence of therapeutic touch in the investigated variables. Significant improvements were observed among the evaluations in the Treated Group and comparing the groups it also demonstrated statistical significance, highlighting the increase in skin scores of variables of skin and attachments, medium ,respectively, of the first, the second and the third evaluation (46.12±0.73a; 49.16±0.73b; 48.92±0.66a) and of sensitivity (5.32±0.21a; 7.76±0.21b; 5.85±0.24a). Furthermore, it was observed among the evaluations, significant decrease in tissue temperature of the feet in 18 investigated points in the Treated Group and when compared to the Control Group, on 15 points there was significantly statistical changes. In blood glucose variables (208.60±10,81a; 178.80±10.81a; 192.92±12,24a) blood circulation (22.36±0.28a; 22.52±0.28a; 22.52±0.39a) and plantar pressure there were no significant changes which could reflect in a satisfactory clinical effect even when compared the two groups. Thus it is possible to infer that this type of complementary intervention reflected benefits on the maintenance of tissue integrity of the feet and on the prevention of skin lesions on the volunteers from the Treated Group through decreasing the tissue temperature of the feet, and increasing in skin and attachments score and sensitivity. However, it is fundamental to develop other clinical studies addressing the different degrees of complications involved in the disease. It is emphasized the importance of the involvement of the nursing professional in experimental research in which the clinical trial works as allowance to prove health interventions did by this professional.