The Effect Of Therapeutic Touch and Music Rest on Sleeping Applied to Children With Liver Transplantation
Condition: Liver Transplant Disorder; Sleep
Study type: Interventional

Summary: 
      Today, the demand for liver transplantation is increasing day by day, since liver
      transplantation is considered the most effective treatment for end-stage liver disease.
      Patients who have undergone major surgery such as liver transplantation may experience
      sleep-related problems due to common complications of surgical procedures. However, in some
      studies, it is stated that practices such as acupuncture, exercise, mindfulness, therapeutic
      touch, listening to music, yoga, etc., performed by nurses, reduce the sleep-related problems
      of patients. In this study, the effects of therapeutic touch and music on the sleep of
      children with liver transplantation will be examined.
    

Detailed description: 
      Liver transplantation is considered the most effective method in the treatment of end-stage
      liver disease. For this reason, the number of patients waiting and receiving liver
      transplantation is increasing day by day. While the total number of adult and pediatric
      patients awaiting liver transplantation in our country in 2018 was 2142, the number of
      patients who received transplantation was 1587, the number of patients awaiting liver
      transplantation in 2019 was 2261, and the number of patients with transplantation was 1776.

      Patients undergoing major surgery, frequently encountered conditions such as pain caused by
      surgical procedures, noise in surgical clinics, stress due to surgical procedure, they may
      experience sleep-related problems due to concerns arising from uncertainties about the
      process. Rabbits et al. reported in their study that poor sleep quality associated with
      postoperative pain is common in children undergoing major surgery. In some studies with
      children who have been transferred, it has been determined that children have complaints such
      as irregular breathing during sleep, excessive daytime sleepiness, daytime behavior problems
      and restless legs. Petersen et al. determined that fatigue was seen in the majority of
      children with liver transplantation and this fatigue was mostly associated with sleep/rest.

      Sleep is a very important process for maintaining a healthy life and human health is
      significantly affected in cases of insomnia or poor sleep quality. While the catabolic
      process is active during wakefulness, the anabolic process is activated during sleep.
      Considering the anabolic process during sleep, it is of great importance for patients to have
      a quality sleep, especially after surgical intervention, in order to regain their old health.
      However, studies show that major surgical interventions cause deterioration in sleep quality.
      With good nursing care after the surgical procedure, patients can have a quality sleep. In
      some studies, it is stated that complementary and alternative treatment methods such as
      acupuncture, exercise, mindfulness, therapeutic touch, listening to music, yoga affect sleep
      positively. One of these complementary and alternative treatment methods is therapeutic
      touch. Therapeutic touch (TD) is based on the assumption that humans have energy fields and
      that these energy fields interact with the environment. In addition, therapeutic touch
      advocates the idea that there are imbalances in the energy fields of the sick individuals and
      that these imbalances can be corrected with the application of TD and contribute to the
      healing process. Efendi et al., in their study with preterm infants, determined that
      therapeutic touch and listening to the mother's voice increase the sleep quality of preterm
      infants. Hedlund et al., in their study with children with fontan (single ventricle)
      circulation, determined that exercise increased sleep quality. When the literature was
      examined, only one study was found to improve the sleep quality of children who had undergone
      surgery. In addition, no study has been found in the literature examining the effect of
      therapeutic touch on the sleep of children with liver transplantation. In this study, the
      effects of therapeutic touch and music on the sleep of children with liver transplantation
      will be examined.
    

Intervention name(s): Therapeutic Touch; Music Rest
Intervention type(s): Other; Other
Intervention description(s): Therapeutic touch; It is a low-cost, non-contra-indications, easy-to-apply and non-invasive form of complementary therapy that can be applied anywhere and at any time (Vanaki et al., 2016). Therapeutic touch was developed by Krieger in 1975 as a nursing intervention to help and even heal the patient by balancing the patient's energy field (Marta et al., 2010). The basic assumption of therapeutic touch is that people have energy fields and these energy fields interact with the environment (Hanley, 2008). Therapeutic touch aims to harmonize, renew and heal the flow of the human energy field by removing the blockages of a person's biofield (Mueller et al., 2019). Unlike other touch-based methods such as massage therapy, therapeutic touch does not require the practitioner to physically touch the patient. Instead, the practitioner uses their hands to focus their energy and intent to help the recipient (Hanley, 2008).; The use of music in the treatment of diseases has been seen in many civilizations since ancient times. In ancient Greek and Roman communities, individuals resorted to music to get rid of their humanitarian problems, while in Ancient Egypt, music was used to give strength to patients during birth (Kor & Adar, 2016). In today's studies, it has been determined that music positively affects the physiological parameters, nutrition, hospital stay and sleep of the patients (O'Toole et al., 2017; Van Der Heijden et al., 2016). It is important that the sound level is within the appropriate limits while listening to music to the patients. The American Academy of Pediatrics recommends a sound level between 45dB- a maximum of 65dB (ACOG - AAP, 2012). The World Health Organization recommends a sound level of 35 dB during the day and 30 dB at night (Berglund et al., 2000).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Liver; Transplant; Therapeutic touch; Music; Sleep