Table 3.

Summary of quantitative evidence for touch interventions in sedated patients versus patients for whom sedation was restricted

Study design, mean group size, key records, country	Patient context	Touch intervention	Strength of evidence in favour of intervention group
			Weak or absent[Link]	Intermediate[Link]	Stronger[Link]
Sedated
Two‐arm RCT, N = 22 Henricson (2008), Henricson, Berglund, et al. (2008), Henricson, Ersson, Määttä, Segesten, and Berglund (2008) Sweden	84% ventilated, minimally responsive to restless No changes to sedatives during procedure	Tactile touch (slow stroking, soft/firm) to hands, feet, stomach, head, face, chest, arms, legs. Music 60 min, once daily ×5	HR, SBP, alertness, blood glucose, blood oxytocin. Insulin, noradrenaline and sedation requirements	Anxiety, DBP
Three‐arm RCT, N = 35 Olleveant (2003) UK	80% ventilated, level of anaesthesia: non to minimal, 73%; moderate to high, 27%	Leg massage (light and gentle) with almond oil 14–20 min repeated once after three days	HR, RR, SBP, DBP, pain, analgesia & sedation requirements, sedation scores, anxiety, depression, quality of life, ICU survival time and length of ICU stay
Sedation restricted
Two‐arm RCT, N = 30 Korhan, Khorshid, and Uyar (2014) Turkey	100% ventilated, GCS ≥9 Sedation (propofol) stopped 30 min prior to intervention	Reflexology to hands, feet & ears 30 min, twice a day ×5	Consciousness component of the AACNSAS		HR, RR, SBP, DBP Average score for agitation, anxiety, sleep and ventilator synchrony components of the AACNSAS
Two‐arm RCT, N = 26 Tsay et al. (2005) Taiwan, China	100% ventilated, 96% tracheostomies, alert, diagnosed with COPD Patients receiving tranquilizers were excluded	Massage (3 min; shoulder and arms) and acupressure points (12 min; hands, ears, wrists) 15 min, once daily ×10		HR	RR, anxiety, dyspnoea
Two‐arm RCT, N = 35 Çınar (2008), Çinar Yücel and Eşer (2015) Turkey	100% ventilated, diagnosed with COPD, GCS 9–15 No sedatives during intervention	Hand massage (10 min) and hand acupressure (8 min) 18 min, once daily ×5	SBP, SpO2	HR, RR, DBP, dyspnoea	Anxiety
Two‐arm RCT, N = 32 Yousefi, Naderi, and Daryabeigi (2015), Yousefi, Naderi, Daryabeigi, and Tajmiri (2015) Iran	63% ventilated, GCS 9–12 Sedatives and narcotics (if required) taken>6 hr prior to sampling	Family interventionist, handholding, touching of head and face and positive verbal support 17 min, twice a day ×1		NA	HR, SBP, DBP, SpO2
Two‐arm cross‐over RCT, N = 35. Souri Lakie, Bolhasani, Nobahar, Fakhr Movahedi, and Mahmoudi (2012) Iran	100% ventilated, agitated, GCS ≥7 Considered clear of sedatives	Wrist holding without pressure 5 min ×1		NA	SpO2
Three‐arm RCT, N = 31 Ebadi, Kavei, Moradian, and Saeid (2015) Iran	100% ventilated (weaning), conscious, postoperative (elective cardiac surgery) No sedatives pre‐intervention	Foot reflexology massage 20 min × 1	HR, RR, SBP, DBP, mean BP, SpO2	NA	Mechanical ventilation weaning time
		Surface touch to heels, without pressure but involved movement[Link] 20 min × 1	HR, RR, SBP, DBP, mean BP, SpO2, mechanical ventilation weaning time	NA

RR: respiratory rate; HR: heart rate; DBP: diastolic blood pressure; SBP: systolic blood pressure; SpO₂: peripheral oxygen saturation; AACNSAS: American Association of Critical‐Care Nurses Sedation Assessment Scale. NA: not applicable because single treatment employed or time series data not reported.

^b,cPercentages are based on results reported for each treatment, with the exception of Korhan et al. (2014), Yousefi, Naderi, and Daryabeigi (2015) and Yousefi, Naderi, Daryabeigi, and Tajmiri (2015) who report mean results for twice daily treatments.

Differences between intervention and control groups either not reported or not statistically significant (p>0.05).

In favour of the intervention group for ≤70% of treatments (p <0.05).

In favour of the intervention group either overall or for >70% of treatments (p <0.05).

A. Ebadi, personal communication, June 8, 2017.