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Chiropractic Research Review

Issues of Touch

From the first handshake to the last pat on the shoulder, healers touch their patients, and patients expect to have hands laid on them in one form or another. Touch has always been used as part of the caring process - to express empathy, give comfort, and ease pain.

The importance of touch for patients' sense of identity, self-esteem, and general well-being is a recurring theme in health care literature

It is important to be aware of cultural and individual differences regarding touch, as well as blurred perceptions that can occur between task-related and nontask-related touching. Task-related touch is the necessary touching involved in clinical care, such as taking a pulse or examining the spine. Nontask-related touch refers to spontaneous forms of touching, which may include holding a patient's hand, stroking a person’s cheek, or putting an arm around someone. It is important that physicians recognize that touch is perceived individually and must not be indiscriminately used. There are boundaries for such tactual communication. The author suggests such guidelines regarding examination:

* Explain to the patient what examination needs to be done and why.
* Explain what the examination involves.
* Obtain the patient's permission to touch.
* Include a third party if a sensitive area is involved.
* Allow privacy for dress and undress.

Conclusion: Clinicians should strive to make sure there is plenty of clinically correct touch in the services offered to patients. Therapeutic touch is typically done well by chiropractic physicians. In the hands of a competent and caring clinician, it contributes to the very nature of healing itself.

Bowers LJ. Intimate strangers: issues of touch. Topics in Clinical Chiropractic 2000:7(3), pp 11-18. Reprints: (800) 638-8437

Chiropractic Research Review

Dynamic Chiropractic
What concerns you most about physical therapists performing spinal manipulation?
Aren't adequately trained to do so
Reduces our potential patient base
Affects our standing with insurers
Reduces referrals from MDs
Compromises our "uniqueness"
Other
It doesn't concern me at all

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