Effect of Touch Care and Fomentation Use in Nursing Care
Examination from Fingertip Pulse
Yoko Hirohashi
1
, Chieko Kato
2
, Shoko Minamiyama
2
,
Hiroaki Hasegawa
2
, Yoshiko Yuki
2
and Toshiko Sasaki
2
1
Department of Nursing Education, Shoin University, Moronosato, Atsugi, Japan
2
Department of Nursing Education, Nayoro City University, W4-N4, Nayoro, Japan
Keywords: Touch care, Foot bathing, Fingertip pulse wave, Nursing care.
Abstract: Concerning the effectiveness of foot bathing and Touch Care as care-giving methods, verification was
obtained by physiological data gathered from fingertip pulse and vital sign readings, as well as a survey
questionnaire. In testing each care method, namely, carbonated water bathing, lower leg Touch Care, foot
bathing, and foot bathing + Touch Care, readings were taken 3 times: before, immediately after, and 10
minutes after completion of the procedures. The results were as follows: These nursing cares showed
effectiveness 77.8% - 90% of the cases. The various methods showed an improvement in participants’ mood
in the following order of effectiveness: foot bathing + Touch Care, Touch Care, carbonated water bathing,
and foot bathing. When comparing only to foot bathing, foot bathing + Touch Care had a greater effectiveness
in warming the body. Touch Care and foot bathing + Touch Care showed effectiveness in improving blood
circulation, and carbonated water bathing showed effectiveness in warming the body without altering vital
signs. The procedures’ results showed the importance of applying these care techniques to the type of care
most suitable for the subjects, and the importance of application in regard to support of mental health.
1 INTRODUCTION
1.1 Research Background and Purpose
Since the birth of nursing care as a specialized
vocation in the 19th century, there has been a
continual search to discover which techniques should
be used to promote patients’ vitality, advancement of
rehabilitation processes, and the most beneficial
means of achieving health of mind and body.
Nursing care related to cleanliness and comfort
goes beyond the general concept of merely being
clean or comfortable, but rather, involves the healing
of disease, the discussion of effective means of
pursuing good health, involving actual cases where
disease conditions are improved by nursing care.
Accordingly, this is not the product of coincidence,
but rather by establishment of nursing care based on
evidence of the effectiveness of intentional
implementation of vocational nursing, and in order to
propagate good nursing, there needs to be an
examination of the scientific techniques of nursing
care.
In 2013 we conducted research into the
examination of the effectiveness of Touch Care (baby
massage) involving mothers and their infants.
Effectiveness with both mothers and their children
was recognized, and in order to promote the
advancement of baby massage, environment, timing,
and related vocations were suggested as important
factors.
Application of Touch Care is a simple and non-
invasive care technique, and is an increasingly
desirable technique on the nursing scene. At the same
time, fomentation - the technique of applying hot
compresses to warm the body - is also spoken of as a
means of nursing care for the effective promotion of
health and relief of pain in patients. Nurses can
individually judge between the practice of these
techniques, and can expect repeated effectiveness
regarding comfort, health promotion, maintenance of
cleanliness, improvement of general condition.
Moreover, these are techniques which are
implemented simply, without the need of reliance
upon medical instruments. It can be said that these
techniques should increasingly be introduced in
267
Hirohashi Y., Kato C., Minamiyama S., Hasegawa H., Yuki Y. and Sasaki T.
Effect of Touch Care and Fomentation Use in Nursing Care - Examination from Fingertip Pulse.
DOI: 10.5220/0005888102670278
In Proceedings of the Fifth International Symposium on Business Modeling and Software Design (BMSD 2015), pages 267-278
ISBN: 978-989-758-111-3
Copyright
c
 2015 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved

medical institutions, elderly care facilities, and
residential settings.
So far, initial research of the effectiveness of
fomentation treatment and Touch Care has involved
examination and understanding of autonomic nerve
balance through testing of saliva, electromyogram,
blood circulation, ECG, as well as EEG, and use of
physiological indexes. This initial research has been
productive, and the effectiveness of these care
techniques has been definitely verified. However, up
to this point, judging the value of the sense of
contentment and mental healing for recipients of
these care techniques has been limited to comments
of the recipients’ awareness, such as “It felt good”, or
“I felt comfortable”. The objective examination of
this kind of emotional effect remains the field of study
for Touch Care and fomentation treatment research.
Our aim this time in research is an objective
examination of the effects of fomentation treatment
and Touch Care nursing care techniques by means of
understanding emotional flexibility and good health
from non-linear analysis of fingertip pulse
fluctuations. At the same time, autonomic nerve
balance will be measured, and effort will be made to
grasp the influence of fomentation treatment and
Touch Care upon the autonomic nervous system.
1.2 The Effect of Touch Care
While foot bathing as one type of fomentation Touch
Care is defined as contact through massage, and has
been described as a means of forming a bonding
relationship between mother and child, the Hirohashi
group, through results of infant fingertip pulse
measurement, determined that “the infant’s
autonomic nervous system was under tension, relaxed
immediately after application of the mother’s Touch
Care, and then 10 minutes after cessation of Touch
Care returned to the prior tension”. This led to the
conclusion that by means of the parent’s close contact
during these fluctuations, bond formation with the
infant was progressing.
There are reports that Touch Care, using light
pressure and causing muscle relaxation, from the time
massage begins, well-known emission of oxytocin is
recognized, and at 10 minutes and again at 20 minutes
after beginning massage, for a brief time oxytocin
concentration roughly doubles. That is to say, with
Touch Care oxytocin levels are a key factor.
Known effects of oxytocin are, 1) decrease in
anxiety, and strengthening of sociability and child-
rearing activities, 2) strengthening of “social
memory”, 3) action affecting tranquility and pain
relief, 4) improvement of learning capacity, 5)
reduction of blood pressure, 6) body temperature
regulation (causing warmth to be transferred to other
body parts, working like a thermostat), 7) regulation
of digestive activity, 8) control of body fluids, 9)
enhancement of growth, and injury healing.
The foot has a high level of nerve sensitivity, and
by means of Touch Care, results such as reduction of
peripheral blood vessel contraction, rise in
temperature at sole of the foot, as well as feelings of
comfort and physiological relaxation are obtained.
This is due to vagus nerve activity, and operates on
the following areas: control and stabilization of
heartrate, blood pressure, and respiration rate,
reduction of norepinephrine and epinephrine
concentrations, reduction of stress-related cortisol
reaction, provides a link to stress relief, and leads to
stabilization of depression and anxiety in both body
and mind. Furthermore, by means of muscle
relaxation, stimulation of the digestive tract to
encourage digestion, as well as advancement of
serotonin secretion, growth rate of newborns and
nursing infants is heightened, sleep activity is
improved, and a smooth transition between sleep and
awakening is clearly observed.
The Kato’s group (2006), in order to ascertain the
influence of cortisol on food intake, conducted a
survey of Touch Care participants using samples of
CgA found in saliva, reported that amounts of CgA in
saliva decreased, and also reported that readings of
middle finger surface blood vessels indicated dilation,
and during contraction showed a reduction of blood
pressure. These findings suggest that there is a
“mutual response” effect between both the giver and
the recipient of massage.
1.3 The Effects of Foot Bathing
In addition to the purpose of maintaining cleanliness,
foot bathing has other experientially known effects,
such as promotion of blood circulation, maintaining
body warmth, relaxation and refreshment. Foot
bathing methods have been the object of various
research studies, examining ways to produce effective
results. Foot bathing, by means of stimulating
warmth, promotes expansion of blood vessels in the
feet, increases body temperature at the surface of the
feet, causes a significant increase of blood flow in the
feet, and by warming the peripheral blood supply
which circulates throughout the body, skin
temperature of the upper limbs is elevated.
Furthermore, through the influence of foot bathing,
the following tendencies are revealed:
1) From the reflection of autonomic nerve activity,
electrocardiogram wave-to-wave intervals
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obtained from the chronological frequency
analysis fluctuations in heartbeat affecting
cardiac autonomic nerve activity.
2) High Frequency and Low Frequency/High
Frequency analysis of rise/fall component from
fluctuations in heartbeat.
3) From analysis of brain waves, observation of
temporary fluctuations of tension in autonomic
nerves.
4) Relaxation effect from control of sympathetic
nervous system and increased activity of
parasympathetic nervous system.
From subjective evaluation of the effects of
warmth and pleasurable sensations, as a result of
using Profile Of Mood States (POMS) and Visual
Analog Scale (VAS), the following results were
reported: trends of measured increase in levels of
“vigor”, decreased levels of “fatigue” , an increase in
responses of “the body is hot”/“the body is warm” .
In addition, regardless of the lack of median
temperature rise from bathing, it was clear that many
participants expressed that their body core and
extremities were warmer. Considering the
psychological effect of an awareness that “I am
warmer” being brought about, the stimulated sense of
warmth signifies a meaningful connection to various
effects of relaxation.
In recent years, carbonated spring water foot
bathing has been used for medical treatment of ulcers
and blockages from arteriosclerosis, and use of
carbonated spring water to increase blood flow to the
skin is clearly superior to that of fresh water bathing.
The phenomenon of red-flushed skin of the feet when
placed in carbonated spring water is considered to be
related to the increase of blood flow due to dilation of
the blood vessels in the skin, a result of prostaglandin
E2 which strongly triggers blood vessel expansion.
Furthermore, foot bathing in carbonated spring water
has the effect of increasing blood circulation at the
skin’s surface over the entire body
, and shows
significant benefits regarding muscle tension,
improvement of joint motion, feelings of
relaxation, as opposed to fresh water bathing.
When viewing the above factors, carbonated spring
water foot bathing appears to show a high degree
of effectiveness of foot bathing.
Treatment and Touch Care (massage) are simple
procedures, and while it is said that these care
techniques produce significant amounts of emotional
calming, the current status is that these techniques are
not often implemented in the busy environments of
hospitals and other facilities. If, through examination
of data from fingertip pulse readings, it can be
verified that fomentation treatment and Touch Care
have a significant effect of improving the
maintenance of mind and body wellness, we believe
that its introduction and promotion in the medical and
health care communities will be advanced.
1.4 Research Significance
While foot bathing as one type of fomentation
treatment and Touch Care (massage) are simple
procedures, and while it is said that these care
techniques produce significant amounts of emotional
calming, the current status is that these techniques are
not often implemented in the busy environments of
hospitals and other facilities. If, through examination
of data from fingertip pulse readings, it can be
verified that fomentation treatment and Touch Care
have a significant effect of improving the
maintenance of mind and body wellness, we believe
that its introduction and promotion in the medical and
health care communities will be advanced.
Also, even without being specifically directed by
physicians, the scientific examination of the
effectiveness of available fomentation treatment and
Touch Care can connect and further the establishment
and development of these techniques as areas of study
in nursing education.
2 RESEARCH METHOD
2.1 Subjects of Survey
Nursing students and faculty members, who
consented to participate, were the subject of this
study. For each type of fomentation treatment and
Touch Care experiment, approximately 10 people
were chosen, with a plan of 40 people in all
participating, but the actual results were obtained
from the following: carbonated hot spring water foot
bathing - 9 persons; lower leg Touch Care - 11
persons; foot bathing – 10 persons; foot bathing and
Touch Care - 15 persons; Total - 45 participants.
Subjects were as follows: Participants – 33 persons;
male participants – 3 persons; female participants -
30; average age – 24.8years old.
2.2 Survey Period
January – March, 2015.
2.3 Survey Method
The following was addressed:
① foot bathing (hot water only, 10 minutes), ②
foot bathing (hot water with carbonation added, 10
Effect of Touch Care and Fomentation Use in Nursing Care: Examination from Fingertip Pulse
269

minutes. 40℃ with approx. 1000 ppm concentration
of carbonic acid. Because carbonic acid concentration
decreases as temperature increases, water was not
able to be heated much.), ③ lower leg Touch Care
(massage foot region / lower leg region / thigh region.
Hand massage was applied for 2 - 4 times), ④ foot
care with combined hot water foot bathing and Touch
Care (10 minutes, 4 types of care were applied).
With each type of care, the participants’ vital
signs (body temperature, pulse, blood pressure), skin
temperature (back of hand, base of thumb, top of foot,
base of big toe, chest area, etc.), and fingertip pulse
were measured at three intervals: before treatment,
immediately following treatment, and 10 minutes
after treatment. Fingertip pulse readings were
obtained by measuring pulse fluctuations by means of
installed computer software LYSPECT, and each
reading measured the pulse for 3 minutes. Upon
completion of measurement readings for all
participants, all data was analyzed for study.
Concerning the analysis method, non-linear / SPSS
analysis with computer software LYSPECT was used.
At the same time, the participants were asked to
complete a questionnaire related to their mood and
level of contentment as a result of the treatment, and
that data was combined with the physical test data for
comparison.
3 types of questionnaire were prepared. The 1st
type showed a 20 - step face scale (Fig.1), and prior
to treatment asked the subject to give their own
assessment, placing a circle around the number of the
face that most closely resembled their mood. The 2nd
type of questionnaire used the same face scale, and
asked the participant to indicate their mood
immediately following treatment, and also at the the
conclusion of the experiment. The 3rd type of
questionnaire asked the participant to indicate their
overall mood regarding the treatment, and in what
kind of scenario would they choose to receive this
kind of treatment again.
Moreover, for lower leg Touch Care and Touch
Care while receiving foot bathing treatment, one
person with proficiency in these techniques was
placed in charge of the group, so as to maintain
uniformity of technique as much as possible.
Figure 1: Face scale.
2.4 Method of Analysis
For each type of care treatment, regarding the
readings of variations in body temperature, pulse,
blood pressure, and skin surface temperature, the
degree of rise and fall of the numerical values was
analyzed. Concerning fingertip pulse, as an indicator
of mental adaptability (wellness), if the Largest
Lyaponov Exponent (LLE) numerical value showed
an increase, it was judged that treatment was
effective. When determining whether the sympathetic
nerve or parasympathetic nerve was superior, if
autonomic nerve balance (ANB) values were near to
a precisely good balance, or if the parasympathetic
nerve showed superiority, and it was observed that the
participant was in a relaxed state, it was judged that
the care treatment was effective.
On the questionnaire, numerical values were
assigned to variations in response on the face scale,
showing the difference in participants’ moods before
and after treatment, and numerical ranking was
assigned to the answers given regarding mood
fluctuations and their associated stimuli.
3 RESULTS
3.1 Subject of Research / Location
27 students and 5 faculty members from the nursing
education department of N University participated as
test subjects. Of these, 3 were male and 29 were
female. The subject numbers for each type of test
were as follows: Carbonated water foot bathing - 9
persons, Touch Care - 11 persons, Foot bathing - 10
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persons, Foot bathing + Touch Care - 15 persons.
Testing was conducted in the training lab of the N
University nursing department; the subjects’ vital
signs, skin temperature, and fingertip pulse readings
were measured before and after the Care application
sessions. Room temperature was 21 - 22 ℃.
Temperature of the water used for foot bathing was
40 ℃. For the carbonated water foot bath and regular
foot bath tests, subjects’ feet were placed in water for
10 minutes. For subjects participating in foot bathing
+ Touch Care, during the 10 minutes feet were in the
water, the subject’s feet were washed with soap and
massaged. For those being tested with lower leg
Touch Care, the feet / lower legs / thighs / upper thigh
areas were massaged.
3.2 Test Measurement Results
3.2.1 Fingertip Pulse Values
Results showed that LLE values rose, and mental
activity was stimulated; ANB values arrived at a good
balance, and parasympathetic nerve activity was
dominant, indicating a relaxing effect. (Fig.2).
3.2.1.1 Carbonated Water Bath
Testing showed that carbonated water bath care was
effective in 77.8% of test subjects (7 out of 9 persons),
and ineffective in 22.2% (2 out of 9 persons) of the
subjects. Of this group, results showing subjects
experiencing effective mental activity stimulation
were 71.4% (5 out of 7 persons), and those showing
signs of relaxation were 28.6% (2 out of 7 persons),
as depicted in Fig. 3.
3.2.1.2 Lower Leg Touch Care
Those recipients showing effectiveness were 90.9%
(10 out of 11 persons), and those showing non-
effectiveness were 9.1% (1 out of 11 persons). Of
these, results showing subjects experiencing effective
mental activity stimulation were 30.0% (3 out of 10
persons), and those showing signs of relaxation were
70.0% (7 out of 10 persons), as depicted in Fig. 4.
Carbonated foot-bath Touch care
Touch care
+Foot bathing
No.1
LLE↓
× 16
LLE↑
○ 31
LLE↑
○
ANB→ ANB↓ ANB→
2
LLE↑
○ 17
LLE↑
○ 32
LLE↓
○
ＡＮＢ↑ ANB↓ ＡＮＢ↓
3
LLE↑
○ 18
LLE↑
○ 33
LLE↓
×
ANB↓ ANB↓ ＡＮＢ↑
4
LLE↓
× 19
LLE↑
○ 34
LLE↑
○
ＡＮＢ↑ ANB↓ ANB↓
5
LLE↑
○ 20
LLE↑
○ 35
LLE↑
○
ANB↓ ANB↓ ANB↓
6
LLE↑
○
Foot bathing
36
LLE↓
×
ANB↓
21
LLE↑
○
ＡＮＢ↑
7
LLE↑
○
ＡＮＢ↑
37
LLE↑
○
ＡＮＢ↑
22
LLE↑
○
ANB↓
8
LLE↑
○
ＡＮＢ↑
38
LLE↑
○
ＡＮＢ↑
23
LLE↓
○
ANB↓
9
LLE↑
○
ＡＮＢ↓
39
LLE↑
○
ＡＮＢ↑
24
LLE↑
○
ＡＮＢ↑
Touch care ＡＮＢ↑
40
LLE↑
○
10
LLE→
○ 25
LLE↓
×
ＡＮＢ↑
ANB↓ ＡＮＢ→
41
LLE↑
○
11
LLE→
× 26
LLE↓
○
ＡＮＢ↑
ANB→ ＡＮＢ↓
42
LLE↑
○
12
LLE↑
○ 27
LLE↓
×
ＡＮＢ↓
ANB↓ ＡＮＢ↑
43
LLE↑
○
13
LLE↑
○ 28
LLE↑
○
ＡＮＢ↓
ANB↓ ANB↓
44
LLE→
○
14
LLE↑
○ 29
LLE↑
○
ANB↓
ＡＮＢ↓ ANB↓
45
LLE↑
○
15
LLE↑
○ 30
LLE↑
○
ＡＮＢ↓
ＡＮＢ↑ ANB↓
3.2.1.3 Foot Bathing
Those recipients showing effectiveness were 90.0%
(9 out of 10 persons), and those showing non-
effectiveness were 10.0% (1 out of 10 persons). Of
Figure 3: LLE rise (active) of carbonated water bathing.
Figure 2: The effect of LLE and ANB.
Effect of Touch Care and Fomentation Use in Nursing Care: Examination from Fingertip Pulse
271

these, results showing subjects experiencing effective
mental activity stimulation were 33.3% (3 out of 9
persons), and those showing signs of relaxation were
66.7% (6 out of 9 persons), as depicted in Fig. 5.
3.2.1.4 Foot Bathing + Touch Care
Those recipients showing effectiveness of foot
bathing + Touch Care were 86.7% (13 out of 15
persons), and those showing non-effectiveness were
13.3% (2 out of 15 persons). Of these, results
showing subjects experiencing effective mental
activity stimulation were 38.5% (5 out of 13 persons),
and those showing signs of relaxation were 61.5% (8
out of 13 persons), as depicted in Figure 6.
The overall results from the 4 different Care
procedures were as follows: responses showing
effectiveness were 86.7% (39 out of 45 persons), and
those showing non-effectiveness were 13.3% (6 out
of 45 persons).
Figure 6: LLE rise ANB down (active and also relax) of
Foot bathing + Touch care.
Figure 7: Effectiveness (= 86.7%).
3.2.2 Skin Temperature and Blood Pressure
/ Pulse Fluctuations
3.2.2.1 Carbonated Water Bath
Temperature readings of the eardrum, chest area,
back of the hand, thumb, top of the foot, and big toe
all showed a significant rise immediately following
carbonated water bathing, and the eardrum
temperature still showed an elevated reading 10
minutes after bathing. There were no indications of
change in blood pressure or pulse readings.
3.2.2.2 Lower Leg Touch Care
The eardrum temperature showed a rise immediately
after the procedure, as well as at 10 minutes
afterward. Blood pressure and pulse readings both
indicated lower readings immediately after the
procedure and at 10 minutes afterward.
3.2.2.3 Foot Bathing
The chest area, back of the hand, top of the foot, and
big toe temperature readings showed a rise
immediately following testing, and only the chest
area showed an increased temperature reading at 10
Figure 4: ANB down (relax) of Touch care.
Fig.5: ANB slightly down (relax) of Foot bathing.
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minutes afterward. However, the eardrum
temperature showed no elevation. Blood pressure and
pulse readings were lower immediately following the
procedure, and at 10 minutes afterward an elevated
fluctuation was observed.
3.2.2.4 Foot Bathing + Touch Care
The eardrum, chest area, back of the hand, thumb, top
of the foot, and big toe temperature readings all
showed a significant rise immediately following foot
bathing + Touch Care. Also, the eardrum, chest area,
back of the hand, and thumb temperatures continued
to be elevated 10 minutes afterward. Blood pressure
readings were lower immediately after the procedure,
as well as 10 minutes later. Pulse readings were lower
immediately following testing, but rose 10 minutes
later.
3.2.3 Questionnaire
3.2.3.1 Face Scale
Of the 45 participants, 42 persons indicated on the
face scale (by selecting a smiling face) that they felt
an improvement to their mood after the Care
procedure, as compared to how they felt prior to the
experiment. After completing the procedure, 3
respondents the selected same face on the scale that
they had chosen prior to the experiment (indicating
no improvement in mood). However, these 3 persons
all had fingertip pulse data that judged the Care
procedure as ineffective in their cases. Also, with
these 3 persons, the comparative breadth of overall
mood improvement suggested that they initially
began the experiment in a negative mood, as depicted
in Fig. 8 and Fig. 9.
3.2.3.2 Application of the Care
On the questionnaire, participants were asked to
indicate in what scenarios they would be inclined to
utilize the Care procedure they had received.
From the participants’ accounting of the results,
the content was divided in order of “sub-category”,
“category”, and “core category”, and thus core factors
were extracted. Numerous respondents indicated that
carbonated water bathing as a type of care which
results in improvement of blood circulation, and care
that supports a person’s mental aspect, would be
desirable. With Touch Care, numerous respondents
recorded that they felt that its implementation helped
their overall mental state, followed by relief from
fatigue and improvement in blood circulation. With
foot bathing and foot bathing + Touch Care,
respondents indicated a support of mental state, and
an improvement in body warmth from feeling chilled.
Figure 8: Non-effectiveness and no change on the face scale
(Case No.4 : Carbonated water bath).
Figure 9: Non-effectiveness and no change on the face scale
(Case No.27: Foot bathing).
4 CONSIDERATION
4.1 Considerations from Results of
Fingertip Pulse Measurements
Analysis of LLE and ANB values taken from
fingertip pulse readings yielded the following results:
carbonated water bathing showed 80% effectiveness,
and Touch Care / foot bathing / foot bathing + Touch
Care all showed 90% effectiveness. Using data
gathered from physiological information, it was
judged that these procedures are effective as methods
of nursing care. From prior research, it is believed that
the methods used in this experiment are effective as
an aid to healing. However, carbonated water bathing
showed an activated effectiveness, and in proportion
to the other methods of Touch Care, foot bathing, and
foot bathing + Touch Care, it showed a high degree
of effectiveness in bringing about relaxation, and
showed a unique pattern different than the others. For
this reason, it became apparent that in order to select
Effect of Touch Care and Fomentation Use in Nursing Care: Examination from Fingertip Pulse
273

the most suitable care for individual subjects,
assessment of whether the subject feels cold, and
observation of their current state of mind and overall
body condition must be carefully noted. It was also
determined that it is good to give the subject an
explanation of the effects from each kind of care, and
allow the subject to choose the type of care most
desirable to them.
4.2 Considerations from Vital Signs
Data
From body temperature readings, it was observed
that, excluding foot bathing, the methods of
carbonated foot bathing / Touch Care / and foot
bathing + Touch Care all brought about a significant
rise in core body temperature. The procedure results
showed an influence upon the body with dilation of
peripheral blood vessels, and a rise in temperature
measured on the sole of the foot. With the foot bath,
body surface temperature rose briefly, but there was
no change detected in core body temperature. With
carbonated water bath, the carbonic acid stimulation
upon the skin surface influenced a rise in body
temperature, resulting in a significant rise in core
body temperature.
Blood pressure and fingertip pulse values showed
a significant decrease as a result of Touch Care, and
foot bathing + Touch Care. These techniques would
be useful for situations when desiring to control
improvement of blood flow. Because carbonated
water bath did not bring about a change in blood flow,
this technique could be implemented in situations
where changes affecting blood circulation are
undesirable. That is to say, this technique
demonstrated the positive trait of maintaining
temperature with no burden that would affect core
body temperature.
4.3 Considerations from Face Scale
Questionnaire Results
In the following order, Touch Care + foot bath, Touch
Care, carbonated water bath, and footbath showed a
high proportion of causing an improvement in mood,
and from subjects’ selection of a smiling face, an
effect showing change in mental attitude was
observed. It is hoped that there will be an active
application of these care techniques tailored to the
condition of subjects who desire to see an
improvement in their frame of mind. In particular, the
results suggest that through these care techniques,
subjects who are experiencing a depressed frame of
mind can see an effective improvement in their
mood/frame of mind, as depicted in Fig.10-13.
Figure 10: The change of Face scale in case of Carbonated
water bath.
Figure 11: The change of Face scale in case of Touch care.
Figure 12: The change of Face scale in case of Foot bathing.
Figure 13: The change of Face scale in case of Foot bathing
+ Touch care.
In cases where the face scale indicated no change
in mood, because physiological indicators LLE and
ANB also showed no recognizable effect, the data
suggest that the resulting effects of the care
techniques served as barometer in revealing the mind
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state of the participants. The importance of grasping
the effectiveness by evaluating mood changes
following the care procedures was clearly seen.
4.4 Considerations from Results of the
Questionnaire (Applicable
Scenarios)
The 4 care techniques had in common the following
result contents that showed scenarios where useful
application could be expected: support of the
psychological aspect, improvement in blood
circulation, improvement regarding factors involving
fatigue and lack of body warmth, and aid to sleep
inducement. Especially noted was that carbonated
water bathing, as a care method helpful to blood
circulation, was useful for bedridden subjects prone
to blood clots (thrombosis), and Touch Care was
effective for improvement of fluid retention (edema)
in the lower legs. The research suggested the
importance of selecting the optimal method of care,
most fitting to the subjects’ condition and vital signs.
5 CONCLUSIONS
1. From results of fingertip pulse
measurements, carbonated water bathing
was seen to have an approximately 80%
effectiveness. Touch Care, foot bathing, and
foot bathing + Touch Care demonstrated an
approximately 90% effectiveness.
2. From LLE and ANB data, in care techniques
that are said to have healing properties,
carbonated water bathing revealed an
effectiveness in activation, while Touch
Care, foot bathing, and foot bathing + Touch
Care showed a proportionally high level of
induced relaxation, and a pattern of
effectiveness was unmistakably evident.
3. In cases where there was no change in mood,
effectiveness was also undetectable in
results from LLE and ANB physiological
data.
4. In the following order, foot bathing + Touch
Care, Touch Care, carbonated water bathing,
and foot bathing all showed effectiveness in
mood improvement.
5. When comparing foot bathing and foot
bathing + Touch Care, foot bathing + Touch
Care showed a higher effectiveness in
warming the body.
6. Both Touch Care and foot bathing + Touch
Care showed an effectiveness in improving
blood circulation, and carbonated water
bathing showed an effectiveness in warming
the body without altering vital signs.
From the above findings, it is considered that
selection of the most suitable nursing care for each
subject, as well as its application, are important. Also,
regarding care that provides mental health support,
for reliable construction of a direct link of that care
with proper subjects, it is our desire to see that
applications of these care techniques be
enthusiastically applied in both clinical settings and
in everyday life.
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