Defense Date


Graduation Date

Fall 1-1-2015


Worldwide Access

Submission Type


Degree Name





School of Nursing

Committee Chair

Gladys Husted

Committee Member

Lynn Simko

Committee Member

Jean Kijek


Complementary and Alternative Medicine, Energy Healing, Focus Groups, Integrative Nursing, Qualitative Research, Therapeutic Touch


Therapeutic Touch® (TT) is a nursing modality, developed in 1972, with a long history of research completion. It is also one of the leading complementary and alternative medicine (CAM) therapies. A comprehensive review of the literature (over 350 studies) from the 1960s to 2015 demonstrated a gap related to delineating expertise related to clinical practice from the view of the practitioner. This study examined the state of expert practice as envisioned by those who themselves qualified as experts in the discipline of TT.

This study utilized a qualitative descriptive independent focus group methodology (Krueger, 1994, 2006; Krueger & Casey, 2001, 2009). This methodology has become popular in nursing studies. The choice of a synchronous method to collect data was made to provide a unique environment supported by the online environment with the university-supported platform. Focus groups were used as a stand-alone and self-contained method to conduct the study (Hupcey, 2005; Morgan, 1997).

The sample consisted of 12 expert, registered nurse (RN) TT practitioners (TTPs), with a minimum of three years of TT experience. They also had attended a minimum of three TT workshops/courses, which included advanced training in the discipline. The use of electronic media facilitated a sample drawn from three countries across two continents. Six very small, synchronous, online focus groups (Toner, 2009) were conducted to reach data saturation and minimum sample size acquisition.

Rich data were collected from these experienced practitioners. Parameters explored were the practitioners' description of expert practice, their own expertise, how research impacted their practice, and the direction TT is headed in the future. Findings were supported by the expert practice literature. Krieger's (2002) concept of transformation was especially apparent in the lives of many of the participants in this study. Respondents described how TT had become an integral part of their lives and influenced their lives immeasurably.

The importance of practice as one factor leading to expertise was very apparent among the participants. Many of the studies stress the need for practice in order to gain expertise in specialty practice. TT is a form of specialty practice by nurses, supported in a holistic framework and caring environment.

Sharing, which includes mentorship, collaboration, and teaching, is an important part of an advanced practice model, and is apparent in the practice of these advanced TTPs. Expert practice includes the components of expert practice knowledge, which is a necessary prequel to the ability to share it with others. It is also a necessary component to provide leadership to others, to conduct research in the field, and to further one's own practice goals.