Clinical Hypnosis in Medical Care: A Mixed-Method Feasibility Study (original) (raw)
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The advantages of hypnosis intervention on breast cancer surgery and adjuvant therapy
The Breast, 2018
Background: In oncology, hypnosis has been used for pain relief in metastatic patients but rarely for induction of anesthesia. Material and method: Between January 2010 and October 2015, 300 patients from our Breast Clinic (Cliniques universitaires Saint-Luc, Universit e catholique de Louvain) were included in an observational, non-randomized study approved by our local ethics committee (ClinicalTrials.gov e NCT03003611). The hypothesis of our study was that hypnosis intervention could decrease side effects of breast surgery. 150 consecutive patients underwent breast surgery while on general anesthesia (group I), and 150 consecutive patients underwent the same surgical procedures while on hypnosis sedation (group II). After surgery, in each group, 32 patients received chemotherapy, radiotherapy was administered to 123 patients, and 115 patients received endocrine therapy. Results: Duration of hospitalization was statistically significantly reduced in group II versus group I: 3 versus 4.1 days (p ¼ 0.0000057) for all surgical procedures. The number of post-mastectomy lymph punctures was reduced in group II (1e3, median value n ¼ 1.5) versus group I (2e5, median value n ¼ 3.1) (p ¼ 0.01), as was the quantity of lymph removed (103 ml versus 462.7 ml) (p ¼ 0.0297) in the group of mastectomies. Anxiety scale was also statistically reduced in the postoperative period among the group of patients undergoing surgery while on hypnosis sedation (p ¼ 0.0000000000000002). The incidence of asthenia during chemotherapy was statistically decreased (p ¼ 0.01) in group II. In this group, there was a statistically non-significant trend towards a decrease in the incidence of nausea/ vomiting (p ¼ 0.1), and the frequency of radiodermitis (p ¼ 0.002) and post-radiotherapy asthenia (p ¼ 0.000000881) was also reduced. Finally, the incidence of hot flashes (p ¼ 0.0000000000021), joint and muscle pain (p ¼ 0.0000000000021) and asthenia while on endocrine therapy (p ¼ 0.000000022) were statistically significantly decreased in group II. Discussion: Hypnosis sedation exerts beneficial effects on nearly all modalities of breast cancer treatment. Conclusion: Benefits of hypnosis sedation on breast cancer treatment are very encouraging and further promote the concept of integrative oncology.
Anesthesiology Research and Practice, 2016
The aim of this review is to summarize data published on the use of perioperative hypnosis in patients undergoing breast cancer surgery (BCS). Indeed, the majority of BCS patients experience stress, anxiety, nausea, vomiting, and pain. Correct management of the perioperative period and surgical removal of the primary tumor are clearly essential but can affect patients on different levels and hence have a negative impact on oncological outcomes. This review examines the effect of clinical hypnosis performed during the perioperative period. Thanks to its specific properties and techniques allowing it to be used as complementary treatment preoperatively, hypnosis has an impact most notably on distress and postoperative pain. During surgery, hypnosis may be applied to limit immunosuppression, while, in the postoperative period, it can reduce pain, anxiety, and fatigue and improve wound healing. Moreover, hypnosis is inexpensive, an important consideration given current financial concern...
Journal of Consulting and Clinical Psychology, 2010
Hypnosis is widely recognized as an empirically supported intervention to improve postsurgical outcomes. However, to date, no research has examined mediators of hypnotic benefit among surgery patients. The present study was designed to test the hypotheses that response expectancies and emotional distress would mediate the effects of an empirically validated presurgical hypnosis intervention on postsurgical side effects (i.e., pain, nausea, and fatigue). In a sample of 200 women undergoing breast conserving surgery (mean age = 48.50 years), structural equation modeling revealed the following: 1) hypnotic effects on postsurgical pain were partially mediated by pain expectancy (p< .0001), but not by distress (p=.12); 2) hypnotic effects on postsurgical nausea were partially mediated by presurgical distress (p=.02), but not by nausea expectancy (p=.10); 3) hypnotic effects on postsurgical fatigue were partially mediated by both fatigue expectancy (p=.0001) and presurgical distress (p=.02). These results improve understanding of the underlying mechanisms responsible for hypnotic phenomena in the surgical setting, and suggest that future hypnotic interventions target patient expectancies and distress to improve postsurgical recovery.
Contemporary Hypnosis, 2006
Despite conclusive evidence for the efficacy of clinical hypnosis in the management of many cancer related symptoms and particularly acute and chronic pain, hypnosis is currently under-utilized in these applications. This paper gives a brief overview of the contemporary uses of hypnosis in paediatric and adult oncology and shows how hypnosis can be integrated into a total therapeutic process based on the needs and goals of the patient and the health care team treating them. The first section describes studies that have evaluated hypnosis in adult oncology. The second half consists of a review of the hypnosis literature in paediatric oncology. The paper concludes with suggestions for future research, and implications for clinical practice, which at the moment lags behind.
Current Practices, Experiences, and Views in Clinical Hypnosis: Findings of an International Survey
International Journal of Clinical and Experimental Hypnosis
An online survey of 691 clinicians who use hypnosis was conducted in 31 countries to gain a broad real-world picture of current practices, views, and experiences in clinical hypnosis. Among 24 common clinical uses, stress reduction, wellbeing and self-esteem-enhancement, surgery preparations, anxiety interventions, mindfulness facilitation, and labor and childbirth applications were the most frequently rated as highly effective (each by >70% of raters) in the clinicians' own experience. Adverse hypnosis-associated effects had been encountered by 55% of clinicians but were generally short-lived and very rarely judged as serious. The most common hypnosis approaches used were Ericksonian style (71%), hypnotic relaxation therapy (55%), and traditional hypnosis (50%). Almost all respondents reported regularly using other therapeutic modalities alongside hypnosis. Among a range of client variables potentially affecting therapy, most clinicians rated hypnotist-client rapport (88%) and client motivation (75%) as very or extremely important factors for successful hypnotherapy. The majority of respondents had conducted hypnosis treatment via teletherapy, and 54% of those estimated it to be as effective as in-person treatment.
Brief presurgery hypnosis reduces distress and pain in excisional breast biopsy patients
International Journal of Clinical and Experimental Hypnosis, 2002
Each year, hundreds of thousands of women undergo excisional breast biopsies for definitive diagnosis. Not only do these patients experience pain associated with the procedure, but they also endure distress associated with the threat of cancer. Hypnosis has been demonstrated as effective for controlling patients' pain in other surgical settings, but breast surgery patients have received little attention. To determine the impact of brief presurgical hypnosis on these patients' postsurgery pain and distress and to explore possible mediating mechanisms of these effects, 20 excisional breast biopsy patients were randomly assigned to a hypnosis or control group (standard care). Hypnosis reduced postsurgery pain and distress. Initial evidence suggested that the effects of hypnosis were mediated by presurgery expectations. The adverse consequences of breast surgery (e.g., pain, distress) are experienced not only by the more than 150,000 women who undergo lumpectomy and mastectomy for breast cancer each year but also by the hundreds of thousands more women who undergo excisional breast biopsies for definitive diagnosis (Landis, Murray, Bolden, & Wingo, 1999; National Cancer Institute, 1999). From the surgical perspective, there is little difference between excisional biopsy and lumpectomy outside the need to take a greater surgical margin with the latter (DeVita, Hellman, & Rosenberg, 1997). Thus, finding interventions to reduce aversive sequella of surgery for these patients is of considerable interest. Chief among the acute aversive side effects of breast surgery are patients' pain and distress. Pain is a nearly ubiquitous side effect of all surgery (Loeser & Melzack, 1999), and women undergoing breast surgery are certainly no exception (Carpenter et al., 1998). In addition to the Manuscript submitted November 14,2000; final revision received March 19,2001 'TIUS research was supported in part by a research grant from the National Cancer Institute (R03CA86562-01). 'We would like to thank the Post Anesthesia Care Unit staff and the ambulatory care staff for their strong support in conducting the study.