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15 Aug

According to a survey of 1,462 seriously ill patients by Karen Steinhauser and her research team at Duke University, freedom from pain is the most important priority at the end of life, followed by being at peace with God and being with loved ones. Other areas that ranked high in importance were good patient-physician communication, being prepared for death, and achieving closure. Items that were considered important by patients but less so by physicians included being mentally alert, not being a burden to others, and having time to plan funeral arrangements. Interestingly, the researchers also found that dying at home was not a priority. People don’t fear death, said Steinhauser at a press conference announcing the survey findings. They fear bad dying.

Citation: Steinhauser KE, Christakis NA, Clipp EC, McNeilly M, Grambow S, Parker J, Tulsky JA. Preparing for the end of life: preferences of patients, families, physicians, and other care providers. Journal of Pain and Symptom Management 2001 Sep;22(3):727-37.

15 Aug

Differential effectiveness of psychological interventions for reducing osteoarthritis pain: a comparison of Erikson hypnosis and Jacobson relaxation.

A new randomized, controlled clinical trial from France investigated the effectiveness of 8-session Eriksonian hypnosis and 8-session Jacobsonian progressive relaxation for the reduction of osteoarthritis pain, using subjects with knee or hip pain. Patients were randomly assigned to one of the intervention groups or a control group. Overall, results demonstrated that the two experimental groups had a lower level of subjective pain than the control group, and that the level of subjective pain decreased with time. In addition, pain reduction occurred more rapidly for the hypnosis group. Results also showed that both hypnosis and relaxation are effective in reducing the amount of analgesic medication taken by participants.

Citation: Gay MC, Philippot P, Luminet O. Differential effectiveness of psychological interventions for reducing osteoarthritis pain: a comparison of Erikson hypnosis and Jacobson relaxation. European Journal of Pain 2002;6(1):1-16.

15 Aug

A group of researchers from the University of Southern Maine took a look the effects of offering Therapeutic Touch (TT) as an adjunct to cognitive behavioral therapy (CBT) for people with chronic pain. Patients were randomized to a relaxation training condition alone or relaxation training plus Therapeutic Touch. All participants attended a relaxation training classes. Preprogram and postprogram data were examined to identify patterns of change in pain intensity, self-efficacy, disability, and perceived distress. In addition, patterns of attrition were examined. The study found that subjects in the study who received TT in addition to the relaxation training fared statistically better in terms of enhanced self-efficacy and unitary power, as well as having lower attrition rates. In addition, there were trends associating TT with less distress and disability. This pilot study lacked a true control condition, and the numbers of subjects are not specified in this abstract. Nonetheless, this pilot suggests that offering TT as an adjunct to CBT may help to improve clinical outcomes, reduce program attrition, and promote self-efficacy in those who suffer from chronic pain.

Citation: Smith DW, Arnstein P, Rosa KC, Wells-Federman C. Effects of integrating therapeutic touch into a cognitive behavioral pain treatment program. Report of a pilot clinical trial. Journal of Holistic Nursing 2002 Dec; 20 (4): pp. 367-87.

15 Aug

A group of researchers from UCLA conducted a study to assess the usefulness of combining acupuncture and hypnosis for chronic pediatric pain. Thirty-three sequentially referred children (21 girls, 12 boys) aged 6-18 years were offered 6 weekly sessions consisting of individually tailored acupuncture treatment together with a 20-minute hypnosis session, conducted while the needles were in place. Parent and child ratings of pain and pain-related interferences in functioning, as well as child ratings of anxiety and depression, were obtained at pre-and post-treatment. The treatment was highly acceptable (only 2 patients refused; > or = 90% completed treatment) and there were no adverse effects. Both parents and children reported significant improvements in children''s pain and interference following treatment. Children''s anticipatory anxiety declined significantly across treatment sessions. Our results support the feasibility and acceptability of a combined acupuncture/hypnosis intervention for chronic pediatric pain.

Citation: Zeltzer LK, Tsao JC, Stelling C, Powers M, Levy S, Waterhouse M. A phase I study on the feasibility and acceptability of an acupuncture/ hypnosis intervention for chronic pediatric pain. Journal of Pain and Symptom Management 2002, Oct;24(4): pp. 437-46.

15 Aug

Stress reactivity to and recovery from a standardised exercise bout: a study of 31 runners practising relaxation techniques.

Researchers at Ulleval University Hospital in Oslo, Norway, compared the value of 2 different kinds of relaxation techniques for improving post-running pain in adult, male runners over a 6 month period. Thirty-one runners were divided up into 3 groups: a meditation group (n = 11); an autogenic training group (a simple self-hypnosis technique similar to the Relaxation Response) (n = 11) and a control group (n = 10).

15 Aug

The effect of music-based imagery and musical alternate engagement on the burn debridement process.
15 Aug

A 1995 study published in the Journal of Holistic Nursing (vol.13: pp255-267) showed that postpartum depression in new mothers is alleviated by guided imagery. The research with 60 first-time mothers showed that those who practiced guided imagery during the first 4 weeks after giving birth had less anxiety and depression and more self-esteem and confidence than their counterparts who did not use guided imagery.

Citation: B. Rees. Effect of Relaxation with Guided Imagery on Anxiety, Depression and Self-Esteem in Primiparas. Journal of Holistic Nursing. 1995(Vol 13):255-67.

15 Aug

In a study at the Beth Israel Medical Center in Boston, Alice Domar and her team randomly assigned 184 women who had been trying to get pregnant for 1-2 years into 3 groups: a 10-session cognitive-behavioral group, a standard support group, or a routine care control group. They were followed for 1 year to see how many became pregnant. Sixty-four women discontinued participation in the study. A total of 47 women in the cognitive-behavioral group became pregnant, and 48 in the support group, as opposed to only 25 in the control group. Because these are statistically significant differences, the study concludes that group psychological interventions appear to lead to increased pregnancy rates in infertile women.

Citation: Domar AD, Clapp D, Slawsby EA, Dusek J, Kessel B, and Freizinger M. Impact of group psychological interventions on pregnancy rates in infertile women. Fertility and Sterility, 2000 Jul;74(1):190.

15 Aug

In a 1996 randomized, controlled pilot study by Irvin, Domar, Clark, Zuttermeister and Friedman at New England Deaconess in Boston, 33 menopausal women between 44-66 years old were assigned to either Relaxation Response training, a support group or a control group.

As many of you know, the Relaxation Response is a technique developed by Herbert Benson that simplifies the essence of ancient mantra and breathing meditation. You do some conscious breathing and repeat a calming word or phrase to yourself, like "Peace" or "All is well". It''s kind of a Meditation 101, and by keeping it simple, calling it "The Relaxation Response", and doing some outcome research with it, the wiley, practical Benson made it acceptable in corporate venues and other traditionally skeptical places ... to which we say, "GOOD FOR YOU, HERB!"

15 Aug

Dr. Paul G. Schauble and his colleagues at the University of Florida at Gainesville randomly assigned 42 pregnant teenagers to receive either counseling or four sessions of instruction in self-hypnosis for childbirth.

Teens in the hypnosis group learned deep relaxation and imagery techniques to help them cope with pain. They also received suggestions to help them respond to possible complications and boost their confidence in their ability to manage anxiety.
15 Aug

When Dr. Rogerio Lobo, Chair of Columbia Presbyterian''s Department of OBGYN, and Dr. Kwang Y. Cha, a researcher at Cha Hospital in Seoul, studied the effect of intercessory prayer on the pregnancy rates of 219 women, aged 26-46 years old, being treated with in vitro fertilization, they found that the prayed-for group had double the pregnancy rate (50% vs. 26%, P = .0013) and double the implantation rate (16.3% vs. 8%, P = .0005).

This was a double-blind, randomized, placebo-controlled clinical trial, in which patients and providers were not informed about the intervention. Statisticians and investigators were masked until all the data had been collected and all the clinical outcomes were known. The setting was an IVF-ET program at Cha Hospital, Seoul, Korea. The intercessory prayer was carried out by prayer groups in the United States, Canada and Australia. The investigators were at Columbia Presbyterian Hospital in the United States.

The study concludes that there was a statistically significant difference for the effect of intercessory prayer on the outcome of In Vitro Fertilization.

A nice write up of the study can be found here.

Citation: Cha KY, Wirth DP, Lobo RA. Does prayer influence the success of in vitro fertilization-embryo transfer? Journal of Reproductive Medicine. 2001 Sep; 46 (9): 781-7.

15 Aug

In a small Swedish pilot study at University Hospital of Linkoping, Sweden, six menopausal women were given relaxation training to see if it had any effect on hot flashes. The women were given “applied relaxation” training in 12 weekly group sessions. The women recorded the number of hot flashes they experienced for a full month before the intervention, through 6 months after. They were rated on menopausal symptoms (Kupperman Index), psychological well-being (Symptom Checklist), and MOOD scale were measured throughout the duration of the study. The six patients showed a mean reduction in hot flashes by a dramatic 73% (59%, 61%, 62%, 67%, 89% and 100% respectively). Scores on the Kupperman and Symptom checklist followed the improvement pattern of the hot flashes, but the MOOD scale was not affected.

Citation: Wijma K, Melin A, Nedstrand E, Hammar M. Treatment of Menopausal Symptoms with Applied Relaxation: A Pilot Study. Journal of Behavioral Therapy & Experimental Psychiatry, 1997, Dec; 28 (4): pp. 251-261.