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15 Aug

Preoperative rehearsal of active coping imagery influences subjective and hormonal responses to abdominal surgery.

A 1995 study reported in Psychosomatic Medicine shows that of 51 patients undergoing abdominal surgery, those who were taught guided imagery before surgery had less postoperative pain than those who did not. They were also less distressed by the surgery, felt as if they had coped with it better and requested less pain medication than patients who did learn imagery skills.

Citation: Manyande A, Berg S, Gettins D, Stanford SC, Mazhero S, Marks DF, Salmon P. Preoperative rehearsal of active coping imagery influences subjective and hormonal responses to abdominal surgery. Psychosomatic Medicine. 1995: 57: 177-182.

15 Aug

In a randomized clinical trial at The Ruttenberg Cancer Center, Mount Sinai School of Medicine, to determine if brief presurgical hypnosis on breast biopsy patients helps with postsurgery pain and distress, 20 biopsy patients were randomly assigned to a hypnosis or control group (standard care). The study found that the brief hypnosis did reduce postsurgery pain and Distress and suggested that presurgery expectations influenced and mediated this outcome.

Citation: Montgomery GH, Weltz CR, Seltz M, Bovbjer DH. Brief presurgery hypnosis reduces distress and pain in excisional breast biopsy patients. International Journal of Clinicial and Experimental Hypnosis. 2002 Jan;50(1): pp.17-32.

15 Aug

One-year follow-up of patients treated for dental fear: effects of cognitive therapy, applied relaxation, and nitrous oxide sedation.

When sixty-two patients were randomly assigned to nitrous oxide sedation (NO), cognitive therapy (CT), or applied relaxation (AR) therapy, to help them reduce their fear of dental procedures, highly significant reductions in fear and general distress were found in all three groups. Patients in the applied relaxation group showed the greatest benefit and the most dramatic reduction on dental fear measures. One year later a majority (95%) of the participants had undergone dental treatment, and on the whole, showed continued favorable effects. Every subject judged the dental fear treatment to have been beneficial, and 80% reported the treatment successful. All three treatment groups scored in the normative range for general distress both at the end of treatment and at one year follow-up.

Citation: T. Willumsen, O. Vassend and A. Hoffart. One-year follow-up of patients treated for dental fear: effects of cognitive therapy, applied relaxation, and nitrous oxide sedation. Acta Odontologica Scandinavica. Vol 59; No: 6 Page: 335-340.

15 Aug

Blue Shield of California: findings developed from data gathered in 2000–2001 based on 900 completed patient surveys.

CALIFORNIA BLUE SHIELD continues to report positive outcomes with its use of our Health Journeys guided imagery. Through the program, begun in 2000, individuals facing one of 90 elective surgeries are sent guided imagery tapes.Outcomes include: 45% of patients experienced high anxiety before listening to the tapes, but less than 5% experienced similar anxiety following use of the tapes pre-surgery, and “the more anxious patients felt, the more frequently they listened to the recordings and the greater improvement they documented. The findings were developed from data gathered in 2000–2001 based on 900 completed patient surveys.

Blue Shield’s research team also compared claims from 166 hysterectomy patients who reported using the guided imagery tapes and completed surveys against a control group of 183 hysterectomy patients who did not listen to the tapes. The result: 4.5% decrease in average total hospital charges billed for surgery among patients who used guided imagery prior to surgery, and an 8.4% decrease in the average hospital pharmacy charges.

 

 

15 Aug

In 1998, a research team led by Linda Halpin at the Inova Heart Center of Inova Fairfax Hospital compared cardiac surgical outcomes between two groups of heart patients - with and without guided imagery. A questionnaire was developed to assess the benefits of the guided imagery program to those who elected to participate in it, and, in addition, data from the hospital financial cost-accounting database were collected and matched to the two groups of patients.

Analysis of the data revealed that patients who completed the guided imagery program had a shorter average length of stay, a decrease in average direct pharmacy costs, and a decrease in average direct pain medication costs while maintaining high overall patient satisfaction with the care and treatment provided.

Guided imagery is now used as a standard, complementary therapy to help reduce anxiety, pain, and length of stay among the cardiac surgery patients at Inova Fairfax.

Citation: Halpin LS, Speir AM, CapoBianco P, Barnett SD. Guided imagery in cardiac surgery. Outcomes in Management & Nursing Practice, 2002 Jul-Sep;6(3):132-7.

15 Aug

Twenty patients awaiting breast biopsy at a Kentucky Correctional Facility were randomly assigned to either 20 minutes of music therapy in the pre-op holding area or standard care. Their blood pressure, heart rate, respiration and anxiety levels were measured before and after the intervention. This pilot study showed that the anxiety and respiratory rates of the patients in the music condition were significantly lower than the controls.

Citation: Haun M, Mainous RO, Looney SW. Effect of Music on Anxiety of Women Awaiting Breast Biopsy. Behavioral Medicine, 2001. Fall; (3): pp. 127-132.

15 Aug

A research team in Hong Kong tested the effectiveness of music therapy on twenty ventilator-dependent patients, measuring blood pressure, respiratory rate and the Chinese version of the Spielberger State-Trait Anxiety instrument. Patients were randomly assigned to either 30 minutes of uninterrupted rest and then 30 minutes of music therapy, or the music therapy first, followed by the rest period. Patients had a choice of Chinese or Western music. Measures were taken at 5-minute intervals during the music intervention. The study showed that music therapy was more effective at decreasing anxiety than the rest interval (p < .01). Blood pressure and respiration did not show differences.

Citation: Wong HL, Lopez-Nahas V, Molassiotis A. Effects of Music Therapy on Anxiety in Ventilator-Dependent Patients. Heart Lung. 2001 Sept-Oct; 30 (5): pp. 376-87.

15 Aug

W J Hamel explored the effects of music therapy on the anxiety levels, heart rate and blood pressure of patients waiting for their scheduled cardiac catheterization. 101 (63 men and 38 women) patients were randomly assigned to listen to 20 minutes of pre-selected music or to a standard care control group. Measurements were taken during the waiting period and just prior to departure for the lab. The intervention group had a significant reduction in anxiety (p = 0.003) and when compared to the controls (p = 0.004). Where the heart rate and systolic blood pressure dropped in the music therapy group, it increased in the control group. This held up whether the patient was male or female, but the men as a group had higher diastolic scores than the women, and the women had higher anxiety scores than the men.

Citation: Hamel, WJ, The Effects of Music Intervention on Anxiety in the Patient Waiting for Cardiac Catheterization, Intensive Critical Care Nursing, 2001 Oct; 17 (5): pp. 279-85.

15 Aug

Here is a study that got past us when it first came out, from our own University Hospitals, Rainbow Babies and Children''s Hospital, and CWRU’s Frances Payne Bolton School of Nursing:

S. A. Lambert’s study examines the effect of hypnosis/guided imagery on the postoperative course of pediatric surgical patients. Fifty-two children (matched for sex, age, and diagnosis) were randomly assigned to an experimental or control group. The experimental group was taught guided imagery by the investigator. The imagery technique included suggestions for a favorable postoperative course. The controls were given standard care.

15 Aug

Clinical hypnosis versus cognitive behavioral training for pain management with pediatric cancer patients undergoing bone marrow aspirations.
15 Aug

A recent study by principal investigator, Carol Ginandes PhD, of McLean Hospital/Harvard Medical School, explored differences in speed and extent of surgical wound healing in 18 breast reduction surgery patients, among 2 experimental conditions and one control condition.

The women were randomly assigned to receive either 8 supportive attention sessions, 8 hypnosis sessions targeting accelerated wound healing, or usual care. Differences in healing were observed at weeks one and seven, through clinical exams by staff who were blind to the intervention received, as well as scored, digitized photographs, patients’ subjectively rated pain, self-percieved healing and general health status.

15 Aug

In a randomized, controlled clinical trial, researchers from Rome, Italy assessed the effects of guided imagery on the postoperative course in proctological patients. Patients undergoing surgery for anorectal diseases were randomized into group 1 (n = 43) with standard care and group 2 (n = 43) with relaxation techniques, where they listened to a guided imagery tape with music and relaxing text before, during, and after surgery. Patients evaluated their own (a) postoperative pain measured by visual analogue score, (b) their quality of sleep measured by a similar score, and (c) the nature of first micturition (ed. note: fancy word for peeing, I believe), evaluated as normal or difficult. Groups were similar in age and sex distribution, type of disease, and operation performed. The pain score was 3.2 +/- 1.4 in GI patients and 4.1 +/- 2.1 in controls (P = 0.07). The quality of sleep score was 4.8 +/- 2.9 in GI patients and 6.4 +/- 2.7 in controls (P = 0.01). The first micturition was painful in 10.3% of GI patients and in 27.3% of controls (P = 0.09). Perioperative relaxation techniques thus showed a trend to reducing pain following anorectal surgery and significantly improving the quality of sleep; a decrease in anxiety and a consequent muscle relaxation may be involved. The study concludes that guided imagery is a low cost and noninvasive procedure, can be recommended as an helpful tool in this type of surgery.

Citation: Renzi C, Peticca L, Pescatori M. The use of relaxation techniques in the perioperative management of proctological patients: preliminary results. International Journal of Colorectal Disease 2000 Nov;15 (5-6): pp. 313-316.