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INTRODUCTION: Parents of children with cancer can experience increased emotional distress. This study aimed to assess the feasibility (i.e., reach, treatment fidelity, and social validity) of Taking Back Control Together (TBCT). METHODS: We assessed reach with the enrollment and dropout ratios. We assessed treatment fidelity using items from existing programs, controlling for the reliability of the items. For social validity, we used an adapted version of the Treatment Evaluation Inventory and compared means with theoretical cut-points. RESULTS: 42 participants enrolled in the intervention. The enrollment and dropout ratios were 39% and 38%, respectively. Treatment fidelity was 77.3-84.3% (95%CI 75.3-86%). Acceptability (M = 90%), satisfaction (M = 87%), and relevance (M = 82%) were significantly positive. CONCLUSION: This study suggests that certain elements of TBCT need to be reassessed before the intervention is pilot tested. Although reach was likely impacted by the COVID-19 pandemic, it could be improved with some modifications to the intervention.
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Estudos de Viabilidade , Neoplasias , Pais , Humanos , Feminino , Masculino , Neoplasias/psicologia , Neoplasias/terapia , Criança , Pais/psicologia , Adulto , COVID-19/psicologia , Pessoa de Meia-Idade , Angústia Psicológica , AdolescenteRESUMO
INTRODUCTION: Parents of children with cancer face psychological challenges that can result in significant distress. It has been found that problem-solving (PS) could mitigate emotional distress (ED) in this population, but mechanisms of this relation are poorly understood. This study aimed to assess whether there is a link between PS and ED through perceived control and self-efficacy. METHODS: We included 119 parents (67 mothers, 52 fathers, including 50 couples) whose child was diagnosed with cancer. We evaluated whether PS was associated with ED through perceived control and self-efficacy in couples of parents. RESULTS: We found no direct association between PS and ED (ß = -0.01, p = 0.92). Our results indicated a significant indirect effect between ED and PS with perceived control as the intermediary variable (ß = -0.24, p < 0.001, 95% CI [-0.41, -0.11]). However, there was no indirect association between ED and PS with self-efficacy as the intermediary variable (ß = -0.04, p = 0.26, 95% CI [-0.11, 0.09]). The effect size was large in magnitude (R2 = 0.59 for ED). CONCLUSION: The mitigating role of PS on ED is better explained by an enhanced experience of control than by improved self-efficacy. Future interventions should directly target the action mechanism behind PS and ED in both mothers and fathers by targeting their perceived control.
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Neoplasias , Angústia Psicológica , Feminino , Criança , Humanos , Autoeficácia , Estresse Psicológico/psicologia , Pais/psicologia , Neoplasias/psicologiaRESUMO
PURPOSE: This pilot-controlled trial aimed to examine the feasibility and acceptability of hypnosis-derived communication (HC) administered by trained nurses during outpatient chemotherapy to optimize symptom management and emotional support - two important aspects of patient well-being in oncology. METHODS: The trial was conducted in two outpatient oncology units: (1) intervention site (usual care with HC), and (2) control site (usual care). Nurses at the intervention site were invited to take part in an 8-h training in HC. Participants' self-ratings of symptoms and emotional support were gathered at predetermined time points during three consecutive outpatient visits using the Edmonton Symptom Assessment Scale and the Emotional Support Scale. RESULTS: Forty-nine patients (24 in the intervention group, 25 in the control group) with different cancer types/stages were recruited over a period of 3 weeks and completed the study. All nurses (N = 10) at the intervention site volunteered to complete the training and were able to include HC into their chemotherapy protocols (about ± 5 min/intervention). Compared to usual care, patients exposed to HC showed a significant reduction in physical symptoms during chemotherapy. In contrast, perception of emotional support did not show any significant effect of the intervention. Participants exposed to HC report that the intervention helped them relax and connect on a more personal level with the nurse during chemotherapy infusion. CONCLUSIONS: Our results suggest that HC is feasible, acceptable, and beneficial for symptom management during outpatient chemotherapy. While future studies are needed, hypnosis techniques could facilitate meaningful contacts between cancer patients and clinicians in oncology. TRIAL REGISTRATION: Clinical Trial Identifier: NCT04173195, first posted on November 19, 2019.
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Hipnose , Pacientes Ambulatoriais , Comunicação , Estudos de Viabilidade , Humanos , Cuidados PaliativosRESUMO
Introduction: Conversational hypnosis (CH) is known to optimize the management of symptoms resulting from antineoplastic treatment. However, the perception of nurses who have been called upon to integrate this practice into their care has yet to be documented. Goal: Describe how nurses perceive the integration of CH into chemotherapy-related care. Methods: Individual interviews and an iterative analysis were conducted with six nurses who had previous experience in CH in an outpatient oncology clinic. Findings: Six themes emerged: 1) the outpatient oncology clinic, a saturated care setting; 2) the key elements supporting the integration of CH into care; 3) an added value for patients; 4) a positive and rewarding experience for nurses; 5) collateral benefits; and 6) CH, an approach that warrants consideration amid the pandemic. Conclusion: These findings shed light on nurses' unique point of view regarding the challenges and benefits of integrating CH into oncology care.
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Transition from pediatric to adult health care setting is a challenge for young patients because of the psychosocial issues they may present that could hinder their commitment to treatment and medical care. Psychologists play a key role in supporting these patients. They intervene with the most vulnerable ones for whom the current transitional practice does not necessarily meet their specific needs and help them to develop an appropriate level of autonomy despite medical condition. To date, few studies have described their clinical practice in this field. This study aimed to gather in-depth information about the elements that characterize their different roles in transition care. Following a semi-structured interviews with ten pediatric psychologists, we conducted a thematic content analysis to identify common themes among participants. The results indicate that the psychologists' practice focuses on four main aspects: assessment, intervention, education, and liaison. Their recommendations point towards a better organization of health care services and a reflection on the best practices in psychology. These results highlight the specific roles that pediatric psychologists play in the transition process within the health care environment.
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Papel do Médico , Psicologia da Criança/métodos , Psicologia , Transição para Assistência do Adulto , Adulto , Estudos de Avaliação como Assunto , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pesquisa QualitativaRESUMO
Intervention programs have been developed to help parents cope with their child's cancer. Despite some studies reporting a high level of evidence, it is unclear how these programs build on each other. Appraising models of change is critical to advance scientific knowledge and provide evidence-based interventions. This review aims to identify existing programs, explicitly formulate their underlying models, evaluate how they translate into concrete activities, as well as identify and discuss their development process. Eleven programs based on models of change from cognitive-behavioral, systemic and counselling theories were identified. Many models included a sound theoretical framework, targeted outcomes, as well as implementation strategies. In most cases, preliminary development studies were conducted, but details were rarely provided on how development stages informed the redesign of intervention programs. Acceptability and treatment fidelity were not available for one-third of the programs. Future reports should document the development and design redesign stages prior to conducting efficacy trials, as this step would provide crucial details to critically appraise programs.
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Adaptação Psicológica , Neoplasias/psicologia , Pais/psicologia , Desenvolvimento de Programas/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Estresse Psicológico/terapia , Criança , Terapia Cognitivo-Comportamental/métodos , Aconselhamento/métodos , Feminino , Humanos , Masculino , Angústia Psicológica , Estresse Psicológico/psicologiaRESUMO
OBJECTIVE: To compare in a multicenter randomized controlled trial the benefits in terms of anxiety regulation of a 15-session single-component group intervention (SGI) based on support with those of a 15-session multiple-component structured manualized group intervention (MGI) combining support with cognitive-behavioral and hypnosis components. METHODS: Patients with nonmetastatic breast cancer were randomly assigned at the beginning of the survivorship period to the SGI (n = 83) or MGI (n = 87). Anxiety regulation was assessed, before and after group interventions, through an anxiety regulation task designed to assess their ability to regulate anxiety psychologically (anxiety levels) and physiologically (heart rates). Questionnaires were used to assess psychological distress, everyday anxiety regulation, and fear of recurrence. Group allocation was computer generated and concealed till baseline completion. RESULTS: Compared with patients in the SGI group (n = 77), patients attending the MGI group (n = 82) showed significantly reduced anxiety after a self-relaxation exercise (P = .006) and after exposure to anxiety triggers (P = .013) and reduced heart rates at different time points throughout the task (P = .001 to P = .047). The MGI participants also reported better everyday anxiety regulation (P = .005), greater use of fear of recurrence-related coping strategies (P = .022), and greater reduction in fear of recurrence-related psychological distress (P = .017) compared with the SGI group. CONCLUSIONS: This study shows that an MGI combining support with cognitive-behavioral techniques and hypnosis is more effective than an SGI based only on support in improving anxiety regulation in patients with breast cancer.
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Ansiedade/prevenção & controle , Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Grupos de Autoajuda , Sobrevivência , Adaptação Psicológica , Adulto , Ansiedade/etiologia , Ansiedade/psicologia , Atitude Frente a Saúde , Neoplasias da Mama/complicações , Medo/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
Hypnosis is an ancient mind-body intervention that has regained interest with the surge of research in the last decade documenting its clinical validity. Yet, theoretical controversies and misconceptions prevail among theorists, clinicians, and the general public, impeding the understanding, acceptance, replication, and use of hypnosis. Providing adequate information, which dispels misconceptions and promotes more balanced views, is warranted to facilitate the implementation and adoption of hypnosis in clinical and research settings. This review re-examines the conceptualisation of hypnosis throughout history and the theoretical controversies surrounding it while highlighting their meeting points and clinical implications. Despite dichotomies, a broad agreement appears across theoretical approaches regarding hypnotic analgesia effects, key components, and vocabulary. Further, theories highlight key factors of hypnotic responding. For instance, social theories highlight social and contextual variables, whereas state theories highlight biopsychosocial mechanisms and individual factors. Based on theories, the terms hypnotherapy or clinical hypnosis are recommended to refer to the therapeutic use of hypnosis in psychotherapeutic and medical contexts, respectively. This review concludes with a model that integrates various theories and evidence and presents hypnosis as a complex multifaceted intervention encompassing multiple procedures, phenomena, and influencing factors. This review intends to deepen our understanding of hypnosis, and promote its more rapid adoption and adequate implementation in research and clinical contexts, in addition to steering research towards evidence-based hypnotic practice. The review can have important research and clinical implications by contributing to advancing knowledge regarding hypnotic procedures, phenomena, and influencing factors.
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Hipnose , Humanos , Hipnose/métodos , Dor , Manejo da Dor , Formação de Conceito , Hipnóticos e SedativosRESUMO
Context: One in four Canadians experiences chronic pain, yet insufficient services and restrictions surrounding prevailing treatments result in inadequate management and significant negative consequences for these individuals. Previous work indicates that hypnotic communication represents a promising complementary treatment; however, training protocols for healthcare professionals are underdeveloped and understudied. Aim: To evaluate the level of satisfaction for a training program on hypnotic communication in pain management clinics. Design: Qualitative study. Methods: Six health professionals who first completed the hypnotic communication training participated in 30 minutes virtual semi-structured interviews. These testimonials allowed them to elaborate on their user experience and potential areas for improvement. Thematic analysis using qualitative data management software NVIVO was conducted on the interview data. Results: Two themes emerged from the interviews. 1) Satisfaction: Participants expressed satisfaction on various structural aspects of the training, including the provided materials, atmosphere, training structure, presentation modalities, practical workshops, acquired knowledge, trainer quality, and training duration. 2) Areas for Improvement: Five main improvement suggestions were identified (providing more material; more practical workshops, more concrete and adapted; testimonials from former patients; follow-up training meeting; and continuing education). Implications for the Profession and/or Patient Care and Conclusion: The results improved the training program to help minimized inherent biases related to this technique, cut associated costs, and identify reasons that would explain its underutilization among medical professionals in Quebec. Our work highlights that healthcare professionals in chronic pain management clinics (eg, respiratory therapists, nurses) can incorporate this simple hypnotic communication technique into their usual care and contribute to the well-being of patients. Impact: This study aimed to address the lack of training protocols for healthcare professionals, that are underdeveloped and understudied. The main findings on participant' satisfaction and the areas of improvement for the training will help the refinement of the training to better suit healthcare professional's needs in hospitals and chronic pain facilities.
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Introduction: Approximately one-quarter of Canadians experience chronic pain, a debilitating condition often necessitating opioid use, which raises concerns regarding dependency and overdose risks. As an alternative, we developed the HYlaDO program (Hypnose de la Douleur, hypnosis of Pain in French), a novel self-hypnosis approach for chronic pain management. The development of this program followed the ORBIT model, a comprehensive framework for designing interventions encompassing several phases ranging from design to efficacy assessment. Methods: In the present work, we conducted a preliminary evaluation of the HYlaDO program with 21 participants (18 of the 21 patients were included in the analysis). The primary objective was to determine one session of the program's effectiveness in altering pain, anxiety and relaxation via pre-post analysis. The secondary goal was to examine the long-term effects across the same measures, in addition to the overall quality of life. Results: The results highlight the benefits of our approach, while participants reported short-term significant pain reduction, decreased anxiety, and increased relaxation. Additionally, preliminary trends suggest improvements in physical activity and quality of life metrics. Discussion: These positive outcomes highlight HYlaDO's potential as an alternative to opioid therapy for chronic pain. Encouraged by these results, we aim to extend our research to a broader and more diverse cohort, paving the way for comprehensive randomized controlled trials. This expansion will further validate HYlaDO's efficacy and its role in transforming chronic pain management.
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Background: Nearly a quarter of Canada's population suffers from chronic pain, a long-lasting medical condition marked by physical pain and psychological suffering. Opioids are the primary treatment for pain management in this condition; yet, this approach involves several undesirable side effects. In contrast to this established approach, non-pharmacological interventions, such as medical hypnosis, represent an efficient alternative for pain management in the context of chronic pain. HYlaDO is a self-hypnosis program designed to improve pain management for people with chronic pain. Purpose: This research aimed to evaluate the HYlaDO program based on the proof-of-concept level of the ORBIT model and investigated participants' subjective experience. Research design: Qualitative study. Study sample: Seventeen participants with chronic pain took part in this study. Data collection: We conducted individual semi-structured interviews with patients who had participated in HYlaDO to identify the three targets of desired change: pain, anxiety and autonomy in self-hypnosis practice. Results: Thematic analysis revealed that the practice of hetero-hypnosis and self-hypnosis decreased (i) pain and (ii) anxiety. Also, it (iii) indicated the development of an independent and beneficial self-hypnosis practice by having integrated the techniques taught. Conclusion: These results confirm that the established targets were reached and support further development, implementation and scaling up of this program. Consequently, we believe it is justified to move to the next step of program development.
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BACKGROUND AND PURPOSE: Hypnosis, a mind-body treatment dating back to early human history, has regained attention in the last decade, with research suggesting its effectiveness for varied physiological and psychological ailments such as distress, pain, and psychosomatic disorders. However, myths and misconceptions have prevailed among the general public and clinicians, hindering the adoption and acceptance of hypnosis. It is important to distinguish myths from facts and discern what is hypnosis and what is not to enhance the understanding, acceptance, and adoption of hypnotic interventions. METHODS: This narrative review traces the history of myths surrounding hypnosis in contrast to the evolution of hypnosis as a treatment modality. In addition to comparing hypnosis to other interventions with similar procedures and features, the review unravels misconceptions that have impeded the adoption and acceptance of hypnosis in clinical and research settings and presents evidence to demystify this intervention. RESULTS: This review examines the roots of myths while presenting historical facts and evidence that support hypnosis as a treatment modality and alleviate misconceptions depicting it as mystical. Further, the review distinguishes hypnotic and non-hypnotic interventions with overlapping procedures and phenomenological features to enhance our understanding of hypnotic techniques and phenomena. CONCLUSION: This review enhances the understanding of hypnosis in historical, clinical, and research contexts by disproving related myths and misconceptions to promote the adoption of hypnosis in clinical and research contexts. Further, this review highlights knowledge gaps requiring further investigations to steer research toward an evidence-based practice of hypnosis and optimise multimodal therapies embedding hypnosis.
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Hipnose , Humanos , Hipnose/métodos , Dor , Terapia CombinadaRESUMO
This systematic review aims to identify current protocols involving the use of hypnosis during the perinatal period and to examine its effects on mothers' well-being. Seven electronic databases were searched for articles published from 1960 to April 1, 2021, that assessed the effectiveness of hypnosis during the perinatal period. All published randomized, controlled trials and nonrandomized, controlled trials studies assessing the effectiveness of hypnosis used during the perinatal period with healthy adult women were included. The quality of the included studies was assessed using the Risk of Bias in Nonrandomized Studies of Interventions or the Revised Cochrane risk-of-bias tool for randomized trials. Article screening, methodological-quality assessment, and data extraction were performed by 2 independent reviewers. Twenty-one articles, corresponding to 16 studies met inclusion criteria. Apart from 2 studies, all included studies reported the benefits of implementing a hypnosis intervention during the perinatal period. However, methodological limitations relative to intervention implementation and assessment methods might have led to the observed variability in results across studies. Future studies should consider a more standardized methodology.
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Hipnose , Gravidez , Adulto , Feminino , Humanos , Hipnose/métodos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
One in four Canadians is affected by chronic pain, frequently treated with opioids, which present a risk of addiction and overdose. The development of non-pharmacological interventions is therefore crucial. In a pilot project, a self-hypnosis training program showed encouraging results in improving breast cancer patients' quality of life. Based on this program, we developed a new self-hypnosis program for chronic pain patients: HYlaDO (Hypnosis of pain in French, HYpnose de la DOuleur). To structure the process of adapting an existing program to a new context, we used the ORBIT model (Obesity-Related Behavioral Intervention Trials), which consists of four development phases. This study aimed to collect patients' opinions and recommendations, and to refine HYlaDO (ORBIT Phase Ib). Fifteen participants took part in individual semi-structured interviews about this program. Two analysts coded the verbatims, and a thematic categorization was performed. Six themes emerged: practice training, expected vs. perceived effects, chronic pain management, individual practice, satisfaction, and participants' recommendations. Improvements to be considered in this type of program were finally discussed.
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Dor Crônica , Hipnose , Humanos , Dor Crônica/terapia , Qualidade de Vida , Projetos Piloto , CanadáRESUMO
Introduction: Studies in pediatric oncology have shown that hypnosis effectively reduces patients' pain and distress during painful procedures. This remains underutilized in the healthcare system due to the staff cost and availability of hypnotherapists. To develop the use of hypnosis-derived communication, we aimed to train nurses to use hypnosis-derived communication while they perform painful procedures. Objectives: This study aimed to (1) develop a brief training in hypnosis-derived communication for pediatric nurses named Rel@x, (2) pretest the training with experienced pediatric oncology nurses, and (3) refine the training based on nurses' suggestions. Methods: The Rel@x training consists of two 4-h sessions: one related to relational aspects and another one presenting one of two selected hypnotic communication techniques ("pleasant place" or "magic glove"). Rel@x makes use of manuals, cue card reminders, visual aids, videos, and an e-learning platform. To refine Rel@x, a complete training cycle was conducted with seven female pediatric oncology nurses. A mixed method study with an evaluation questionnaire and a post-training focus group interview was conducted. Results: Quantitative data showed that nurses overall positively rated the training program: relevance and acceptability (median average of 5.4/6); use of hypnotic communication (median average of 5.2/6); expected effects (median average of 5.4/6); program implementation (5.6/6). Two general themes emerged from the qualitative data: perceptions of hypnotic communication and the evaluation of the Rel@x training program. Based on nurses' suggestions, Rel@x was refined by adding more practical components, more time for practice, more time between the two sessions and additional tools (cue card reminders, keywords, virtual e-learning recap module). Conclusion and clinical implications: The use of hypnosis-derived communication during painful procedures and the Rel@x training were viewed favorably amongst pediatric nurses. Rel@x offers a complete training in hypnosis-derived communication for pediatric nurses. This training fosters the optimal use of hypnosis-derived communication during care and may significantly reduce children's procedural pain and distress.
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BACKGROUND: Maintaining quality of life is a primary goal of palliative care (PC). Complementary interventions can help meet the needs of patients at the end of life. OBJECTIVES: This meta-analysis aims to (1) evaluate the feasibility, acceptability and fidelity of music and hypnosis interventions designed for patients in PC and (2) evaluate the impact of these interventions on pain, anxiety, sleep and well-being. METHODS: Relevant studies were sourced from major databases. We selected both randomised controlled trials (RCTs) and studies relying on pre-post design with details of the intervention(s). RESULTS: Four RCT and seven non-randomised pre-post studies met the inclusion criteria. Overall, the feasibility and acceptability of the interventions reached an adequate level of satisfaction. However, only three studies reported using a written protocol. The meta-analysis of RCT indicated a significant decrease in pain with an effect size of -0.42, p=0.003. The small number of RCT studies did not allow us to quantify the effects for other variables. Analyses of data from pre-post designs indicated a favourable outcome for pain, anxiety, sleep and well-being. CONCLUSION: Despite the limited number of studies included in our meta-analysis, hypnosis and music intervention in the context of PC shows promising results in terms of feasibility and acceptability, as well as improvements on pain, anxiety, sleep and well-being. The available studies are insufficient to compare the efficacy across interventions and assess the potential benefits of their combinations. These results underscore the importance of further research on well-described complementary interventions relying on hypnosis and music. PROSPERO REGISTRATION NUMBER: CRD-42021236610.
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Background: The palliative care people present needs that can be partially met by complementary intervention. Approaches based on the use of hypnosis and music are increasingly being studied and have shown potential benefits on pain, anxiety, and wellbeing for many populations including those in palliative care. Objective: This study aims to present the initial process of creating and refining a hypnosis and music intervention program intended for persons in palliative care, with a panel of experts of diverse relevant backgrounds. It also aims to evaluate its feasibility, preliminary acceptability, and content. Methods: To achieve the objectives, we followed ORBIT recommendations for the development and redesign of behavioral interventions (phase I a-b). Based on a meta-analysis, reference interventions were identified and then adapted to the target population. Twenty-two experts from different backgrounds were consulted to obtain their evaluation on the acceptability, feasibility, and content of the interventions. Result: The various components of the program were deemed appropriate or very appropriate by over 80% of the experts. However, possible risks were raised related to some uncertainty about the reactions of individuals to the intervention. Several experts (32%) indicated potential adverse effects consisting of negative emotional experiences during the sessions. Modifications were proposed specifically to reduce or mitigate this risk. Over 90% of the experts considered that the revised program provides a safer and more appropriate intervention for palliative care persons. Conclusion: A mixed intervention program with hypnosis and music has been developed and attained a high level of consensus by the experts. The proposed intervention is ready to be assessed for clinical efficacy in a pilot study (ORBIT Phase II).
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Despite novel drugs and autologous HCT, MM remains incurable, with short survival in patients with poor biological characteristics. Allo HCT may be curative in some patients but is hampered by high rates of toxicity and relapse. We hypothesized that bortezomib (BTZ), with its anti-myeloma and immunologic properties, could improve PFS and cGVHD after allo HCT in newly diagnosed MM patients. In this prospective phase II study, we included 39 young (≤50 years) and high-risk patients who received a tandem auto-allo HCT followed by BTZ. Patients had prospective minimal residual disease (MRD) evaluations using Next-Generation Flow cytometry prior to allo HCT, prior BTZ and every 3 months for 2 years. With a median follow-up of 48 months, we report PFS and OS at 5 years of 41% and 80%, with a non-relapse mortality of 12%. Incidences of grade II-IV aGVHD at 12 months and moderate/severe cGVHD at 2 years were 26% and 57%. In a multivariate analysis model including cytogenetics, ISS and MRD status, MRD positivity prior to allo HCT (HR 3.75, p = 0.037), prior BTZ (HR 11.3, p = 0.018) and 3 months post-BTZ initiation (HR 9.7, p = 0.001) was highly predictive of progression. Peritransplant MRD assessment thus strongly predicts disease progression.
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Transplante de Células-Tronco Hematopoéticas , Mieloma Múltiplo , Receptores de Antígenos Quiméricos , Aloenxertos , Bortezomib/farmacologia , Bortezomib/uso terapêutico , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Pessoa de Meia-Idade , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/terapia , Recidiva Local de Neoplasia , Neoplasia Residual/diagnóstico , Estudos Prospectivos , Resultado do TratamentoRESUMO
OBJECTIVES: To explore the effects of a hypnotic communication (HC) training for paediatric nurses in decreasing patients' pain and distress during venipunctures. METHODS: A 4-day theoretical and practical HC training was offered to five paediatric oncology nurses. The effects of HC were tested with 22 young cancer patients (13 girls, 9 boys, 10 ± 4 years) over four time points, with 88 encounters being video-recorded and coded in stable professional-patient dyads. Patients' pain and distress were rated by patients and parents with visual analogue scales and coded from recordings using the Faces, Legs, Activity, Cry and Consolability (FLACC) scale. RESULTS: We observed a significant decrease in pre-post distress reported by parents (d = 0.45, p = 0.046). Two out of five nurses with higher skills acquisition had larger reduction in patients' self-reported pain (d = 1.03, p = 0.028), parents perceived pain (d = 1.09, p = 0.042), distress (d = 1.05, p = 0.043) as well as observed pain (d = 1.22, p = 0.025). Favourable results on pain and distress did not maintain at follow-up. CONCLUSION AND CLINICAL IMPLICATIONS: Training nurses in HC may translate into improved pain and distress in patients, both self-rated and observed provided that skills are used in practice. HC training is a promising non-pharmacological intervention to address pain in paediatrics.