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1.
Dermatol Online J ; 26(3)2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-32609440

RESUMO

Efforts to increase patient comfort by minimizing pain and anxiety have been shown to improve clinical outcomes, reduce pain thresholds, decrease analgesic requirements and complication risk, strengthen the physician-patient relationship, and increase overall patient satisfaction. Patients also have a strong preference for patient-centered communication and educational discussion with physicians. In recent years, the increasing emphasis on patient experience scores as a metric for quality care has had significant implications for physician practice and has reinforced attempts to provide more patient-centered care. Though different pharmacologic agents and techniques have been extensively reviewed in the dermatologic literature, there have been few studies of non-pharmacologic strategies for improving patient-centered care. This evidence-based review describes alternative techniques that have been suggested for use in dermatologic surgery. Mechanoanesthesia, cold therapy, verbal and audiovisual distraction, music, optimal needle insertion methods, hypnosis and guided-imagery, perioperative communication, and educational strategies have been reported to improve the patient experience in dermatologic surgery. These interventions are often cost-effective and easy to implement, avoid medication side effects, and serve as adjunct approaches to enhance patient comfort. This review examines the corresponding evidence for these nonpharmacologic strategies to provide a clinical resource for the dermatologic surgeon seeking to optimize the patient experience.


Assuntos
Ansiedade/prevenção & controle , Procedimentos Cirúrgicos Dermatológicos/psicologia , Humanos , Hipnose , Imagens, Psicoterapia , Terapias Mente-Corpo , Filmes Cinematográficos , Música , Dor/prevenção & controle , Educação de Pacientes como Assunto , Satisfação do Paciente
2.
Rev Med Suisse ; 16(700): 1354-1357, 2020 Jul 15.
Artigo em Francês | MEDLINE | ID: mdl-32672013

RESUMO

Perioperative pain is a burden that often is insufficiently addressed. Considering the limitations of pharmacological approaches in this context, hypnosis is a promising technique as part of a multimodal management plan for acute surgical pain. There is a growing interest for hypnosis from patients and the medical community. It can be practiced in the pre- or post-operative setting for acute symptom management (pain and anxiety), as well as per-operatively as a substitute to anesthetic care, or as a complement (hypnosedation). This article aims to clarify these different uses of hypnosis for perioperative analgesia, as well as the benefits that can be expected.


Assuntos
Analgésicos , Hipnose , Ansiedade , Humanos , Dor , Manejo da Dor , Medição da Dor
3.
Ann Otol Rhinol Laryngol ; 129(10): 1030-1039, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32449369

RESUMO

OBJECTIVE: Laryngopharyngeal reflux (LPR) and associated symptoms can be refractory to treatment with acid suppressing medication. We investigated the role and evidence for complementary and alternative medicine (CAM) for LPR in this systematic review. REVIEW METHODS: Complementary and alternative treatment was defined in this systematic review as any non-acid suppressing medication, treatment, or therapy. A literature search was performed by two authors in consultation with a medical librarian using controlled vocabulary for "complementary and alternative medicine" and "laryngopharyngeal reflux" in the databases PubMed and EMBASE, with supplemental searches with Google Scholar. RESULTS: Twenty articles were included in this review for the modalities: alginate, diet modification, prokinetics, respiratory retraining, voice therapy, rikkunshito (RKT), hypnotherapy, and sleep positioning. The studies were analyzed for bias based on the Cochrane criteria for RCTs and Methodological Index for non-RCT (MINORS) criteria for all other studies. For each modality a level of evidence was assigned to the current body of evidence using the GRADE approach. CONCLUSION: There is mixed evidence with a high degree of bias and heterogeneity between studies for the modalities presented in the paper. Based on this review, an anti-reflux diet is recommended for all patients and there is some low-quality evidence to support alkaline water. For patients with predominant vocal symptoms there is evidence that supports voice therapy. There is insufficient evidence to recommend prokinetics at this time. For patients with predominant globus symptoms, alginate, RKT, and relaxation strategies may be used in conjunction with acid suppressing medications for symptom relief.


Assuntos
Alginatos/uso terapêutico , Exercícios Respiratórios , Terapias Complementares , Dietoterapia , Medicamentos de Ervas Chinesas/uso terapêutico , Hipnose , Refluxo Laringofaríngeo/terapia , Treinamento da Voz , Viés , Humanos , Postura , Sono
4.
PLoS One ; 15(5): e0230704, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32357152

RESUMO

BACKGROUND: Cortisol has been used to capture psychophysiological stress during childbirth and postpartum wellbeing. We explored the effect of a brief antenatal training course in self-hypnosis on salivary cortisol during childbirth and 6 weeks postpartum. METHODS: In a randomized, controlled trial conducted at Aarhus University Hospital Skejby Denmark during the period January 2010 until October 2010, a total of 349 healthy nulliparous women were included. They were randomly allocated to a hypnosis group (n = 136) receiving three one-hour lessons in self-hypnosis with additional audio-recordings, a relaxation group (n = 134) receiving three one-hour lessons in various relaxation methods with audio-recordings for additional training, and a usual care group (n = 79) receiving ordinary antenatal care only. Salivary cortisol samples were collected during childbirth (at the beginning of the pushing state, 30 minutes, and 2 hours after childbirth), and 6 weeks postpartum (at wake up, 30 minutes after wake up, and evening). Cortisol concentrations were compared using a linear mixed-effects model. Correlations between cortisol concentrations and length of birth, experienced pain and calmness during birth were examined by a Spearman rank correlation test. FINDINGS: During childbirth, week correlations were found between cortisol concentrations 30 minutes after childbirth and length of birth. In the beginning of the pushing state and 2 hours after childbirth, we found a tendency towards higher cortisol concentrations in the hypnosis group compared to the other two groups (hypnosis versus relaxation p = 0.02 and 0.03, hypnosis versus usual care p = 0.08 and 0.05). No differences were observed in cortisol concentrations between the groups 30 minutes after childbirth (hypnosis versus relaxation p = 0.08, hypnosis versus usual care 0.10) or 6 weeks postpartum (hypnosis versus relaxation: p = 0.85, 0.51, and 0.68, hypnosis versus usual care: p = 0.85, 0.93, and 0.96). CONCLUSION: Antenatal hypnosis training may increase the release of cortisol during childbirth with no long-term consequences. Further research is needed to help interpret these findings.


Assuntos
Hipnose/métodos , Dor do Parto/terapia , Parto/metabolismo , Terapia de Relaxamento , Adulto , Analgesia Obstétrica/efeitos adversos , Parto Obstétrico , Feminino , Humanos , Hidrocortisona/metabolismo , Dor do Parto/metabolismo , Dor do Parto/fisiopatologia , Trabalho de Parto/fisiologia , Parto/fisiologia , Satisfação do Paciente , Período Pós-Parto/metabolismo , Período Pós-Parto/fisiologia , Gravidez , Cuidado Pré-Natal , Saliva/metabolismo
5.
PLoS One ; 15(4): e0230853, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32271781

RESUMO

Variation of information in the firing rate of neural population, as reflected in different frequency bands of electroencephalographic (EEG) time series, provides direct evidence for change in neural responses of the brain to hypnotic suggestibility. However, realization of an effective biomarker for spiking behaviour of neural population proves to be an elusive subject matter with its impact evident in highly contrasting results in the literature. In this article, we took an information-theoretic stance on analysis of the EEG time series of the brain activity during hypnotic suggestions, thereby capturing the variability in pattern of brain neural activity in terms of its information content. For this purpose, we utilized differential entropy (DE, i.e., the average information content in a continuous time series) of theta, alpha, and beta frequency bands of fourteen-channel EEG time series recordings that pertain to the brain neural responses of twelve carefully selected high and low hypnotically suggestible individuals. Our results show that the higher hypnotic suggestibility is associated with a significantly lower variability in information content of theta, alpha, and beta frequencies. Moreover, they indicate that such a lower variability is accompanied by a significantly higher functional connectivity (FC, a measure of spatiotemporal synchronization) in the parietal and the parieto-occipital regions in the case of theta and alpha frequency bands and a non-significantly lower FC in the central region's beta frequency band. Our results contribute to the field in two ways. First, they identify the applicability of DE as a unifying measure to reproduce the similar observations that are separately reported through adaptation of different hypnotic biomarkers in the literature. Second, they extend these previous findings that were based on neutral hypnosis (i.e., a hypnotic procedure that involves no specific suggestions other than those for becoming hypnotized) to the case of hypnotic suggestions, thereby identifying their presence as a potential signature of hypnotic experience.


Assuntos
Encéfalo/fisiologia , Eletroencefalografia , Hipnose , Processamento de Sinais Assistido por Computador , Adulto , Entropia , Feminino , Humanos , Masculino
6.
MMW Fortschr Med ; 162(2): 31, 2020 02.
Artigo em Alemão | MEDLINE | ID: mdl-32016719
8.
Am J Clin Hypn ; 62(3): 171, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31928522

Assuntos
Hipnose , Música , Biópsia , Humanos
9.
Int Heart J ; 61(1): 60-66, 2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-31956143

RESUMO

Transcatheter aortic valve implantation (TAVI) using a transfemoral approach under local anesthesia with conscious sedation (LACS) is becoming an increasingly common TAVI strategy. However, patients who are awake during the TAVI procedure can experience stress, anxiety, and pain, even when LACS is used. Clinical hypnotherapy is an anxiolytic intervention that can be beneficial for patients undergoing invasive surgery. This study aimed to assess the perioperative outcomes of adjunctive hypnotherapy undergoing transfemoral TAVI with LACS.Consecutive patients (n = 143) with symptomatic severe aortic stenosis who underwent transfemoral TAVI with LACS only (n = 107) or with LACS and hypnotherapy (n = 36) between January 2015 and April 2016 were retrospectively included in the study. The clinical outcomes were compared between the two groups. The LACS with hypnotherapy group had a significantly shorter length of stay in the intensive care unit (ICU; LACS only versus LACS with hypnotherapy: 4.0 (4.0-5.5) days versus 3.0 (3.0-5.0) days, P < 0.01). Moreover, the use of anesthetics (propofol and remifentanil) and norepinephrine was significantly lower in the LACS with hypnotherapy group (e.g., for propofol, LACS only versus LACS with hypnotherapy: 96.4 ± 104.7 mg versus 15.0 ± 31.8 mg, P < 0.001). The multiple regression analysis showed that being male, hypnotherapy, and the composite complication score were independently associated with the length of stay in the ICU.The adjunctive hypnotherapy on LACS among transfemoral TAVI patients may facilitate perioperative management. However, a prospective randomized study is necessary to confirm the efficacy of hypnotherapy among TAVI patients.


Assuntos
Estenose da Valva Aórtica/cirurgia , Sedação Consciente/métodos , Hipnose/métodos , Substituição da Valva Aórtica Transcateter/métodos , Idoso , Idoso de 80 Anos ou mais , Anestesia Local , Feminino , Humanos , Masculino , Norepinefrina/administração & dosagem , Período Perioperatório , Complicações Pós-Operatórias , Propofol/administração & dosagem , Estudos Prospectivos , Análise de Regressão , Remifentanil/administração & dosagem , Estudos Retrospectivos , Resultado do Tratamento
10.
Zhongguo Zhen Jiu ; 40(1): 37-40, 2020 Jan 12.
Artigo em Chinês | MEDLINE | ID: mdl-31930897

RESUMO

OBJECTIVE: To observe the effect of hypnosis on pain and fear in the healthy acupuncture subjects. METHODS: A total of 52 healthy subjects were randomized into an observation group and a control group, 26 cases in each one. In the observation group, the subjects received the first-time acupuncture under hypnosis. After wakened up and 30 min later, the subjects received the second-time acupuncture under clear consciousness condition. In the control group, the subjects received the first-time acupuncture under clear consciousness condition, 30 min later, received the second-time acupuncture under hypnosis. Likert scale was adopted to investigate the relaxation, pain sensation and the willingness in the subjects at the normal condition before acupuncture, after the first-time and the second-time acupuncture of the two groups separately. Using Boeran electronic blood pressure monitor, the pulse and blood pressure were measured in the subjects at the normal condition and after the first-time acupuncture of the two groups. RESULTS: Compared with the normal condition, the relaxation degree was increased, the pain sensation decreased and the willingness enhanced after acupuncture either after hypnosis or after wakened-up in the observation group (P<0.001). The difference was not significant in each index between acupuncture after hypnosis and acupuncture after wakened-up in the observation group (P>0.05). In the control group, compared with the normal condition, after the first-time acupuncture (acupuncture in clear consciousness), the relaxation degree was decreased, pain was alleviated and the willingness was increased when acupuncture was exerted once again (P<0.001, P<0.05); compared with the normal condition, after the second-time acupuncture (acupuncture after hypnosis), pain was alleviated and the willingness increased (P<0.001), but the difference in relaxation was not significant (P>0.05); compared with the first-time acupuncture, the relaxation degree was increased, pain alleviated and willingness enhanced after the second-time acupuncture (acupuncture after hypnosis) (P<0.05, P<0.001). Compared with the control group after the first-time acupuncture (acupuncture in clear consciousness), the relaxation degree and willingness were increased and the pain sensation was reduced in the observation group during acupuncture either after hypnosis or after wakened-up (P<0.001). Compared with the control group the second-time acupuncture (during acupuncture after hypnosis), the relaxation degree was increased and pain sensation reduced in the observation group during acupuncture either after hypnosis or after wakened-up (P<0.01, P<0.001), but the difference was not significant in willingness (P>0.05). In the control group, compared with the normal condition, the pulse was faster, both the diastolic pressure and systolic pressure were increased after the first-time acupuncture (P<0.05, P<0.01). In the observation group, compared with the normal condition, the pulse was getting slow and blood pressure was reduced after the first-time (acupuncture under hypnosis, P<0.01). Compared with the first-time acupuncture in the control group, pulse was getting slow and blood pressure was reduced in the observation group after acupuncture under hypnosis (P<0.001). CONCLUSION: During acupuncture, with hypnosis combined, the fear alleviates, pain reduces and the willingness of acupuncture increases in the subjects.


Assuntos
Terapia por Acupuntura , Medo , Hipnose , Manejo da Dor , Humanos , Dor
11.
J Altern Complement Med ; 26(2): 107-112, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31904997

RESUMO

Introduction: Clinical hypnosis for pain management cultivates specific skills to enhance general self-regulation and address pain. Hypnosis is well suited to integrative medicine settings; however, questions persist about its feasibility. This article describes a financially viable hypnosis practice model implemented in an integrative medicine clinic, providing initial feasibility data about rates of referral, participation, reimbursement, and provider retention. The specific processes required to establish and implement hypnosis services were detailed, including instruction in billing, reimbursement data, and a training model to enhance reach of services. Materials and methods: Insurer reimbursement data and operational costs were examined from three hypnosis groups conducted between September 2017 and March 2018. Furthermore, information on referral patterns and enrollment in treatment was collected from program initiation in September 2017 to January 2019. Provider retention in training with the expansion of supervision in the program's second year was also examined. Results: Of 258 individuals referred to hypnosis, 124 (48%) enrolled in group treatment. Analysis of insurer reimbursement over a subset of enrollees from three completed groups (N = 26) indicated an average collection of $95.85 per patient per session, equating to $706.86 per patient for the eight-session treatment. This extrapolates to $4,926.82 in total per seven-person group for the entirety of the eight-session treatment. After an annual training workshop, provider retention significantly increased (to 81% of eligible trained providers) with the initiation of twice-monthly clinical supervision focusing on transitioning from training to practice. Conclusion: This analysis indicates that a training- and practice-based research model of clinical hypnosis is feasible and financially sustainable in an integrative medicine setting.


Assuntos
Dor Crônica/terapia , Hipnose , Instituições de Assistência Ambulatorial , Humanos , Medicina Integrativa , Encaminhamento e Consulta , Autogestão
12.
J Clin Nurs ; 29(9-10): 1488-1498, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31989720

RESUMO

AIMS AND OBJECTIVES: To describe what is known from the existing literature on nonpharmacological interventions targeting pain in patients admitted to the ICU. BACKGROUND: Patients receiving intensive care nursing are exposed to a wide range of pain provoking tissue damage, diseases, surgery and other medical procedures in addition to the pain caused by nursing care procedures. The present shift to light sedation to improve patient outcomes and comfort underscores the need for effective pain management. Opioids are the mainstay for treating pain in the ICUs, whereas nonpharmacological treatments are understudied and possibly under-used. METHOD: A scoping review was undertaken using five of the six steps in the Arksey and O´Malley framework: (a) identification of the research question, (b) identification of relevant studies, (c) study selection, (d) charting the data and (e) collating, summarising and reporting the results. CINAHL, MEDLINE, PubMed, BMJ Best Practice, British Nursing Index and AMED databases were searched using relevant keywords to capture extensive evidence. Data were analysed using the six-step criteria for scoping reviews suggested by Arksey and O´Malley for data extraction. To ensure quality and transparency, we enclosed the relevant Equator checklist PRISMA. RESULTS: Our search yielded 10,985 articles of which 12 studies were included. Tools for pain assessments were VAS, NRS, ESAS and BPS. Interventions explored were hypnosis, simple massage, distraction, relaxation, spiritual care, harp music, music therapy, listening to natural sounds, passive exercise, acupuncture, ice packs and emotional support. Reduction in pain intensity was conferred for hypnosis, acupuncture and natural sounds. CONCLUSION: The findings support further investigations of acupuncture, hypnosis and listening to natural sounds. RELEVANCE TO CLINICAL PRACTICE: The main finding suggests the use of comprehensive multimodal interventions to investigate the effects of nonpharmacological treatment protocols on pain intensity, pain proportion and the impact on opioid consumption and sedation requirements.


Assuntos
Unidades de Terapia Intensiva/organização & administração , Manejo da Dor/métodos , Humanos , Hipnose/métodos , Massagem/métodos , Musicoterapia/métodos , Recursos Humanos de Enfermagem no Hospital/organização & administração , Recursos Humanos de Enfermagem no Hospital/psicologia , Manejo da Dor/psicologia , Conforto do Paciente/métodos , Modalidades de Fisioterapia
14.
Am J Obstet Gynecol ; 222(2): 159.e1-159.e16, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31449805

RESUMO

BACKGROUND: Urgency urinary incontinence afflicts many adults, and most commonly affects women. Medications, a standard treatment, may be poorly tolerated, with poor adherence. This warrants investigation of alternative interventions. Mind-body therapies such as hypnotherapy may offer additional treatment options for individuals with urgency urinary incontinence. OBJECTIVE: To evaluate hypnotherapy's efficacy compared to medications in treating women with urgency urinary incontinence. MATERIALS AND METHODS: This investigator-masked, noninferiority trial compared hypnotherapy to medications at an academic center in the southwestern United States, and randomized women with non-neurogenic urgency urinary incontinence to weekly hypnotherapy sessions for 2 months (and continued self-hypnosis thereafter) or to medication and weekly counseling for 2 months (and medication alone thereafter). The primary outcome was the between-group comparison of percent change in urgency incontinence on a 3-day bladder diary at 2 months. Important secondary outcomes were between-group comparisons of percent change in urgency incontinence at 6 and 12 months. Outcomes were analyzed based on noninferiority margins of 5% for between group differences (P < 0.025) (that is, for between group difference in percentage change in urgency incontinence, if the lower bound of the 95% confidence interval was greater than -5%, noninferiority would be proved). RESULTS: A total of 152 women were randomized to treatment between April 2013 and October 2016. Of these women, 142 (70 hypnotherapy, 72 medications) had 3-day diary information at 2 months and were included in the primary outcome analysis. Secondary outcomes were analyzed for women with diary data at the 6-month and then 12-month time points (138 women [67 hypnotherapy, 71 medications] at 6 months, 140 women [69 hypnotherapy, 71 medications] at 12 months. There were no differences between groups' urgency incontinence episodes at baseline: median (quartile 1, quartile 3) for hypnotherapy was 8 (4, 14) and medication was 7 (4, 11) (P = .165). For the primary outcome, although both interventions showed improvement, hypnotherapy did not prove noninferior to medication at 2 months. Hypnotherapy's median percent improvement was 73.0% (95% confidence interval, 60.0-88˖9%), whereas medication's improvement was 88.6% (95% confidence interval, 78.6-100.0%). The median difference in percent change between groups was 0% (95% confidence interval, -16.7% to 0.0%); because the lower margin of the confidence interval did not meet the predetermined noninferiority margin of greater than -5%, hypnotherapy did not prove noninferior to medication. In contrast, hypnotherapy was noninferior to medication for the secondary outcomes at 6 months (hypnotherapy, 85.7% improvement, 95% confidence interval, 75.0-100%; medications, 83.3% improvement, 95% confidence interval, 64.7-100%; median difference in percent change between groups of 0%, 95% confidence interval, 0.0-6.7%) and 12 months (hypnotherapy, 85.7% improvement, 95% confidence interval, 66.7-94.4%; medications, 80% improvement, 95% confidence interval, 54.5-100%; median difference in percent change between groups of 0%, 95% confidence interval, -4.2% to -9.5%). CONCLUSION: Both hypnotherapy and medications were associated with substantially improved urgency urinary incontinence at all follow-up. The study did not prove the noninferiority of hypnotherapy compared to medications at 2 months, the study's primary outcome. Hypnotherapy proved noninferior to medications at longer-term follow-up of 6 and 12 months. Hypnotherapy is a promising, alternative treatment for women with UUI.


Assuntos
Hipnose/métodos , Antagonistas Muscarínicos/uso terapêutico , Incontinência Urinária de Urgência/terapia , Adulto , Idoso , Feminino , Humanos , Ácidos Mandélicos/uso terapêutico , Pessoa de Meia-Idade , Método Simples-Cego , Tartarato de Tolterodina/uso terapêutico , Resultado do Tratamento
15.
Ann Otol Rhinol Laryngol ; 129(3): 256-264, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31658815

RESUMO

BACKGROUND: Surgery with hypnosis avoids the use of general anesthesia (GA). It also shortens hospitalization and promotes outpatient surgery. The objective of this study has been to assess the satisfaction of operated patients. No previous study has focused on patient satisfaction in a prospective design. METHODS: In this prospective, non-randomized, observational study, all patients operated with hypnosis between 2009 and 2017 in the Ear, Nose, and Throat department of a tertiary care hospital were selected. All patients were asked to fill a questionnaire based on a previously validated questionnaire incremented with complementary questions. Questionnaires were completed immediately after surgery for 31 patients and after 6 months for 20 patients. Global Satisfaction Index (GSI) was self-assessed on a scale ranging from 1 to 10. Patients were asked; whether they felt comfortable during the operation, whether hypnosis helped them, whether the experience matched their expectations, whether they would revisit or recommend it to someone else and whether they considered to have been sufficiently informed before the procedure. The data was analyzed using a linear regression model with P < .05 considered as statistically significant. RESULTS: During the inclusion period, no patient required conversion to GA. A total of 48 questionnaires were evaluated. The median of the GSI was 8/10. GSI significantly correlated with patient comfort (P < 0.0001) and quality of preoperative information (P = .002). The percentage of patients who found hypnosis helpful correlated with the duration of surgery (P = .04). The probability for a patient to consider hypnosis as an experience matching their expectation increased with surgical team experience OR 0.55 (0.3-0.9). CONCLUSION: This study reveals that patients' global satisfaction after hypnosis is high. This is significantly related to the quality of preoperative information and to the experience of the surgical team. It also suggests that patients are more likely to benefit from hypnosis if the surgery is longer.


Assuntos
Hipnose , Procedimentos Cirúrgicos Otorrinolaringológicos , Satisfação do Paciente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anestésicos Locais/administração & dosagem , Feminino , Humanos , Lidocaína/administração & dosagem , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Educação de Pacientes como Assunto , Estudos Prospectivos , Autoavaliação , Inquéritos e Questionários , Adulto Jovem
16.
Br J Anaesth ; 124(3): 292-298, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31862159

RESUMO

BACKGROUND: Clinicians traditionally warn patients of pain before peripheral i.v. cannulation (PIVC). However, using words related to pain or undesirable experiences can result in greater pain and anxiety. The use of positive words can improve pain perception and subjective patient experience. We aimed to compare the effects of three types of communication, including hypnotic communication, on pain, comfort, and anxiety in patients during PIVC. METHODS: The Effect of Language and Confusion on Pain During Peripheral Intravenous Catheterization (KTHYPE) trial is a randomised, parallel, single-blind, multicentre study of patients undergoing PIVC on the dorsal face of the hand before surgery. Patients from three hospitals were randomly allocated to one of three groups: PIVC performed with a hypnosis technique (hypnosis group), negative connotation (nocebo group), and neutral connotation (neutral group). The primary outcome measure was the occurrence of pain measured with a 0-10 numerical rating scale just after PIVC. RESULTS: Of the 272 subjects analysed (hypnosis, n=89; nocebo, n=92; neutral, n=91), pain after PIVC was lower in the hypnosis group (mean [standard deviation]; range) (1.5 [1.9]; 0-5) compared with the neutral (3.5 [2.3]; 0-9; P<0.0001) and nocebo groups (3.8 [2.5]; 0-10; P<0.0001). Whilst anxiety was higher and comfort lower before PIVC in the hypnosis group, anxiety decreased and comfort perception increased after PIVC when hypnosis was used. CONCLUSIONS: This is one of the first well-designed RCTs showing a significant benefit of a hypnosis technique during a routine procedure, such as PIVC. The results could facilitate implementation of hypnosis in daily clinical care. CLINICAL TRIAL REGISTRATION: NCT02662322.


Assuntos
Ansiedade/prevenção & controle , Cateterismo Periférico/efeitos adversos , Comunicação , Hipnose/métodos , Dor/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/etiologia , Ansiedade/psicologia , Cateterismo Periférico/métodos , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Dor/psicologia , Medição da Dor/métodos , Percepção da Dor , Método Simples-Cego , Adulto Jovem
17.
Am J Clin Hypn ; 62(1-2): 168-170, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31265371

Assuntos
Hipnose , Humanos
18.
Am J Clin Hypn ; 62(1-2): 166-167, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31265375

Assuntos
Ego , Hipnose , Humanos , Psicoterapia
19.
Am J Clin Hypn ; 62(1-2): 12-30, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31265365

RESUMO

To build bridges between hypnosis and contemporary psychoanalysis, this article addresses how hypnosis, when used in psychotherapy, facilitates curative action through its relational essence. The author's extensive experience with hypnosis, psychotherapy, and psychoanalysis orient the narrative toward the unconscious patient-therapist interaction, with particular attention paid to the ethics of the inherent hypnotic seduction. Whether used primarily in relief-oriented ways or geared toward more transformative therapeutic aims, powerful unconscious factors are in play for both patient and therapist and are explicated to illustrate the interactive and frequently unformulated, intersubjective factors that facilitate effective, psychotherapeutic hypnosis. Consequently, therapists attuned to such intersubjective dynamics can make use of their own internal mental activities to understand a patient's current state of mind and level of developmental functioning, and thereby subsequently formulate mutative interventions. For instance, because hypnotizability reflects the ability to play in imaginative space, the regression promoted in hypnotherapy may activate both an illusion of omnipotence and its optimal disillusionment through the relational context. This requires going beyond more traditional, procedural ways of bifurcating hypnotic interventions as being either direct or indirect and instead further distinguish hypnotic interventions in accordance with their maternal and paternal relational dimensions. Arguably, then, the skillful hypnotherapist needs to maintain a coupling interplay between the maternal, maximally receptive and the paternal, more active modes of functioning within hypnotic play space.


Assuntos
Hipnose , Teoria Psicanalítica , Humanos , Hipnose/ética , Imaginação , Relações Profissional-Paciente/ética , Psicanálise , Aliança Terapêutica , Inconsciente Psicológico
20.
Am J Clin Hypn ; 62(1-2): 1-11, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31265366

RESUMO

In this guest editorial, the authors introduce a special issue of the American Journal of Clinical Hypnosis that focuses on relational factors of hypnosis in psychotherapy. The authors have invited a number of esteemed colleagues to comment on aspects of the therapeutic relationship, and how it informs and influences the processes, techniques, and outcomes of hypnosis and therapy. In addition to summarizing each of these articles, this article analyzes the major relational themes that present across the articles.


Assuntos
Hipnose , Humanos , Aliança Terapêutica
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