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1.
Nat Commun ; 11(1): 4853, 2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32978377

RESUMO

In hypnotic responding, expectancies arising from imaginative suggestion drive striking experiential changes (e.g., hallucinations) - which are experienced as involuntary - according to a normally distributed and stable trait ability (hypnotisability). Such experiences can be triggered by implicit suggestion and occur outside the hypnotic context. In large sample studies (of 156, 404 and 353 participants), we report substantial relationships between hypnotisability and experimental measures of experiential change in mirror-sensory synaesthesia and the rubber hand illusion comparable to relationships between hypnotisability and individual hypnosis scale items. The control of phenomenology to meet expectancies arising from perceived task requirements can account for experiential change in psychological experiments.


Assuntos
Mãos , Hipnose/métodos , Ilusões/fisiologia , Manejo da Dor/métodos , Sinestesia/terapia , Adolescente , Adulto , Feminino , Humanos , Imaginação , Masculino , Pessoa de Meia-Idade , Dor , Sugestão , Adulto Jovem
2.
Lancet Gastroenterol Hepatol ; 5(10): 890-899, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32679040

RESUMO

BACKGROUND: Functional gastrointestinal disorders are common and costly to the health-care system. Most specialist care is provided by a gastroenterologist, but only a minority of patients have improvement in symptoms. Although they have proven to be effective, psychological, behavioural, and dietary therapies are not provided routinely. We aimed to compare the outcome of gastroenterologist-only standard care with multidisciplinary care. METHODS: In an open-label, single-centre, pragmatic trial, consecutive new referrals of eligible patients aged 18-80 years with Rome IV criteria-defined functional gastrointestinal disorders were randomly assigned (1:2) to receive gastroenterologist-only standard care or multidisciplinary clinic care. The multidisciplinary clinic included gastroenterologists, dietitians, gut-focused hypnotherapists, psychiatrists, and behavioural (biofeedback) physiotherapists. Randomisation was stratified by Rome IV disorder and whether referred from gastroenterology or colorectal clinic. Outcomes were assessed at clinic discharge or 9 months after the initial visit. The primary outcome was a score of 4 (slightly better) or 5 (much better) on a 5-point Likert scale assessing global symptom improvement. Modified intention-to-treat analysis included all patients who attended at least one clinic visit and who had answered the primary outcome question. This study is registered with ClinicalTrials.gov, NCT03078634. FINDINGS: Between March 16, 2017, and May 10, 2018, 1632 patients referred to the hospital gastrointestinal clinics were screened, of whom 442 were eligible for a screening telephone call and 188 were randomly assigned to receive either standard care (n=65) or multidisciplinary care (n=123). 144 patients formed the modified intention-to-treat analysis (n=46 in the standard-care group and n=98 in the multidisciplinary-care group), 90 (63%) of whom were women. 61 (62%) of 98 patients in the multidisciplinary-care group patients saw allied clinicians. 26 (57%) patients in the standard-care group and 82 (84%) patients in the multidisciplinary-care group had global symptom improvement (risk ratio 1·50 [95% CI 1·13-1·93]; p=0·00045). 29 (63%) patients in the standard-care group and 81 (83%) patients in the multidisciplinary-care group had adequate relief of symptoms in the past 7 days (p=0·010). Patients in the multidisciplinary-care group were more likely to experience a 50% or higher reduction in all Gastrointestinal Symptom Severity Index symptom clusters than were patients in the standard-care group. Of the patients with irritable bowel syndrome, a 50-point or higher reduction in IBS-SSS occurred in 10 (38%) of 26 patients in the standard care group compared with 39 (66%) of 59 patients in the multidisciplinary-care group (p=0·017). Of the patients with functional dyspepsia, a 50% reduction in the Nepean Dyspepsia Index was noted in three (11%) of 11 patients in the standard-care group and in 13 (46%) of 28 in the multidisciplinary-care group (p=0·47). After treatment, the median HADS scores were higher in the standard-care group than in the multidisciplinary-care group (13 [8-20] vs 10 [6-16]; p=0·096) and the median EQ-5D-5L quality of life visual analogue scale was lower in the standard-care group compared with the multidisciplinary-care group (70 [IQR 50-80] vs 75 [65-85]; p=0·0087). The eight SF-36 scales did not differ between the groups at discharge. After treatment, median Somatic Symptom Scale-8 score was higher in the standard-care group than in the multidisciplinary-care group (10 [IQR 7-7] vs 9 [5-13]; p=0·082). Cost per successful outcome was higher in the standard-care group than the multidisciplinary-care group. INTERPRETATION: Integrated multidisciplinary clinical care appears to be superior to gastroenterologist-only care in relation to symptoms, specific functional disorders, psychological state, quality of life, and cost of care for the treatment of functional gastrointestinal disorders. Consideration should be given to providing multidisciplinary care for patients with a functional gastrointestinal disorder. FUNDING: None.


Assuntos
Assistência à Saúde/economia , Gastroenterologistas/normas , Gastroenteropatias/terapia , Síndrome do Intestino Irritável/terapia , Adulto , Assistência Ambulatorial/estatística & dados numéricos , Austrália/epidemiologia , Biorretroalimentação Psicológica/métodos , Feminino , Gastroenteropatias/diagnóstico , Gastroenteropatias/psicologia , Humanos , Hipnose/métodos , Análise de Intenção de Tratamento/métodos , Comunicação Interdisciplinar , Síndrome do Intestino Irritável/diagnóstico , Síndrome do Intestino Irritável/psicologia , Masculino , Pessoa de Meia-Idade , Nutricionistas/normas , Psiquiatria/normas , Qualidade de Vida , Índice de Gravidade de Doença , Resultado do Tratamento
3.
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
4.
J Clin Neurosci ; 77: 41-48, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32409219

RESUMO

Hypnosis could extend the time of Intraoperative Neuropsychological Testing and Brain Mapping in Awake Surgery. A clinical validation for the Hypnosis aided AS (HAs) is still ongoing and further evidences are required. The objective of the present study is to compare two homogeneous cohorts of patients undergoing AS, the first with the aid of the hypnosis and the second according to a standard AS (SAs) protocols. The clinical, radiological and surgical data of two comparable procedures cohorts were retrospectively examined for the present study. All surgeries in Group A were performed with a HAs protocol. Procedures belonging to Group B were performed with a SAs protocol. Endpoints: to compare 1. Incidence of complications in the immediate postoperative period, 2. Clinical and neurological status in the immediate postoperative period and 30 days after surgery, 3. Duration of surgical interventions, 4. Extent of Resection (EOR). The final cohort is composed of 15 procedures; 6 belonging to Group A and 9 to Group B. The different methods outline statistically comparable results from the clinical (Neurological outcomes) both in the postoperative period and one month after surgery and from the surgical point of view (comparable EOR). The incidence of complications is comparable either. The duration of the procedures was significantly longer in HAs group. Hypnosis is a promising approach to increasing the duration of intraoperative "testability" of patients at the price of a longer operative time. A specific professional is needed to induce hypnosis in the difficult intraoperative setting.


Assuntos
Neoplasias Encefálicas/cirurgia , Gerenciamento Clínico , Glioma/cirurgia , Hipnose/métodos , Monitorização Intraoperatória/métodos , Vigília , Adulto , Mapeamento Encefálico/métodos , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/psicologia , Estudos de Coortes , Craniotomia/métodos , Feminino , Glioma/diagnóstico por imagem , Glioma/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores/métodos , Testes Neuropsicológicos , Duração da Cirurgia , Estudos Retrospectivos
5.
Complement Ther Med ; 49: 102334, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32147052

RESUMO

Pain and vaso-occlusive crises (VOC) are hallmark complications of sickle cell disease (SCD) and result in significant physical and psychosocial impairment. The variability in SCD pain frequency and triggers for the transition from steady state to VOC are not well understood. This paper summarizes the harmful physiological effects of pain and emotional stressors on autonomically-mediated vascular function in individuals with SCD and the effects of a cognitive, neuromodulatory intervention (i.e. hypnosis) on microvascular blood flow. We reviewed recent studies from the authors' vascular physiology laboratory that assessed microvascular responses to laboratory stressors in individuals with SCD. Results indicate that participants with SCD exhibit marked neurally mediated vascular reactivity in response to pain, pain-related fear, and mental stress. Further, pilot study results show that engagement in hypnosis may attenuate harmful microvascular responses to pain. The collective results demonstrate that autonomically-mediated vascular responses to pain and mental stress represent an important SCD intervention target. This ongoing work provides physiological justification for the inclusion of cognitive, neuromodulatory and complementary treatments in SCD disease management and may inform the development of targeted, integrative interventions that prevent the enhancement of autonomic vascular dysfunction in SCD.


Assuntos
Anemia Falciforme/complicações , Hipnose/métodos , Microcirculação , Manejo da Dor/métodos , Dor/etiologia , Estresse Psicológico/etiologia , Estresse Psicológico/terapia , Anemia Falciforme/psicologia , Humanos , Dor/psicologia
6.
J Womens Health (Larchmt) ; 29(3): 461-463, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32186967

RESUMO

Poor sleep is one of the most frequent health concerns among menopausal women. All stages of sleep can be impacted by the menopause transition. Negative outcomes of poor sleep are multidimensional and include poor physical, psychological, cognition, and social outcomes. Hypnosis is a nonpharmacological treatment for poor sleep and hot flashes in menopausal women. The goal of hypnosis is to educate and train subjects to perform self-hypnosis to alleviate the underlying symptom. The use of hypnosis as a treatment for poor sleep has shown benefits for both acute and chronic insomnia. Initial findings from the National Center for Complementary and Integrative Health (NCCIH) Hypnosis Intervention for Sleep in Menopause: Examination of Optimal Dose and Method of Delivery randomized control trial of 90 women were presented. Results showed that program and treatment satisfaction were high in all groups, adherence to daily practice met or exceeded adherence benchmarks. There were significant reduction of poor sleep quality in all groups with a significant increase in minutes slept in all groups. The majority of women also showed clinical improvements of duration. There were clinically meaningful improvements in reducing the perception of poor sleep quality in 50%-77% of women across time. Overall, the use of self-hypnosis as a treatment program for sleep problems related to menopause was acceptable for women. Data further support that hypnosis is a promising technique to improve sleep in menopausal women with sleep and hot flashes. Further research is ongoing on self-hypnosis delivery and implementation into wider populations of women using clear definition and control groups.


Assuntos
Hipnose/métodos , Menopausa/psicologia , Transtornos do Sono-Vigília/terapia , Sono/fisiologia , Adulto , Idoso , Congressos como Assunto , Feminino , Fogachos/complicações , Humanos , Pessoa de Meia-Idade , Transtornos do Sono-Vigília/complicações
7.
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
8.
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
9.
Am J Clin Hypn ; 62(3): 231-266, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31928517

RESUMO

Although hypnotizability exhibits high across-time and across-test consistencies, it is not clear (a) how different preambles to a hypnotic procedure (metasuggestions) influence responsiveness to suggestions and the strength of the association between two hypnotizability scales and (b) how hypnotizability relates to absorption and empathy. In Experiment 1, nonclinical participants (N = 152 women) were administered the Modified Tellegen Absorption Scale (MODTAS), Interpersonal Reactivity Index (IRI), Hypnotic Induction Profile (HIP), and Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C). In Experiment 2, nonclinical participants (N = 188; 105 women and 83 men) were administered the MODTAS, IRI, and Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A). The induction scores of the HIP (HIP-IND) and the SHSS:C scores showed a significantly stronger correlation when the HIP was introduced to the participants after hypnosis metasuggestion (HIP-H-IND) than after imagination metasuggestion (HIP-I-IND). Metasuggestion was a moderator of the association between HIP-IND and SHSS:C scores. Participants with low and medium, but not with high, hypnotizability levels on the SHSS:C showed significantly higher scores on the HIP-I-IND than on the HIP-H-IND. The strong correlations between the SHSS:C, HIP-H-IND, and HIP eye-roll (HIP-ER) scores indicate that both the HIP-H-IND and HIP-ER are robust measures of hypnotizability. Absorption and empathy were not significantly associated with hypnotizability. Women were more hypnotizable than men, as assessed by the HGSHS:A. The clinical relevance of metasuggestions, intended to increase responsiveness to suggestions, is discussed as a strategy to improve treatment outcomes.


Assuntos
Empatia , Hipnose , Avaliação de Processos e Resultados em Cuidados de Saúde , Psicometria/instrumentação , Adulto , Empatia/fisiologia , Feminino , Humanos , Hipnose/métodos , Masculino , Fatores Sexuais , Sugestão
10.
Am J Clin Hypn ; 62(3): 172-177, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31928521
11.
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
12.
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
13.
G Ital Cardiol (Rome) ; 20(11): 651-657, 2019 Nov.
Artigo em Italiano | MEDLINE | ID: mdl-31697272

RESUMO

BACKGROUND: The purpose of this study was to use hypnosis in patients with congenital heart disease undergoing transesophageal echocardiography (TEE). METHODS: From January 2016 to July 2017, 50 adult patients undergoing TEE were randomly assigned to two groups: TEE in hypnosis (n = 23), TEE in sedation (n = 27). Vital parameters (heart rate [HR], blood pressure [BP], oxygen saturation [SO2] before, during and after the procedure) and drug administration were recorded. The State-Trait Anxiety Inventory was performed before and after TEE, the memory and experience of TEE through a structured interview were assessed. RESULTS: All patients in the hypnosis group performed TEE without any sedation. As for anxiety before TEE, no significant differences were observed between groups; after TEE all patients were less anxious than at the beginning (p<0.001) with a greater decrease in patients of the hypnosis group (p<0.001). Before TEE, there were no significant differences also in HR, BP and SO2. During TEE in both groups a similar increase in HR and BP was found (p<0.001), whereas SO2 values remained stable. In the responses to the structured interview, 94% of patients in the sedation group remembered everything vs 36% of the hypnosis group (p<0.05). No differences were found in the other answers between the two groups. CONCLUSIONS: Hypnosis in TEE is useful to improve the emotional experience of patients with congenital heart disease.


Assuntos
Ecocardiografia Transesofagiana/métodos , Cardiopatias Congênitas/diagnóstico por imagem , Hipnose/métodos , Hipnóticos e Sedativos/administração & dosagem , Adulto , Idoso , Ansiedade/prevenção & controle , Pressão Sanguínea/fisiologia , Ecocardiografia Transesofagiana/psicologia , Feminino , Cardiopatias Congênitas/psicologia , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
Ann Palliat Med ; 8(4): 498-503, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31431022

RESUMO

Hypnosis has a long history of use for anesthesia and pain management, as well as in assisting patient to prepare for medical procedures. This article reviews the history of hypnosis applications in clinical medicine and dentistry. Research on hypnotic susceptibility or hypnotic ability shows that the ability to respond effectively to hypnosis is a relatively stable trait, partially heritable, and measurable by means of several standard procedures. Persons low in hypnotic ability may benefit from alternative therapeutic interventions; however, the majority of medical patients will benefit from the integration of adjunctive hypnotic therapies into their medical and dental care. The article closes with a discussion of the stronger evidence-based applications of hypnosis in healthcare, and the need for well-trained certified hypnosis practitioners.


Assuntos
Anestesia/métodos , Dor Crônica/prevenção & controle , Dentística Operatória/métodos , Hipnose/métodos , Procedimentos Cirúrgicos Obstétricos/métodos , Certificação , Competência Clínica/normas , Medicina Baseada em Evidências , Pessoal de Saúde/normas , Humanos , Relações Interprofissionais , Manejo da Dor/métodos , Confiança
15.
Med Hypotheses ; 130: 109274, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31383343

RESUMO

The topic of multiple personality, redefined as Dissociative Identity Disorders (DIDs) in the DSM-5, is an intriguing and still debated disorder with a long history and deep cultural and epistemological implications, extending up to the idea of possession. Hypnosis is an appealing and valuable model to manipulate subjective experience and get an insight on both the physiology and the pathophysiology of the mind-brain functioning; it and has been closely connected with DIDs and possession since its origin in 18th century and as recently proved the capacity to yield a loss of sense of agency, mimicking delusions of alien control and spirit possession. In this study we report on five very uncommon "hypnotic virtuosos" (HVs) free from any psychiatric disorder, spontaneously undergoing the emergence of multiple identities during neutral hypnosis; this allowed us to check the relationship between their experience and fMRI data. During hypnosis the subjects underwent spontaneous non-intrusive experiences of other selves which were not recalled after the end of the session, due to post-hypnotic amnesia. The fMRI showed a significant decrease of connectivity in the Default Mode Network (DMN) especially between the posterior cingulate cortex and the medial prefrontal cortex. Our results and their contrast with the available data on fMRI in DIDs allows to draw the hypothesis of a continuum between healthy mind - where multiple identities may coexist at unconscious level and may sometimes emerge to the consciousness - and DIDs, where multiple personalities emerge as dissociated, ostensibly autonomous components yielding impaired functioning, subject's loss of control and suffering. If this is the case, it seems more reasonable to refrain from seeking for a clear-cut limit between normality (anyway a conventional, statistical concept) and pathology, and accept a grey area in between, where ostensibly odd but non-pathological experiences may occur (including so-called non-ordinary mental expressions) without calling for treatment but, rather, for being properly understood.


Assuntos
Transtorno Dissociativo de Identidade/diagnóstico , Transtorno Dissociativo de Identidade/terapia , Hipnose/métodos , Transtornos Mentais/terapia , Adulto , Idoso , Estudos de Casos e Controles , Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos Dissociativos/psicologia , Transtorno Dissociativo de Identidade/fisiopatologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Transtornos Mentais/fisiopatologia , Saúde Mental , Pessoa de Meia-Idade , Modelos Psicológicos , Adulto Jovem
16.
Breast Cancer Res Treat ; 178(2): 357-365, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31399932

RESUMO

BACKGROUND: Sexual dysfunction, fueled by body image stress, is prevalent in women with a history of breast or gynecologic cancer. Preliminary data support that mind-body connections may improve sexual health outcomes through improving body image. OBJECTIVE: This randomized controlled trial compared hypnosis to progressive muscle relaxation (PMR). The primary outcome was body image at week 6 as measured by the Impact of Treatment Scale for women who have or have had breast or gynecologic cancer. INTERVENTIONS/METHODS: Consented participants were randomized 2:1 to hypnosis or PMR. Both arms consisted of three face-to-face sessions delivered by a trained therapist. Sessions were every 2 weeks for 6 weeks; participants practiced at home between sessions using an audio recording. RESULTS: Eighty-seven women were randomized, 59 to hypnosis and 28 to PMR. Both groups reported significant improvements on body image over time (within group effect size Cohen's d = 0.49-0.75) with no significant difference between groups (p = 0.15). Secondary outcomes were not significantly different between groups. The hypnosis group improved more in sexual satisfaction and sexual interest while the PMR group improved more in positive affect. CONCLUSIONS: Interventions facilitating mind-body connections such as hypnosis and PMR may help to improve body image. This study suggests that stress relieving strategies of hypnosis and PMR may contribute to providing a re-connection to one's body, improved positive affect, and overall better sexual health.


Assuntos
Treinamento Autógeno , Imagem Corporal , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Neoplasias dos Genitais Femininos/diagnóstico , Neoplasias dos Genitais Femininos/terapia , Hipnose , Treinamento Autógeno/métodos , Neoplasias da Mama/psicologia , Feminino , Neoplasias dos Genitais Femininos/psicologia , Humanos , Hipnose/métodos , Qualidade de Vida , Resultado do Tratamento
17.
Complement Ther Med ; 45: 65-70, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31331584

RESUMO

OBJECTIVES: Hypnotherapy is recognised in the UK's National Institute for Health and Care Excellence (NICE) guidelines as a potential treatment for Irritable Bowel Syndrome (IBS). However, little is known about the views of people with IBS regarding hypnotherapy. This qualitative study aimed to identify perceptions of and barriers to hypnotherapy for IBS by people with the condition. DESIGN: One-to-one semi-structured interviews using thematic analysis. SETTING: Convenience sampling in the UK. Participants were recruited by poster advertising and online IBS support groups. Interviews were conducted at the interviewees' preferred location or via video calling. PARTICIPANTS: 17 people (15 female, 2 male) who self-identified as having refractory IBS according to a provided definition. RESULTS: Four hypnotherapy related themes arose from the data: conceptualisation of hypnotherapy, hypnotherapy for IBS, barriers to hypnotherapy for IBS, ideal format of hypnotherapy for IBS. Participants saw hypnosis as an altered state in which change was possible, but many had not considered it for IBS. They were broadly open to hypnotherapy for IBS, but a variety of potential barriers were apparent, including cost and therapist validity. Group hypnotherapy was less acceptable than one-to-one treatment. Hypnotherapy via video call was seen as convenient, but there were concerns about its effectiveness. CONCLUSION: People with IBS may be put off hypnotherapy by a lack of understanding of how it works for their condition and lack of awareness of it as a therapeutic option. Uptake may be improved through effective promotion of the approach which addresses its mechanisms of effect.


Assuntos
Síndrome do Intestino Irritável/tratamento farmacológico , Síndrome do Intestino Irritável/terapia , Adulto , Feminino , Humanos , Hipnose/métodos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Projetos de Pesquisa , Inquéritos e Questionários , Adulto Jovem
18.
Int J Clin Exp Hypn ; 67(3): 313-335, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31251706

RESUMO

This study examined the development and effect of an online hypnosis program for the treatment of migraines. Forty-three participants were randomly assigned to a wait-list control or a treatment group. The treatment group received hypnosis mp3s developed for the study. Pain catastrophizing (PCS), headache disability (HDI), migraine frequency, duration, severity, and medication usage were measured. There was a 48% reduction in mean HDI score in the treatment group and 2% reduction in the control group. There was a 60% reduction in mean PCS score in the treatment group. There were no significant between-group differences in the proportion of subjects experiencing decreased frequency or severity of migraines. There was a significant between-group difference in the change in migraine duration. This study demonstrated that a hypnosis intervention delivered online was effective in reducing headache symptoms in migraine sufferers.


Assuntos
Hipnose/métodos , Transtornos de Enxaqueca/terapia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
19.
Int J Clin Exp Hypn ; 67(3): 297-312, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31251707

RESUMO

Dysphagia, the perceived impediment to swallowing food, is a common postsurgical symptom that can have debilitating consequences. This study presents the successful treatment of severe esophageal dysphagia with a problem-focused and patient-centered approach to hypnosis, informed by long-term empirical follow-up. The authors describe a case history involving significant and persistent difficulty swallowing for which no medical or surgical treatment could be found. Over the course of 10 sessions, the patient was assessed, treated with imaginal exposure, and instructed in self-hypnosis. Outcomes were measured at treatment conclusion, and 6-, 9-, and 18-month follow-ups. Following hypnosis, the patient exhibited significant and reliable change (RC) in visceral hypersensitivity (RC = -3.16, p = .002), emotional distress (RC = -2.21, p= .03), subjective well-being (RC = 4.14, p< .0001), and posttraumatic symptoms (RC = -3.33, p= .001). Gains were maintained at 18-month follow-up.


Assuntos
Transtornos de Deglutição/terapia , Hipnose , Complicações Pós-Operatórias/terapia , Vértebras Cervicais/cirurgia , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/psicologia , Discotomia/efeitos adversos , Feminino , Humanos , Hipnose/métodos , Pessoa de Meia-Idade , Cervicalgia/cirurgia , Complicações Pós-Operatórias/psicologia , Sugestão
20.
Int J Clin Exp Hypn ; 67(3): 278-296, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31251708

RESUMO

This review examines the effectiveness of hypnotherapy for the relief of overactive bladder (OAB) symptoms. Ten studies examining outcomes of hypnotherapy for OAB were located from searches of electronic databases. Most reports were case studies or observational, but there were two randomized, controlled trials. Hypnotherapeutic treatment regimens were idiosyncratic and tailored to individual patients. All studies suggested benefits from hypnotherapy as an adjunct treatment for OAB, especially in terms of subjective reports of symptoms and increasing self-efficacy. These benefits suggest hypnotherapy increases patients' abilities to engage in relaxation, reduces condition-associated anxiety, and improves patients' perceptions of their symptom-coping abilities. Although strong objective evidence of improvement in OAB symptoms is lacking, these subjective improvements, combined with increasing use and acceptance of hypnotherapy in obstetric and gynecological settings, suggest the utility of hypnotherapy as a psychological adjunctive procedure in the treatment of OAB.


Assuntos
Hipnose , Bexiga Urinária Hiperativa/terapia , Humanos , Hipnose/métodos , Resultado do Tratamento , Bexiga Urinária Hiperativa/psicologia
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