Q28.
Locate a piece of
hypnotherapy research on pain control. Include statistical evidence
and explanation. Explain the scientific methodology used in this
research and its advantages. Properly cite your reference sources.
Learning outcomes: 5.5
Student
answer
Article:
Montgomery,
G.H., Bovbjerg, D.H.; Schnur, J.B.; David, D.; Goldfarb, A.;
Weltz,
C.R.; Schechter,
C.; Graff-Zivin,
J.;
Tatrow,
K.; Price, D.D.; Silverstein, J.H. (2007) A Randomized Clinical
Trial of a Brief Hypnosis Intervention to Control Side Effects in
Breast Surgery Patients. Journal
Of The National Cancer Institute
Vol 99: pp1304–1312
Montgomery
et al (2007) conducted a
randomized clinical trial of 200 women who were undergoing a
breast biopsy (excisional) or having a lumpectomy. These are
considered minor surgical procedures which are associated with
clinically significant side effects which include postsurgical
pain, nausea, and fatigue. The side effects often result in longer
recovery room stay, delay in discharge and increased mediation.
Their
hypothesis was that a brief hypnosis session before surgery would
means that less anesthesia would be used during surgery and there
would be a reduction in post operative analgesic use and in the
side effects associated with breast cancer surgery would also
reduce. The reduction in analgesia can be linked with experience of
pain.
Patients
from the sample were randomly
assigned to one of two groups. One received a 15-minute hypnosis
session before surgery and the other received nondirective
empathic listening as a control group. Both interventions were
undertaken by 4 psychologists and took place in private – away
from the surgical team. There was no statistical differences
between therapists. No blinding or matching within the sample
allocation took place and there were no statistical variances on
demographics between groups. The hypnosis intervention consisted
of a relaxation-based induction which included muscle relaxation
imagery and specific symptom-focused suggestions of reduced pain,
nausea, and fatigue. It also included suggestion as to how the
client could use self -hypnosis after the intervention. The
nondirective empathic listening involved the patients
directing the flow of the conversation with attentive listening.
The
anesthesia/sedatives (lidocaine; fentanyl; propofol and
midazolam) used were recorded. Patients were asked to report pain
and side effects on a scale (0–100) at the point of discharge.
Costs of medication used and time spent in surgery were also
analysed.
Statistical
analysis of the results revealed the following statistically
significant results:
Patients in the hypnosis group
There
were no statistically significant differences within the use of
fentanyl, midazolam, or in the use of analgesics within the
recovery room.
A
cost saving of $772.71 per patient was reported for those who
received hypnotherapy.
This
research was conducted because whilst other areas of surgery had
reported demonstrable effects from using hypnotherapy; this had
not been extended to breast surgery which represents the largest
number of female cancer surgeries in the United States. Therefore
this ???
Montgomery
et al concluded that the
results support
the use of pre-operative hypnosis with breast cancer surgery
patients. This research was conducted as there was a lack of
research in the area and the authors felt that there was a benefit
to using hypnosis. The findings supported their hypothesis in a
way that can justify the use of hypnosis both in terms of benefit
and in cost savings. By conducting and publishing the research
Montgomery et al have increased the likelihood of hypnotherapy
being increasingly used before breast surgery.
(LO 5.5 A
demonstrable ability to locate hypnotherapy research)
|
Tutor
feedback (DO NOT delete/edit feedback. Write amendments,
additional information & thoughts underneath this table)
Correct.
Thank you for this example of a furthering of the profession of
Hypnotherapy and its collaboration with the medical community. It
is a piece of research well worth sharing with others and citing
at every opportunity. Long may your ability to locate
hypnotherapy research such as this serve you well.
|
Further Student Example Answer:
Hypnotherapy
for the Management of Chronic Pain
Fibromyalgia
In
a controlled study, Haanen
et al. (1991)
randomly assigned 40 patients with fibromyalgia to groups that
received either eight 1-hour sessions of hypnotherapy with a
self-hypnosis home-practice tape over a 3-month period, or physical
therapy (that included 12 to 24 hours of massage and muscle
relaxation training) for 3 months. Outcome was assessed pre- and post
treatment and at 3-month follow-up. The hypnosis intervention
included an arm-levitation induction and suggestions for ego
strengthening, relaxation, improved sleep, and “control of muscle
pain.” Compared with patients in the physical therapy group, the
patients who received hypnosis showed significantly better outcomes
on measures of muscle pain, fatigue, sleep disturbance, distress, and
patient overall assessment of outcome. These differences were
maintained at the 3-month follow-up assessment and the average
percent decrease in pain among patients who received hypnosis (35%)
was clinically significant, whereas the percent decrease in the
patients who received physical therapy was marginal (2%).
Controlled
trial of hypnotherapy in the treatment of refractory fibromyalgia.
Haanen
HC, Hoenderdos HT, van Romunde LK, Hop WC, Mallee C, Terwiel JP,
Hekster GB J Rheumatol. 1991 Jan; 18(1):72-5.
Int
J Clin Exp Hypn. Author manuscript; available in PMC 2009 Sep 25.
Published
in final edited form as:
The
above abstract includes the statistical data of how many patients
were selected for the trial, the period of the experiment and
follow-up assessments as well as a basic report on the findings, the
two basic methods of treatment are also reported.
A
random number of subjects from a selected pool of previously
diagnosed Fibromyalgia sufferers were given hypnosis and hypnotic
recordings to listen to over a 3-month period whilst another group of
subjects were given massage and muscle relaxation training.
At
the end of the initial experiment all the subjects were again
measured for any changes/improvements in their symptoms and measured
again after a 3-month period to monitor how these
changes/improvements had lasted.
The
results showed that hypnosis and hypnotic recordings were
significantly more effective in pain management and managing the
other symptoms of Fibromyalgia than simple massage and muscle
relaxation.
The
advantages of these experiments is that the subjects all have a known
medical condition which has measurable symptoms and as such can
provide a repeatable set of results. This experiment has been
repeated by several different research facilities utilising other
forms of treatment from pharmaceuticals to massage etc. verses
hypnosis as well as hypnosis in conjunction with these traditional
treatments and they have all found hypnosis improves the subject’s
condition.
Q28.
Correct. You have demonstrated
your ability to locate hypnotherapy research and to comment and
evaluate on this particular subject of fibromyalgia treatment with
good citations throughout.
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