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Source: Stanford University Medical Center
Date: 2005-01-16
Stanford Study Shows Hypnosis
Helps Kids Undergoing Difficult Procedure
STANFORD, Calif. - Elaine Miller desperately wanted
to find a way to help her daughter, Hannah, endure an awkward and painful
medical examination in which doctors insert a catheter into her bladder,
inject a dye and ask her to urinate while being X-rayed.
The girl had been through the procedure four times by age
7, and she dreaded going through it again. So when researchers at the
Stanford University School of Medicine offered hypnosis, Miller welcomed
the chance. "I had tried every angle I could to either avoid the test for
my daughter or make it less traumatic," she said.
Researchers found that hypnosis lessened distress in
Hannah and other young patients who, because of an anomaly in their
urinary tracts, must undergo the difficult annual exam called voiding
cystourethography, or VCUG, to see if urine is backing up into their
kidneys. "Hypnosis was really the only thing that helped," said Miller.
Many clinical reports suggest that hypnosis can make it
easier to quit smoking, reduce the pain of cancer and giving birth and
help reduce the stress of medical procedures, but reviews of the
literature call for better-designed, randomized studies that place such
uses of hypnosis squarely in the domain of evidence-based medicine. The
Stanford study, published Jan. 3 in the online version of Pediatrics, is
one of only a handful of randomized trials to look at whether hypnosis
reduces pain and stress during medical procedures in children.
Four or five patients undergo the stressful VCUG
catheterization on any given day at Lucile Packard Children's Hospital at
Stanford. Many doctors wish that they could avoid putting children through
the procedure, as it is so unpleasant, but there's no alternative. And
sedation is out of the question because children have to be alert enough
to urinate during the VCUG. "It's abusive, almost," said Linda Shortliffe,
MD, professor of urology and the hospital's chief of pediatric urology.
"It involves using some force in a sensitive place, but we can't do the
exam without the catheter."
Hypnosis, the researchers hypothesized, would give the
children more control of their experience by teaching them to focus on
being somewhere else, potentially helping them to deal with the anxiety
and pain caused by the catheterization.
Forty-four children participated in the study. All had
been through at least one distressing VCUG in the past. About half,
including Hannah, received self-hypnosis training while the other half
received routine care, which included a preparation session with a
recreational therapist who taught some breathing techniques and
demonstrated the VCUG using a doll.
According to the paper, the use of hypnosis reduced the
procedure's duration from an average of 50 minutes down to 35. Although
children in the study did not report experiencing less fear or pain after
hypnosis, researchers suggested that this result might be due to kids'
desire to assert their displeasure in a bid to discourage being subject to
another VCUG in the future. And, indeed, attending parents and neutral
observers participating in the study reported less distress in hypnotized
children compared with those given recreational therapy.
"With hypnosis we saw less crying, less distress during
the preparation for the procedure and the technicians said the procedure
was much easier to perform," said David Spiegel, MD, the Jack, Lulu and
Samuel Willson Professor in Medicine and associate chair of psychiatry and
behavioral sciences. Spiegel also directs the Stanford Center for
Integrative Medicine and the Psychosocial Treatment Laboratory at Stanford
and is an attending psychiatrist at the children's hospital.
To learn self-hypnosis, Hannah Miller met with Spiegel a
week before she was due for a VCUG. As Hannah remembers it, Spiegel asked
her to imagine that a balloon tied to her wrist could take her anywhere
she wanted to go and to picture doing her favorite things in that place.
"So I pictured myself ice-skating in Hawaii," she said, "and swimming and
snorkeling." After practicing self-hypnosis at home with her mother's help
during the ensuing week, Hannah said the examination went much better than
it had in the past. "We narrowed down the worst 30 seconds of the test,
and that's when the visualization really helped," she said.
The study is one more step toward getting hypnosis covered
by health plans. Although insurers do not reimburse for such stress-relief
therapy - research funds paid for the hypnosis involved in this study -
that could change if more evidence is developed that documents the
benefits of hypnosis.
Funding for the research was provided by the Innovations
in Patient Care Program at Lucile Packard Children's Hospital.
Stanford University Medical Center integrates research,
medical education and patient care at its three institutions - Stanford
University School of Medicine, Stanford Hospital & Clinics and Lucile
Packard Children's Hospital at Stanford. For more information, please
visit the Web site of the medical center's Office of Communication &
Public Affairs at
http://mednews.stanford.edu.
Lucile Packard Children's Hospital at Stanford is a
264-bed hospital devoted to the care of children and expectant mothers.
Providing pediatric and obstetric medical and surgical services and
associated with Stanford School of Medicine, LPCH offers patients locally,
regionally and nationally the full range of health-care programs and
services - from preventive and routine care to the diagnosis and treatment
of serious illness and injury. To learn more about Lucile Packard
Children's Hospital, please visit our Web site at
http://www.lpch.org.
Editor's Note: The original news release can be
found here. This story has been adapted from a news release issued by
Stanford University Medical Center. Can't find it? Try searching
ScienceDaily or the entire web with: Google Web
sciencedaily.com
http://www.sciencedaily.com/releases/2005/01/050111123332.htm |
