Hypnosis or cognitive behavioral training for the reduction of pain and nausea during cancer treatment: a controlled clinical trial.
Few controlled clinical trials have tested the efficacy of psychological techniques for reducing cancer pain or post-chemotherapy nausea and emesis. In this study, 67 bone marrow transplant patients with hematological malignancies were randomly assigned to one of four groups prior to beginning transplantation conditioning: (1) hypnosis training (HYP); (2) cognitive behavioral coping skills training (CB); (3) therapist contact control (TC); or (4) treatment as usual (TAU; no treatment control). Patients completed measures of physical functioning (Sickness Impact Profile; SIP) and psychological functioning (Brief Symptom Inventory; BSI), which were used as covariates in the analyses. Biodemographic variables included gender, age and a risk variable based on diagnosis and number of remissions or relapses. Patients in the HYP, CB and TC groups met with a clinical psychologist for two pre-transplant training sessions and ten in-hospital "booster" sessions during the course of transplantation. Forty-five patients completed the study and provided all covariate data, and 80% of the time series outcome data. Analyses of the principal study variables indicated that hypnosis was effective in reducing reported oral pain for patients undergoing marrow transplantation. Risk, SIP, and BSI pre-transplant were found to be effective predictors of inpatient physical symptoms. Nausea, emesis and opioid use did not differ significantly between the treatment groups. The cognitive behavioral intervention, as applied in this study, was not effective in reducing the symptoms measured.
Fred Hutchinson Cancer Research Center, Seattle, WA 98104 USA Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195 USA.
Karen L
KL
Syrjala
Claudette
C
Cummings
Gary W
GW
Donaldson
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D006990:Hypnosis; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology / Q000628:therapy*; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D010146:Pain / Q000209:etiology; D059408:Pain Management
D000701:Analgesics, Opioid; D000970:Antineoplastic Agents