Psychological Preparation for Pediatric Oncology Patients Undergoing Painful Procedures: A Methodological Critique of the Research

Abstract

Hypnosis and cognitive-behavioral packages are effective in preparing pediatric oncology patients for bone marrow aspiration and lumbar puncture. However, the relative efficacy of different preparations has not been determined, and potent components of preparation packages have yet to be identified. Further, factors hypothesized to moderate effectiveness of preparation (e.g., cognitive development) have not been investigated. Finally, due to a failure to employ process measures, the extent to which hypothesized mediators of behavior change (e.g., self-efficacy) are modified by preparation is unclear. Following an overview of empirical investigations, we make recommendations for addressing these limitations in future research.

Use of hypnosis in controlling lumbar puncture distress in an adult needle-phobic dementia patient

“…There is ample evidence that hypnosis can significantly alleviate procedural distress during LPs in pediatric populations (HagemanWenselaar, 1988;Kellerman, Zeltzer, Ellenberg, & Dash, 1983;Milling & Costantino, 2000;Rape & Bush, 1994;Zeltzer & LeBaron, 1982). There is also substantial evidence that hypnosis can be a very effective technique for adults experiencing chronic pain (Barber, 1996;Chaves, 1994;Manuscript submitted March 19,1999;final revision received June 1,1999.…”

Tranceformations: Hypnosis in Brain and Body

“…They can use self-hypnosis to imagine themselves being somewhere else, a place that they associate with physical comfort, such as floating in a bath, a lake, a hot tub, or just floating in space, thereby dissociating their mental experience from the physical discomfort and contextual anxiety related to the procedure. It can also be used as a means of mastering the anxiety associated with potentially threatening diagnostic procedures, [69] such as endoscopies, [70,71] colonoscopies, [72,73] imaging techniques (i.e., computed tomography and magnetic resonance imaging), [74][75][76][77][78] bone marrow aspirations, [79][80][81] needle phobia, [82][83][84][85][86][87] liver biopsy, [88] dental procedures, [89] and lumbar punctures. [81,86,90] Hypnosis is also helpful in helping patients through therapeutic interventions such as chemotherapy [75,[91][92][93][94][95][96][97][98][99][100][101][102][103] Faymonville et al 1995, external beam radiation therapy, [104,105] surgery and its recovery, [106,107] and interventional radiology.…”

Behavioral Interventions in the Diagnosis, Treatment and Rehabilitation of Children with Cancer

“…Although hypnosis has been used for over a century, most of the research regarding its effectiveness is anecdotal or based on case reports (2,10,11,42,43). Despite imprecision in definitions, a general lack of standardized interventions, and few controlled studies, hypnosis has been found to be effective in alleviating distress associated with a number of cancer treatment procedures.…”