Relief of anxiety and pain in children and adolescents with cancer: Quantitative measures and clinical observations

Hilgard, Josephine R.; LeBaron, Samuel

doi:10.1080/00207148208407277

Cited by 142 publications

(79 citation statements)

References 12 publications

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“…Earlier studies in pediatric samples have shown that anticipatory anxiety predicts postoperative pain ratings (Palermo & Drotar, 1996) and pain reactions to bone marrow aspiration (Hilgard & LeBaron, 1982), but the potential role of AS and anxious symptomatology in relation to such procedures has not been assessed. Our results suggest that interventions designed to target AS may lead to reductions in anticipatory anxiety which may in turn have beneficial effects on children's responses to acute pain.…”

Section: Discussionmentioning

confidence: 99%

Relationships among Anxious Symptomatology, Anxiety Sensitivity and Laboratory Pain Responsivity in Children

Tsao

Lü

Kim

et al. 2006

Cognitive Behaviour Therapy

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Existing laboratory-based research in adult samples has suggested that anxiety sensitivity (AS) increases an individual's propensity to experience pain-related anxiety which in turn enhances pain responsivity. Such relationships have not been examined in younger populations. Thus, the present study used structural equation modeling (SEM) to test a conceptual model in which AS would evidence an indirect relationship with pain intensity via its contribution to state-specific anticipatory anxiety in relation to a variety of laboratory pain tasks (cold pressor, thermal heat, and pressure pain) in 234 healthy children (116 girls; mean age = 12.6 years, range = 8-18 years). The model further hypothesized that existing anxious symptomatology would demonstrate a direct relationship with pain intensity. Results of the SEM supported the proposed conceptual model with the total indirect effect of AS accounting for 29% of the variance in laboratory pain intensity via its effects on painrelated anticipatory anxiety. AS did not however, evidence a direct relationship with pain intensity. Anxious symptomatology on the other hand, demonstrated a significant direct effect on pain intensity, accounting for 15% of variance. The combined effects of AS, anxiety symptoms, and anticipatory anxiety together explained 62% of the variance in pain intensity. These relationships did not differ for boys and girls indicating no moderating effect of sex in the proposed model. The present results support the potential benefit of assessing both AS and anxiety symptoms in children prior to undergoing painful stimulation.

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Section: Discussionmentioning

confidence: 99%

Relationships among Anxious Symptomatology, Anxiety Sensitivity and Laboratory Pain Responsivity in Children

Tsao

Lü

Kim

et al. 2006

Cognitive Behaviour Therapy

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“…Gender differences in studies of children's expression of intense negative emotions (e.g., distress reactions to medical procedures) have not been as common as in studies of less intense emotional experiences, although when such differences are uncovered, girls display more overt distress than boys (e.g., Hilgard & LeBaron, 1982;Zeltzer, Fanurik, & LeBaron, 1989;Quas et al, 1999;). Katz et al (1980) found that girls were more distressed than boys during chemotherapy treatment and did not calm as readily.…”

Section: Gender Age Emotion and Reactivitymentioning

confidence: 99%

Dissociations between psychobiologic reactivity and emotional expression in children

et al. 2000

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“…The recreation therapist was also present during the VCUG to assist the child. Although most children are highly hypnotizable, 16,19,22 …”

Section: Routine Care With Recreational Therapymentioning

confidence: 99%

“…There is considerable evidence that hypnosis can provide anxiety and pain relief to children with medical conditions, 18-21 including cancer, [22][23][24][25] cystic fibrosis, 26 pain problems, 27,28 pulmonary symptoms, 29 and postoperative course. 30 In addition, hypnosis is a noninvasive intervention with minimal risk, which returns control of the experience to the child.…”

mentioning

confidence: 99%

Hypnosis Reduces Distress and Duration of an Invasive Medical Procedure for Children

Butler¹,

Symons²,

Henderson

et al. 2005

Pediatrics

142

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ABSTRACT. Objective. Voiding cystourethrography (VCUG) is a commonly performed radiologic procedure in children that can be both painful and frightening. Given the distress that some children experience during the VCUG and the need for children to be alert and cooperative during the procedure, finding a psychological intervention that helps children to manage anxiety, distress, and pain is clearly desirable. This study was designed to examine whether relaxation and analgesia facilitated with hypnosis could reduce distress and procedure time for children who undergo this procedure.Methods. Forty-four children who were scheduled for an upcoming VCUG were randomized to receive hypnosis (n ‫؍‬ 21) or routine care (n ‫؍‬ 23) while undergoing the procedure. The sample consisted of 29 (66%) girls and 15 (34%) boys with a mean age of 7.6 years (SD: 2.5; range: 4 -15 years). Ethnic/racial backgrounds were 72.7% white, 18.2% Asian, 4.5% Latino, 2.3% black, and 2.3% Filipino. The mean number of previous VCUGs was 2.95 (SD: 2.51; mode: 2; range: 1-15). Potential participants were identified through computerized hospital records of upcoming VCUGs. Parents were contacted by telephone and invited to participate if their child was eligible. To be eligible for the study, the child must have undergone at least 1 previous VCUG, been at least 4 years of age at that time, and experienced distress during that procedure, and both the child and the participating parent had to be English speaking. Each eligible child and parent met with the research assistant (RA) before the day of the scheduled procedure for an initial assessment. Children were queried regarding the degree of crying, fear, and pain that they had experienced during their most recent VCUG. Parents completed a series of parallel questions. Immediately after this assessment, those who were randomized to the hypnosis condition were given a 1-hour training session in self-hypnotic visual imagery by a trained therapist. Parents and children were instructed to practice using the imaginative self-hypnosis procedure several times a day in preparation for the upcoming procedure. The therapist was also present during the procedure to conduct similar exercises with the child. The majority (83%) of those who were randomized to the routine care control group chose to participate in a hospital-provided recreation therapy program (offered as part of routine care). The program includes demonstration of the procedure with dolls, relaxation and breath work training, and assistance during the procedure. On the day of the VCUG, the RA met the family at the clinic before the procedure, and both the child and the parent rated the child's present level of fearfulness. During the procedure, the RA recorded observational ratings of the child's emotional tone and behavior and timed the overall procedure and its phases. Immediately after the VCUG, the child was asked how much crying, fear, and pain he or she had experienced during the procedure; the parent rated the child's experience on the same ...

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Relief of anxiety and pain in children and adolescents with cancer: Quantitative measures and clinical observations

Cited by 142 publications

References 12 publications

Relationships among Anxious Symptomatology, Anxiety Sensitivity and Laboratory Pain Responsivity in Children

Relationships among Anxious Symptomatology, Anxiety Sensitivity and Laboratory Pain Responsivity in Children

Dissociations between psychobiologic reactivity and emotional expression in children

Hypnosis Reduces Distress and Duration of an Invasive Medical Procedure for Children

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