Hypnosis is a state between wakefulness and sleep, a state of heightened focal concentration and receptivity, an altered state of consciousness of a state of focused attention that results in suspension of peripheral cues. The effect of a hypnotic state results in alteration in perception and attention. Hypnosis has been tested for effect in pain, anxiety, depression, chemotherapy-induced nausea and vomiting (CINV), hot flashes, and fatigue in patients with cancer. Hypnosis has been delivered in various formats, including individual inperson sessions and use of a CD program for induction and training in self-hypnosis. Hypnosis has differing effectiveness according to the synthesis of evidence for CINV when used for anticipatory CINV versus for treatment of actual CINV.
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Databases searched were MEDLINE, PsycINFO, PSYNDEX, and CANCERLIT (1980-Dec., 1995).
Search keywords were relaxation techniques, progressive muscle relaxation (PMR), autogenic training, hypnosis, imagination, and guided imagery in combination with neoplasms, cancer treatment, chemotherapy, radiotherapy, drug therapy, and bone marrow transplantation.
A total of 280 abstracts were found, 58 studies were relevant, and 15 met the inclusion criteria for meta-analysis. Moderator variables included intensity, schedule, and focus of intervention.
A total of 742 primarily female subjects with variable malignancies receiving highly emetogenic chemotherapy and trained in progressive muscle relaxation (PMR) were part of this review.
Consistent positive results in meta-analysis studies showed clinically significant reductions in nausea and other symptoms. Relaxation during the courses of treatment made the experience less stressful, reducing side effects. Studies supported the implementation of relaxation training into clinical routines as standard adjunctive treatment.
Redd, W.H., Montgomery, G.H., & DuHamel, K.N. (2001). Behavioral intervention for cancer treatment side effects. Journal of the National Cancer Institute, 93, 810-823.
Silva, D.R.F., dos Reis, P.E.D., Gomes, I.P., Funghetto, S.S., & Ponce de Leon, C.G.R.M. (2009). Non pharmacological interventions for chemotherapy induced nausea and vomits: Integrative review. Online Brazilian Journal of Nursing, 8(1).
To identify the evidence in scientific literature related to nonpharmacologic interventions for the treatment of chemotherapy-induced nausea and vomiting (CINV)
Databases searched were Cochrane, PubMed, Latin American and Caribbean Health Sciences Literature (LILACSO), and Brazilian Nursing Database (BDENF).
Search keywords were nausea, vomiting, chemotherapy, nursing care, cursing care protocols for cancer chemotherapy, and chemotherapy induced nausea and vomiting.
Studies were included in the review if they
This review demonstrated no substantial effects among the interventions included. Findings regarding the use of acupuncture, acupressure, and electroacupuncture were mixed. Most studies using acupuncture and acupressure involved use of the p6 point on the wrist.
This review included a limited number of studies.
The evidence does not demonstrate significant effect of these interventions for CINV. However, these interventions may be useful as adjuncts to pharmacologic treatment. Nonpharmacologic interventions appear to be most effective in the prevention of acute vomiting rather than symptoms of nausea.
Marchioro, G., Azzarello, G., Viviani, F., Barbato, F., Pavanetto, M., Rosetti, F., … Vinante, O. (2000). Hypnosis in the treatment of anticipatory nausea and vomiting in patients receiving cancer chemotherapy. Oncology, 59, 100–104.
To evaluate the use of hypnosis in the management of anticipatory nausea and vomiting
Patients received two hours of training in progressive relaxation, followed by a one-hour hypnosis program. No drugs were given in association with the hypnotherapy. After the intervention, patients immediately went to their scheduled chemotherapy.
All patients were from an outpatient setting.
A Visual Analog Scale (VAS) was used to measure complete response (CR) (mild nausea with no vomiting), major response (moderate to severe nausea and one vomiting episode), or no response (none of the above).
In all of the 16 patients in the study, anticipatory nausea and vomiting disappeared. Major responses (moderate to severe nausea, with one vomiting episode) to chemotherapy-induced emesis control occurred in 14 of the 16 patients.
Caution should be used regarding patient selection; some patients should not be hypnotized.