Feasibility and Usefulness of Self-Hypnosis in Patients Undergoing Double-Lung Transplantation During the Pre- and Postoperative Periods: A Randomized Study
Hypnosis can reduce pain and anxiety in surgical patients. This study aimed to demonstrate that implementing self-hypnosis in the setting of lung transplantation could improve patients' pain and quality of life.
DESIGN:A randomized, single-center study.
SETTING:Foch University Hospital, Suresnes, France.
PARTICIPANTS:The participants were patients aged 15 years or older who needed a double-lung transplant. Patients were excluded if they participated in only 1 learning self-hypnosis session before transplantation.
INTERVENTIONS:Patients were included at the time of their final evaluation before inscription on the waiting list. They were taught self-hypnosis at this time and were asked to perform it by themselves before and after transplantation, as frequently as possible.
MEASUREMENTS AND MAIN RESULTS:The main outcome of the study was self-reported pain 1 month after lung transplantation. Secondary outcomes were self-reported pain, anxiety, coping, catastrophism, and self-reported quality of life evaluated at their registration, 7 days and 1 and 4 months after the transplantation. Seventy-eight patients were included, but only 28 patients in the control group and 33 in the self-hypnosis group were evaluated at the fourth postoperative month. Practice of self-hypnosis was high before transplantation (76.6%), lower after, from 32.3% in the intensive care unit to 51.6% during the last 3 months of the study. Group-time interactions were not statistically significant whatever the concerned outcome, especially pain score at 1 month (p = 0.16).
CONCLUSION:Implementation of self-hypnosis is possible, but the study failed to demonstrate an improvement in patients' experience, perhaps due to the variable compliance with the technique.
CET Conclusion
| Reviewer: | Dr Liset Pengel, Centre for Evidence in Transplantation, Nuffield Department of Surgical Sciences University of Oxford |
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| Conclusion: | The randomised controlled trial evaluated whether self-hypnosis before and after lung transplantation improves pain and quality of life. Patients awaiting a double-lung transplant aged ≥15 years were randomised online according to a computer-generated randomisation sequence. The sample size calculation showed that 78 patients needed to be included in the study for a power of 80%. Participants received at least two teaching sessions by psychologists and anaesthesiologists who underwent the same hypnosis training. Seventy-eight participants were randomised and 61 participants were included in the analysis at 4 months posttransplant. Most participants (77%) used self-hypnosis regularly or occasionally before the transplant but less often after the transplant. Forty-two percent of patients were very enthusiastic about self-hypnosis, which they considered helpful in many circumstances and 68% said that self-hypnosis was difficult to practice alone. There were no statistically significant differences between groups for any of the pain scores, anxiety or quality of life up to 4 months posttransplant. The authors highlight some factors that may have influenced the results including adherence to self-hypnosis, particularly in the immediate posttransplant period, and other stressors. |
Methodological quality
| Jadad score | 3 |
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| Allocation concealment | YES |
| Data analysis | INTENTION TO TREAT |
Study Details
| Aims: | This study aimed to investigate whether the implementation of self-hypnosis in a lung transplantation setting leads to improvements in patients’ pain and quality of life. |
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| Interventions: | Participants were randomised to either the self-hypnosis group or the usual care group. |
| Participants: | 78 patients who needed a double-lung transplant. |
| Outcomes: | The primary endpoint was pain 1 month posttransplantation. The secondary endpoints included pain, anxiety, coping, catastrophism, quality of life, and compliance with the self-hypnosis technique prior to surgery, in the intensive care unit (ICU) and post-transplantation. |
| Follow Up: | 4 months |
Metadata
| Funding: | Non-industry funding |
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| Publication type: | Randomized Controlled Trial, Randomised Controlled Trial |
| Trial registration: | ClinicalTrials.gov - NCT02237976 |
| Organ: | Lung |
| Language: | English |
| Author email: | m.fischler@hopital-foch.com |
| MeSH terms: | Adolescent; Adult; Feasibility Studies; Humans; Hypnosis; Lung Transplantation; Pain, Postoperative; Quality of Life; Pain; Postoperative Period |