Do professionals change their communication behaviours following a training in hypnosis-derived communication? A feasibility study in pediatric oncology

Cultivating Comfort: Examining Participant Satisfaction with Hypnotic Communication Training in Pain Management

Context

One in four Canadians experiences chronic pain, yet insufficient services and restrictions surrounding prevailing treatments result in inadequate management and significant negative consequences for these individuals. Previous work indicates that hypnotic communication represents a promising complementary treatment; however, training protocols for healthcare professionals are underdeveloped and understudied.

Aim

To evaluate the level of satisfaction for a training program on hypnotic communication in pain management clinics.

Design

Qualitative study.

Methods

Six health professionals who first completed the hypnotic communication training participated in 30 minutes virtual semi-structured interviews. These testimonials allowed them to elaborate on their user experience and potential areas for improvement. Thematic analysis using qualitative data management software NVIVO was conducted on the interview data.

Results

Two themes emerged from the interviews. 1) Satisfaction: Participants expressed satisfaction on various structural aspects of the training, including the provided materials, atmosphere, training structure, presentation modalities, practical workshops, acquired knowledge, trainer quality, and training duration. 2) Areas for Improvement: Five main improvement suggestions were identified (providing more material; more practical workshops, more concrete and adapted; testimonials from former patients; follow-up training meeting; and continuing education).

Implications for the Profession and/or Patient Care and Conclusion

The results improved the training program to help minimized inherent biases related to this technique, cut associated costs, and identify reasons that would explain its underutilization among medical professionals in Quebec. Our work highlights that healthcare professionals in chronic pain management clinics (eg, respiratory therapists, nurses) can incorporate this simple hypnotic communication technique into their usual care and contribute to the well-being of patients.

Impact

This study aimed to address the lack of training protocols for healthcare professionals, that are underdeveloped and understudied. The main findings on participant' satisfaction and the areas of improvement for the training will help the refinement of the training to better suit healthcare professional's needs in hospitals and chronic pain facilities.

Hypnotherapy and therapeutic suggestion: bridging the gap between evidence and utility

The use of hypnotherapy in psychiatry has been controversial. However, evidence presented by Chan and colleagues shows that it is beneficial to the promotion of good mental health and well-being, specifically being applicable in the management of mental disorders. But what does this mean for practice? This commentary looks at what we agree and disagree with, what we opine is missing from the article and what now needs to happen. Patients should be able to access hypnotherapy or hypnosis routinely on the National Health Service. Since it works, who may it work for and how may we make this available to those who could benefit from it?

Development and refinement of Rel@x:A training in hypnosis-derived communication for pediatric nurses to prevent procedural pain

Introduction

Studies in pediatric oncology have shown that hypnosis effectively reduces patients' pain and distress during painful procedures. This remains underutilized in the healthcare system due to the staff cost and availability of hypnotherapists. To develop the use of hypnosis-derived communication, we aimed to train nurses to use hypnosis-derived communication while they perform painful procedures.

Objectives

This study aimed to (1) develop a brief training in hypnosis-derived communication for pediatric nurses named Rel@x, (2) pretest the training with experienced pediatric oncology nurses, and (3) refine the training based on nurses' suggestions.

Methods

The Rel@x training consists of two 4-h sessions: one related to relational aspects and another one presenting one of two selected hypnotic communication techniques ("pleasant place" or "magic glove"). Rel@x makes use of manuals, cue card reminders, visual aids, videos, and an e-learning platform. To refine Rel@x, a complete training cycle was conducted with seven female pediatric oncology nurses. A mixed method study with an evaluation questionnaire and a post-training focus group interview was conducted.

Results

Quantitative data showed that nurses overall positively rated the training program: relevance and acceptability (median average of 5.4/6); use of hypnotic communication (median average of 5.2/6); expected effects (median average of 5.4/6); program implementation (5.6/6). Two general themes emerged from the qualitative data: perceptions of hypnotic communication and the evaluation of the Rel@x training program. Based on nurses' suggestions, Rel@x was refined by adding more practical components, more time for practice, more time between the two sessions and additional tools (cue card reminders, keywords, virtual e-learning recap module).

Conclusion and clinical implications

The use of hypnosis-derived communication during painful procedures and the Rel@x training were viewed favorably amongst pediatric nurses. Rel@x offers a complete training in hypnosis-derived communication for pediatric nurses. This training fosters the optimal use of hypnosis-derived communication during care and may significantly reduce children's procedural pain and distress.

Definition and refinement of HYlaDO, a self-hypnosis training program for chronic pain management: A qualitative exploratory study

One in four Canadians is affected by chronic pain, frequently treated with opioids, which present a risk of addiction and overdose. The development of non-pharmacological interventions is therefore crucial. In a pilot project, a self-hypnosis training program showed encouraging results in improving breast cancer patients' quality of life. Based on this program, we developed a new self-hypnosis program for chronic pain patients: HYlaDO (Hypnosis of pain in French, HYpnose de la DOuleur). To structure the process of adapting an existing program to a new context, we used the ORBIT model (Obesity-Related Behavioral Intervention Trials), which consists of four development phases. This study aimed to collect patients' opinions and recommendations, and to refine HYlaDO (ORBIT Phase Ib). Fifteen participants took part in individual semi-structured interviews about this program. Two analysts coded the verbatims, and a thematic categorization was performed. Six themes emerged: practice training, expected vs. perceived effects, chronic pain management, individual practice, satisfaction, and participants' recommendations. Improvements to be considered in this type of program were finally discussed.

Comment mener une recherche interventionnelle en psycho-oncologie ? Développement, évaluation et implémentation en pratique clinique

Cet article a pour objectif de décrire les méthodes pouvant être utilisées pour développer, évaluer et implémenter en pratique clinique de nouvelles interventions en psycho-oncologie. Pour cela, deux modèles de référence à l’international sont présentés afin d’apporter un éclairage scientifique aux différents acteurs impliqués dans ces recherches. Ce travail concerne cliniciens, chercheurs, acteurs institutionnels et patients ; cela afin de développer de nouveaux projets utilisant une rigueur méthodologique et d’intérêt pour améliorer les conditions des patients et des proches.

Développement et évaluation d’un programme d’entraînement à la communication hypnotique à destination des infirmières en oncologie pédiatrique : la formation Rel@x

Les enfants atteints d’un cancer sont régulièrement confrontés à des procédures douloureuses au cours de leur prise en charge. Afin de les accompagner au mieux dans leurs soins, des techniques de communication dérivées de l’hypnose ont montré d’excellents niveaux d’efficacité sur la réduction de la détresse et de la douleur associées à ces procédures. Nous avons mené une étude préliminaire évaluant les effets d’une formation à la communication hypnotique sur la pratique des infirmières lors de procédures douloureuses auprès d’enfants atteints d’un cancer. Les résultats ont montré une bonne acquisition des techniques par les infirmières et des effets importants de ces techniques sur les niveaux de douleurs et de détresse des enfants. Cette étude a aussi permis de récolter des recommandations d’amélioration de la formation pour développer un design plus simple de la formation Rel@x, qui sera testée auprès d’un échantillon d’infirmières et de patients plus important.

How Fast Can Nurses Learn Therapeutic Communication Skills? A Pilot Study on Brief Hypnotic Communication Training Conducted with Oncology Nurses

Objective: This project aimed to train nurses on an oncology unit in hypnotic communication to reduce treatment-related pain and anxiety in their patients. A pilot study was conducted to assess changes in hypnotic communication behaviors associated with the training.

Methods: Nurses were recruited and their interactions during a simulated patient admission for treatment (before and after training) were recorded. Hypnotic communication skills were assessed by independent reviewers using a training checklist listing different hypnotic communication techniques and a validated assessment scale (Sainte-Justine Hypnotic Communication Assessment Scale, SJ-HCAS).

Results: Seven nurses were evaluated. Wilcoxon paired-sample tests (pre–post) reported significant improvement with large effect sizes in the total score of the training grid (P = 0.034, r = 0.832) and significant improvement with large effect sizes in the relational (P = 0.018, r = 0.930) and total (P = 0.021, r = 0.903) scores of the SJ-HCAS.

Conclusion: This pilot study shows promising results regarding the effectiveness of hypnotic communication training for nurses. These acquired skills could translate into improved treatment experience with patients and could be transferred to other professionals and settings in the health care system.

Does practising hypnosis-derived communication techniques by oncology nurses translate into reduced pain and distress in their patients? An exploratory study

Objectives

To explore the effects of a hypnotic communication (HC) training for paediatric nurses in decreasing patients' pain and distress during venipunctures.

Methods

A 4-day theoretical and practical HC training was offered to five paediatric oncology nurses. The effects of HC were tested with 22 young cancer patients (13 girls, 9 boys, 10 ± 4 years) over four time points, with 88 encounters being video-recorded and coded in stable professional-patient dyads. Patients' pain and distress were rated by patients and parents with visual analogue scales and coded from recordings using the Faces, Legs, Activity, Cry and Consolability (FLACC) scale.

Results

We observed a significant decrease in pre-post distress reported by parents (d = 0.45, p = 0.046). Two out of five nurses with higher skills acquisition had larger reduction in patients' self-reported pain (d = 1.03, p = 0.028), parents perceived pain (d = 1.09, p = 0.042), distress (d = 1.05, p = 0.043) as well as observed pain (d = 1.22, p = 0.025). Favourable results on pain and distress did not maintain at follow-up.

Conclusion and clinical implications

Training nurses in HC may translate into improved pain and distress in patients, both self-rated and observed provided that skills are used in practice. HC training is a promising non-pharmacological intervention to address pain in paediatrics.