Potential adjunctive applications of hypnosis in the management of periodontal diseases

When expectations predict experience: the influence of psychological factors on chemotherapy toxicities

CONTEXT

Patients with cancer undergoing similar treatments experience variable severity and frequency of side effects not adequately explained by pharmacological mechanisms, suggesting psychological influence.

OBJECTIVES

First, this study aimed to further examine the relationship between patients' expectations of multiple chemotherapy-related toxicities and experiences. Second, this study aimed to explore the impact of anxiety and cancer coping styles to aid in informing interventions to lessen such expectations.

METHODS

A total of 59 eligible, consenting patients with cancer rated their expectations of 20 chemotherapy toxicities on 100-point linear analogue self-assessment indicators before treatment and completed the Spielberger State Anxiety Inventory and the Mental Adjustment to Cancer scale. Patients then rated their experience of side effects after one chemotherapy session.

RESULTS

Regressions controlling primary treating nurse influence and patient performance status showed toxicity experience was significantly predicted by patient expectations of mood changes, bleeding, skin itchiness, hair loss, feeling tired, and sleep disturbance (β=0.30-0.55). Anxiety was significantly related to expectations of nervousness and mood changes; the coping style Fighting Spirit showed no significant associations, whereas conversely, Anxious Preoccupation showed some degree of association with all 20 toxicities (r=0.11-0.34).

CONCLUSION

Findings support the growing contention that patient expectations influence experience, negatively impacting quality of life. As it is unethical to withhold treatment information, research into screening for at-risk patients and offering brief interventions to minimize Anxious Preoccupation could be one way to reduce overall side effect burden, perhaps in the case of many medical interventions.

Hypnosis and dental anesthesia in children: a prospective controlled study

The authors of this prospective study initially hypothesized that hypnosis would lower the anxiety and pain associated with dental anesthesia. Thirty children aged 5 to 12 were randomly assigned to 2 groups receiving hypnosis (H) or not (NH) at the time of anesthesia. Anxiety was assessed at inclusion in the study, initial consultation, installation in the dentist's chair, and at the time of anesthesia using the modified Yale preoperative anxiety scale (mYPAS). Following anesthesia, a visual analogue scale (VAS) and a modified objective pain score (mOPS) were used to assess the pain experienced. The median mYPAS and mOPS scores were significantly lower in the H group than in the NH group. Significantly more children in the H group had no or mild pain. This study suggests that hypnosis may be effective in reducing anxiety and pain in children receiving dental anesthesia.