The effects of hypnosis on anxiety, depression, fatigue, and sleepiness in people undergoing hemodialysis: a clinical report

The effect of psychosocial interventions on depression, anxiety, and quality of life in hemodialysis patients: a systematic review and a meta-analysis

PURPOSE

Hemodialysis has become a standard therapy for adults with end-stage renal diseases. Adults undergoing hemodialysis have to cope with unique psychological issues that make their care journey particularly fatiguing. In this systematic review and meta-analysis, we aimed to summarize and evaluate the effects of psychosocial interventions on the reduction of anxiety and depression in adults with HDs.

METHODS

We included randomized controlled trials and quasi-experimental studies that measure change in depression, anxiety, and quality of life.

RESULTS

We identify three categories of psychosocial interventions delivered to adults undergoing hemodialysis. Based on our analysis, there was a medium effect of psychosocial intervention on depression (SMD - 0.85, 95%CI - 1.17; - 0.52, I2 = 80%, p < 0.01) and anxiety (SMD - 0.99, 95%CI - 1.65; - 0.33, I2 = 88%, p < 0.01) in adults undergoing hemodialysis.

CONCLUSIONS

Psychosocial interventions, such as psychological support or relaxation-based therapy, seems all to reduce depression and anxiety in adults undergoing HD. Preliminary evidence suggests that there may be a benefit of psychosocial interventions on the quality of life for adults undergoing HD.

An exploratory study of hypnosis-induced blood count changes in chronically stressed individuals

Hypnosis is a clinically accepted relaxation technique known for stress reduction. Results from hematological research provide evidence of changes in blood components through hypnosis. However, these hematological effects have been rarely examined. Hence, we exploratively investigated the effect of a single relaxation hypnosis on the hemogram in stressed individuals, assuming a reduction of leukocytes, thrombocytes, and erythrocytes (primary outcomes). Additionally, a reduction in the erythrocyte-related parameters (hemoglobin, hematocrit), and an increase in plasma volume was hypothesized (secondary outcomes). Forty-four either individuals (89 % women) with chronic stress and moderate to high hypnotic suggestibility were randomized to a hypnosis condition (20 min relaxation hypnosis; n = 20) or a control condition (20 min documentary; n = 24). Venous blood was drawn before and after the intervention and used to generate a differential hemogram and determine the plasma volume. The relaxation hypnosis led to a significant reduction in erythrocytes (Cohen's d=0.23) and consequently to a decrease in erythrocyte-related parameters (hemoglobin, d=0.27; hematocrit, d=0.37) as well as to a reduction in thrombocytes (d=0.15) in the hypnosis compared to the control condition. Putatively, this could be the consequence of an increased plasma volume (d=0.10), estimated by the hematocrit concentration and body weight. A hypnosis-induced change in leukocyte count could not be confirmed. Thus, a single session of relaxation hypnosis already alters specific blood count parameters. While relaxation-induced vasodilatation might explain these changes, it is still not completely clear how these changes affect our stress response system.

The effect of hand and foot massage on fatigue in hemodialysis patients: A randomized controlled trial

OBJECTIVE

The aim of this study was to examine the effect of hand massage and foot massage on fatigue in hemodialysis patients.

METHODS

This randomized, controlled and quasi-experimental study was conducted between October 19, 2018 and February 11, 2019 with patients receiving hemodialysis therapy in the dialysis unit of a public hospital in Turkey. Data were collected using a Patient Identification Form and the Visual Analogue Scale for Fatigue. The study was carried out with 82 patients in three groups: a hand massage group (n = 27), a foot massage group (n = 27) and a control group (n = 28). The patients in the control group were not administered any treatments except for standard nursing interventions in the hemodialysis unit.

RESULTS

In between-groups comparison the hand and foot massage groups' mean fatigue score decreased after the application compared to that of the control group (p < 0.05).

CONCLUSIONS

Hand and foot massage were found to reduce fatigue in patients receiving hemodialysis.

Nonpharmacologic Treatments for Opioid Reduction in Patients With Advanced Chronic Kidney Disease

Opioid analgesics carry risk for serious health-related harms in patients with advanced chronic kidney disease (CKD) and end-stage kidney disease. In the general population with chronic noncancer pain, there is some evidence that opioid reduction or discontinuation is associated with improved pain outcomes; however, tapering opioids abruptly or without providing supportive interventions can lead to physical and psychological harms and relapse of opioid use. There is emerging evidence that nonpharmacologic treatments such as psychosocial interventions, acupuncture, and interdisciplinary pain management programs are effective approaches to support opioid dose reduction in patients experiencing persistent pain, but research in this area still is relatively new. This review describes the current evidence for nonpharmacologic interventions to support opioid reduction in non-CKD patients with pain and discusses the application of the available evidence to patients with advanced CKD who are prescribed opioids to manage pain.

Hypnosis and end-stage renal disease: Review and treatment

ABSRACT End-stage renal disease is an irreversible, fatal, condition. There are two treatments that extend life, dialysis, and transplant. Both are accompanied by recognized consequences. Although the emotional impacts are extensive, and the symptoms are treatable, there have been very few reports of their amelioration by hypnosis. This article summarizes what research has been done and proposes a manual for self-care to meet this worldwide and growing clinical challenge.

Beneficial Effects of Guided Imagery or Clinical Massage on the Status of Patients in a Progressive Care Unit

BACKGROUND

Patients in the progressive care unit typically experience high levels of pain and anxiety and exhibit difficulty sleeping.

OBJECTIVE

To determine whether either clinical massage or guided imagery could reduce pain and anxiety and improve sleep.

METHODS

This study included 288 inpatients on 2 floors of a progressive care unit. On 1 floor, each patient was offered daily a 15-minute complimentary clinical massage, whereas the patients on the other floor were provided access to a 30-minute guided-imagery recording. Patients were asked to rate their pain and anxiety levels immediately before and after the massage intervention or were asked whether the guided-imagery intervention was helpful for pain, anxiety, or insomnia.

RESULTS

The massage intervention showed an immediate and significant reduction in self-reported pain and anxiety (P < .001); likewise, a significant number of patients self-reported that guided imagery helped alleviate pain, anxiety, and insomnia (P < .001).

CONCLUSION

The results of this study indicate that clinical massage and guided imagery can benefit patients in the progressive care unit.

[An evaluation of hypnosis practices in palliative care.]

There are very few studies in existence today that look at the value of hypnosis in palliative care.The aim of our study was to measure the impact of hypnosis on managing symptoms in palliative care. This quantitative retrospective monocentric observational study evaluated pain and patient satisfaction using monitoring and evaluation sheets, which included a rating scale before and after hypnosis sessions in a palliative care unit.For two years, thirty-seven patients participated in hypnosis sessions mostly for pain (41%) and anxiety (27%). 51% reported a decrease in symptoms, with 35% even reporting that the intensity of their symptoms vanished. Most of the patients were satisfied with the approach and at the end of the study some of them were able to recreate its effects by using self-hypnosis.Despite the small sample, the results confirm those found in the few palliative studies that do exist, particularly relating to the improvement of symptoms such as pain, anxiety, nausea, and respiratory disorders.

Anxiety Reduction Among Breast-Cancer Survivors Receiving Hypnotic Relaxation Therapy for Hot Flashes

Anxiety is common among breast-cancer survivors. This analysis examined the effect of a hypnotic relaxation therapy, developed to reduce hot flashes, on anxiety levels of female breast-cancer survivors. Anxiety was assessed using a numeric analog scale and the Hospital Anxiety and Depression Scale-Anxiety subscale. Significant reductions in anxiety were found from pre- to postintervention for each weekly session and were predictive of overall reductions in anxiety from baseline to after the last intervention. In this analysis, hypnotizability did not significantly predict for anxiety reductions measured before and after each session or from baseline to exit. These data provide initial support for the use of hypnotic relaxation therapy to reduce anxiety among breast-cancer survivors.

Efficacy and cost-effectiveness: A study of different treatment approaches in a tertiary pain centre

BACKGROUND

Chronic pain is considered to be a complex phenomenon, involving an interrelation of biological, psychosocial and sociocultural factors. Currently, no single treatment or therapy can address all aspects of this pathology. In our expert tertiary pain centre, we decide to assess the effectiveness of four treatments for chronic pain classically proposed in our daily clinical work: physiotherapy; psycho-education; physiotherapy combined with psycho-education; and self-hypnosis/self-care learning.

METHODS

This study included 527 chronic pain patients, with a mean duration of pain of 10 years. Patients were allocated either to one of the four pre-cited treatment groups or to the control group. Pain intensity, quality of life, pain interference, anxiety and depression were assessed before and after treatment.

RESULTS

This study revealed a significant positive effect on pain interference and anxiety in patients included in the physiotherapy combined with psycho-education group, after 20 sessions spread over 9 months of treatment. The most prominent results were obtained for patients allocated to the self-hypnosis/self-care group, although they received only six sessions over a 9-month period. These patients showed significant benefits in the areas of pain intensity, pain interference, anxiety, depression and quality of life.

CONCLUSIONS

This clinical report demonstrates the relevance of biopsychosocial approaches in the improvement of pain and psychological factors in chronic pain patients. The study further reveals the larger impact of self-hypnosis/self-care learning treatment, in addition to a cost-effectiveness benefit of this treatment comparative to other interventions.

Effect of Regular Exercise Program on Depression in Hemodialysis Patients

Background and Aim. Depression is the most common psychological disorder in hemodialysis patients which decreases their quality of life and increases the mortality. This study was conducted to assess the effect of regular exercise on depression in hemodialysis patients. Methods. In a randomized clinical trial, 51 hemodialysis patients were allocated in two groups. Beck Depression Inventory (BDI) scale was used to assessing depression rate in participants. Designed program was educated using poster and face-to-face methods for case group. Intervention was carried out three times a week for ten weeks. At the beginning and the end of the study, depression rate of the subjects was assessed. Data was analyzed by SPSS16 software and descriptive and inferential statistics. Findings. According to the results of this study, there were no differences between case and control groups in depression rate at the beginning of the study, but there was significant difference after intervention (P = 0.016). In the beginning of the study, the mean and SD of depression in case group were 23.8 ± 9.29 and reduced to 11.07 ± 12.64 at the end (P < 0.001). Conclusion. The regular exercise program could reduce the depression in hemodialysis patients; therefore it is suggested for training this program for hemodialysis patients. This trial is registered with Iranian Registry of Clinical Trial (IRCT) number IRCT201205159763N1.