Cardiac coherence and medical hypnosis: a feasibility study of a new combined approach for managing preoperative anxiety in patients with breast or gynaecological cancer

BJA open Pub Date : 2024-09-24 DOI:10.1016/j.bjao.2024.100309

Jibba Amraoui , Gilles Leclerc , Marta Jarlier , Jesus Diaz , Ridvan Guler , Clément Demoly , Catherine Verin , Sophie Rey Dit Guzer , Patrick Chalbos , Aurore Moussion , Christophe Taoum , Mathias Neron , Laurent Philibert

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Abstract

Background

Non-pharmaceutical approaches can help manage preoperative anxiety, but few studies have evaluated psychoeducational programmes, especially for cancer surgery. We assessed the feasibility of the COHErence Cardiaque (COHEC) programme where cardiac coherence and medical hypnosis are combined to manage preoperative anxiety in patients undergoing breast or gynaecological cancer surgical interventions (BGCSI).

Methods

Patients undergoing BGCSI were enrolled and followed a daily home programme with cardiac coherence and medical hypnosis sessions, starting 7 days before the procedure. The primary endpoint was optimal patient adherence (i.e. completion of ≥14 sessions). Secondary endpoints were anxiety levels, measured using the Visual Analogue Scale (VAS) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS), satisfaction (EVAN-G), and quality of postoperative recovery (QoR-15).

Results

In total, 53 patients [mean age: 55 (34–82) yr] were included; 83.7% had breast cancer and 15.1% had gynaecological cancer. Optimal adherence was achieved by 64.2% (95% confidence interval: 49.8–76.9%) of the intention-to-treat population. Among the 43 patients who completed at least one session, exploratory analysis showed that anxiety on the day before (P=0.02) and the morning of the intervention (P=0.04) was decreased in patients with severe anxiety at baseline (VAS ≥70). The median VAS satisfaction score for the programme was 10 (4–10). Overall, 94% of patients were willing to include the COHEC programme in their daily routine.

Conclusions

The implementation of a psychoeducational programme combining cardiac coherence and medical hypnosis is feasible and might potentially help patients undergoing BGCSI to manage preoperative anxiety. A randomised trial is underway to assess the efficacy of the COHEC programme.

Clinical trial registration

NCT03981731.

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心电协调和医学催眠：针对乳腺癌或妇科癌症患者术前焦虑症管理的新组合方法的可行性研究

背景非药物方法有助于控制术前焦虑，但很少有研究对心理教育计划进行评估，尤其是针对癌症手术的心理教育计划。我们对 COHErence Cardiaque (COHEC) 计划的可行性进行了评估，该计划将心脏协调和医学催眠结合起来，用于控制接受乳腺癌或妇科癌症手术干预（BGCSI）的患者的术前焦虑。主要终点是患者的最佳依从性（即完成≥14次疗程）。次要终点是焦虑水平（使用视觉模拟量表（VAS）和阿姆斯特丹术前焦虑和信息量表（APAIS）测量）、满意度（EVAN-G）和术后恢复质量（QoR-15）。结果共纳入 53 名患者[平均年龄：55（34-82）岁]；83.7% 患有乳腺癌，15.1% 患有妇科癌症。64.2%（95% 置信区间：49.8-76.9%）的意向治疗人群达到了最佳依从性。在至少完成一次治疗的 43 名患者中，探索性分析显示，基线焦虑严重（VAS ≥70）的患者在干预前一天（P=0.02）和干预当天早上（P=0.04）的焦虑程度有所减轻。该计划的 VAS 满意度中位数为 10（4-10）分。总体而言，94% 的患者愿意将 COHEC 计划纳入他们的日常工作中。结论结合心脏一致性和医学催眠实施心理教育计划是可行的，有可能帮助接受 BGCSI 的患者控制术前焦虑。目前正在进行一项随机试验，以评估 COHEC 计划的疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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