Biomedical subjects

Joel Marcus

Publications and source records attributed to Joel Marcus.

10 recordsLinked to original sources

PubMed2007

Pilot evaluation of hypnosis for the treatment of hot flashes in breast cancer survivors.

This single arm, pilot study investigated the use of hypnosis to reduce hot flashes in 16 breast cancer survivors. Each patient provided baseline data and received 4 weekly sessions of hypnosis that followed a standardized transcript. Patients were also instructed in self-hypnosis. Throughout the clinical care, patients completed daily diaries of the frequency and severity of their hot flashes. Patients also completed baseline and post-treatment ratings of the degree to which hot flashes interfered with daily activities and quality of life. Results indicated a 59% decrease in total daily hot flashes and a 70% decrease in weekly hot flash scores from their baselines. There was also a significant decrease in the degree to which hot flashes interfered with daily activities for all measures including work, social activities, leisure activities, sleep, mood, concentration, relations with others, sexuality, enjoyment of life, and overall quality of life. This pilot study suggests that clinical hypnosis may be an effective non-hormonal and non-pharmacological treatment for hot flashes. A randomized, controlled clinical trial is planned to more definitively elucidate the efficacy and applicability of hypnosis for reducing hot flashes.

Activities of Daily Living↗

PubMed2006

Intensive hypnotherapy for smoking cessation: a prospective study.

This study reports on a prospective pilot trial of intensive hypnotherapy for smoking cessation. The hypnotherapy involved multiple individual sessions (8 visits) over approximately 2 months, individualization of hypnotic suggestions, and a supportive therapeutic relationship. Twenty subjects were randomly assigned to either an intensive hypnotherapy condition or to a wait-list control condition. The target quitting date was 1 week after beginning treatment. Patients were evaluated for smoking cessation at the end of treatment and at Weeks 12 and 26. Self-reported abstinence was confirmed by a carbon-monoxide concentration in expired air of 8 ppm or less. The rates of point prevalence smoking cessation, as confirmed by carbon-monoxide measurements for the intensive hypnotherapy group, was 40% at the end of treatment; 60% at 12 weeks, and 40% at 26 weeks (p < .05).

Adult↗

PubMed2006

Hypnosis to manage anxiety and pain associated with colonoscopy for colorectal cancer screening: Case studies and possible benefits.

This study explored using hypnosis for pain and anxiety management in 6 colonoscopy patients (5 men, 1 woman), who received a hypnotic induction and instruction in self-hypnosis on the day of their colonoscopy. Patients' levels of anxiety were obtained before and after the hypnotic induction using Visual Analogue Scales (VAS). Following colonoscopy, VASs were used to assess anxiety and pain during colonoscopy, perceived effectiveness of hypnosis, and patient satisfaction with medical care. Hypnotizability was assessed at a separate appointment. The authors also obtained data (time for procedure, number of vasovagal events, and recovery time) for 10 consecutive patients who received standard care. Results suggest that hypnosis appears to be a feasible method to manage anxiety and pain associated with colonoscopy, reduces the need for sedation, and may have other benefits such as reduced vasovagal events and recovery time.

Aged↗

PubMed2005

Noncompliance with behavioral recommendations following bariatric surgery.

BACKGROUND: Bariatric surgery has been increasingly utilized for treatment of severe obesity. Although initial weight loss following surgery is almost completely assured, little is known about long-term out-come and patient compliance with post-surgical behavioral recommendations for diet and exercise that would improve outcome. The purpose of this study was to examine the rate of noncompliance with behavioral recommendations and to identify the incidence of psychological concerns following bariatric surgery. METHOD: Subjects were identified from an active clinical data-base of prospective clinical follow-up of all bariatric surgery patients. 100 consecutive patients who underwent Roux-en-Y gastric bypass were identified, and a chart review was conducted at 6 and 12 months postoperatively to gather demographic data and identify the prevalence of noncompliance identified in monthly follow-up visits. Also, patients were asked about depression, relationship/sexual concerns, and medical complications. RESULTS: 81 women and 19 men were followed for 1 year. The majority of patients reported noncompliance in at least one area, with lack of exercise and snacking being most frequently cited (41%, 37% respectively overall). Most patients were compliant with eating protein first and avoiding sodas. At 12 months follow-up, 12% reported depression, 4% reported sexual concerns and 2% reported relationship problems. Also, 9% reported having experienced some medical complication related to their surgery. CONCLUSION: Noncompliance with behavioral recommendations is pervasive following bariatric surgery, with lack of exercise being the most likely area of noncompliance. Because of the importance of compliance with behavioral recommendations for the successful outcome of bariatric surgery, further research is warranted to further clarify the factors that impact long-term outcome and to design interventions to improve compliance.

Adaptation, Psychological↗

PubMed2005

Complementary and alternative medicine use by psychiatric inpatients.

82 psychiatric inpatients hospitalized for acute care were interviewed about their use of complementary and alternative medicine (CAM) modalities. The clinical diagnoses of respondents included Depressive Disorder (61%), Substance Abuse (26%), Schizophrenia (9%), and Anxiety Disorders (5%). Analysis indicated that 63% used at least one CAM modality within the previous 12 mo. The most frequently used modality was herbal therapies (44%), followed by mind-body therapies such as relaxation or mental imagery, hypnosis, meditation, biofeedback (30%), and spiritual healing by another (30%). Physical modalities such as massage, chiropractic treatment, acupuncture, and yoga were used by 21% of respondents. CAM therapies were used for a variety of reasons ranging from treatment of anxiety and depression to weight loss. However, most respondents indicated they did not discuss such use with their psychiatrist or psychotherapist.

Adult↗

PubMed2004

Can hypnosis reduce hot flashes in breast cancer survivors? A literature review.

Hot flashes are a significant problem for many breast cancer survivors and can cause discomfort, insomnia, anxiety, and decreased quality of life. In the past, the standard treatment for hot flashes has been hormone replacement therapy. However, recent research has found an increased risk of breast cancer in women receiving hormone replacement therapy. As a result, many menopausal women and breast cancer survivors reject hormone replacement therapy and many women want non-pharmacological treatment. In this critical review we assess the potential use of hypnosis in reducing the frequency and intensity of hot flashes. We conclude that hypnosis is a mind-body intervention that may be of significant benefit in treatment of hot flashes and other benefits may include reduced anxiety and improved sleep. Further, hypnosis may be a preferred treatment because of the few side-effects and the preference of many women for a non-hormonal therapy. Two case studies are included to illustrate hypnosis for hot flashes. However this intervention has not been adequately studied. We discuss an NIH-funded randomized clinical trial of hypnosis for hot flashes in breast cancer survivors that is presently being conducted.

Breast Neoplasms↗

PubMed2004

Use of a numeric visual analog anxiety scale among patients undergoing colorectal surgery.

The aim of this study was to evaluate the utility of a Numeric Visual Analog Anxiety Scale (NVAAS) as a potentially accurate and efficient way to determine presurgery anxiety among patients undergoing colorectal surgery. A secondary aim was to determine the relationship between NVAAS ratings of anxiety and postsurgery pain. Thirty-six patients scheduled for colorectal surgery were asked to rate their state anxiety on the NVAAS and to complete the State-Trait Anxiety Inventory (STAI). The NVAAS correlated significantly with STAI-state anxiety (0.64, p <.0001). The NVAAS measure of presurgery anxiety also correlated significantly with STAI-trait anxiety (0.46, p <.005) and postsurgery Visual Analog Scale pain ratings (0.35, p <.038). The NVAAS appears to be a valid and sensitive measure of anxiety among patients undergoing colorectal surgery. The NVAAS also has the advantage of being convenient and easy to use at bedside, increasing its clinical utility in medical nursing care.

Aged↗

PubMed2004

Prevalence of anxiety among patients undergoing colorectal surgery.

To assess prevalence of anxiety 36 consecutive patients undergoing colorectal surgery with general anesthesia were interviewed on the day of surgery and completed the State-Trait Anxiety Inventory. Postsurgical ratings of pain and anxiety were obtained within 24 hours after surgery. Analysis indicated that 29 scored moderate or higher on the State Anxiety scale prior to surgery. The correlations for scores on presurgical Trait Anxiety with postsurgical pain and Trait Anxiety scores were significant (p<.01) but not that for pre- and postsurgical State Anxiety

Adult↗

PubMed2003

The integration of hypnosis into a model of palliative care.

There exists a need for a broad and inclusive model of integration of mind-body interventions for palliative care. Symptoms relating to psychological distress and existential concerns are even more prevalent than pain and other physical symptoms among those with life-limiting conditions. The hypnotic model's purpose is to improve the patient's total psychological, social, and spiritual well-being. A 4-stage model of interventions is offered to assist the clinician in developing and implementing appropriate hypnotherapeutic treatment for noncurative patients. The focus of the hypnotherapy is to ameliorate the effects of pain and dyspnea to restore a level of psychological and physical wellbeing. Within this model of therapy for patients with active, progressive, far-advanced disease and a short life expectancy, the goals of the hypnotic intervention are to provide relief from pain and shortness of breath. Other focuses include assisting the patient with the psychological adjustment to their noncurative and ultimately final state.

Holistic Health↗

PubMed2003

A model of hypnotic intervention for palliative care.

The World Health Organization defines palliative care as "the active total care of patients whose disease is not responsive to curative treatment." One of the primary issues of palliative care for patients with advanced cancer is symptom control and quality-of-life issues. The purpose of the hypnotic model presented here is to improve the patient's total psychological, social, and spiritual well-being. There exists a need for a broad and inclusive model of mind-body interventions for palliative care. This is supported by the observation that symptoms related to psychological distress and existential concerns are even more prevalent than pain and other physical symptoms among those with life-limiting conditions. The following model integrates naturalistic, solution-oriented hypnosis within the framework of a situational 4-stage crisis matrix. The four stages of the matrix are: (1) The Initial Crisis, (2) Transition, (3) Acceptance, and (4) Preparation for Death. Hypnotic interventions are tailored to each stage in the crisis matrix.

Adaptation, Psychological↗