Biomedical subjects
Publications and source records attributed to M Greenleaf.
The first section of this article focuses on epidemiology, cause, diagnosis, and treatment of brain tumors in children and adolescents. The second section addresses the long-term consequences of tumors and their treatment, and a special emphasis is paid to cognitive and psychological outcomes.
We studied 32 coronary bypass patients to examine the effect of hypnosis on recovery from surgery. The patients were assessed for hypnotizability with the Hypnotic Induction Profile (HIP) and assigned to experimental groups with a random stratification procedure to equate for differences in hypnotizability, age, and severity of illness. We taught patients in groups one and two formal hypnosis with different treatment strategies; patients in group three were not taught formal hypnosis or a treatment strategy. Scores on the HIP were significant predictors of recovery, independent of experimental treatment with formal hypnosis. Patients who scored "Midrange" stabilized more quickly in the intensive care unit (ICU) than those who scored "High" or "Low" (p = < .05). Patients who scored "High" had more labile blood pressure in the ICU compared to the "Midrange" and "Lows" (p = < .05). Measured hypnotizability was associated with the recovery sequence from surgery.
Since Mesmer, there has been much confusion about the inter-relationship between an individual's degree of hypnotizability, the personality style of the individual and the importance of the therapeutic strategy. Empirical and experimental research supports the hypotheses that there are: 1) biopsychosocial components of hypnotizability on a continuum ranging from ecologically insensitive (not modifiable by external stimuli) to ecologically sensitive (very modifiable by external stimuli); 2) biopsychosocial components that can be measured to identify an individual's degree of hypnotic capacity and responsivity; 3) distinct personality styles which correlate with low, mid-range and high hypnotizability on a fix (ecologically insensitive)-flex (ecologically sensitive) continuum; and 4) different clinical syndromes which correlate with these categorical distinctions. We propose that measuring hypnotizability and personality style is a way to clarify diagnosis and choose appropriate treatment strategies to maximize existing biopsychosocial resources of an individual with a specific problem in a particular context.
The need for crisis intervention and brief psychotherapy is becoming more evident with the increase of impersonal "high tech" approaches to patient care and the need to treat situational stress. The hospital experience has become one in which complex technology and bureaucracy may overpower all the participants, making it difficult for patients to respond optimally to available treatment. The hypnotic modality, with identification of individual capacity and responsivity, can be a bridge to transmit caring, comfort and respect; encourage patient participation to enhance biopsychosocial responses to illness, treatment and hospitalization; and to improve the skills of the health care provider. The Hypnotic Induction Profile (HIP) will be discussed as a rapid and efficient method to identify individual resources and develop treatment strategies. Cases are presented to illustrate this approach.
Screening flexible sigmoidoscopy (FS) is an effective tool for the detection of colon cancer. Nonetheless, persons are reluctant to undergo FS for a variety of reasons such as anxiety, discomfort, and the possibility of abnormal findings. Nurses caring for FS patients can implement interventions to allay anxiety and promote comfort in an effort to enhance satisfaction and future compliance. Music therapy is one nonpharmacologic intervention that has been shown to be effective in allaying anxiety, reducing discomfort, and promoting satisfaction in other patient populations. A two-group pretest, posttest experimental design with repeated measures study recruited 64 subjects undergoing FS from one Midwestern tertiary care center. Subjects were randomly assigned to a control condition of usual procedural care or to an experimental condition of music therapy during the examination. State and trait anxieties were measured at pretest. State anxiety, discomfort, satisfaction, and perceived compliance with future screening were measured after the procedure. Subjects in the music group reported less anxiety and discomfort than subjects in the control group. There were no differences on satisfaction ratings or perceived compliance with screening guidelines. Nurses caring for patients undergoing screening FS can offer music therapy as one nonpharmacologic intervention to ameliorate anxiety and reduce discomfort.