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Hypnosis to Reduce Distress in Children Undergoing Anorectal Manometry: A Randomized Controlled Pilot Trial
Desiree F Baaleman1,2,3, Mana H Vriesman1,2, Ilan J N Koppen1,2
1Division of Gastroenterology, Hepatology, and Nutrition, Nationwide Children's Hospital, Columbus, OH, USA.
Insights
Hypnosis significantly reduced distress in children before anorectal manometry (ARM). This brief intervention is feasible and well-received by children and parents, although distress during the procedure did not differ.
Area of Science:
- Pediatric Gastroenterology
- Psychological Interventions
- Medical Procedure Support
Background:
- Functional constipation is a common pediatric issue.
- Anorectal manometry (ARM) is a diagnostic procedure that can cause distress in children.
- Minimizing procedural distress is crucial for pediatric patient experience.
Purpose of the Study:
- To evaluate the effectiveness and feasibility of using hypnosis to reduce distress in children undergoing ARM.
- To assess the impact of a brief hypnosis session on children's anxiety before and during ARM.
Main Methods:
- A partially-blinded randomized controlled pilot trial involving 32 children (ages 4-18) undergoing ARM.
- Children were randomized to receive either a brief hypnosis session or standard care prior to the procedure.
- Distress levels were assessed using the Observation Scale of Behavioral Distress and a 4-point Likert scale by blinded and non-blinded observers.
Main Results:
- Children in the hypnosis group showed significantly lower distress levels before ARM compared to the standard care group (P=0.009 and P=0.044).
- No significant differences in distress were observed during the ARM procedure itself.
- Hypnosis was positively perceived, with 92.9% of parents and children reporting it helped with relaxation. No procedural differences were noted.
Conclusions:
- A brief hypnosis session is an easily integrated intervention to lower pre-procedural distress in children undergoing ARM.
- Hypnosis is a feasible and positively received method for managing pediatric procedural anxiety.
- Further research may explore sustained effects and broader applications in pediatric procedures.
Background/Aims:
To assess the effectiveness and feasibility of a brief session of hypnosis to reduce distress in children with functional constipation undergoing anorectal manometry (ARM).
Methods:
A partially-blinded randomized controlled pilot trial was conducted in children 4-18 years old scheduled for ARM. Children were randomized to receive a brief session of hypnosis prior to ARM or standard care. Non-blinded and blinded observers rated the child's level of distress using the Observation Scale of Behavioral Distress and a 4-point-Likert scale, respectively. Differences between groups were analyzed using Fisher's exact test or Mann-Whitney U test as appropriate.
Results:
Data from 32 children (15 hypnosis and 17 standard care) were analyzed. Prior to insertion of the catheter, the observed mean levels of distress were lower in the hypnosis group according to both the non-blinded observer (median 0.0 [interquartile range {IQR} 0.0-0.3] vs 1.4 [IQR 0.3-2.4]; P = 0.009) and the blinded observer (median 0.0 [IQR 0.0-0.0] vs 0.5 [IQR 0.0-1.0]; P = 0.044). During ARM, observed and reported levels of distress did not differ significantly. In the hypnosis group, 92.9% of parents and children reported that hypnosis helped the child to relax. There were no significant differences in resting pressure, squeeze pressure, or duration of the procedure between both groups.
Conclusion:
A brief session of hypnosis for children before ARM is an easily incorporable intervention that lowers distress levels prior to the procedure and is positively perceived by children and parents.
