Richardson, J., Smith, J.E., McCall, G., Richardson, A., Pilkington, K., & Kirsch, I. (2007). Hypnosis for nausea and vomiting in cancer chemotherapy: A systematic review of the research evidence. European Journal of Cancer Care, 16, 402–412. 

DOI Link

Purpose

STUDY PURPOSE: To systematically review the research evidence on the effectiveness of hypnosis for chemotherapy-induced nausea and vomiting (CINV)

TYPE OF STUDY: Systematic review

Search Strategy

DATABASES USED: MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Library
 
YEARS INCLUDED: Overall for all databases, database inception to March 2005
 
INCLUSION CRITERIA: Controlled clinical trials of patients with a diagnosis of cancer undergoing chemotherapy; an intervention defined by the study investigators as “hypnosis” or “hypnotherapy” that involved both “induction” and “suggestion”; comparative therapy or no treatment controls; measured frequency and severity of nausea and vomiting
 
EXCLUSION CRITERIA: Studies in which the intervention was not defined as hypnosis by investigator; controlled clinical trials in which only the abstract was available; uncontrolled studies

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 16
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Investigators appraised the literature using a standardized appraisal framework that was developed based on the Centre for Reviews and Dissemination (2001, 2nd edition) report number 4, \"Undertaking Systematic Reviews of Research on Effectiveness.\" Two researches independently appraised only randomized, controlled trials. Disagreements were resolved by discussion. A third investigator was available if resolution was not met. Post-treatment means and standard deviations for nausea and vomiting were calculated, and a single mean effective size was calculated to compare hypnotherapy and nonhypnotherapy. Effect sizes were calculated to show differences after hypnosis versus other therapies, and mean effect sizes for all trials (D) were based on sample size.

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 6 (5 of the studies are focused on pediatric patients)
  • TOTAL PATIENTS INCLUDED IN REVIEW = 206
  • SAMPLE RANGE ACROSS STUDIES: 12-67 patients
  • KEY SAMPLE CHARACTERISTICS: Pediatric patients undergoing chemotherapy with anticipated CINV and adult patients with hematologic lymphoma and bone transplantation

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active treatment
  • APPLICATIONS: Pediatrics, palliative care

Results

All the studies that focused on pediatrics were consistent in that hypnosis was a better treatment option than standard or controlled care. The weighted mean effect sizes indicated that hypnosis was even more effective when followed by therapist contact (D = 0.43) and cognitive behavior therapy (D = 0.18).

Conclusions

Hypnotherapy could be a clinically valuable intervention for anticipatory and acute CINV in children with cancer, but this older systemic review did not show the same results with adults.

Limitations

Limited number of studies included

Nursing Implications

Nurses caring for pediatric patients should understand that hypnosis should be part of the toolbox for children who suffer from acute and anticipatory CINV.      

Legacy ID

6394