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1

What is the title of the article?

A randomized trial of hypnosis for relief of pain and anxiety in adult cancer patients undergoing bone marrow procedures

2

What are two things that play a central role in the diagnosis and follow-up of many hematological disorders?

Bone marrow aspiration and biopsy

3

How many patients undergo bone marrow aspirates and biopsies annually for diagnosis and disease monitoring of blood and bone marrow cancers in the US?

More than 300 000

4

How do cancer patients find medical procedures as? 2 things

As a source of psychological and physiological stress

5

What are two effect of psychological and physiological stress?

High levels of anxiety and distress

6

What kind of procedure are also a common source of pain and distress besides medical procedures?

Needle-related procedures

7

Are bone marrow aspirations and biopsies regarded as painful and traumatic procedures?

yes

8

What is the purpose of local anesthesia?

To help a person be insensitive to pain

9

Where is local anesthesia usually appiled to? 3 things

Skin
Subcutaneous tissue
Periosteum

10

What is the problem of local anesthesia? 2 things

It does not prevent the transient pain experienced during the suction and penetration of the needle into the bone, nor does it prevent the anxiety associated with the procedure

11

Puntillo found that less than ___ of patients undergoing potentially painful procedures received preprocedure opiates.

Puntillo found that less than 20% of patients undergoing potentially painful procedures received preprocedure opiates.

12

Why do patients who took pain or anxiety medication report pain and discomfort from the procedure?

Because of the penetration of the needle into the bone and aspiration

13

What is the problem of taking analegsic and anxiolytic medications (pain medications)? 1 things

They have unpleasant side effects

14

What are two side effects of lorazepam?

Prolonged sedation and amnesia

15

What can anxiety increase? 2 things

Pain perception and pain severity

16

How does anxiety increase pain perception?

Memory can cause anxiety about subsequent procedures which increase pain perception in later procedures

17

What is an intervention (a solution to decrease pain and anxiety) for children and adolescents undergoing bone marrow aspirates and biopsies?

Hypnosis

18

What are some of the problems with the studies of using hypnosis to decrease pain and anxiety during a procedure?

Some of the studies have some methodological limitations including underpowered sample sizes and lack of reporting of the method of randomization.

19

Out of the five published studies of using hypnosis to decrease pain and anxiety, who has the largest sample sized of 48 patients with an unknown method of randomization?

Kuttner

20

What is the support for the effectiveness of hypnotic interventions limited by? 3 things

Heterogeneity (the quality or state of being diverse in character or content)
Small sample size
Absence of treatment manuals

21

Why wasn't the field of child hypnosis a popular intervention?

Because it wasn't the "gold standard" yet

22

What does gold standard mean?

The method which detects it with the highest sensitivity and accuracy or a diagnostic, test or benchmark that is the best available under reasonable conditions.

23

What are three disadvantages of taking premedication before the procedures?

Patients who are premedicated cannot drive
They cannot engage in work involving machinery
Medication adds to healthcare system

24

What does pediatric mean?

relating to the branch of medicine dealing with children and their diseases.

25

What are two other therapy beside hypnosis?

art therapy and cognitive-behavioral therapy

26

For adult hematologic patients, which type of method have been broadly accepted and why? 3 reasons

Behavioral method because of their positive impact on patient distress and suffering, the ease of their application and the sense of control their use provides to a vulnerable patient population

27

What type of therapy reduces emotional distress?

Hypnosis

28

Who were the three people that conducted a meta-analytic review of 18 articles and 27 effect sizes to detemine the effectiveness of hypnosis for pain relief?

Montgomery, DuHamel, and Redd

29

Who conducted a meta-analytic review of hypnosis on emotional distress?

Schnur

30

Which behavioral methods have the greatest potential for benefit to the patient?

Hypnosis