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肠易激综合征的催眠疗法:患者的期望与认知

Hypnotherapy for irritable bowel syndrome: patient expectations and perceptions.

作者信息

Donnet Anne-Sophie, Hasan Syed Shariq, Whorwell Peter J

机构信息

Neurogastroenterology Unit, Wythenshawe Hospital, Manchester, UK.

Hypnotherapy Unit, Wythenshawe Hospital, Manchester, UK.

出版信息

Therap Adv Gastroenterol. 2022 Feb 15;15:17562848221074208. doi: 10.1177/17562848221074208. eCollection 2022.

Abstract

INTRODUCTION

Numerous studies have shown that hypnotherapy (HT) is effective in irritable bowel syndrome (IBS) using traditional symptom severity end points. However, there is now interest in capturing the patient's perception of their illness and treatment because what patients expect from their treatment may differ from that of their healthcare provider.

OBJECTIVE

To record patient perceptions and expectations of hypnotherapy as well as their symptom response.

METHODS

150 consecutive IBS patients (116 females, 34 males, aged 16-81 years) receiving hypnotherapy completed questionnaires recording IBS symptom severity, quality of life, noncolonic symptoms, anxiety and depression levels before and after treatment. Their expectations and perceptions of HT were also recorded, including a free text reflection.

RESULTS

121 patients (81%) responded to treatment consistent with our previous experience. Symptom severity scores, noncolonic symptoms, quality of life, anxiety and depression significantly all improved after HT ( < 0.001). Expectancy of an improvement with hypnotherapy was greater in those who did not respond to treatment (63%) than those who did (57%,  < 0.001). Scepticism and apprehension were common before treatment and replaced with enthusiasm afterwards. Free text responses after treatment were overwhelmingly positive. Patients also reported a variety of other benefits and even 20 of 29 symptom nonresponders (70%) still considered treatment worthwhile.

CONCLUSION

Although initially perceived negatively, hypnotherapy improved symptoms and resulted in a wide range of additional benefits. Expectation did not necessarily influence outcome. Recording IBS symptoms alone does not fully capture the patient's experience of treatment and needs to be considered in future research.

摘要

引言

众多研究表明,使用传统的症状严重程度终点指标时,催眠疗法(HT)对肠易激综合征(IBS)有效。然而,现在人们开始关注了解患者对自身疾病和治疗的看法,因为患者对治疗的期望可能与医疗服务提供者的期望不同。

目的

记录患者对催眠疗法的看法和期望以及他们的症状反应。

方法

150名连续接受催眠疗法的IBS患者(116名女性,34名男性,年龄16 - 81岁)完成了问卷调查,记录治疗前后的IBS症状严重程度、生活质量、非结肠症状、焦虑和抑郁水平。还记录了他们对催眠疗法的期望和看法,包括一段自由文本反馈。

结果

121名患者(81%)对治疗的反应与我们之前的经验一致。催眠疗法后,症状严重程度评分、非结肠症状、生活质量、焦虑和抑郁均显著改善(<0.001)。未对治疗产生反应的患者中,对催眠疗法改善的期望更高(63%),高于有反应的患者(57%,<0.001)。治疗前怀疑和担忧很常见,之后被热情所取代。治疗后的自由文本回复绝大多数是积极的。患者还报告了各种其他益处,甚至29名症状无反应者中有20名(70%)仍认为治疗是值得的。

结论

尽管最初被负面看待,但催眠疗法改善了症状并带来了广泛的额外益处。期望不一定影响结果。仅记录IBS症状并不能完全体现患者的治疗体验,未来研究需要加以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baa1/8859690/f9827b4e7f38/10.1177_17562848221074208-fig1.jpg

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