Hypnotherapeutic Ego Strengthening with Male South African Coronary Artery Bypass Patients

American Journal of Clinical Hypnosis,  Oct 2004  by de Klerk, Jacoba E,  Plessis, Wynand F du,  Steyn, Hendrik S,  Botha, Mike

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Procedure

Patients provided informed consent to participate in the experimental or control group. They were interviewed, given the biographical questionnaire, BDI-II and POMS, assured of confidentiality and informed that they could answer questionnaires anonymously. Researcher assistance was provided during preassessment. Nursing staff consent concurred with that of the thoracic surgeon. Since nursing professionals only had to provide privacy for assessment and therapeutic interventions, no education was necessary. Likewise, nursing personnel caring for the two groups in the intensive care unit (ICU) and relevant open wards received no education or insight, so as not to influence participants' responses.

The experimental group (EG) was given appropriate information on hypnotherapy and its advantages. The subjects then attended two 60-minute preoperative HES sessions individually in a private room the evening preceding surgery and on the morning thereof. The intervention included a progressive relaxation induction and special-place deepening technique. Then a metaphor focusing on spiritual inner strength and age progression was introduced. The second preoperative session included a preoperative rehearsal. The inner-strength and age-progression intervention was repeated in three postoperative HES sessions, and was presented on audiocassette during their postoperative hospital stay at a rate of one session daily. The principal author's voice was used with classical music and administered under her care. Posttesting was scheduled individually at discharge and at 6-week follow-up. Patients were assisted in questionnaire completion since many found it impossible to respond otherwise.

The control group (CG) attended no inputs other than the pre-, post-, and follow-up assessment, and there were not any placebos involved. However, the control group patients were offered access to counseling services after their 6-week follow-up visit and thanked for their participation.

Results

Pre-intervention group equivalence

Although not evident in Table 1, the statistical analysis confirmed nonsignificant differences between the experimental and control group with regard to biographical variables, medical history, anxiety, and depression. Thus pre-treatment group equivalence was endorsed (De Klerk, 2003).

Reliability of measuring instruments.

Although not standardized for South African populations, Cronbach alpha values of both measuring instruments indicated satisfactory internal consistency of 0.82 and 0.89 for anxiety and depression on the POMS respectively. The BDI-IFs internal reliability was 0.84.

Postintervention findings

Depression. Figure 1 shows that on the BDI-II a significant group by time interaction (p

Figure 2 shows that on the POMS a significant group by time interaction (p

Anxiety. Figure 3 reflects that on the POMS a significant group by time interaction (p

Discussion

The results confirmed the presence of psychological comorbidity in CABS patients who experienced a sense of loss, uncertainty, and vulnerability. Participants experienced significant reductions in postoperative mood states like anxiety and depression, which was maintained at 6-week follow-up. Hence the results suggested that HES techniques provided patients with coping mechanisms for alleviating CABS distress. In contrast, morbidity was not reduced in the control group.