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to the distraction or control groups at first intervention,
whereas the distraction group only
showed significant results in pain and anxiety after
the second intervention. The authors suggest
that coping skills for younger children
need to be learnt over one or more sessions before
any effect can be observed. By contrast, in
the older patients (aged 7--10), both the hypnosis
and distraction groups showed significant reductions
in observer-rated pain and anxiety as
compared to controls. This is a small sample
with unknown method of randomization. The
contamination of the control group by the
staff’s increasing knowledge and adoption of
the other two treatments was problematic. Furthermore,
nurses were inadequately blinded
to group allocation. A lack of pretreatment pain
measures and high attrition rate further limit
the conclusions that can be reached.
Katz et al.
36
report the findings of an RCT
involving 36 pediatric patients aged 6--11,
who were undergoing BMA. Patients were
stratified for analysis by sex (24 males and
8 females) based on previous findings of gender
differentiation in outcome.
39
Patients were
randomized to 20 minutes training in hypnosis
and self-hypnosis (active imagery, deep muscle
relaxation, imagery, and suggestions for anesthesia
and self-mastery) or to nondirected play