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the need to include both observer- and
patient-reported ratings when measuring levels
of pain and distress (McCall, personal communication).
Anticipatory anxiety as a specific
outcome measure is not frequently measured
in the research. However, anecdotal evidence
(Liossi, personal communication) suggests
that hypnosis can have a positive effect on anticipatory
anxiety prior to pediatric procedures.
This suggests the need for future
research into the impact of hypnosis on anticipatory
anxiety in addition to procedure-related
distress.
Hypnotizability
Level of hypnotizability was shown to have
some influence on analgesic effect. Level of
hypnotizability was measured in some studies
15,17,33,34
using the Stanford Hypnotic Clinical
Scale for Children.
25
This is an appropriate
and validated measure for children. Other
measures of hypnotizability were used, including
arm levitation exercise and rating
scales.
36,38
However, the reliability and validity
of such measures have not been established for
this patient group. Studies that show an association
between measures of hypnotizability and
response to hypnotic analgesia are described
elsewhere,
40
but this is an area that requires
further investigation with this population.