Effectiveness of Relaxation and Hypnosis Interventions in Distressed Patients With Chronic Diabetic Foot Ulcers: A Longitudinal Pilot Randomised Controlled Trial.

IF 2.7 2区 心理学 Q2 PSYCHIATRY
M Graça Pereira, Margarida Vilaça, Susana Pedras, André Carvalho, Kavita Vedhara, M Jesus Dantas, Alberto Lopes, Susana Faria
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Abstract

Diabetic foot ulcer (DFU) healing is a complex and slow process that depends on several factors such as the patient's physical health. However, psychological factors such as distress, which are commonly reported by patients with DFU, may also influence DFU development and recurrence. This pilot randomised control trial (RCT) assesses the effectiveness of progressive muscle relaxation and hypnosis on DFU healing and quality of life (QoL) in distressed patients. Sixty-nine patients who received standard care treatment were randomly assigned to one of four groups: muscle relaxation (TG1), hypnosis (TG2), neutral sessions (active control: ACG), and no intervention (passive control: PCG). Primary outcomes were both DFU healing and QoL. Secondary outcomes were perceived stress, psychological morbidity, and illness (DFU) representations. Patients were assessed at baseline (T0), 2 months after the baseline (T1), and 4 months later (T2). Regarding primary outcomes, comparisons between groups showed significant differences only in DFU healing: TG1, TG2, and ACG reported more improvements than PCG at T1, while TG1 showed more improvements than TG2 and PCG at T2. Results for secondary outcomes revealed less threatening DFU representations in TG1 compared to TG2 and ACG, and more psychological morbidity in TG2 than TG1, both at T1. Within-group analysis in primary outcomes showed DFU healing and physical QoL improvement in all groups, DFU-related QoL improvement in all groups except PCG, and an increase in mental QoL only in TG2 and ACG. Regarding secondary outcomes, results showed a decrease in DFU's representations only in TG1, and a significant decrease in stress and psychological morbidity in TG1, TG2, and ACG. Results suggest that both stress-reduction interventions should be included in the multidisciplinary treatment and rehabilitation plan for distressed patients with DFU(s).

放松和催眠干预对慢性糖尿病足溃疡患者的疗效:一项纵向先导随机对照试验。
糖尿病足溃疡(DFU)的愈合是一个复杂而缓慢的过程,取决于患者的身体健康等多种因素。然而,DFU患者通常报告的心理因素,如痛苦,也可能影响DFU的发展和复发。本随机对照试验(RCT)评估渐进式肌肉放松和催眠对痛苦患者DFU愈合和生活质量的有效性。69名接受标准治疗的患者被随机分为四组:肌肉放松(TG1)、催眠(TG2)、中立(主动控制:ACG)和不干预(被动控制:PCG)。主要结局为DFU愈合和生活质量。次要结局是感知压力、心理发病率和疾病(DFU)表征。分别在基线(T0)、基线后2个月(T1)和4个月后(T2)对患者进行评估。关于主要结局,组间比较仅在DFU愈合方面显示显著差异:TG1、TG2和ACG在T1时比PCG改善更多,而TG1在T2时比TG2和PCG改善更多。次要结局的结果显示,与TG2和ACG相比,TG1的DFU症状威胁性较低,TG2的心理发病率高于TG1,两者在T1时都是如此。组内主要结局分析显示,各组DFU愈合和身体生活质量均有改善,除PCG外各组DFU相关生活质量均有改善,仅TG2和ACG组精神生活质量有所改善。至于次要结局,结果显示仅在TG1中DFU的表现有所下降,而在TG1、TG2和ACG中应激和心理发病率显著下降。结果表明,减压干预措施应纳入DFU患者的多学科治疗和康复计划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Stress and Health
Stress and Health 医学-精神病学
CiteScore
6.40
自引率
4.90%
发文量
91
审稿时长
>12 weeks
期刊介绍: Stress is a normal component of life and a number of mechanisms exist to cope with its effects. The stresses that challenge man"s existence in our modern society may result in failure of these coping mechanisms, with resultant stress-induced illness. The aim of the journal therefore is to provide a forum for discussion of all aspects of stress which affect the individual in both health and disease. The Journal explores the subject from as many aspects as possible, so that when stress becomes a consideration, health information can be presented as to the best ways by which to minimise its effects.
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