New Zealand Rehabilitation Association, Inc.

Wiechman Askay, S., Patterson, D. R., Jensen, M. P., & Sharar, S. R. (2007). A randomized controlled trial of hypnosis for burn wound care. Rehabilitation Psychology, 52(3), 247-253.

Hypnosis has been the subject of many a sceptic’s website, so papers such as this one, particularly in reputable journals, often tend to jump out at the reader.  Reading on through the abstract only heightens one’s interest – these authors report a single-blinded randomized controlled trial which finds in favour of hypnosis as a pain management strategy for people undergoing wound debridement for burns - which surely must be one of the more unpleasant, painful clinical procedures.  So what’s the story here?

The researchers recruited 57 English-speaking adults with burn injuries requiring daily wound care.  These participants were randomly allocated to receive hypnosis by a trained psychologist prior to wound debridement or to a control group.  The hypnosis group also received a tape of the hypnotic induction during wound cares followed by music of their choice.  The control group received a visit by the psychologist of a similar duration, but for general discussion of their injuries and no hypnosis, plus were given a tape of relaxing music to listen to during wound debridement.  The nurses and assistants who performed the wound cares were blinded to group allocation as were those who collected data on outcomes.  The primary outcomes measured for this study was the Short Form McGill Pain Questionnaire (SF-MPQ) and a visual analogue scale of pain for worst pain intensity and average pain intensity during care.

The findings indicated that while scores on the SF-MPQ showed statistically significant differences between the two patient groups, there was no different on the other measures of pain.  The authors attributed this difference to the SF-MPQ being a multi-variable measure of pain in comparison to the single variable score provided by the visual analogue scale. However, they believed this finding supported a conclusion that hypnosis may be of benefit for people undergoing painful clinical procedures. 

Limitations of this study included lack of concealment of randomization (if it occurred it was not reported) and low sample size.  Also of interest, the 57 participants from this study were recruited from an original sample of 200 patients.  The reasons for people wanting or not wanting to participate in a study such as this could quite possibly influence their response to hypnosis. Indeed, 80% of the sample reported having received a benefit from the study regardless of which group they had been allocated to.  The authors stated for ethical reasons they were unable to include a ‘no intervention’ control group – but obviously, this is another missing piece to the puzzle.