Sight, sounds of nature ease pain of procedure
Sight, sounds of nature ease pain of procedure
Bronchoscopy patients achieve 43% improvement
Patients who were distracted during and after bronchoscopy by the gurgle of a brook and a pastoral mountain mural were 43% more likely to report pain control as either very good or excellent in a recent study conducted by Johns Hopkins Medical Institution in Baltimore. The study was conducted in the summer of 2000.
"During previous patient studies, we had found what we thought was a surprisingly high amount of pain — more than we were comfortable with — despite the use of a fair amount of medication to try to prevent pain," notes Gregory Diette, MD, MHS, assistant professor of pulmonary and critical care medicine at Hopkins. "This despite the fact that we err on the high side in this area."
In light of this situation, a particular form of distraction therapy called Bedscapes, provided by Healing Environments International of Woodstock, NY, sounded very attractive to Diette and his colleagues. Bedscapes incorporates what are known as "biophilic" images and sounds, he explains. "One definition of biophilic is those sights and sounds that provoke a positive or healing response in people who are sick," Diette says. "Common features involve nature, the color green, images of water and trees — often spaced apart."
There were two selections available to Hopkins — a mountain scene, or a beach scene with ocean sounds and sea gull cries. "We just preferred the mountain option; we felt it would do a better job," says Diette. The mural was a 42 inch by 52 inch photograph of a mountain stream in a spring meadow that was mounted by the bedside in the recovery area and mounted from the ceiling in procedure rooms. A continuous tape of sounds — water in a stream, birds chirping, and so on — was played with a portable tape player and used with headphones by the patient.
Diette was not surprised with the results. "Biophilic images and nature sounds fit into the general area of distraction therapy," he notes. "For example, in pediatrics, when kids have blood drawn, it’s not unusual to have someone distract them. I have seen studies using PET scans that show that when people are distracted, there is a difference in blood flow to areas of the brain where pain is perceived. It’s quite possible there’s a region in the brain that’s not getting signals it would have gotten if the patients were not distracted."
Other applications possible
Diette and his fellow researchers theorize this type of therapy may be applicable in other invasive procedures such as endoscopies, sigmoidoscopies, or interventional radiological exams. "It would be nice to offer it to all of our patients," Diette says. "It should not be thrust upon them, but it would be nice if they had a choice."
Expense would not be a problem. "The Bed-scapes retail for $249 apiece, which includes the screen, the means to hang the screen, and the tape. Theoretically, it is reusable, so two or three could go a long way," says Diette.
How does Diette feel about the fact that many would categorize this approach as an "alternative medicine" intervention? Does he believe alternative medicine has a role in improving quality of care? "I think the answer is yes,’ to the extent that we can test these kinds of things and demonstrate that they should be part of conventional medicine," he replies. "If we subject them to the same kind of rigorous testing, they ought to be incorporated. This is an exciting and basically a harmless intervention," Diette explains.
Need more information?
For more on the fibromyalgia program, contact:
• Gregory Diette, MD, MHS, Johns Hopkins Medical Institution, 1830 E. Monument St., Baltimore, MD 21205. Telephone: (410) 502 7037. E-mail: [email protected].
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