Over 90% of the 175,000 women diagnosed with breast cancer in 1999 will undergo surgical treatment. Despite improvements in pharmacological management, surgical procedures under general anesthesia continue to be associated with clinically significant side effects, chief among which are pain and nausea. These clinical problems are particularly severe following surgical treatment for breast cancer and can require additional pharmacologic intervention, prolong recovery room stay, delay discharge, and lead to unanticipated readmission. Clinical research with other surgical populations has indicated that hypnosis is effective for control of postoperative symptoms and enhancing recovery (e.g., reducing pain, nausea, hospital stays), however to our knowledge, the treatment efficacy of hypnotic techniques with breast surgical patients has not been established. The goals of this study are twofold: 1) To apply hypnotic techniques proven efficacious with other surgical patients to patients underlying lumpectomy for breast cancer; and 2) To better understand the basic behavioral mechanisms responsible for hypnosis effects by examining two likely ":active ingredients" (i.e., patients preoperative levels of distress and their expectations of side effects) of the hypnosis intervention. To achieve these goals, 140 breast cancer patients scheduled for lumpectomy will be randomly assigned to a hypnosis intervention group or a standard care control group. The impact of the hypnotic intervention on postoperative nausea, pain and recovery from surgery will be analyzed within an experimental study design. The influence of pre-surgery distress and expectations of side effects will be analyzed within a perspective study design using correlational approaches. In both analyses, the potential influence of additional factors (e.g., medical, demographic, patient characteristics) will be assessed. The results of this proposal to apply a hypnotic intervention to a new population (i.e., surgical breast cancer patients) and to examine the basic behavioral mechanisms responsible for beneficial effects of hypnotic suggestions will establish the background necessary for a more extended background of research to investigate the mechanisms and modifiers of the effects of hypnotic suggestion in this population.
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