Positive Audio Suggestions for Critical Illness-Related Stress
Palo Alto (17 mi)Overseen byLioudmila Karnatovskaia, MD
Age: 18+
Sex: Any
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: N/A
Recruiting
Sponsor: Mayo Clinic
No Placebo Group
Trial Summary
What is the purpose of this trial?The purpose of this study is to assess the use of an audio recording containing positive suggestion as a means to provide needed psychological support to critically ill patients in a feasible and reliable manner.
Is the treatment of listening to positive suggestions via MP3 messages helpful for stress in critically ill patients?Yes, listening to positive suggestions via MP3 messages seems promising for reducing stress in critically ill patients. Studies show it can shorten ICU stays and time on ventilators, and help reduce anxiety, pain, and tension.15689
What safety data exists for positive audio suggestions in critical care?The available research suggests that positive audio suggestions, delivered via MP3 messages, are feasible and potentially beneficial for reducing psychological distress in critically ill patients. Studies indicate that these interventions can be comforting and may reduce anxiety, depression, and acute stress. They have been associated with shorter ICU stays and reduced ventilation time. The interventions are generally well-received, with no significant safety concerns reported. However, larger randomized studies are needed to further assess efficacy and safety.357911
Do I need to stop my current medications for this trial?The trial protocol does not specify whether you need to stop taking your current medications.
What data supports the idea that Positive Audio Suggestions for Critical Illness-Related Stress is an effective treatment?The available research shows that Positive Audio Suggestions for Critical Illness-Related Stress can be comforting to patients. In one study, 7 out of 13 patients found it comforting when doctors used positive suggestions. Additionally, the treatment might help reduce anxiety compared to past patients who didn't receive it. Another study suggests that using trained companions, like doulas, to deliver these positive suggestions could be a good way to support patients emotionally during their ICU stay. This approach is seen as a potential way to help patients feel better mentally while they are in critical care.2491011
Eligibility Criteria
This trial is for ICU patients with acute respiratory failure or those needing vasopressors, expected to stay in the ICU for over 48 hours. It's not suitable for individuals with dementia, mental retardation, a history of suicide attempts or psychotic disorders like schizophrenia, alcohol/substance issues, severe metabolic encephalopathy, on comfort care, not expected to survive their hospital stay, hearing impaired or non-English speakers.Inclusion Criteria
I am experiencing severe breathing problems or need medication to maintain my blood pressure.
I am expected to be in the ICU for more than 48 hours.
I am currently in the Intensive Care Unit.
Exclusion Criteria
I am receiving care focused on my comfort.
I have a severe brain disorder due to a metabolic problem.
Treatment Details
The study tests psychological support through positive suggestions delivered via pre-recorded MP3 messages. The goal is to see if these audio recordings can help critically ill patients by providing reliable and feasible psychological support during intensive care.
2Treatment groups
Experimental Treatment
Active Control
Group I: PSBPS AudiorecordingExperimental Treatment1 Intervention
Thirty minute daily administration of audio recording containing messages of psychological support based on positive suggestion delivered via headphones
Group II: ControlActive Control1 Intervention
Standard of care
Find a clinic near you
Research locations nearbySelect from list below to view details:
Mayo Clinic in RochesterRochester, MN
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Who is running the clinical trial?
Mayo ClinicLead Sponsor
References
Stress-reducing effect of physician's tape-recorded support on cardiac surgical patients in the intensive care unit. [2022]Staying in an intensive care unit (ICU) is very stressful for patients after heart surgery. Although it is a general belief that support from doctors is important to reduce patients' tension, no quantitative data are available. We investigated the stress-reducing effects of a tape-recorded message from the physician which provided information regarding the surgery and emotional support for heart surgery patients postoperatively in the ICU. Sixty patients who underwent cardiac surgery were randomly allocated to two equal groups. The patients in the experimental group listened to a tape-recorded message from their attending surgeon soon after they recovered from anesthesia, while the control group rested during the study period. The effectiveness of the tape-recorded support program was evaluated by the influence on heart rate, blood pressure, and finger skin temperature, as well as the degree of subjective pain, tension, anxiety, depression, and anger. The pain and tension levels of the patients were measured using a visual analogue scale, while the severity of anxiety, depression, and anger was evaluated using the Brief Symptom Rating Scale. Patients' evaluation of the usefulness of the program was also assessed. After listening to the physician's recorded message, the mean increase in the skin finger temperature in the experimental group was higher than in the control group (0.44 degree C vs 0.25 degree C, p = 0.0513). The experimental group had significant decreases in their mean scores of pain (-1.11 vs 0.36, p = 0.0043), tension (-2.26 vs -0.25, p = 0.0001), anxiety (-1.3 vs -0.57, p = 0.0473), and depression (-2.24 vs -0.37, p = 0.0253). The patients showed a high need for this support program (mean need score 8.4). These findings show that a physician's tape-recorded message providing information and emotional support can reduce stress in heart surgery patients in the ICU postoperatively.
Counselling and support in intensive care. [2015]Counselling and support can improve psychological care and help patients and relatives through the emotional distress of critical illness. This paper considers the dual role of nurse and counsellor. Experience of developing a counselling and support service are shared. Choosing a theory and the counselling process is considered.
[Use of positive suggestions in medical practice: experiences in the intensive care unit]. [2015]The stressful states (e.g. the state of illness, sickness, acute or chronic pain, comatose and perioperative states) can be considered as psychological states in which we are more susceptible to all suggestions, including the deliberate or involuntary, direct or implicit ones. Under these conditions whether conscious of unconscious, peoples' thinking processes change, become literal, direct and somewhat paranoid, overly sensitive for not only to the direct, but to the implicit, inner meanings of communicative messages, as well. Research evidence shows that even the comatose people may maintain contact with the environment, therefore the conversation around and other communicative effects may serve as a special suggestion. These messages can be (unconsciously) interpreted by the patients following different logic than it would have been processed in the waking state. Treating people who are in these special stressful states one should carefully analyze all of the meaning layers of his/her communication, to make the helpful, positive suggestions more effective, and avoid the negative, destructive ones. The possible negative suggestions are those words, labels, and actions, that may be proper from practical, economical or organisational point of view, but we do not take their implicit suggestive meanings into considerations. The paper gives a detailed overview about the role of suggestions used during the management of a patient in intensive care situations, and some guidelines are outlined to make our (possible) negative suggestions to be helpful and positive.
Psychological support and outcomes for ICU patients. [2022]To critically review evidence on the effects of psychological support during intensive care unit (ICU) treatment on adult ICU patients' psychological and physiological outcomes. Evidence from intervention studies on imagery and relaxation has been included, as well.
Shortening the length of stay and mechanical ventilation time by using positive suggestions via MP3 players for ventilated patients. [2021]Long stay in intensive care unit (ICU) and prolonged ventilation are deleterious for subsequent quality of life and surcharge financial capacity. We have already demonstrated the beneficial effects of using suggestive communication on recovery time during intensive care. The aim of our present study was to prove the same effects with standardized positive suggestive message delivered by an MP3 player. Patients ventilated in ICU were randomized into a control group receiving standard ICU treatment and two groups with a standardized pre-recorded material delivered via headphones: a suggestive message about safety, self-control, and recovery for the study group and a relaxing music for the music group. Groups were similar in terms of age, gender, and mortality, but the SAPS II scores were higher in the study group than that in the controls (57.8 ± 23.6 vs. 30.1 ± 15.5 and 33.7 ± 17.4). Our post-hoc analysis results showed that the length of ICU stay (134.2 ± 73.3 vs. 314.2 ± 178.4 h) and the time spent on ventilator (85.2 ± 34.9 vs. 232.0 ± 165.6 h) were significantly shorter in the study group compared to the unified control. The advantage of the structured positive suggestive message was proven against both music and control groups.
The role of psychosomatic medicine in intensive care units. [2019]Critically ill patients, their relatives, and intensive care staff are consistently exposed to stress. The principal elements of this exceptional burden are confrontation with a life-threatening disease, specific environmental conditions at the intensive care unit, and the social characteristics of intensive care medicine. The short- and long-term consequences of these stressors include a feeling of helplessness, distress, anxiety, depression, and even posttraumatic stress disorders. Not only the patients, but also their relatives and intensive care staff are at risk of developing such psychopathologies. The integration of psychosomatic medicine into the general concept of intensive care medicine is an essential step for the early identification of fear and anxiety and for understanding biopsychosocial coherence in critically ill patients. Preventive measures such as the improvement of individual coping strategies and enhancing the individual's resistance to stress are crucial aspects of improving wellbeing, as well as the overall outcome of disease. Additional stress-reducing measures reported in the published literature, such as hearing music, the use of earplugs and eye-masks, or basal stimulation, have been successful to a greater or lesser extent.
Providing psychological support to people in intensive care: development and feasibility study of a nurse-led intervention to prevent acute stress and long-term morbidity. [2021]Adverse psychological outcomes, following stressful experiences in critical care, affect up to 50% of patients. We aimed to develop and test the feasibility of a psychological intervention to reduce acute stress and prevent future morbidity.
Preventing Posttraumatic Stress in ICU Survivors: A Single-Center Pilot Randomized Controlled Trial of ICU Diaries and Psychoeducation. [2019]Critical illness can have a significant psychological impact on patients and their families. To inform the design of a larger trial, we assessed feasibility of ICU diaries and psychoeducation to prevent posttraumatic stress disorder, depression, and anxiety following ICU stays.
Feasibility of a Behavioral Intervention to Reduce Psychological Distress in Mechanically Ventilated Patients. [2021]Many survivors of acute respiratory failure suffer from mood disorders following discharge from the hospital. We investigated the feasibility of intensivists delivering psychological support based on positive suggestion (PSBPS) to 20 intubated patients to reduce their psychological distress. Thirteen patients completed follow-up surveys. Of those, 9 remembered the intensive care unit physician talking to them, and 7 described it as comforting. Five patients (38%) met criteria for anxiety, depression, and acute stress. In comparison to historical controls, intervention may be associated with lower estimated odds of anxiety. PSBPS can be performed with patients in parallel with medical treatment to potentially reduce psychological morbidity and to humanize critical care. A larger randomized study is warranted to assess the efficacy of PSBPS.
Improving patient diary use in intensive care: A quality improvement report. [2022]Patients surviving critical illness are at risk of developing psychological symptoms that affect quality of life and recovery. Patient diaries may improve psychological outcomes by reducing gaps in memory and contextualising what has happened during admission. Factors including lack of guidelines, lack of awareness and time constraints may lead to poor diary use.
System of Psychological Support Based on Positive Suggestions to the Critically Ill Using ICU Doulas. [2022]Surviving critical illness often creates a lasting psychological impact, including depression, anxiety, and post-traumatic stress. Memories of frightening and delusional experiences are the largest potentially modifiable risk factor, but currently, there is no proven intervention to improve these inciting factors. Psychological support based on positive suggestion is a psychotherapeutic approach that can be provided even to patients in altered cognitive states and is therefore a viable psychotherapy intervention throughout the ICU stay. Traditional ICU care team members have limited time and training to provide such psychological support to patients. Doulas are trained supportive companions who have been effectively used to provide patient advocacy and emotional support in other clinical settings and may address this need. Our aim was to train and implement a psychological support based on positive suggestion program for the critically ill using doulas, and measure acceptance of this intervention through stakeholder feedback.