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肿瘤手术术前焦虑与医学催眠相关的心脏相干性评估 (COHEC2)

III 期研究通过固定频率引导呼吸(心脏相干性)评估非药物干预(NDI)计划与医学催眠对肿瘤手术术前焦虑的影响

The investigator proposes to use the cardiac coherence technique (Cardiac Coherence) coupled with a hypnosis session to reduce pre-operative anxiety.

研究概览

详细说明

The perioperative period is recognized as anxiety-provoking for most patients. In oncology, 60 to 80% of patients suffer from stress throughout their treatment. If for some patients, this anxiety is more or less manageable, for others, it is the major concern with regard to their intervention.

For many years, pharmacological premedication, especially with benzodiazepines, has been the gold standard for the treatment of preoperative anxiety, but this systematic prescription is increasingly controversial, especially in populations most exposed to side effects, such as elderly subjects and patients with cardiac or respiratory pathologies.

The aim of this study is to propose an alternative to pharmacological premedication by a non-drug approach.

The two techniques (the Fixed Rate Guided Breathing Technique = cardiac coherence and hypnosis) can potentiate each other and become synergistic. Thus, for patients undergoing oncological surgery, regular practice of cardiac coherence coupled with hypnosis prior to their surgery should enable them to better manage perioperative anxiety and thus significantly reduce their level of anxiety on the day of their surgery.

The association of the 2 techniques combines several advantages:

  • It is totally "physiological", free and immediately available for the patient and without any undesirable effect;
  • It gives autonomy to the patient to manage his stress, making him independent of chemical molecules, the presence of a third party or expensive equipment.
  • It will allow oncology patients to use it throughout their care (invasive examinations, MRI imaging, heavy and complex care such as certain dressings, etc.)

This work will allow:

  • To give oncology patients the possibility to be actors of their care by a self-management of their anxiety in substitution or complement of a medicated approach;
  • To map anxiety in oncology surgery using a simple scale such as the EVA, which has not yet been done;
  • To identify the most anxious patients in order to provide them with the appropriate management (pharmacological and/or NMI) before their surgery;
  • To evaluate the correlation between the level of preoperative anxiety and the occurrence of postoperative adverse events;
  • To evaluate the correlation between the level of anxiety and the quality of recovery (QoR) and the postoperative experience (EVAN-G).

Patients in the experimental group will be interviewed to explain how to perform the cardiac coherence and hypnosis sessions at home before the surgery.

研究类型

介入性

注册 (实际的)

332

阶段

  • 不适用

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

      • Lyon、法国
        • Centre Léon Bérard
      • Toulouse、法国
        • Institut Universitaire du Cancer Toulouse - Oncopole
      • Villejuif、法国
        • Institut Gustave Roussy
    • Hérault
      • Montpellier、Hérault、法国、34298
        • Institut régional du cancer de Montpellier

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

描述

Inclusion Criteria:

  1. Age ≥ 18 years old
  2. Patient with a scheduled surgery for a cancer (suspected or declared) with a classic or ambulatory hospitalization
  3. Patients requiring general anesthesia with or without associated loco-regional anesthesia or loco-regional anesthesia alone
  4. Patient with a smartphone or a tablet or a computer and able to install the application
  5. Inclusion of the patient minimum 7 days before the date of the surgery
  6. Patient who signed the informed consent
  7. Patient affiliated to a French social security system

Exclusion Criteria:

  1. Emergency surgery
  2. Plastic surgery for reconstruction: lipomodelling
  3. Prophylactic surgery: no suspected or existing cancer
  4. Bradycardia (< 50 beats/minute) with β-blockers
  5. Severe heart failure with ventricular ejection fraction < 40%
  6. Uncontrolled chronic pain for more than three months on morphine
  7. Patient with unstable epilepsy or respiratory pathology with rest dyspnea
  8. Patient used to and having a regular and habitual practice of relaxation techniques such as yoga, hypnosis, sophrology, meditation, music therapy, virtual reality, ...
  9. Medical (neurological, psychiatric, etc.) or psychological conditions not allow for participation in the protocol (completion of questionnaires and booklet, compliance with the cardiac coherence program coupled with hypnosis)
  10. Deaf patient without hearing aids
  11. Patient under guardianship or curatorship

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:支持治疗
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:无(打开标签)

武器和干预

参与者组/臂
干预/治疗
实验性的:Experimental group

Classic management of the preoperative period with a cardiac coherence program coupled with hypnosis.

At home the patient will perform the cardiac coherence sessions between 7 days and a maximum of 15 days before the surgery through the application "Respirelax": 3 sessions per day, lasting 5 minutes with a breathing frequency of 6 cycles/min for a period of 7 days minimum and maximum 15 days.

An audio tape read in a hypnotic tone can be listened to by the patient during the cardiac coherence program or at another time of the day (see the text of the audio tape).

无干预:Control group

Classic management of the preoperative period

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Visual Analogue Scale (VAS) of global anxiety
大体时间:The morning of the surgery (Day 0) upon arrival in the operating room

Visual Analogue Scale (VAS) of global anxiety is a anxiety self-assessment scale that allows the patient to self-assess his or her anxiety using a cursor. The scale ranges from 0 (no anxiety) to 100 (maximum anxiety).

The morning of the surgery (Day 0) upon arrival in the operating room

次要结果测量

结果测量
措施说明
大体时间
Program compliance
大体时间:Between -15 to -7 days before surgery (Day -15 to Day -7) until the day of surgery (Day 0)

Program compliance rate of patients in the experimental group. A patient is considered compliant if he declares to have completed at least 2/3 of the proposed Cardiac Coherence sessions + listening to hypnotic tape (at least 5 days /7).

Between -15 to -7 days before surgery (Day -15 to Day -7) until the day of surgery (Day 0)
Measurement of global and specific anxiety level by using a Visual Analogue Scale (VAS)
大体时间:Between -15 to -7 days before surgery (Day -15 to Day -7)

Visual Analogue Scale (VAS) of anxiety is a anxiety self-assessment scale that allows the patient to self-assess his or her anxiety using a cursor. The scale ranges from 0 (no anxiety) to 100 (maximum anxiety). The patient assesses his global and specific anxiety related to: surgery, anesthesia, COVID infectious risk, fear of the unknown, oncological disease

Between -15 to -7 days before surgery (Day -15 to Day -7)
Measurement of global anxiety level by using a Visual Analogue Scale (VAS)
大体时间:Between -15 to -7 days before surgery and the day of surgery (Day 0)

Visual Analogue Scale (VAS) of global anxiety is a anxiety self-assessment scale that allows the patient to self-assess his or her anxiety using a cursor. The scale ranges from 0 (no anxiety) to 100 (maximum anxiety).

Between -15 to -7 days before surgery and the day of surgery (Day 0)
The preoperative anxiety score by using the Amsterdam Preoperative Anxiety and Information Scale (APAIS)
大体时间:Between -15 to -7 days before surgery

The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a self-report questionnaire comprising six questions that have been developed and validated to evaluate the preoperative anxiety of patients. This global index assesses three separate areas: anxiety about anaesthesia, anxiety about surgery, and the desire for information.

The scale scores six items from 1 to 5 (1 = absence, 5 = extreme). The APAIS scale will be used to determine the psychological profile of patients between "blunting" and "monitoring" types

Between -15 to -7 days before surgery
VAS values and individual psycho-clinical characteristics
大体时间:Between -15 to -7 days before surgery and the day of surgery (Day 0)

Visual Analogue Scale (VAS) of global anxiety is a anxiety self-assessment scale that allows the patient to self-assess his or her anxiety using a cursor. The scale ranges from 0 (no anxiety) to 100 (maximum anxiety) (defined as VAS at Day 0 ≥ 40), and individual psycho-clinical characteristics (gender, smoking, psychological questionnaires).

Between -15 to -7 days before surgery and the day of surgery (Day 0)
Number of patients taking benzodiazepine
大体时间:The day after surgery (Day 1)

Rate of patients taking benzodiazepines in the 2 groups

The day after surgery (Day 1)
Number of days of hospitalization
大体时间:The day after surgery (Day -1) and up to 1 month

Length of hospital stay in the 2 groups

The day after surgery (Day -1) and up to 1 month
VAS values and mode of hospitalization and importance of the surgical procedure
大体时间:The morning of the surgery (Day 0) upon arrival in the operating room

Visual Analogue Scale (VAS) of global anxiety is a anxiety self-assessment scale that allows the patient to self-assess his or her anxiety using a cursor, and the mode of hospitalization (ambulatory or conventional) and the importance of the surgical procedure (minor, intermediate or major)

The morning of the surgery (Day 0) upon arrival in the operating room
Doses of hypnotic and morphine drugs
大体时间:During anesthetic induction (Day 0)

Doses of hypnotic and morphine drugs administered during anesthetic induction (Day 0) in the 2 groups

During anesthetic induction (Day 0)
Value of preoperative VAS and adverse events
大体时间:The morning of the surgery (Day 0) upon arrival in the operating room

Visual Analogue Scale (VAS) of global anxiety is a anxiety self-assessment scale that allows the patient to self-assess his or her anxiety using a cursor and adverse event variables: pain, agitation, postoperative nausea and vomiting (PONV), ...

The morning of the surgery (Day 0) upon arrival in the operating room
Number of Self-questionnaire completed
大体时间:From the day of the anesthesia consultation until the end of the study

Self-questionnaire completion rates for each of the 2 pre- and postoperative periods

From the day of the anesthesia consultation until the end of the study
Evaluation of the Vecu of General Anesthesia questionnaire (EVAN-G)
大体时间:Two day after surgery (Day 2)

The EVAN-G questionnaire includes 26 questions whose results are grouped together to define 6 dimensions: Attention Focus, Information, Privacy, Pain, Discomfort and Wait Times. From these scores, an overall satisfaction score is calculated. The total score of the six dimensions reduced to 100.

Two day after surgery (Day 2)
Visual Analogue Scale (VAS) of pain
大体时间:At 1, 2 and 3 month after surgery

Visual Analogue Scale (VAS) of pain is a pain self-assessment scale that allows the patient to self-assess his or her pain using a cursor

At 1, 2 and 3 month after surgery
Quality of Recovery (QoR)
大体时间:The day after surgery (Day 1)

The QoR-15 questionnaire assesses five dimensions of recovery : physical comfort; emotional state; physical independence; physiological support; and pain. Each item was rated on a ten-point Likert scale: none of the time, some of the time, usually, most of the time, and all the time. The total score of 15 ranges from 0 (poorest quality of recovery) to 150 (best quality of recovery).

The day after surgery (Day 1)
Insomnia Severity Index Scale (ISI)
大体时间:The day after surgery (Day 1)

The Insomnia Severity Index (ISI) includes 7 questions which assesses the nature of the insomnia, the person's satisfaction with sleep, daily functioning and anxiety about sleep problems. Add scores for all seven items, sum from 0-7 = No clinically significant insomnia to 22-28 = Clinical insomnia (severe).

The day after surgery (Day 1)
VAS of on satisfaction with overall management and anesthesia
大体时间:The day after surgery (Day 1)

Visual Analogue Scale (VAS) of on satisfaction with overall management and anesthesia is a satisfaction self-assessment scale that allows the patient to self-assess his or her satisfaction using a cursor. The scale ranges from 0 (not at all satisfied) to 100 (completely satisfied)

The day after surgery (Day 1)

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 首席研究员:Régis FUZIER, MD、Institut Universitaire du Cancer Toulouse - Oncopole
  • 首席研究员:Lauriane Bordevane, MD、Gustave Roussy, Cancer Campus, Grand Paris
  • 学习椅:Jibba AMRAOUI, MD、Institut régional du cancer de Montpellier

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

一般刊物

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2022年6月1日

初级完成 (实际的)

2026年7月30日

研究完成 (实际的)

2026年9月30日

研究注册日期

首次提交

2021年12月8日

首先提交符合 QC 标准的

2022年1月14日

首次发布 (实际的)

2022年1月20日

研究记录更新

最后更新发布 (实际的)

2026年11月9日

上次提交的符合 QC 标准的更新

2026年11月5日

最后验证

2026年11月1日

更多信息

与本研究相关的术语

其他研究编号

  • PROICM 2021-09 COH
  • 2021-A01524-37 (注册表标识符:ID RCB)

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

是的

IPD 计划说明

All data will be available after publication of the results in peer-reviewed revues, and in national and international meetings. It includes all de-identified participants' data, the study protocol, the statistical analysis plan and the clinical study report. The corresponding author will provide data and datasets generated and/or analyzed during the study upon reasonable request.

IPD 共享时间框架

Access to study data upon written detailed request sent to ICM, from 6 months until 5 years after publication of summary data.

IPD 共享访问标准

The data shared will be limit to that required for independent mandated verification of the published results, the applicant will need authorization from ICM for personal access, and data will only be transferred after signing of a data access agreement.

IPD 共享支持信息类型

  • 研究方案
  • 树液
  • 企业社会责任

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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