May 20, 2001
MEDIA CONTACT: Kate O'Rourke
Investigators at Johns Hopkins have proven that distracting patients during and after bronchoscopy with the gurgle of a brook and a colorful panorama of tranquil meadow improves pain control by approximately 43 percent.
"Natural sounds and images, if they’re the right ones in the right format, are a safe, inexpensive, effective way to reduce the pain and anxiety of inserting tubes through the nose or mouth to see the lungs," reports Noah Lechtzin, M.D., a postdoctoral fellow at Hopkins who will present the study at the American Thoracic Society’s annual meeting May 20.
Tests of these so-called biophilic images and sounds were so successful in easing discomfort that they should be considered for other invasive procedures such as endoscopies, sigmoidoscopies or interventional radiological exams, according to Lechtzin.
The Hopkins researcher emphasizes that sound and sight distraction therapy is not a substitute for pain medication, but a way to enhance pain control. One of several complimentary medicine approaches being explored by critical care specialists, the Hopkins group tested the natural sights and sounds on 41 men and women during their 25-minute bronchoschopies and three-hour recovery periods. Individuals looked at cloth murals hung by their bedsides and listened to nature sounds through headphones and a tape player. Thirty-nine similar patients underwent the procedures without distraction therapy, but with comparable levels of care and pain control.
Both groups of subjects filled out questionnaires rating their pain on a five point scale, along with their anxiety, perceptions of privacy, difficulty in breathing, willingness to have the procedure done again, and safety.
"What stood out was pain control," says Gregory Diette, M.D., an assistant professor of pulmonary and critical care medicine at Hopkins and lead author of the study. "That was the only area of significant improvement. Patients who listened to the nature sounds and looked at the mural during the bronchoscopy were 43 percent more likely to report pain control as very good or excellent, even after controlling for such factors as pain medication, health, race and education."
According to Lechtzin, others have studied the effects of music on bronchoscopy experience with mixed results. "We believe we are the first group to study a particular combination of audio and visual distraction using biophilic images," he says. The Hopkins group next plans to test the distractions on bone marrow transplant patients who often have lengthy hospital visits and considerable pain.
Doctors perform bronchoscopies on people with known or expected lung disease and to identify a cause of infection for pneumonia. The procedure involves inserting a fiber optic tube, about the diameter of a pencil, through the nose or mouth through which doctors can see the throat and lungs and collect lung secretions or tissue specimens. Patients receive some medications to prevent pain and dull memory, but remain conscious.
Other authors of the study include Edward Haponik, Teresa Withers, Aline Devreotes, and Haya Rubin. Healing Environments International provided the equipment, Bedscapes (http://www.bedscapes.com), for the study. To learn more about lung diseases, visit http://www.hopkins-lungs.org.
To view a photo of a mural, visit http://www.hopkinsmedicine.org/press/2001/MAY/mural.html
To hear a sample of the sounds used during this procedure, click here: Mountain Stream