Difference between revisions of "Allen"
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| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 130%;">'''Videotaped modelling and film distraction reduced the proportion of patients failing to complete a prescribed course of hyperbaric oxygen therapy.'''</span> |
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| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Clinical | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Clinical Bottom Line:''' </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">1. A combination of videotaped modelling and distraction by film significantly reduced the proportion of patients withdrawing from hyperbaric treatment. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Appraised by:''' Mike Bennett, Dept of Diving and Hyperbaric Medicine, Prince of Wales Hospital, Sydney; Friday, 15 January, 1999</span> |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;"> | ||
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">''' | ||
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">''' | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Clinical Scenario:''' A patient presenting for hyperbaric oxygen treatment for a problem wound. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Three-part Question:''' When administering hyperbaric oxygen therapy, does the use of modelling and distraction techniques as compared to an explanation and reassurance approach, result in any decrease in patient anxiety or a reduction in the number of patients requesting termination of treatment? </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Search Terms:''' Behaviour therapy/*methods, Attention.</span> |
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| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;"> | ||
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;"> | ||
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Study:''' </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Non-blinded randomised controlled trial with intention-to-treat. Adult patients referred for HBOT for a variety of non-emergency indications. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Control group (N = 6; 6 analysed): Patients were given a standard preparation talk by hyperbaric unit staff prior to entry to the chamber for their first treatment. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Experimental group (N = 5; 5 analysed): As above but also watched a 9 minute video about the hyperbaric experience which included a patient describing a number of coping strategies. Patients were also permitted to watch a video of choice for distraction during the first treatment.</span> |
| − | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Evidence:'''</span> | |
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| + | {| class="Table" style="border:solid windowtext 1.0pt" | ||
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| − | | <span style'''"font-family: | + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Outcome</span></span>'''</span></p> |
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Control rate</span></span>'''</span></p> | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Video rate</span></span>'''</span></p> | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Relative risk reduction</span></span>'''</span></p> | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Absolute risk reduction</span></span>'''</span></p> | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal">'''<span style="font-size:13.0pt"><span style="font-family:" arial",sans-serif"="">NNT</span></span>'''</span></p> | ||
|- | |- | ||
| − | | <span style'''"font-family: | + | | style="border:solid windowtext 1.0pt" | |
| + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Did not complete prescribed course</span></span>'''</span> | ||
| + | |||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.83</span></span></span></p> | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0</span></span></span></p> | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">100%</span></span></span></p> | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.83</span></span></span></p> | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:13.0pt"><span style="font-family:" arial",sans-serif"="">1</span></span></span></p> | ||
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| − | | <span style | + | | style="border:solid windowtext 1.0pt" | |
| + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">95% CI:</span></span>'''</span> | ||
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| + | | style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | | ||
| + | | style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | | ||
| + | | style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.54 to 1.13</span></span></span></p> | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:13.0pt"><span style="font-family:" arial",sans-serif"="">1 to 2</span></span></span></p> | ||
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| − | | <span style'''"font-family: | + | | style="border:solid windowtext 1.0pt" | |
| + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Failure to complete one treatment</span></span>'''</span> | ||
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| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.33</span></span></span></p> | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0</span></span></span></p> | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">100%</span></span></span></p> | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.33</span></span></span></p> | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:13.0pt"><span style="font-family:" arial",sans-serif"="">3</span></span></span></p> | ||
|- | |- | ||
| + | | style="border:solid windowtext 1.0pt" | | ||
| + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">95% CI:</span></span>'''</span> | ||
| + | |||
| + | | style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | | ||
| + | | style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | | ||
| + | | style="border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" | | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.04 to 0.71</span></span></span></p> | ||
| + | | style="border:solid windowtext 1.0pt" | <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">NNT1 to INF</span></span></span></p> <p style="margin-bottom: 0.0001pt; padding: 0.75pt; text-align: center;"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">NNH=23 to INF</span></span></span></p> | ||
|} | |} | ||
| − | + | '''Non-Event Outcomes Control group Experimental group P-value''' | |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Distress rating before </span> | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Distress rating before </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Treatment (scale 0-10) 5.8 3.5 <0.05</span> |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Treatment (scale 0-10) 5.8 3.5 <0.05 </span> | ||
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Comments:''' </span> | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Comments:''' </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">1. Very high rate of failure to complete course of therapy in the control group is probably unusual in most settings. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">2. Presumed to be associated with monoplace rather than multiplace facility. It is not clear how applicable these results would be in a multiplace facility where patients witness actual coping behaviour. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">3. Anxiety scores during treatment seem to support main findings but are not presented in detail.</span> |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">1. Very high rate of failure to complete course of therapy in the control group is probably unusual in most settings. </span> | ||
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">2. Presumed to be associated with monoplace rather than multiplace facility. It is not clear how applicable these results would be in a multiplace facility where patients witness actual coping behaviour. </span> | ||
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">3. Anxiety scores during treatment seem to support main findings but are not presented in detail. </span> | ||
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Expiry date:''' January | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Expiry date:''' January 2024</span> |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''References:''' 1. Allen KD, Danforth JS, Drabman RS. Videotaped modeling and film distraction for fear reduction in adults undergoing hyperbaric oxygen therapy. Journal of Consulting and Clinical Psychology 1989; 57:554-558. </span> | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''References:''' 1. Allen KD, Danforth JS, Drabman RS. Videotaped modeling and film distraction for fear reduction in adults undergoing hyperbaric oxygen therapy. Journal of Consulting and Clinical Psychology 1989; 57:554-558.</span> |
| − | <span style="display: block; text-align: center;"> | + | <span style="display: block; text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</span> |
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| − | + | <span style="display: block; text-align: center;"><span style="color: #7c00ff; font-family: arial,helvetica,sans-serif; font-size: 26px;">[[Miscellaneous|BACK]]</span></span> | |
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Latest revision as of 23:24, 17 May 2020
Videotaped modelling and film distraction reduced the proportion of patients failing to complete a prescribed course of hyperbaric oxygen therapy.
Clinical Bottom Line: 1. A combination of videotaped modelling and distraction by film significantly reduced the proportion of patients withdrawing from hyperbaric treatment. Appraised by: Mike Bennett, Dept of Diving and Hyperbaric Medicine, Prince of Wales Hospital, Sydney; Friday, 15 January, 1999
Clinical Scenario: A patient presenting for hyperbaric oxygen treatment for a problem wound. Three-part Question: When administering hyperbaric oxygen therapy, does the use of modelling and distraction techniques as compared to an explanation and reassurance approach, result in any decrease in patient anxiety or a reduction in the number of patients requesting termination of treatment? Search Terms: Behaviour therapy/*methods, Attention.
The Study: Non-blinded randomised controlled trial with intention-to-treat. Adult patients referred for HBOT for a variety of non-emergency indications. Control group (N = 6; 6 analysed): Patients were given a standard preparation talk by hyperbaric unit staff prior to entry to the chamber for their first treatment. Experimental group (N = 5; 5 analysed): As above but also watched a 9 minute video about the hyperbaric experience which included a patient describing a number of coping strategies. Patients were also permitted to watch a video of choice for distraction during the first treatment.
The Evidence:
Outcome |
Control rate |
Video rate |
Relative risk reduction |
Absolute risk reduction |
NNT |
|
Did not complete prescribed course |
0.83 |
0 |
100% |
0.83 |
1 |
|
95% CI: |
0.54 to 1.13 |
1 to 2 | |||
|
Failure to complete one treatment |
0.33 |
0 |
100% |
0.33 |
3 |
|
95% CI: |
0.04 to 0.71 |
NNT1 to INF NNH=23 to INF |
Non-Event Outcomes Control group Experimental group P-value
Distress rating before Treatment (scale 0-10) 5.8 3.5 <0.05
Comments: 1. Very high rate of failure to complete course of therapy in the control group is probably unusual in most settings. 2. Presumed to be associated with monoplace rather than multiplace facility. It is not clear how applicable these results would be in a multiplace facility where patients witness actual coping behaviour. 3. Anxiety scores during treatment seem to support main findings but are not presented in detail.
Expiry date: January 2024
References: 1. Allen KD, Danforth JS, Drabman RS. Videotaped modeling and film distraction for fear reduction in adults undergoing hyperbaric oxygen therapy. Journal of Consulting and Clinical Psychology 1989; 57:554-558.
