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Nature Sights and Sounds to Reduce Pain in Cancer Patients Undergoing Bone Marrow Aspiration and Biopsy

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00315796
Recruitment Status : Completed
First Posted : April 19, 2006
Last Update Posted : April 1, 2015
National Center for Complementary and Integrative Health (NCCIH)
Information provided by:
Johns Hopkins University

Brief Summary:
Pain is a common and difficult problem for patients with cancer. It has been reported that over 80% of cancer patients suffer from pain. Much of this pain is iatrogenic and related to procedures. Dr. Grossman recently demonstrated that most patients undergoing bone marrow biopsy have poor pain control during the procedure. Treatment of pain is almost entirely with analgesic medications, principally opioids. These medications have numerous undesirable effects such as sedation, confusion, hypotension and constipation that limit their efficacy and utility. Drs. Diette, Lechtzin, Rubin and colleagues recently demonstrated that use of nature sights and sounds (NSS), a simple, safe, and inexpensive intervention, decreases pain during fiberoptic bronchoscopy, a procedure commonly performed to diagnose cancer and to detect pulmonary complications of cancer therapy. Patients were randomly assigned to either standard care with intravenous narcotics and benzodiazepines or standard care coupled with view of a nature scene and use of nature sounds before, during, and after bronchoscopy. The group assigned to the NSS reported significantly better pain control than the control group. While these findings are novel and exciting, they raised several new questions that suggest logical extensions of this work. It is not known whether this intervention can be applied to patients in other settings, nor is it known whether comparison to standard care is an appropriate control group. Further, the mechanism of action of NSS needs to be determined. NSS may simply be a form of distraction therapy but it may have other properties. The theory of biophilia proposes there are specific elements in nature imagery that exert beneficial health effects. Because NSS appears to be a promising and safe intervention for the treatment of pain, these investigators plan to perform a controlled clinical trial in cancer patients undergoing invasive procedures. Patients will be randomly assigned to one of three arms, standard care, NSS, and a non-nature based distraction technique. We will study the efficacy of NSS for the management of procedure-related pain in oncology patients. The findings will provide necessary background information to develop more definitive studies of NSS that should be competitive for external funding. This exciting study will help develop a harmless, inexpensive method to treat pain in cancer patients, that may complement or replace analgesic medications.

Condition or disease Intervention/treatment Phase
Cancer Device: Biophilic Nature Scene and Sound Phase 3

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Study Type : Interventional  (Clinical Trial)
Enrollment : 120 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Nature Sights and Sounds to Reduce Pain in Cancer Patients Undergoing Bone Marrow Aspiration and Biopsy
Study Start Date : August 2004
Study Completion Date : June 2005

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Biopsy

Primary Outcome Measures :
  1. Pain ratings: Hopkins Pain Rating Instrument

Secondary Outcome Measures :
  1. Affective Distress: Profile of Moods States

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Diagnosis of cancer
  • Age>18
  • Outpatient in the Weinberg Cancer Pavilion
  • Capable of providing informed consent
  • Undergoing bone marrow aspirate/biopsy
  • Lack of any exclusion criteria

Exclusion Criteria:

  • Visual impairment precluding use of nature scenes or city skyline photo
  • Hearing impairment precluding use of compact discs or nature sounds
  • Altered mental status (mental status score <25)
  • Infection requiring contact isolation
  • Language barrier that would limit ability to answer English language questionnaires
  • Karnofsky performance score below 60
  • Patients receiving conscious sedation

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00315796

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United States, Maryland
Johns Hopkins Hospital
Baltimore, Maryland, United States, 21205
Sponsors and Collaborators
Johns Hopkins University
National Center for Complementary and Integrative Health (NCCIH)
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Principal Investigator: Noah Lechtzin, MD, MHS Johns Hopkins University
Publications automatically indexed to this study by Identifier (NCT Number):
Layout table for additonal information Identifier: NCT00315796    
Other Study ID Numbers: J0387
NCCAM: AT00437
First Posted: April 19, 2006    Key Record Dates
Last Update Posted: April 1, 2015
Last Verified: January 2005
Keywords provided by Johns Hopkins University:
Mind-Body Intervention
bone marrow aspirate
bone marrow biopsy