The effect of spiritual hypnosis intervention on the level of comfort, pain, and endorphin in post-operative femoral fracture patients

Context: Several studies investigated the effectiveness of non-pharmacological pain management, including hypnosis. Spiritual hypnosis helps an individual find spiritual comfort in their pain experience, turning the perception of pain into something positive. Aims: To evaluate the effect of spiritual hypnosis on comfort, pain, and endorphin levels in post-operative femur fracture patients in four hospitals in East Java. Methods: This study used a pre-post-test quasi-experiment with a control group design. Thirty-four samples of post-operative femur fracture patients were divided into two equally divided groups: the control and treatment groups. The level of comfort was measured with a general comfort scale questionnaire, the pain was assessed with a visual analog scale, and endorphin levels were measured with the ELISA test. The control group received the standard intervention, while the treatment group received the spiritual hypnosis. The spiritual hypnosis was performed by a certified hypnotherapist in six stages: pre-induction, induction, deepening, deep-level test, suggestion, and termination. Results: The findings indicated that spiritual hypnosis significantly decreased pain (Δ=0.00) and significantly improved the comfort level (Δ=0.00) with no change in the endorphin level (Δ=0,506). Spiritual hypnosis may reduce pain by enhancing comfort without the mediation of endorphins. When patients are treated with spiritual hypnosis interventions, they are guided into a calm and relaxed state, turning their perception of pain into a positive thing. Furthermore, the American Psychological Association stated that hypnosis can reduce pain through sensations, perceptions, thoughts, and habits. However, endorphins may not be involved in hypnotic analgesia. Because hypnosis is not primarily mediated by opiating endorphins. Future research needs to consider the patients’ environmental and physical conditions, as they may affect pain and comfort levels during the spiritual hypnosis treatment. Conclusion: Hypnosis can be used independently or along with analgetic medications. In addition, future research may also focus on the effect of spiritual hypnosis on cortisol levels and the role of cortisol in reducing pain.