| Yoga | Beheshtipoor et al. 2005 26 | Semi-experimental Pre-post-test design | Evaluate effects of yoga on quality of life in children and adolescents with haemophilia.
Involved 27 boys, aged 8-16 years | • Significant differences were noted in quality of life dimensions, number of bleeding episodes and number of school absences
• Yoga improved the physical, psychological and social domains |
| Relaxation exercises Guided imagery | Lichstein et al. 1985 24 | Combined multiple baseline partial cross-over design | Effects of progressive and self-controlled relaxation on spontaneous bleeding and collateral symptoms.
Seven PWH | • No strong evidence that the treatment affected bleeding frequency or perceived pain
• Results failed to replicate previous findings and cast doubt on the stress theory of spontaneous bleeding
• Further research is needed to clarify the role of psychological interventions for PWH |
| Distraction | Elander et al. 2009 22 | Cross-sectional study | Evaluation of influence of active pain coping, passive adherence coping and negative thoughts about pain, activity engagement and pain willingness on physical and mental aspects of quality of life.
209 men with haemophilia A or B. | • Pain intensity had the main influence on physical quality of life; negative thoughts had the main influence on mental quality of life
Activity engagement and pain willingness had small but significant influences on physical and mental quality of life
• Pain willingness mediated the influence of pain intensity on physical quality of life and activity engagement
• Pain willingness mediated the influence of negative thoughts on mental quality of life
• Negative thoughts moderated the influence of pain intensity on mental quality of life
• There was no evidence that active pain coping influenced quality of life
• Findings suggest that quality of life for PWH could potentially be improved by interventions to increase pain acceptance and reduce negative thoughts about pain |
| Elander et al. 2011 20 | Randomised controlled trial | Two-phase motivational-volitional model of readiness to self-manage pain, including the personal experiences of PWH. 164 PWH with arthritic pain | • Findings are consistent with a two-phase, motivational-volitional model of pain self-management, and provide the first insights in our knowledge of readiness to self-manage pain in PWH
• Low-intensity interventions in DVD format can improve the motivational impact of written information and could be used to help prepare people with chronic pain for more intensive self-management interventions |
| Dunn et al. 2017 21 | Single centre randomised 2:1 pilot study | Evaluating the difference in procedure time of IV insertion with use of virtual reality in children with haemophilia.
25 children with haemophillia, median age 12.2 years | Children and their parents viewed the virtual reality (VR) method as a positive distraction
• No adverse disruption in clinic flow
• No significant difference in group allocation between sex, age, type of haemophilia, haemophilia severity or use of prophylaxis
• Median VR procedure time was ten minutes
• No difference in scores between groups in terms of nervousness prior to IV, or impact of distraction technique on level of engagement, impact on pain, anxiety or likability. In the VR cohort, the median scores for ease of use and desire to use VR for future procedures was highly positive for patients, nurses and parents |
| Cognitive refraining | Elander et al. 2013 23 | Longitudinal study | Low-intensity psycho-educational program to promote readiness to self-manage chronic joint pain.
101 male PWH | • Reduced pain intensity predicted better physical quality of life, regardless of age, haemophilia severity, baseline pain intensity and baseline physical quality of life
• Lower baseline passive coping and changed (increased) pain acceptance predicted better mental quality of life, regardless of age, haemophilia severity and baseline mental quality of life
• Increased activity engagement predicted better mental quality of life
• Reduced negative thoughts predicted better mental quality of life
• Active pain coping did not predict physical or mental QoL |
| Hypnosis | Swirsky-Sacchetti, Margolis 1986 25 | Random design Pre-post-test design | Study of comprehensive self-hypnosis training to decrease stress and assess amount of clotting factor usage for bleeding in persons trained in hypnosis vs controls.
30 severe PWH randomly assigned. | • The general level of distress was significantly reduced in the treatment group
• Treatment significantly reduced the amount of factor concentrate used to control bleeding in comparison to controls |
| LaBaw 1975 19 | Randomised controlled study | Randomised to hypnosis therapy or control group.
20 PWH participated | • Statistical analysis of the data confirmed the clinical observation of a greater improvement among patients in the experimental group in reduction of transfused products |
