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Beneficial Effects of Noetic Therapies on Mood Before Percutaneous Intervention for Unstable Coronary Syndromes

Seskevich, Jon E.; Crater, Suzanne W.; Lane, James D.; Krucof, Mitchell W.


Background: Many common medical, surgical, and diagnostic procedures performed for conscious patients can be accompanied by significant anxiety. Mind-body-spirit interventions could serve as useful adjunctive treatments for the reduction of stress.

Objective: To evaluate the effects of stress management, imagery, touch therapy, remote intercessory prayer, and standard therapy on mood in patients awaiting percutaneous interventions for unstable coronary syndromes as part of the Monitoring and Actualization of Noetic Training (MANTRA) trial, which explored the feasibility and efficacy of noetic interventions on clinical outcomes in a randomized clinical trial.

Methods: A total of 150 patients were randomized to one of the five treatment conditions. Stress management, imagery, and touch therapy were administered in 30-minute treatment sessions immediately before the cardiac intervention. Intercessory prayer was not necessarily contemporaneous with these treatments. Mood was assessed by a set of visual analog scales before and after treatment for a similar length of time for the standard therapy and prayer groups.

Results: Analysis of complete data from 108 patients showed that stress management, imagery, and touch therapy all produced reductions in reported worry, as compared with standard therapy, whereas remote intercessory prayer had no effect on mood. The ratings of other similar moods were not affected, perhaps because of the relatively positive emotional state observed in the participants before treatment.

Conclusions: The results suggest that at least some noetic therapies may have beneficial effects on mood in the course of medical and surgical interventions. Administration of these interventions was feasible even in the hectic environment of the coronary intensive care unit. Given their relatively low cost and limited potential for adverse effects, these interventions merit further study as therapeutic adjuncts.

Jon E. Seskevich, RN, BSN, BA, CHTP, is Nurse Clinician, Department of Advanced Practice Nursing, Duke University Hospital, Durham, North Carolina.

Suzanne W. Crater, RN, MSN, ANP-C, is Nurse Practitioner, Division of Cardiology, Department of Medicine, Duke University Medical Center/Duke Clinical Research Institute, Durham, North Carolina.

James D. Lane, PhD, is Associate Research Professor, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.

Mitchell W. Krucoff, MD, is Associate Professor, Division of Cardiology, Department of Medicine, Duke University Medical Center/Duke Clinical Research Institute, Durham, North Carolina.

Accepted for publication October 5, 2003.

The study was conducted at the Durham Veterans Administration Medical Center, Durham, NC.

Corresponding author: Jon Seskevich, Box 3677, Duke University Medical Center, Durham, NC 27710 (e-mail:

© 2004 Lippincott Williams & Wilkins, Inc.