By: Margaret Gerulski, Diane Kumar, & Brea Yang
Ferris State University
Fall 2011
(google.com, n.d.)
Introduction
What is the impact of guided imagery as a
nursing intervention in the management of
acute and chronic pain?
(google.com, n.d.)
Definition
•“Guided imagery is a
technique that utilizes stories or
narratives to influence the
images and patterns that the
mind creates” (Hart, 2008, p.
295).
(google.com, n.d.)
•“Thought process that invokes
and uses the senses of vision,
hearing, smell, taste,
movement, position, and touch”
(Young & Koopsen, 2011, p.
76).
Background
 Used in ancient times
 Cultural and religious uses
 Variety of uses
 Mind / Body connection
(google.com, n.d.)
“Pain is inevitable; suffering is optional”
--Hindu Spiritual-- (Bresler, 2010)
Effects of Guided Imagery on Outcomes of Pain, Functional
Status, and Self-efficacy in Persons Diagnosed with
Fibromyalgia (Menzies, Taylor, and Bourguignon, 2006)
• Objective: Effects of on pain levels, functional status, and
self-efficacy in persons with fibromyalgia (FM) with
Guided Imagery.
• Method: Randomized Control Clinical Trial
• Participants: 48 people were recruited from physicians’
offices &clinics in the University of Virginia Health System.
• Intervention: 3 guided imagery audiotapes with average of 20
minute per audiotape for 2 weeks each
• Measures: Pain, functional status, and self-efficacy
• Outcomes: Improvement on functional status and self-efficacy,
but not change in pain levels
Changes in the Meaning of Pain with the use of
Guided Imagery (Lewandowski, Good, & Draucker, 2005)
• Purpose: determine how verbal descriptions pain
•
•
•
•
•
changed after guided imagery
Method: Mixed method, concurrent nested design, and
use of verbal pain descriptors
Participants: Computer randomized selection
Interventions: Use of a guided imagery tape was used
over a 4 day period
Measures: 102 pain descriptors
Outcomes: Improved pain verbal pain descriptions in
the treatment group.
Guided Imagery as a Therapeutic Recreation
Modality to Reduce Pain (Bonadies, V., 2010)
•Purpose: Impact of guided imagery on chronic pain
•Method: Use of visual analog scale
•Participants: 1 participant at a 206 bed residential
health care facility
•Interventions: Guided imagery using a pain intensity
scale
•Measures: Verbalization of client of pain levels
•Outcomes: Improved level of pain
What is the impact of guided imagery as a nursing
intervention in the management of pain and chronic pain?
 Nursing Responsibility
 Use in Chronic and Acute Pain
 Use in Childbirth
 Part of Holistic Nursing
(google.com, n.d.)
 Evidence-Based Nursing intervention
Limitations in Research
 Practicing imagery 15-20 minute daily will increase the





success, therefore can be seen as a time consuming activity.
Limited time frames to evaluate effectiveness.
Research studies on alternative therapies is limited.
More studies on chronic pain than acute pain.
“Limitations of these studies were small sample size, lack of
randomization, non-equality of treatment and control groups,
and lack of control for opioid intake and imagery ability”
(Lewandowski, et al., 2005)
Pain is subjective
Limitations for use of Guided
Imagery in Practice
 Short hospital stays
 Limited nursing time
 Lack of education of nursing staff
 For optimal effectiveness
o Clients and families need to have knowledge
o Willingness to participate
o Continual practice
Conclusion
(Bresler, 2010)
References
Academy for Guided Imagery. Retrieved on 11/25/11 at http://www.academyfor
guidedimagery.com/whatisguidedimagery/index.html
Bonadies, V. (2010). Guided imagery as a therapeutic recreation modality to reduce pain. Annual
in Therapeutic Recreation, 18, p. p. 164-174.
Bresler, D. (2010). Raising pain tolerance using guided imagery. Practical Pain Management,
July/August, 10(6), 25-31.
Empowered Within. (n.d.) Retrieved November 20, 2011 from:
http://www.empoweredwithin.com/main%20info/Historyof guidedimagery.html
Google.com. (n.d.). All images retrieved November 20, 2011 from: www.google.com
(guided_imagery.jpg).
Hart, J. (2008). Guided imagery. Alternative and Complementary Therapies, 14 (6), pp. 295-299.
doi: 10.1089/act.2008.14606.
Koehn, M. L. (2000). Alternative and complementary therapies for labor and birth: An application
of Kokcaba’s Theory of Holistic Comfort. Holistic Nursing Practice, 15(1), p.p. 66-77.
Retrieved November 15, 2011 from: http://0ovidsp.ovid.com.libcat.ferris.edu/ovidweb.cgi?T+JS20000100000000009&LSLINK=80&D+ovft.
References
Koehn, M. L. (2000). Alternative and complementary therapies for labor and birth: An application of
Kokcaba’s Theory of Holistic Comfort. Holistic Nursing Practice, 15(1), p.p. 66-77. Retrieved
November 15, 2011 from: http://0ovidsp.ovid.com.libcat.ferris.edu/ovidweb.cgi?T+JS20000100000-000009&LSLINK=80&D+ovft.
Lewandowski, W. A. (2004). Patterning of pain and power with guided imagery. Nursing Science
Quarterly, 17(3), p.p. 233-241. doi: 10.1177/0894318404266322.
Lewandowski, W., Good, M., & Draucker, C. B. (2005). Changes in the meaning of pain with the use of
guided imagery. Pain Management Nursing, 6(2), p.p. 58-67.
Menzies, V., Taylor, A. G., Bourguignon, C. (2006). Effects of guided imagery on outcomes of pain,
functional status, and self-efficacy in person diagnosed with fibromyalgia. The Journal of Alternative
and Complementary Medicine, 12 (1), pp. 23-30
Naparstek, B. (2007). Guided imagery: A best practice for pregnancy and childbirth. International
Journal of Childbirth Education, 22(3), p. 4-8.
National Pain Foundation. (n.d.). Retrieved November 15, 2011 from:
http://www.nationalpainfoundation.org/articles/93/guided-imagery-and-pain-relief
THE END
Group 5: Research Topic and Presentation:
Grading Criteria and Comments
Group 5: A wonderful presentation. The class discussion reflected the interest and your knowledge of the
topic. Great teamwork to pull off such a solid presentation. Combined score of 96 is annotated bibs plus the
presentation.
Introduction: Description and analysis of the practice issue
concerning spirituality and health outcomes
Points Possible
Points Awarded
Comments
Clear Introductory Description of Practice Concern/Interest:
Describes reason for interest or concern
5
5
What a great way to start with the guided
imagery
Practice Environment: Provides clear description of the topic related
to patients’ spirituality and health outcomes. Provides background
information and an overview. Provides clarification of terminology if
needed.
10
10
Good overview
Research Question: Provides a clear research question to investigate.
5
5
Literature Review
Research Findings: Shares the findings of a minimum of 3 research
studies from professional journals. Briefly describes the research
approaches and findings or the main thesis of each study/article.
Critique of the Research: Attempts to point out any research
limitations/credibility of the studies.
15
15
Very good articles to use to support your topic
and question
5
5
20
20
APA: Adheres to APA manual guidelines. Narration included.
5
5
Annotated Bibliography Three annotated bibliographies focused on
summarizing the article, assessing the article, and reflecting your
opinion. APA format followed
15
(11)
Graded separately
Class Discussion: Presents research question and related finding to
class and responds to peers in a knowledgeable manner reflecting a
solid understanding of the topic in all postings. A strong focus on
application to practice is expected.
10
10
Excellent.
100
85 + 11 = 96
Conclusion
Implications For Practice: Identifies potential practice implications of
research. This goes beyond implications included in the study itself, to
include perceptions of implications for personal practice.
A very strong aspect of this presentation
Standards and APA Criteria
TOTAL POINTS