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