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Adrien V, Bosc N, Peccia Galletto C, Diot T, Claverie D, Reggente N, Trousselard M, Bui E, Baubet T, Schoeller F. Enhancing Agency in Posttraumatic Stress Disorder Therapies Through Sensorimotor Technologies. J Med Internet Res 2024; 26:e58390. [PMID: 38742989 PMCID: PMC11250045 DOI: 10.2196/58390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/17/2024] [Accepted: 05/02/2024] [Indexed: 05/16/2024] Open
Abstract
Posttraumatic stress disorder (PTSD) is a significant public health concern, with only a third of patients recovering within a year of treatment. While PTSD often disrupts the sense of body ownership and sense of agency (SA), attention to the SA in trauma has been lacking. This perspective paper explores the loss of the SA in PTSD and its relevance in the development of symptoms. Trauma is viewed as a breakdown of the SA, related to a freeze response, with peritraumatic dissociation increasing the risk of PTSD. Drawing from embodied cognition, we propose an enactive perspective of PTSD, suggesting therapies that restore the SA through direct engagement with the body and environment. We discuss the potential of agency-based therapies and innovative technologies such as gesture sonification, which translates body movements into sounds to enhance the SA. Gesture sonification offers a screen-free, noninvasive approach that could complement existing trauma-focused therapies. We emphasize the need for interdisciplinary collaboration and clinical research to further explore these approaches in preventing and treating PTSD.
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Affiliation(s)
- Vladimir Adrien
- Department of Infectious and Tropical Diseases, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
- Institute of Psychiatry and Neuroscience of Paris, Inserm UMR-S 1266, Université Paris Cité, Paris, France
- Department of Psychopathology, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
| | - Nicolas Bosc
- Department of Psychopathology, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
| | | | - Thomas Diot
- Department of Adult Psychiatry, Impact, Mondor Hospital, AP-HP, Université Paris-Est Créteil, Créteil, France
| | - Damien Claverie
- Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
| | - Nicco Reggente
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
| | - Marion Trousselard
- Institut de Recherche Biomédicale des Armées, Brétigny-sur-Orge, France
- INSPIIRE, Inserm UMR 1319, Université de Lorraine, Nancy, France
- ADES, CNRS UMR 7268, Aix-Marseille Université, Marseille, France
| | - Eric Bui
- Department of Psychiatry, Caen Normandy University Hospital, Normandie Université, Caen, France
- Physiopathology and Imaging of Neurological Disorders, UNICAEN, Inserm UMR-S 1237, Normandie Université, Caen, France
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Thierry Baubet
- Department of Psychopathology, Avicenne Hospital, AP-HP, Université Sorbonne Paris Nord, Bobigny, France
- Unité Transversale de Psychogénèse et Psychopathologie, Université Sorbonne Paris Nord, Villetaneuse, France
- Centre National de Ressources et de Résilience, Lille, France
| | - Félix Schoeller
- Institute for Advanced Consciousness Studies, Santa Monica, CA, United States
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, United States
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Irvine A, Luke D. Apophenia, absorption and anxiety: Evidence for individual differences in positive and negative experiences of Hallucinogen Persisting Perceptual Disorder. JOURNAL OF PSYCHEDELIC STUDIES 2022. [DOI: 10.1556/2054.2022.00195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
Background and Aims
Little is known about individual differences in Hallucinogen Persisting Perceptual Disorder (HPPD). This study investigated visual processing style and personality across two HPPD types (HPPD I and HPPD II) and a Non-HPPD group.
Methods
An online survey was delivered to participants sourced from online HPPD and psychedelic user groups and forums (N = 117). Using one-way ANOVA, respondents were compared across four measures of individual difference. Using logistic regression, a range of visual symptoms and experiences were investigated as potential predictors of group categorisation.
Results
The HPPD I group had higher absorption and visual apophenia scores than the other groups and was predicted by higher drug use. The HPPD II group showed significantly higher trait anxiety than both other groups. Across the HPPD groups, HPPD II categorisation was also predicted by increased negative precipitating experiences, lack of prior knowledge and pre-existing anxiety diagnoses.
Conclusions
Anxiety, negative precipitating experiences and lack of prior knowledge are associated with negative experiences of persistent visual symptoms following hallucinogen use, whilst higher absorption and visual apophenia are associated with positive or neutral experiences. Together these findings indicate that differences in personality may play a role in determining an individual's experience of HPPD, highlighting the role of individual difference research in expanding knowledge around HPPD.
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Affiliation(s)
| | - David Luke
- University of Greenwich, Greenwich, London
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Kealy D, McCloskey KD, Cox DW, Ogrodniczuk JS, Joyce AS. Getting absorbed in group therapy: Absorption and cohesion in integrative group treatment. COUNSELLING & PSYCHOTHERAPY RESEARCH 2019. [DOI: 10.1002/capr.12226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- David Kealy
- Department of Psychiatry University of British Columbia Vancouver British Columbia Canada
| | - Katharine D. McCloskey
- Department of Psychiatry University of British Columbia Vancouver British Columbia Canada
- Educational and Counselling Psychology University of British Columbia Vancouver British Columbia Canada
| | - Daniel W. Cox
- Educational and Counselling Psychology University of British Columbia Vancouver British Columbia Canada
| | - John S. Ogrodniczuk
- Department of Psychiatry University of British Columbia Vancouver British Columbia Canada
| | - Anthony S. Joyce
- Department of Psychiatry University of Alberta Edmonton Alberta Canada
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Haruna M, Matsuzaki M, Ota E, Shiraishi M, Hanada N, Mori R. Guided imagery for treating hypertension in pregnancy. Cochrane Database Syst Rev 2019; 4:CD011337. [PMID: 31032884 PMCID: PMC6487386 DOI: 10.1002/14651858.cd011337.pub2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hypertension (high blood pressure) in pregnancy carries a high risk of maternal morbidity and mortality. Although antihypertensive drugs are commonly used, they have adverse effects on mothers and fetuses. Guided imagery is a non-pharmacological technique that has the potential to lower blood pressure among pregnant women with hypertension. Guided imagery is a mind-body therapy that involves the visualisation of various mental images to facilitate relaxation and reduction in blood pressure. OBJECTIVES To determine the effect of guided imagery as a non-pharmacological treatment of hypertension in pregnancy and its influence on perinatal outcomes. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register, and two trials registers (October 2018). We also searched relevant conference proceedings and journals, and scanned the reference lists of retrieved studies. SELECTION CRITERIA We included randomised controlled trials (RCTs). We would have included RCTs using a cluster-randomised design, but none were identified. We excluded quasi-RCTs and cross-over trials.We sought intervention studies of various guided imagery techniques performed during pregnancy in comparison with no intervention or other non-pharmacological treatments for hypertension (e.g. quiet rest, music therapy, aromatherapy, relaxation therapy, acupuncture, acupressure, massage, device-guided slow breathing, hypnosis, physical exercise, and yoga). DATA COLLECTION AND ANALYSIS Three review authors independently assessed the trials for inclusion, extracted data, and assessed risk of bias for the included studies. We checked extracted data for accuracy, and resolved differences in assessments by discussion. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We included two small trials (involving a total of 99 pregnant women) that compared guided imagery with quiet rest. The trials were conducted in Canada and the USA. We assessed both trials as at high risk of performance bias, and low risk of attrition bias; one trial was at low risk for selection, detection, and reporting bias, while the other was at unclear risk for the same domains.We could not perform a meta-analysis because the two included studies reported different outcomes, and the frequency of the intervention was slightly different between the two studies. One study performed guided imagery for 15 minutes at least twice daily for four weeks, or until the baby was born (whichever came first). In the other study, the intervention included guided imagery, self-monitoring of blood pressure, and thermal biofeedback-assisted relaxation training for four total hours; the participants were instructed to practice the procedures twice daily and complete at least three relief relaxation breaks each day. The control groups were similar - one was quiet rest, and the other was quiet rest as bed rest.None of our primary outcomes were reported in the included trials: severe hypertension (either systolic blood pressure of 160 mmHg or higher, or diastolic blood pressure of 110 mmHg or higher); severe pre-eclampsia, or perinatal death (stillbirths plus deaths in the first week of life). Only one of the secondary outcomes was measured.Low-certainty evidence from one trial (69 women) suggests that guided imagery may make little or no difference in the use of antihypertensive drugs (risk ratio 1.27, 95% confidence interval 0.72 to 2.22). AUTHORS' CONCLUSIONS There is insufficient evidence to inform practice about the use of guided imagery for hypertension in pregnancy.The available evidence for this review topic is sparse, and the effect of guided imagery for treating hypertension during pregnancy (compared with quiet rest) remains unclear. There was low-certainty evidence that guided imagery made little or no difference to the use of antihypertensive drugs, downgraded because of imprecision.The two included trials did not report on any of the primary outcomes of this review. We did not identify any trials comparing guided imagery with no intervention, or with another non-pharmacological method for hypertension.Large and well-designed RCTs are needed to identify the effects of guided imagery on hypertension during pregnancy and on other relevant outcomes associated with short-term and long-term maternal and neonatal health. Trials could also consider utilisation and costs of health service.
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Affiliation(s)
- Megumi Haruna
- The University of TokyoDepartment of Midwifery and Women’s Health, Division of Health Sciences & Nursing, Graduate School of Medicine7‐3‐1 HongoTokyoJapan113‐0033
| | - Masayo Matsuzaki
- Osaka University Graduate School of MedicineDepartment of Children and Women's Health1‐7 YamadaokaSuitaOsakaJapan565‐0871
| | - Erika Ota
- St. Luke's International UniversityGlobal Health Nursing, Graduate School of Nursing Sciences10‐1 Akashi‐choChuo‐KuTokyoMSJapan104‐0044
| | - Mie Shiraishi
- Osaka UniversityDepartment of Children and Women's Health1‐7 YamadaokaSuitaOsakaJapan565‐0871
| | - Nobutsugu Hanada
- National Center for Child Health and DevelopmentDepartment of Health Policy2‐10‐1 OkuraTokyoJapan166‐0014
| | - Rintaro Mori
- National Center for Child Health and DevelopmentDepartment of Health Policy2‐10‐1 OkuraTokyoJapan166‐0014
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The effectiveness of progressive muscle relaxation and interactive guided imagery as a pain-reducing intervention in advanced cancer patients: A multicentre randomised controlled non-pharmacological trial. Complement Ther Clin Pract 2019; 34:280-287. [DOI: 10.1016/j.ctcp.2018.12.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/23/2018] [Accepted: 12/23/2018] [Indexed: 01/18/2023]
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Kasos E, Kasos K, Pusztai F, Polyák Á, Kovács KJ, Varga K. CHANGES IN OXYTOCIN AND CORTISOL IN ACTIVE-ALERT HYPNOSIS: Hormonal Changes Benefiting Low Hypnotizable Participants. Int J Clin Exp Hypn 2018; 66:404-427. [PMID: 30152735 DOI: 10.1080/00207144.2018.1495009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
It is increasingly clear that oxytocin and cortisol play an intricate role in the regulation of behavior and emotions impacting health, relationships, and well-being. Their long-term, cross-generational effect makes them an important focus of the present study. This exploratory research examined changes in oxytocin and cortisol levels and their correlations with different phenomenological measures in both hypnotist and subject during active-alert hypnosis. The level of oxytocin increased whereas the level of cortisol decreased in the hypnotist. When comparing the oxytocin changes of subjects with their hypnotizability, those with low hypnotizability scores experienced an increase in oxytocin, and those with medium and high hypnotizability scores showed no change or decrease. This could explain why clients' hypnotizability is not considered an important factor during hypnotherapy.
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Affiliation(s)
- Eniko Kasos
- a Doctoral School of Psychology , Eötvös Loránd University , Budapest , Hungary
| | - Krisztian Kasos
- a Doctoral School of Psychology , Eötvös Loránd University , Budapest , Hungary
| | - Fanni Pusztai
- a Doctoral School of Psychology , Eötvös Loránd University , Budapest , Hungary
| | - Ágnes Polyák
- b Institute of Experimental Medicine , Budapest , Hungary
| | | | - Katalin Varga
- c Institute of Psychology , Eötvös Loránd University , Budapest , Hungary
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Robb SL, Hanson-Abromeit D, May L, Hernandez-Ruiz E, Allison M, Beloat A, Daugherty S, Kurtz R, Ott A, Oyedele OO, Polasik S, Rager A, Rifkin J, Wolf E. Reporting quality of music intervention research in healthcare: A systematic review. Complement Ther Med 2018; 38:24-41. [PMID: 29857877 PMCID: PMC5988263 DOI: 10.1016/j.ctim.2018.02.008] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/21/2018] [Accepted: 02/22/2018] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Concomitant with the growth of music intervention research, are concerns about inadequate intervention reporting and inconsistent terminology, which limits validity, replicability, and clinical application of findings. OBJECTIVE Examine reporting quality of music intervention research, in chronic and acute medical settings, using the Checklist for Reporting Music-based Interventions. In addition, describe patient populations and primary outcomes, intervention content and corresponding interventionist qualifications, and terminology. METHODS Searching MEDLINE, PubMed, CINAHL, HealthSTAR, and PsycINFO we identified articles meeting inclusion/exclusion criteria for a five-year period (2010-2015) and extracted relevant data. Coded material included reporting quality across seven areas (theory, content, delivery schedule, interventionist qualifications, treatment fidelity, setting, unit of delivery), author/journal information, patient population/outcomes, and terminology. RESULTS Of 860 articles, 187 met review criteria (128 experimental; 59 quasi-experimental), with 121 publishing journals, and authors from 31 countries. Overall reporting quality was poor with <50% providing information for four of the seven checklist components (theory, interventionist qualifications, treatment fidelity, setting). Intervention content reporting was also poor with <50% providing information about the music used, decibel levels/volume controls, or materials. Credentialed music therapists and registered nurses delivered most interventions, with clear differences in content and delivery. Terminology was varied and inconsistent. CONCLUSIONS Problems with reporting quality impedes meaningful interpretation and cross-study comparisons. Inconsistent and misapplied terminology also create barriers to interprofessional communication and translation of findings to patient care. Improved reporting quality and creation of shared language will advance scientific rigor and clinical relevance of music intervention research.
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Affiliation(s)
- Sheri L. Robb
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Deanna Hanson-Abromeit
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Lindsey May
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Eugenia Hernandez-Ruiz
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Megan Allison
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Alyssa Beloat
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Sarah Daugherty
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Rebecca Kurtz
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Alyssa Ott
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | | | - Shelbi Polasik
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Allison Rager
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
| | - Jamie Rifkin
- University of Kansas, School of Music, Music Education and Music Therapy, Lawrence, Kansas 66045, United States
| | - Emily Wolf
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, United States
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Abstract
BACKGROUND Guided imagery (GI) has been recommended as a mind-body therapy for pain relief following orthopaedic surgery, but little is known about the acceptability of the intervention. PURPOSE Describe the perceptions of patients undergoing total knee replacement (TKR) surgery regarding the acceptability of a customized GI intervention to promote TKR outcomes. METHODS Narrative and survey data collected during a randomized controlled trial of the GI intervention were analyzed to assess the acceptability of the intervention. RESULTS Most participants were satisfied with and actively engaged in the intervention, and they perceived it to be helpful. For the smaller group of participants who did not find the intervention to be acceptable, reasons for dissatisfaction and barriers to engagement were identified. CONCLUSIONS Guided imagery is an acceptable intervention for many persons undergoing TKR surgery. The results of this study can provide information to further develop a targeted and customized GI intervention for this population.
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Tindle HA, Barbeau EM, Davis RB, Eisenberg DM, Park ER, Phillips RS, Rigotti NA. Guided Imagery for Smoking Cessation in Adults: A Randomized Pilot Trial. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/1533210106296773] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This pilot study describes a randomized controlled trial of an audio CD—based interactive guided imagery program for smoking cessation for adults versus a wait-listed control. Feasibility, process measures, and biochemically validated abstinence were assessed at end of treatment (6 weeks) and 12 weeks, as well as at 52 weeks for intervention participants. Fifty-nine percent of intervention participants attended four of six guided imagery sessions, and 94% found the technique helpful for smoking cessation. Intervention participants had greater readiness to quit (Readiness to Quit Ladder, 8.3 vs. 7.2, p < .05) and lower state anxiety (Spielberger Index, 32 vs. 38, p < .05) at end of treatment than the control group. Abstinence rates in the intervention versus control groups were 36% versus 18% ( p = .43) at 6 weeks and 30% versus 12% ( p = .40) at 12 weeks, respectively. At 1 year, 24% of intervention participants remained abstinent. A guided imagery program for smoking cessation was feasible, perceived to be helpful, improved intermediate measures, and resulted in a trend toward smoking cessation.
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Affiliation(s)
- Hilary A. Tindle
- Center for Research on Health Care, 200 Meyran Avenue,
Suite 200, Pittsburgh, PA 15213,
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Abstract
Guided imagery is an intervention used by nurses in a variety of settings. It has been suggested that better outcomes will occur with continued practice. No studies were found that examined the relationship between practice duration and strength of outcomes. The focus of this meta-analysis was the effect size of guided imagery intervention studies with different durations. Statistical findings of 10 studies of various durations were converted to d statistics and plotted against the duration of study. The results show an increase in effect size of guided imagery over the first 5 to 7 weeks; however, the effect was decreased at 18 weeks.
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Koplin G, Müller V, Heise G, Pratschke J, Schwenk W, Haase O. Effects of psychological interventions and patients' affect on short-term quality of life in patients undergoing colorectal surgery. Cancer Med 2016; 5:1502-9. [PMID: 27139502 PMCID: PMC4863926 DOI: 10.1002/cam4.739] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 02/17/2016] [Accepted: 03/26/2016] [Indexed: 11/12/2022] Open
Abstract
Psychological interventions can improve Quality of Life (QoL). Object of interest was if different psychological interventions influence short-term QoL after colonic resection for carcinoma. Furthermore, we wanted to see if there is a correlation between patients` preoperative affect and postoperative QoL. Sixty patients that underwent colorectal surgery were divided into three groups. Group one (n = 20) received Guided Imagery and group 2 (n = 22) Progressive Muscle Relaxation. The third group (Control, n = 18) had no intervention. Quality of Life (QoL) was measured using the EORTC QLQ-C30 and the Gastrointestinal Quality of life Index (GIQLI). Patients' affect was measured by the PANAS questionnaire. The higher the preoperative Negative Affect was, the lower were the scores for QoL on the 30th postoperative day. Patients' QoL was highest preoperatively and lowest on the third postoperative day. On the 30th postoperative day scores for QoL were almost as high as preoperative without difference between the three groups. Neither Guided Imagery nor Progressive Relaxation was influencing short-term QoL measured by the EORTC QLQ-C30 and the GIQLI questionnaire after colorectal surgery for cancer. Screening patients' with the PANAS questionnaire might help to identify individuals that are more likely to have a worse QoL postoperatively.
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Affiliation(s)
- Gerold Koplin
- Department of General, Visceral, Vascular and Thoracic Surgery, Charité - University Medicine Berlin, Campus Mitte, Berlin, Germany
| | - Verena Müller
- Department of General, Visceral, Vascular and Thoracic Surgery, Charité - University Medicine Berlin, Campus Mitte, Berlin, Germany
| | - Grit Heise
- Department of General, Visceral, Vascular and Thoracic Surgery, Charité - University Medicine Berlin, Campus Mitte, Berlin, Germany
| | - Johann Pratschke
- Department of General, Visceral, Vascular and Thoracic Surgery, Charité - University Medicine Berlin, Campus Mitte, Berlin, Germany
| | - Wolfgang Schwenk
- Department of General and Visceral Surgery, Asklepios Klinik Altona, Hamburg, Germany
| | - Oliver Haase
- Department of General, Visceral, Vascular and Thoracic Surgery, Charité - University Medicine Berlin, Campus Mitte, Berlin, Germany
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Haruna M, Matsuzaki M, Ota E, Shiraishi M, Hanada N, Mori R. Guided imagery for treating hypertension in pregnancy. Hippokratia 2014. [DOI: 10.1002/14651858.cd011337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Megumi Haruna
- The University of Tokyo; Department of Midwifery and Women's Health; 7-3-1 Hongo Bunkyo-ku Tokyo Japan 113-0033
| | - Masayo Matsuzaki
- The University of Tokyo; Department of Midwifery and Women's Health; 7-3-1 Hongo Bunkyo-ku Tokyo Japan 113-0033
| | - Erika Ota
- National Center for Child Health and Development; Department of Health Policy; 2-10-1 Okura, Setagaya-ku Tokyo Japan 157-8535
| | - Mie Shiraishi
- The University of Tokyo; Department of Midwifery and Women's Health; 7-3-1 Hongo Bunkyo-ku Tokyo Japan 113-0033
| | - Nobutsugu Hanada
- National Center for Child Health and Development; Department of Health Policy; 2-10-1 Okura, Setagaya-ku Tokyo Japan 157-8535
| | - Rintaro Mori
- National Center for Child Health and Development; Department of Health Policy; 2-10-1 Okura, Setagaya-ku Tokyo Japan 157-8535
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Bridging the Gap Between Mind and Body: A Biobehavioral Model of the Effects of Guided Imagery on Pain, Pain Disability, and Depression. Pain Manag Nurs 2013; 14:368-378. [DOI: 10.1016/j.pmn.2011.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 07/25/2011] [Accepted: 08/08/2011] [Indexed: 01/24/2023]
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Bradshaw DH, Donaldson GW, Jacobson RC, Nakamura Y, Chapman CR. Individual differences in the effects of music engagement on responses to painful stimulation. THE JOURNAL OF PAIN 2011; 12:1262-73. [PMID: 22071366 PMCID: PMC3258530 DOI: 10.1016/j.jpain.2011.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Revised: 07/28/2011] [Accepted: 08/29/2011] [Indexed: 11/23/2022]
Abstract
UNLABELLED Engaged attention, including music listening, has shown mixed results when used as a method for reducing pain. Applying the framework of constructivism, we extend the concept of engagement beyond attention/distraction to include all cognitive and emotional/motivational processes that may be recruited in order to construct an alternative experience to pain and thus reduce pain. Using a music-listening task varying in task demand, we collected stimulus-evoked potentials, pupil dilation, and skin conductance responses to noxious electrocutaneous stimulations as indicators of central and peripheral arousal, respectively. Trait anxiety (Spielberger State-Trait Anxiety Inventory) and absorption (Tellegen Absorption Scale) provided indicators of individual differences. One hundred and fifty-three healthy, normal volunteers participated in a test session in which they received 3 stimulus intensity levels while listening to background tones (No Task) or performing a music-listening task. Linear slopes indicating net engagement (change in stimulus arousal relative to task performance) decreased with increasing task demand and stimulus level for stimulus-evoked potentials. Slopes for pupil dilation response and skin conductance response varied with task demand, anxiety, and absorption, with the largest engagement effect occurring for high anxiety/high absorption participants. Music engagement reduces pain responses, but personality factors like anxiety and absorption modulate the magnitude of effect. PERSPECTIVE Engaging in music listening can reduce responses to pain, depending on the person: people who are anxious and can become absorbed in activities easily may find music listening especially effective for relieving pain. Clinicians should consider patients' personality characteristics when recommending behavioral interventions like music listening for pain relief.
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Affiliation(s)
- David H Bradshaw
- Pain Research Center, Department of Anesthesiology, University of Utah, Salt Lake City, Utah 84108, USA.
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Jacobson AF, Lewandowski W, Palmieri PA, Myerscough RP. Feasibility trial of guided imagery and control interventions in mock subjects. Appl Nurs Res 2011; 24:45-52. [DOI: 10.1016/j.apnr.2009.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Revised: 10/26/2008] [Accepted: 01/03/2009] [Indexed: 11/30/2022]
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Thompson T, Steffert T, Steed A, Gruzelier J. A randomized controlled trial of the effects of hypnosis with 3-D virtual reality animation on tiredness, mood, and salivary cortisol. Int J Clin Exp Hypn 2011; 59:122-42. [PMID: 21104488 DOI: 10.1080/00207144.2011.522917] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Case studies suggest hypnosis with a virtual reality (VR) component may be an effective intervention; although few follow-up randomized, controlled trials have been performed comparing such interventions with standard hypnotic treatments. Thirty-five healthy participants were randomized to self-hypnosis with VR imagery, standard self-hypnosis, or relaxation interventions. Changes in sleep, cortisol levels, and mood were examined. Self-hypnosis involved 10- to 20-min. sessions visualizing a healthy immune scenario. Trait absorption was also recorded as a possible moderator. Moderated regression indicated that both hypnosis interventions produced significantly lower tiredness ratings than relaxation when trait absorption was high. When trait absorption was low, VR resulted in significantly higher engagement ratings, although this did not translate to demonstrable improvement in outcome. Results suggest that VR imagery may increase engagement relative to traditional methods, but further investigation into its potential to enhance therapeutic efficacy is required.
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Affiliation(s)
- Trevor Thompson
- Department of Psychology & Counselling, University of Greenwich, London, UK.
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Moffatt FW, Hodnett E, Esplen MJ, Watt-Watson J. Effects of guided imagery on blood pressure in pregnant women with hypertension: a pilot randomized controlled trial. Birth 2010; 37:296-306. [PMID: 21083721 DOI: 10.1111/j.1523-536x.2010.00424.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hypertension occurs in nearly 10 percent of pregnancies, and is associated with higher risk of infant and maternal morbidity and mortality than in normal pregnancies. Previous studies have suggested that relaxation therapies reduce blood pressure in nonpregnant adults. The objectives of this pilot randomized trial were to provide preliminary evidence of whether relaxation by means of guided imagery would reduce blood pressure in hypertensive pregnant women, and to assess the feasibility of a larger trial. METHODS A total of 69 pregnant women with hypertension were randomized to periods of guided imagery or of quiet rest, twice daily for 4 weeks or until delivery, whichever came first. Daytime ambulatory mean arterial pressure, systolic and diastolic blood pressure, and anxiety were measured weekly for up to 4 weeks. RESULTS Women allocated to guided imagery had lower mean arterial pressure elevations over time than those allocated to quiet rest (guided imagery: M = 1.58 mmHg, SD = 7.63; quiet rest: M = 5.93 mmHg, SD = 6.55; t = 2.36, p = 0.02). However, when adjusted for baseline mean arterial pressure and gestation, the effect was not significant (p = 0.14). Numbers of women prescribed antihypertensive medication postrandomization were similar (guided imagery: n = 16; quiet rest: n = 13, χ(2) = 0.74, p = 0.46). There was also no evidence of an effect on women's anxiety. Nearly 90 percent (n = 26) of the guided imagery group indicated that they would use it again. CONCLUSIONS Further rigorous study is warranted to determine effects of guided imagery on maternal blood pressure and perinatal health outcomes.
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Abstract
Over half of the patients diagnosed with cancer suffer from pain. Often, analgesic medications do not completely relieve the pain and alternative measures are sought out for relief. Mind—body techniques such as guided imagery (GI) have been thought to be helpful and used as an adjuvant to pain relief. This article evaluates and summarizes studies performed from 2001 to 2008, which investigated the use of GI for relief of cancer pain. Electronic databases were searched with the keywords cancer pain, visualization, and guided imagery, for any studies utilizing GI with an outcome measure of pain. Five studies included pain as either a primary or a secondary outcome measure. In three of those, pain intensity and pain-related distress decreased in the GI intervention versus control. There is inconsistency in the methodological qualities of these trials and further research is necessary to provide better evidence for the use of GI in cancer pain.
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Affiliation(s)
- Kelly King
- University of Washington, Seattle, WA, USA,
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Thompson T, Steffert T, Gruzelier J. Effects of guided immune-imagery: The moderating influence of openness to experience. PERSONALITY AND INDIVIDUAL DIFFERENCES 2009. [DOI: 10.1016/j.paid.2009.06.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Menzies V, Taylor AG, Bourguignon C. Absorption: an individual difference to consider in mind-body interventions. J Holist Nurs 2009; 26:297-302. [PMID: 19126883 DOI: 10.1177/0898010107307456] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Given that mind-body interventions constitute a major portion of complementary and alternative medicine used by the public, it seems important to explore those human characteristics that may contribute to the efficacy of mind-body interventions in those who are most likely to benefit. One such characteristic, absorption, reflects an individual's cognitive capacity for involvement in sensory and imaginative experiences in ways that alter an individual's perception, memory, and mood with behavioral and biological consequences. Thus, one's level of absorption may potentially create differential treatment effects in mind-body intervention outcomes. Conducting practical clinical trials helps address the challenge of determining whether a specific mind-body modality intervention may be effective. Such trials may be strengthened by including measures of personality dimensions such as absorption.
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Affiliation(s)
- Victoria Menzies
- Virginia Commonwealth University, School of Nursing, Richmond, VA 23298-0567, USA.
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Shapiro JR, Pisetsky EM, Crenshaw W, Spainhour S, Hamer RM, Dymek-Valentine M, Bulik CM. Exploratory study to decrease postprandial anxiety: Just relax! Int J Eat Disord 2008; 41:728-33. [PMID: 18528873 DOI: 10.1002/eat.20552] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Critical first steps in the treatment of anorexia nervosa (AN) include re-nutrition and weight restoration, both highly anxiety provoking for patients. We explored the impact of progressive muscle relaxation (PMR), guided imagery (GI), self-directed relaxation (SR), and control (C) on reducing postprandial anxiety in 64 females with AN. METHOD Participants began the study upon hospital admission. They received relaxation training after lunch for 15 days. Pre- and post-session anxiety and treatment acceptability ratings were made daily. RESULTS Although all conditions improved relaxation and decreased anxiety, feelings of fullness, and thoughts about weight, the three active conditions significantly reduced anxiety and increased relaxation more than C (p < .0001). Participants significantly enjoyed the three active treatments, were more likely to recommend them to a friend, and were more likely to use either PMR or GI again versus C (p < .0001). CONCLUSION Relaxation may be a valuable component for reducing postprandial anxiety in AN.
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Affiliation(s)
- Jennifer R Shapiro
- Department of Psychiatry, University of North Carolina at Chapel Hill, North Carolina, USA.
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Kwekkeboom KL, Bumpus M, Wanta B, Serlin RC. Oncology nurses' use of nondrug pain interventions in practice. J Pain Symptom Manage 2008; 35:83-94. [PMID: 17959348 DOI: 10.1016/j.jpainsymman.2007.02.037] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2006] [Revised: 02/14/2007] [Accepted: 02/19/2007] [Indexed: 11/30/2022]
Abstract
Cancer pain management guidelines recommend nondrug interventions as adjuvants to analgesic medications. Although physicians typically are responsible for pharmacologic pain treatments, oncology staff nurses, who spend considerable time with patients, are largely responsible for identifying and implementing nondrug pain treatments. Oncology nurses' use of nondrug interventions, however, has not been well studied. The purpose of this study was to describe oncology nurses' use of four nondrug interventions (music, guided imagery, relaxation, distraction) and to identify factors that influence their use in practice. A national sample of 724 oncology staff nurses completed a mailed survey regarding use of the nondrug interventions in practice, beliefs about the interventions, and demographic characteristics. The percentages of nurses who reported administering the strategies in practice at least sometimes were 54% for music, 40% for guided imagery, 82% for relaxation, and 80% for distraction. Use of each nondrug intervention was predicted by a composite score on beliefs about effectiveness of the intervention (e.g., perceived benefit; P<0.025) and a composite score on beliefs about support for carrying out the intervention (e.g., time; P<0.025). In addition, use of guided imagery was predicted by a composite score on beliefs about characteristics of patients who may benefit from the intervention (e.g., cognitive ability; P<0.05). Some nurse demographic, professional preparation, and practice environment characteristics also predicted use of individual nondrug interventions. Efforts to improve application of nondrug interventions should focus on innovative educational strategies, problem solving to secure support, and development and testing of new delivery methods that require less time from busy staff nurses.
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Danhauer SC, Marler B, Rutherford CA, Lovato JF, Asbury DY, McQuellon RP, Miller BE. Music or guided imagery for women undergoing colposcopy: a randomized controlled study of effects on anxiety, perceived pain, and patient satisfaction. J Low Genit Tract Dis 2007; 11:39-45. [PMID: 17194950 DOI: 10.1097/01.lgt.0000230206.50495.4c] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE It was hypothesized that music or guided imagery versus usual care would result in less anxiety and perceived pain for colposcopy patients. MATERIALS AND METHODS Patients were randomized to music, guided imagery, or usual care after completing a baseline questionnaire. All patients completed a postprocedure questionnaire. RESULTS Study participants (N=170) had a mean age of 28.4 years (SD=9.6; range 18-60) and formed a racially diverse group. Education/income levels were low. No between-group differences were found for postprocedure anxiety or pain rating. CONCLUSIONS Mind-body interventions had no statistically significant impact on reported anxiety, perceived pain, or satisfaction with care, even for those who anticipated the most pain or started with high anxiety.
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Affiliation(s)
- Suzanne C Danhauer
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1082, USA.
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Menzies V, Taylor AG, Bourguignon C. Effects of guided imagery on outcomes of pain, functional status, and self-efficacy in persons diagnosed with fibromyalgia. J Altern Complement Med 2006; 12:23-30. [PMID: 16494565 PMCID: PMC3712642 DOI: 10.1089/acm.2006.12.23] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES (1) To investigate the effects of a 6-week intervention of guided imagery on pain level, functional status, and self-efficacy in persons with fibromyalgia (FM); and (2) to explore the dose-response effect of imagery use on outcomes. DESIGN Longitudinal, prospective, two-group, randomized, controlled clinical trial. SETTING AND SUBJECTS The sample included 48 persons with FM recruited from physicians' offices and clinics in the mid-Atlantic region. INTERVENTION Participants randomized to Guided Imagery (GI) plus Usual Care intervention group received a set of three audiotaped guided imagery scripts and were instructed to use at least one tape daily for 6 weeks and report weekly frequency of use (dosage). Participants assigned to the Usual Care alone group submitted weekly report forms on usual care. MEASURES All participants completed the Short-Form McGill Pain Questionnaire (SF-MPQ), Arthritis Self- Efficacy Scale (ASES), and Fibromyalgia Impact Questionnaire (FIQ), at baseline, 6, and 10 weeks, and submitted frequency of use report forms. RESULTS FIQ scores decreased over time in the GI group compared to the Usual Care group (p = 0.03). Ratings of self-efficacy for managing pain (p = 0.03) and other symptoms of FM also increased significantly over time (p = < 0.01) in the GI group compared to the Usual Care group. Pain as measured by the SF-MPQ did not change over time or by group. Imagery dosage was not significant. CONCLUSIONS This study demonstrated the effectiveness of guided imagery in improving functional status and sense of self-efficacy for managing pain and other symptoms of FM. However, participants' reports of pain did not change. Further studies investigating the effects of mind-body interventions as adjunctive self-care modalities are warranted in the fibromyalgia patient population.
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Affiliation(s)
- Victoria Menzies
- Florida International University, School of Nursing, Miami, FL 33199, USA.
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Abstract
The purpose of this exploratory study was to describe children's use of imagery before and after ambulatory surgery (AS). The study sample was a subset of 75 children (7-12 years) who were randomly assigned to the treatment group (n = 38) from five AS settings in a larger study on the effectiveness of imagery after surgery. They listened to an audiotape of imagery before surgery, after surgery, and after discharge from AS. Imagery use was evaluated with the Imagery Assessment Questionnaire and a home diary. Imagery tapes were used significantly more times at home after surgery than before surgery. There were no significant changes in the children's Imagery Assessment Questionnaire scores at any time point. Children most often imagined going to the park when they used the tape.
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Affiliation(s)
- Myra Martz Huth
- Center for Professional Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
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Watanabe E, Fukuda S, Shirakawa T. Effects among healthy subjects of the duration of regularly practicing a guided imagery program. Altern Ther Health Med 2005; 5:21. [PMID: 16368006 PMCID: PMC1343583 DOI: 10.1186/1472-6882-5-21] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2004] [Accepted: 12/20/2005] [Indexed: 11/11/2022]
Abstract
Background We examined a large number of healthy adults in the general community who had individually participated in a guided imagery (GI) program daily and for various durations, to examine the psychophysiological effects of a GI program within a healthy group. Methods We studied 176 subjects who had participated in sessions that were part of a guided imagery program, and who had practiced GI at home for 20 minutes once daily in a quiet place after mastering GI in the group sessions. The average duration of GI practiced at home was 6.88 ± 14.06 months (n = 138, range: 0 to 72). The Multiple Mood Scale (MMS), Betts (1909) Shortened Questionnaire on Mental Imagery (QMI), and a visual analog scale (VAS) of imagery vividness, salivary cortisol (CS) levels, general stress and general health were used in the sessions. Results We examined the relationship between the duration of daily GI practiced at home and MMS, QMI, CS, general health, and general stress at baseline. The subjects who had practiced GI at home longer had lower negative mood scores at baseline and lower severity of stress, and higher positive mood at baseline (both at a session and at home), general health, and QMI scores at baseline. The MMS change during a session and the duration of daily GI practiced at home were not correlated. Repeated-measures analysis of covariance showed that the duration of daily GI practiced as the covariate was not associated with changes in the three CS levels. Conclusion Although regularly practicing a GI program daily for 20 min did not affect the CS level or mood during a GI session for several hours, it kept a good condition of the general mental, physical well-being and their overall stress of the practitioners as they had practiced it for long duration. We postulate that subjects who have the high ability of imaging vividness showed the better mood, health status and less stress than those subjects who have the low ability of it did. The ability of image vividness of the long-term regular practitioners of GI was higher than its short-term or inexperienced practitioners, which allowed practitioners to produce more comfortable imagery. Consequently, the longer the duration that they had practiced GI program once a day regularly, the lower scores of their stress were and the higher scores of their health were. We suggest that the regular daily practice of a GI program might be connected to less stress and better health.
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Affiliation(s)
- Eri Watanabe
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Public Health, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
| | - Sanae Fukuda
- Department of Physiology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahimachi Abeno Osaka 545-8585, Japan
| | - Taro Shirakawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Public Health, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan
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Roffe L, Schmidt K, Ernst E. A systematic review of guided imagery as an adjuvant cancer therapy. Psychooncology 2005; 14:607-17. [PMID: 15651053 DOI: 10.1002/pon.889] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AIM The aim of this paper is to summarise and critically evaluate the evidence available from controlled clinical trials regarding the use of guided imagery as a sole adjuvant therapy for cancer patients. METHODS Electronic searches for controlled clinical trials were carried out in eight databases and two clinical trial registers. Trials that featured guided imagery as a sole adjuvant therapy were included. No language restrictions were imposed. Data were extracted and validated independently by two researchers. RESULTS Six randomised clinical trials were included. Detailed results were available for four studies only. Poor reporting and heterogeneous populations, interventions and outcome measures across trials precluded statistical pooling of results. The methodological quality was on average low. Three studies reported significant differences in measures of anxiety, comfort or emotional response to chemotherapy for patients who received guided imagery over the control groups. Two studies showed no differences between guided imagery and other interventions in any of the outcome measures. CONCLUSION Guided imagery, as a sole adjuvant cancer therapy may be psycho-supportive and increase comfort. There is no compelling evidence to suggest positive effects on physical symptoms such as nausea and vomiting. The data seem sufficiently encouraging for the use of guided imagery as an adjuvant cancer therapy to merit further research.
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Affiliation(s)
- Liz Roffe
- School of Nursing and Midwifery, University of Southampton, Highfield, Southampton S017 1BJ, UK
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Abstract
The aim of this study was to explore the effects of guided imagery relaxation in people with chronic obstructive pulmonary disease (COPD) using a randomized controlled design. Half of 26 participants were allocated to the treatment group in which six practice sessions on guided imagery were conducted, while the control group was instructed to take rest quietly during the six sessions. At the seventh session, physiological changes: partial percentage of oxygen saturation; heart rate; upper thoracic surface electromyography; skin conductance; and peripheral skin temperature were recorded during a 30-minute session with a sampling frequency of one minute. Repeated measures analysis of variance was used to explore the changes of the parameters between the groups. Mann-Whitney U test was used to compare the change of perceived dyspnoea between the groups. Results showed there was a statistically significant (p < 0.05) increase in partial percentage of oxygen saturation in the treatment group, but no significant effects on the other physiological parameters. Further study exploring the psychological effects of guided imagery is suggested.
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Kwekkeboom KL, Kneip J, Pearson L. A pilot study to predict success with guided imagery for cancer pain. Pain Manag Nurs 2003; 4:112-23. [PMID: 14566709 DOI: 10.1016/s1524-9042(02)54213-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Guided imagery, as other nonpharmacologic strategies, has been demonstrated to be useful for some patients. However, no tested method exists to identify which patients are likely to benefit from this pain management strategy. This pilot study tested a model to predict success with guided imagery. Major concepts tested included imaging ability, outcome expectancy, history of imagery use, match with preferred coping style, and perceived credibility of the imagery provider. A one-group pretest-posttest design was used. A sample of 62 hospitalized cancer patients currently experiencing pain rated >/=3 on a 0 to 10 scale completed questionnaires and used an audiotaped imagery intervention. Pain outcomes examined included mean pain intensity and distress, positive and negative affect, and perceived control over pain. A path analysis was conducted using multiple regression to evaluate relationships proposed in the model. Previous history with imagery predicted outcome expectancy. Imaging ability predicted mean pain intensity, positive affect, and perceived control over pain. Outcome expectancy was not a significant predictor of any pain outcomes. Baseline status and concurrent symptoms, measured as covariates, also played a significant role in predicting outcomes. Variance explained in pain outcomes ranged from 10% to 52% (adjusted R(2) = 3% to 48%). Further exploration of model variables is warranted. Findings suggest that after considering current symptom experience, imaging ability may be a useful variable to assess in order to determine whether guided imagery is an appropriate intervention for individual patients.
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Affiliation(s)
- Kristine L Kwekkeboom
- The University of Iowa College of Nursing, 314 Nursing Building, , Iowa City, IA 52242, USA.
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Abstract
Cognitive-behavioral therapy focuses on the cognitive, affective, and behavioral components of the pain experience. Cognitive-behavioral strategies can be used to treat chronic pain and chronic intermittent pain. The strategies concentrate on emotional, behavioral, and social responses, helping patients to increase their feelings of control or feelings of self efficacy regarding control.
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Affiliation(s)
- Jo Ann Dalton
- School of Nursing, University of North Carolina at Chapel Hill, 7460 Carrington Hall, Chapel Hill, NC 27599, USA.
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Abstract
Objective:To assess whether mental imagery of gripping prevents the loss of grip strength associated with forearm immobilization.Design:Pretest–posttest randomized-group design.Setting:Laboratory.Participants:13 female and 5 male university students, age between 17 and 30 years, randomly assigned into 2 groups—1 control and 1 experimental.Interventions:Both groups had their nondominant forearms immobilized for 10 days. The experimental group undertook three 5-min mental-imagery sessions daily, during which they imagined they were squeezing a rubber ball.Main Outcome Measures:Wrist-flexion and -extension and grip strength before and after immobilization.Results:There was no significant change in wrist-flexion or -extension strength in the mental-imagery group. The control group experienced a significant decrease in wrist-flexion and -extension strength during the period of immobilization (P< .05).Conclusions:Despite study limitations, the results suggest that mental imagery might be useful in preventing the strength loss associated with short-term muscle immobilization
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Abstract
The purpose of this study was to determine the effects of relaxation and imagery on the sleep of critically ill adults. The study was an experimental clinical trial with random assignment to two groups. Analysis used repeated measures ANOVA. Thirty-six adults (17 males and 19 females) with a variety of physical diagnoses in three critical-care units in two large metropolitan hospitals were studied. Outcome measures were scores on a visual analog sleep scale, measured on three mornings. The intervention was a combination of relaxation and imagery, delivered on two evenings. All subjects' sleep improved over time. There were significant interaction effects between the intervention, gender, and time, with males' scores improving rapidly, and females' scores first dropping, then improving rapidly. A combination of relaxation and imagery is effective in improving the sleep of the critically ill adult, with men responding immediately to relaxation and imagery with improved sleep, and women taking more time to respond to the intervention.
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Affiliation(s)
- Stephanie Richardson
- College of Nursing, Center for Teaching and Learning Excellence, University of Utah, Salt Lake City 84112-0511, USA.
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Frazier SK, Moser DK, Daley LK, McKinley S, Riegel B, Garvin BJ, An K. Critical Care Nurses’ Beliefs About and Reported Management of Anxiety. Am J Crit Care 2003. [DOI: 10.4037/ajcc2003.12.1.19] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
• Background Anxiety is associated with increased morbidity and mortality. Critical care nurses are uniquely positioned to reduce anxiety in their patients. Critical care nurses’ beliefs about and frequency of use of strategies to reduce anxiety have not been studied.• Objectives To explore critical care nurses’ beliefs about the importance of anxiety management and to describe nurses’ reported use of strategies to manage anxiety in their patients.• Methods A random sample (N = 2500) of members of the American Association of Critical-Care Nurses was asked to complete the Critical Care Nurse Anxiety Identification and Management Survey.• Results Respondents (n = 783) were primarily female (92%), white (88.5%) staff nurses (74.1%) who thought that anxiety is potentially harmful (mean, 4.1; SD, 0.8; range, 1 = no harm to 5 = life-threatening harm), that anxiety management is important (mean, 4.8; SD, 0.6; range, 1 = not important to 5 = very important), and that effective anxiety management is beneficial (mean, 4.6; SD, 0.6; range, 1 = no benefit to 5 = profound benefit). A majority commonly used pharmacological management; most also used information and communication interventions. Fewer subjects used the presence of patients’ family members to alleviate patients’ anxiety; few reported using stress-reduction techniques.• Conclusion Most respondents thought that treating anxiety is important and beneficial. Commonly used strategies included pharmacological relief of anxiety and pain and information and communication interventions. Although these strategies are useful, they may not effectively reduce anxiety in all patients.
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Affiliation(s)
- Susan K. Frazier
- The Ohio State University College of Nursing, Columbus, Ohio (SKF, LKD, BJG), University of Kentucky, Lexington, Ky (DKM), University of Technology, Sydney, Australia (SM), University of Pennsylvania, Philadelphia, Pa (BR), and Ewha Women’s University, College of Nursing, Ewha, South Korea (KA)
| | - Debra K. Moser
- The Ohio State University College of Nursing, Columbus, Ohio (SKF, LKD, BJG), University of Kentucky, Lexington, Ky (DKM), University of Technology, Sydney, Australia (SM), University of Pennsylvania, Philadelphia, Pa (BR), and Ewha Women’s University, College of Nursing, Ewha, South Korea (KA)
| | - Linda K. Daley
- The Ohio State University College of Nursing, Columbus, Ohio (SKF, LKD, BJG), University of Kentucky, Lexington, Ky (DKM), University of Technology, Sydney, Australia (SM), University of Pennsylvania, Philadelphia, Pa (BR), and Ewha Women’s University, College of Nursing, Ewha, South Korea (KA)
| | - Sharon McKinley
- The Ohio State University College of Nursing, Columbus, Ohio (SKF, LKD, BJG), University of Kentucky, Lexington, Ky (DKM), University of Technology, Sydney, Australia (SM), University of Pennsylvania, Philadelphia, Pa (BR), and Ewha Women’s University, College of Nursing, Ewha, South Korea (KA)
| | - Barbara Riegel
- The Ohio State University College of Nursing, Columbus, Ohio (SKF, LKD, BJG), University of Kentucky, Lexington, Ky (DKM), University of Technology, Sydney, Australia (SM), University of Pennsylvania, Philadelphia, Pa (BR), and Ewha Women’s University, College of Nursing, Ewha, South Korea (KA)
| | - Bonnie J. Garvin
- The Ohio State University College of Nursing, Columbus, Ohio (SKF, LKD, BJG), University of Kentucky, Lexington, Ky (DKM), University of Technology, Sydney, Australia (SM), University of Pennsylvania, Philadelphia, Pa (BR), and Ewha Women’s University, College of Nursing, Ewha, South Korea (KA)
| | - Kyungeh An
- The Ohio State University College of Nursing, Columbus, Ohio (SKF, LKD, BJG), University of Kentucky, Lexington, Ky (DKM), University of Technology, Sydney, Australia (SM), University of Pennsylvania, Philadelphia, Pa (BR), and Ewha Women’s University, College of Nursing, Ewha, South Korea (KA)
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Frazier SK, Moser DK, O'Brien JL, Garvin BJ, An K, Macko M. Management of anxiety after acute myocardial infarction. Heart Lung 2002; 31:411-20. [PMID: 12434142 DOI: 10.1067/mhl.2002.129445] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Anxiety is common after acute myocardial infarction (AMI) and may induce complications and poorer outcome because of activation of the sympathetic nervous system and the hypothalamic pituitary adrenal axis. Little is known about critical care nurses' management of anxiety in the initial days after AMI. OBJECTIVE The purpose of this study was to describe pharmacological and nonpharmacological anxiety management practices in a sample of patients with AMI and to determine the association between patient self-reported anxiety level, clinician anxiety assessment, and subsequent anxiety management by clinicians. METHODS In this descriptive, correlational investigation, subjects (n = 101) were requested to complete the Spielberger State Anxiety Inventory (SAI) within 48 hours of hospital admission for AMI. After hospital discharge, the investigators performed a thorough medical records review to evaluate the use of pharmacological and nonpharmacological anxiety management strategies for the period that encompassed 12 hours before and 12 hours after administration of the SAI. RESULTS Subjects were primarily white (93%), married (72%) individuals with a hospital admission Killip classification of I (71%). Documentation of subjective anxiety assessment was found for only 45 subjects (44.6%). Subject rating of anxiety with SAI ranged from 20 (no anxiety) to 77 (extreme anxiety; mean, 37.2 +/- 12.4). Seventy-two subjects had documentation of anxiety management (pharmacological, 25.7%; nonpharmacological, 45.6%). No significant relationship was seen between the subject SAI score and the clinician assessment of anxiety (lambda = 0.03; P < .05). Although documentation was seen that 72 subjects received anxiety management, no association was found between the clinician evaluation of anxiety and the use of anxiety management strategies (pharmacological: lambda = 0.11; P = .65; nonpharmacological: lambda = 0.07; P = .08). A small but significant relationship was found between the subject SAI score and the use of pharmacological anxiety management (lambda = 0.10; P = .03) but no association was found between SAI score and the use of nonpharmacological anxiety management (lambda = 0.6; P = .50). Evaluation of efficacy was not routinely documented (pharmacological, 58%; nonpharmacological, 2%). Only 2 subjects (2%) received consultation to social work for management of anxiety. CONCLUSION Anxiety was not systematically and accurately assessed or logically managed in this sample of patients with AMI. Critical care clinicians need a comprehensive understanding about the importance of anxiety to patient outcome in addition to objective, reliable, and valid anxiety measures and a useful repertoire of evidence-based management strategies to effectively manage anxiety. Effective management of anxiety positively influences patient outcome and should be a goal for all critical care patients.
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Affiliation(s)
- Susan K Frazier
- College of Nursing, The Ohio State University, Columbus, Ohio 43210, USA
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Bender CM, McDaniel RW, Murphy-Ende K, Pickett M, Rittenberg CN, Rogers MP, Schneider SM, Schwartz RN. Chemotherapy-induced nausea and vomiting. Clin J Oncol Nurs 2002; 6:94-102. [PMID: 11889684 DOI: 10.1188/02.cjon.94-102] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Nausea and vomiting (N&V) is among the most distressing side effects of chemotherapy, despite the development of more efficacious antiemetic agents. As many as 60% of patients who receive cancer chemotherapy experience some degree of N&V. However, the actual incidence is difficult to determine with accuracy because of the variety of drugs, doses, and health conditions of the patients who receive cancer treatments. This article examines the state of the science related to chemotherapy-induced nausea and vomiting and reviews both pharmacologic and behavioral strategies that have demonstrated efficacy in managing these distressing symptoms.
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Affiliation(s)
- Catherine M Bender
- University of Pittsburgh School of Nursing, 3500 Victoria Street, Room 415, Victoria Building, Pittsburgh, PA 15261, USA.
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36
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Lau OW, Leung LN, Wong LO. Cognitive Behavioural Techniques for Changing the Coping Skills of Patients with Chronic Pain. Hong Kong J Occup Ther 2002. [DOI: 10.1016/s1569-1861(09)70013-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Abstract
Mediators and moderators are variables that affect the association between an independent variable and an outcome variable. Mediators provide additional information about how or why two variables are strongly associated. In contrast, moderators explain the circumstances that cause a weak or ambiguous association between two variables that were expected to have a strong relationship. Mediators and moderators are often overlooked in research designs, or the terms are used incorrectly. This article summarizes the conceptual differences between mediators and moderators. The statistical analysis of moderators and mediators in multiple regression is briefly described and two examples are presented.
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Affiliation(s)
- J A Bennett
- School of Nursing, San Diego State University, CA, USA
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Abstract
Imaging ability, defined as the ability to create vivid mental images and to experience those images as if they were almost real, has been suggested as a moderator in effective use of guided imagery for symptom relief. Persons with good imaging ability are thought to be more likely to succeed in relieving a symptom with guided imagery than persons with poor imaging ability. The purpose of this paper is to describe the development of an instrument designed to measure imaging ability, the Imaging Ability Questionnaire (IAQ). A descriptive correlational design was used to conduct item analyses and explore psychometric properties of the IAQ. A total of 200 persons from the Midwest completed a 54-item version of the IAQ. Twenty-two items that failed to discriminate among levels of imaging ability were eliminated from the questionnaire. The final version of the IAQ contained 32 items and demonstrated good internal consistency (alpha =.93) and test-retest reliability (r =.92). Support for construct validity of the questionnaire was provided by demonstrating expected differences in IAQ score between persons for whom imagery worked and persons for whom imagery did not work. Future testing and use of the questionnaire in research and practice are discussed.
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Affiliation(s)
- K L Kwekkeboom
- University of Iowa, College of Nursing 314 Nursing Building, Iowa City, IA 52242-1121, USA
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Deisch P, Soukup SM, Adams P, Wild MC. GUIDED IMAGERY. Nurs Clin North Am 2000. [DOI: 10.1016/s0029-6465(22)02479-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Kwekkeboom KL. A model for cognitive-behavioral interventions in cancer pain management. IMAGE--THE JOURNAL OF NURSING SCHOLARSHIP 1999; 31:151-6. [PMID: 10380391 DOI: 10.1111/j.1547-5069.1999.tb00456.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To propose a model for predicting success with cognitive-behavioral interventions in cancer pain management. Practice guidelines are useful, however nurses currently have little theoretic or empiric basis for choosing one particular strategy over another. Moreover, nurses have no way of knowing if a particular intervention is likely to work. ORGANIZING CONSTRUCT The model indicates characteristics of a person in relation to interventions including skill and ability, outcome expectancies, perceived credibility, history of use, preferred coping style, and pain outcomes. SOURCES The model was developed using sources identified through a literature search of relevant topics in MEDLINE, CINAHL, and Psychlit (1996-1997), as well as through clinical experience. CONCLUSIONS Continued empiric testing of the model is necessary to confirm proposed relationships and to assess accuracy of the model's predictions with various cognitive-behavioral interventions. With this testing, the model can help nurses select appropriate interventions for individual patients.
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Affiliation(s)
- K L Kwekkeboom
- School of Nursing, University of Wisconsin, Madison, USA.
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