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RESEARCH ON GUIDED IMAGERY, HYPNOSIS, AND RELAXATION TECHNIQUES

There have been many excellent studies to verify the efficacy of these techniques to assist people in their healing challenges. These techniques empower the listener to participate in their own healing. Below you will find a wide range of studies that reflect the value of these approaches with convenient links to the guided imagery MP3s, and CDs created by InnerVision Studio, Inc

Relaxation | Immunity | Pain Management | Cancer | Radiation Therapy | Chemotherapy | All Surgery | Bone Marrow & Stem Cell Transplant | Anxiety | Insomnia | MRI | Empowerment


Relaxation:

Psychol Rep 2000 Feb; 86(1):15-20
Relationship between relaxation by guided imagery and performance of working memory.

Hudetz JA, Hudetz AG, Klayman J

Department of Anesthesiology, Medical College of Wisconsin, Milwaukee 53226, USA. jhudetz@uwm.edu

This study tested the hypothesis that relaxation by guided imagery improves working-memory performance of healthy participants. 30 volunteers (both sexes, ages 17-56 years) were randomly assigned to one of three groups and administered the WAIS-III Letter-Number Sequencing Test before and after 10-min. treatment with guided imagery or popular music. The control group received no treatment. Groups' test scores were not different before treatment. The mean increased after relaxation by guided imagery but not after music or no treatment. This result supports the hypothesis that working-memory scores on the test are enhanced by guided imagery and implies that human information processing may be enhanced by prior relaxation.

Relaxation and Balancing | Top of Page


J Music Ther 1999; 36(1):39-55 
The Effects of Guided Imagery and Music Therapy on Reported Change in Normal Adults.

Maack C, Nolan P
Institut f&uulm;r k&oulm;rperorientierte Psychotherapie, Hamburg, Germany.

This study explores the main changes gained from Guided Imagery and Music (GIM) therapy as described by former clients. It also explores whether gains are integrated into the clients' lives and if those changes stabilize over periods of time after finishing GIM therapy. Questionnaires were sent to GIM therapists who forwarded them to former GIM clients. Twenty-five former GIM clients returned questionnaires directly to the researcher. Results show that the main gains reported by former clients of GIM therapy are (a) getting more in touch with one's emotions, (b) gaining insights into some problems, (c) spiritual growth, (d) increased relaxation, and (e) discovering new parts of oneself. Results also show that GIM therapy might be helpful for clients with symptoms of anxiety and/or fear, and for clients who want to increase their self-esteem. Changes gained during GIM therapy appear to stabilize over a period of time after finishing GIM therapy. They improved after termination of therapy, especially in the mental and transpersonal areas.

Relaxation and Balancing | Empowerment | Top of Page


The Journal of Invasive Cardiology.  April 1999 Vol 11. Number 4. 
Tusek, Diane

This article emphasized the many uses of guided imagery in health care. It discusses how it can significantly reduce stress, pain, side effects of treatments, blood pressure, headaches and strength immune functioning. Patients are encouraged to be active participants in their care. Patients, family members, and staff have demonstrated positive benefits.

Relaxation and Balancing | Pain Management | Immune System For Cancer | Cancer Surgery  |  All Surgery | Top of Page


The Journal of Head and Face Pain. May 1999, Vol. 39, Number 5.

Effect of Guided Imagery on Quality of Life for Patients with Chronic Tension-Type Headache.

Mannix L, Tusek D., Solomon G.:

Dr. Mannix from the Headache Wellness Center, Greensboro, NC. discussed the positive effects guided imagery had on the severity of headaches and quality of life. The study was conducted at The Cleveland Clinic Foundation.

Relaxation and Balancing | Pain Management | Top of Page


Journal of the National Cancer Institute, 7/00.
STRESS AND CANCER

Few events are as stressful as a diagnosis of cancer. But reducing stress may be key to survival.

Stanford University doctors found that among women with metastatic breast cancer, those with high daytime levels of the stress hormone cortisol-a marker for psychological stress-died on average one year sooner than those with normal levels of the hormone.

Meditation, guided imagery, even listening to music are among the many mind-body techniques that can help contain stress.

The calming influence of meditation, for example, has been shown to reduce flare-ups of psoriasis, lower blood pressure, lessen addictive cravings, and mitigate depression. And other techniques, such as yoga and breathing exercises, are now employed at a number of clinics to ease the stress of infertility and boost fertility rates

Immune System For Cancer | Relaxation and Balancing | Top of Page



Nurs Clin North Am 1995 Dec; 30(4):697-709   (ISSN: 0029-6465)
Relaxation and the relief of cancer pain.

Sloman R

University of Sydney, Faculty of Nursing, Australia.

Progressive muscle relaxation combined with guided imagery has the potential to promote relief of cancer pain. The techniques appear to produce a relaxation response that may break the pain-muscle-tension-anxiety cycle and facilitate pain relief through a calming effect. The techniques can be taught by nurses and readily learned by patients. The techniques provide a self-care strategy that, to a limited extent, shifts the locus of control from clinician to patient.

Relaxation and Balancing | Pain Management | Top of Page


Annu Rev Nurs Res 1999; 17:57-84   (ISSN: 0739-6686)
Guided imagery interventions for symptom management.

Eller LS

For the past several decades, papers in the nursing literature have advocated the use of cognitive interventions in clinical practice. Increasing consumer use of complementary therapies, a cost-driven health care system, and the need for evidence-based practice all lend urgency to the validation of the efficacy of these interventions. This review focuses specifically on guided imagery intervention studies identified in the nursing, medical and psychological literature published between 1966 and 1998. Included were 46 studies of the use of guided imagery for management of psychological and physiological symptoms. There is preliminary evidence for the effectiveness of guided imagery in the management of stress, anxiety and depression, and for the reduction of blood pressure, pain and the side effects of chemotherapy.

Chemotherapy | Anxiety | M.R.I. Test | Relaxation and Balancing

Pain Management | Top of Page


Insomnia

Web MD: Insomnia

Cognitive-Behavioral Techniques

Cognitive-behavioral techniques are helpful for retraining healthy sleep patterns. Such techniques combine sleep hygiene, relaxation techniques, and changing the habits and thought patterns that might cause wakefulness. Combinations may work best. A 1993 study reported that after only ten weeks, people with insomnia who used sleep restriction therapy, sleep hygiene, and relaxation techniques achieved a 75% reduction in the time taken to fall asleep (an average of 19 minutes). Such behavioral methods are also effective in elderly patients and, in fact, work better than drugs in this population as well as other age groups. If treating underlying problems and establishing proper sleep hygiene do not relieve sleeplessness, the patient may need to experiment with different behavioral approaches.

Insomnia | Relaxation and Balancing | Top of Page


Immunity:

STUDY: RELAXATION TECHNIQUES HELP CANCER PATIENTS

LONDON (Reuters) April 15, 2000, 10:34 AM

Cancer patients can think themselves to a stronger immune system using relaxation and guided imagery techniques, a British researcher said on Saturday.

Professor Leslie Walker, the director of the Institute of Rehabilitation and Oncology Health at the University of Hull in northern England, said the psychological techniques can also help patients to cope better with the disease. "Our results show that relaxation and guided imagery can bring about measurable changes in the body's own immunological defenses," he said in a statement.  "However, the study provides strong evidence that, for some patients, relaxation and imagery have a very beneficial effect on quality of life," he said.

Walker and his colleagues tested relaxation techniques on 80 women suffering from breast cancer. They presented their findings to the annual meeting of the British Psychological Society. All of the women received standard medical treatments for breast cancer, but half were randomly selected for training in muscular relaxation, guided imagery and cue-controlled relaxation. Guided imagery involves imagining the body's natural defenses battling the cancerous cells. In cue-controlled relaxation patients learn to relax by thinking of special words.
When the researchers tested all the women, they found that those practicing the relaxation techniques had higher numbers of important immune system cells.

Immune System | Chemotherapy | Radiation Therapy | Top of Page


Altern Ther Health Med 1997 Sep.; 3(5):62-70
Coping, life attitudes, and immune responses to imagery and group support after breast cancer treatment.

Richardson MA, Post-White J, Grimm EA, Moye LA, Singletary SE, Justice B

Center for Alternative Medicine Research, University of Texas-Houston School of Public Health, USA.


BACKGROUND: The pilot study used clinical trial methodology to differentiate the effects of imagery and support on coping, life attitudes, immune function, quality of life, and emotional well-being after breast cancer. METHODS: Women (N = 47) who completed treatment for primary breast cancer, excluding stage IV, were randomly assigned to standard care (n = 15) or six weekly support (n = 16) or imagery (n = 16) sessions. Self-report measures included Ways of Coping-Cancer, Life Attitude Profile, Quality of Life (FACT-B), Profile of Mood States, and Functional Support. Immune measures included natural killer cell activity, plasma neopterin, interferon-gamma, interleukins 1 alpha, 1 beta, and 2, and beta-endorphin levels. Differences between groups over time were tested using general linear models, adjusted for pretest score and covariates (age, stage, and months posttreatment). RESULTS: For all women, interferon-gamma increased, neopterin decreased, quality of life improved, and natural killer activity remained unchanged. Compared with standard care, both interventions improved coping skills (seeking support) and perceived social support, and tended to enhance meaning in life. Support boosted overall coping and death acceptance. When comparing imagery with support, imagery participants tended to have less stress, increased vigor, and improved functional and social quality of life. CONCLUSION: Although imagery reduced stress and improved quality of life, both imagery and support improved coping, attitudes, and perception of support. The clinical implications of these changes warrant further testing.

Immune System Imagery | Chemotherapy | Radiation Therapy | Top of Page


Pain Management:

Annu Rev Nurs Res 1999; 17:57-84   (ISSN: 0739-6686)
Guided imagery interventions for symptom management.

Eller LS

For the past several decades, papers in the nursing literature have advocated the use of cognitive interventions in clinical practice. Increasing consumer use of complementary therapies, a cost-driven health care system, and the need for evidence-based practice all lend urgency to the validation of the efficacy of these interventions. This review focuses specifically on guided imagery intervention studies identified in the nursing, medical and psychological literature published between 1966 and 1998. Included were 46 studies of the use of guided imagery for management of psychological and physiological symptoms. There is preliminary evidence for the effectiveness of guided imagery in the management of stress, anxiety and depression, and for the reduction of blood pressure, pain and the side effects of chemotherapy.

Pain Management | Relaxation and BalancingChemotherapy | AnxietyTop of Page


The Journal of Invasive Cardiology. April 1999 Vol 11. Number 4.
Tusek, Diane

This article emphasized the many uses of guided imagery in health care. It discusses how it can significantly reduce stress, pain, side effects of treatments, blood pressure, headaches and strength immune functioning. Patients are encouraged to be active participants in their care. Patients, family members, and staff have demonstrated positive benefits.

Pain Management | All Surgery |Cancer Surgery | Relaxation and Balancing | Top of Page


Nurs Clin North Am 1995 Dec; 30(4):697-709
Relaxation and the relief of cancer pain.

Sloman R
University of Sydney, Faculty of Nursing, Australia.


Progressive muscle relaxation combined with guided imagery has the potential to promote relief of cancer pain. The techniques appear to produce a relaxation response that may break the pain-muscle-tension-anxiety cycle and facilitate pain relief through a calming effect. The techniques can be taught by nurses and readily learned by patients. The techniques provide a self-care strategy that, to a limited extent, shifts the locus of control from clinician to patient.

Pain Management | Immune System Imagery | Chemotherapy | Radiation Therapy | Relaxation and Balancing | Top of Page


Cancer:

Journal of the National Cancer Institute, 7/00.
STRESS AND CANCER

Few events are as stressful as a diagnosis of cancer. But reducing stress may be key to survival.

Stanford University doctors found that among women with metastatic breast cancer, those with high daytime levels of the stress hormone cortisol-a marker for psychological stress-died on average one year sooner than those with normal levels of the hormone.

Meditation, guided imagery, even listening to music are among the many mind-body techniques that can help contain stress.

The calming influence of meditation, for example, has been shown to reduce flare-ups of psoriasis, lower blood pressure, lessen addictive cravings, and mitigate depression. And other techniques, such as yoga and breathing exercises, are now employed at a number of clinics to ease the stress of infertility and boost fertility rates

Immune System Imagery | Relaxation and Balancing | Top of Page


STUDY: RELAXATION TECHNIQUES HELP CANCER PATIENTS LONDON (Reuters) April 15, 2000, 10:34 AM

Cancer patients can think themselves to a stronger immune system using relaxation and guided imagery techniques, a British researcher said on Saturday.

Professor Leslie Walker, the director of the Institute of Rehabilitation and Oncology Health at the University of Hull in northern England, said the psychological techniques can also help patients to cope better with the disease. "Our results show that relaxation and guided imagery can bring about measurable changes in the body's own immunological defenses," he said in a statement. "However, the study provides strong evidence that, for some patients, relaxation and imagery have a very beneficial effect on quality of life," he said.

Walker and his colleagues tested relaxation techniques on 80 women suffering from breast cancer. They presented their findings to the annual meeting of the British Psychological Society. All of the women received standard medical treatments for breast cancer, but half were randomly selected for training in muscular relaxation, guided imagery and cue-controlled relaxation. Guided imagery involves imagining the body's natural defenses battling the cancerous cells. In cue-controlled relaxation patients learn to relax by thinking of special words.

When the researchers tested all the women, they found that those practicing the relaxation techniques had higher numbers of important immune system cells.

Immune System Imagery | Pain Management | Chemotherapy |Cancer Surgery | Radiation Therapy | Top of Page 


Alternative & Complementary Medicine
1999, American Health Consultants
Oncology (Huntingt) 1997 Aug;11(8):1179-89; discussion 1189-95

Guided Imagery as Supportive Therapy in Cancer Treatment

Many challenges face the clinician providing supportive care to cancer patients. Psychological problems and deterioration of quality of life caused by severe nausea, cachexia, and pain are just a few of the hurdles faced by those fighting this disease. Guided Imagery, a cognitive intervention, has been implemented with increasing frequency as a therapeutic option for many encountering these difficulties.

Immune System Imagery | Pain Management | Chemotherapy | Radiation Therapy | Top of Page 


Imagery and hypnosis in the treatment of cancer patients.

Spiegel D, Moore R
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, California, USA.


Many patients with cancer often seek some means of connecting their mental activity with the unwelcome events occurring in their bodies, via techniques such as imagery and hypnosis. Hypnosis has been shown to be an effective method for controlling cancer pain. The techniques most often employed involve physical relaxation coupled with imagery that provides a substitute focus of attention for the painful sensation. Other related imagery techniques, such as guided imagery, involve attention to internally generated mental images without the formal use of hypnosis. The most well-known of these techniques involves the use of "positive mental images" of a strong army of white blood cells killing cancer cells. However, 10-year follow-up of a randomized trial involving 86 women with cancer showed that a year of weekly "supportive/expressive" group therapy significantly increased survival duration and time from recurrence to death. This intervention encourages patients to express and deal with strong emotions and also focuses on clarifying doctor-patient communication. Numerous other studies suggest that suppression of negative affect, excessive conformity, severe stress, and lack of social support predict a poorer medical outcome from cancer. Thus, further investigation into the interaction between body and mind in coping with cancer is warranted.

See www.wellness-community.org  for group information and links.

Immune System Imagery | Pain Management | Top of Page


Nurs Clin North Am 1995 Dec; 30(4):697-709
Relaxation and the relief of cancer pain.

Sloman R
University of Sydney, Faculty of Nursing, Australia.

Progressive muscle relaxation combined with guided imagery has the potential to promote relief of cancer pain. The techniques appear to produce a relaxation response that may break the pain-muscle-tension-anxiety cycle and facilitate pain relief through a calming effect. The techniques can be taught by nurses and readily learned by patients. The techniques provide a self-care strategy that, to a limited extent, shifts the locus of control from clinician to patient.

Pain Management | Immune System For Cancer | Chemotherapy | Radiation Therapy | Relaxation and Balancing | Top of Page


Pain 1995 Nov; 63(2):189-98
Relaxation and imagery and cognitive-behavioral training reduce pain during cancer treatment: a controlled clinical trial.

Syrjala KL, Donaldson GW, Davis MW, Kippes ME, Carr JE
Fred Hutchinson Cancer Research Center, Seattle, WA 98104, USA.

Few controlled clinical trials of psychological interventions for cancer pain relief exist in spite of frequent support for their importance as adjuncts to medical treatment. This study compared oral mucositis pain levels in 4 groups of cancer patients receiving bone marrow transplants (BMT): (1) treatment as usual control, (2) therapist support, (3) relaxation and imagery training, and (4) training in a package of cognitive-behavioral coping skills which included relaxation and imagery. A total of 94 patients completed the study which involved two training sessions prior to treatment and twice a week 'booster' sessions during the first 5 weeks of treatment. Results confirmed our hypothesis that patients who received either relaxation and imagery alone or patients who received the package of cognitive-behavioral coping skills would report less pain than patients in the other 2 groups. The hypothesis that the cognitive-behavioral skills package would have an additive effect beyond relaxation and imagery alone was not confirmed. Average visual analogue scale (VAS) report of pain within the therapist support group was not significantly lower than the control group (P = 0.103) nor significantly higher than the training groups. Patient reports of relative helpfulness of the interventions for managing pain and nausea matched the results of VAS reports. From these results, we conclude that relaxation and imagery training reduces cancer treatment-related pain; adding cognitive-behavioral skills to the relaxation with imagery does not, on average, further improve pain relief.

Pain Management | Bone Marrow-Stem Cell Transplant | Immune System Imagery

Top of Page 


Gen Hosp Psychiatry 1994 Sep; 16(5):340-7
Progressive muscle relaxation and guided imagery in cancer patients.

Baider L, Uziely B, De-Nour AK
Department of Oncology, Hadassah University Hospital, Jerusalem, Israel.


The aim of this study was to gather information on the immediate and long-term effects of six sessions of group Progressive Muscle Relaxation with Guided Imagery on the psychological distress of self-referred cancer patients. Patients' psychological distress and coping with cancer were assessed by three self-reports: the Multiple Locus of Control, the Impact of Events Scale (IES), and the Brief Symptom Inventory (BSI). Of the 123 patients who started group therapy, 37 dropped out during its course. The 86 patients who completed the intervention showed marked improvement on both BSI and IES, an improvement maintained over the next 6 months in 58 patients who continued assessment through the follow up period.

Immune System Imagery | Chemotherapy | Radiation Therapy | Relaxation and Balancing | Top of Page


Radiation Therapy:

STUDY: RELAXATION TECHNIQUES HELP CANCER PATIENTS LONDON (Reuters) April 15, 2000, 10:34 AM

Cancer patients can think themselves to a stronger immune system using relaxation and guided imagery techniques, a British researcher said on Saturday.

Professor Leslie Walker, the director of the Institute of Rehabilitation and Oncology Health at the University of Hull in northern England, said the psychological techniques can also help patients to cope better with the disease. "Our results show that relaxation and guided imagery can bring about measurable changes in the body's own immunological defenses," he said in a statement. "However, the study provides strong evidence that, for some patients, relaxation and imagery have a very beneficial effect on quality of life," he said.

Walker and his colleagues tested relaxation techniques on 80 women suffering from breast cancer. They presented their findings to the annual meeting of the British Psychological Society. All of the women received standard medical treatments for breast cancer, but half were randomly selected for training in muscular relaxation, guided imagery and cue-controlled relaxation. Guided imagery involves imagining the body's natural defenses battling the cancerous cells. In cue-controlled relaxation patients learn to relax by thinking of special words.

When the researchers tested all the women, they found that those practicing the relaxation techniques had higher numbers of important immune system cells.

Radiation Therapy | Immune System Imagery | Chemotherapy | Top of Page 


Oncol Nurs Forum 1999 Jan-Feb; 26(1):67-72
The effects of guided imagery on comfort of women with early stage breast cancer undergoing radiation therapy.

Kolcaba K, Fox C
College of Nursing, University of Akron, Ohio, USA.


PURPOSE/OBJECTIVES: To measure the effectiveness of customized guided imagery for increasing comfort in women with early stage breast cancer. DESIGN: Experimental longitudinal, random assignment to groups. SETTING: Two urban radiation oncology departments. SAMPLE: 53 women (26 in the experimental group, 27 in the control group) aged 37-81; 80% European and 10% African American with stage I or II breast cancer about to begin radiation therapy. METHODS: The experimental group was to listen to a guided imagery audiotape once a day for the duration of the study. The Radiation Therapy Comfort Questionnaire was self-administered at three time points: prior to the introduction of intervention and the beginning of radiation therapy (Time 1), three weeks later (Time 2), and three weeks after completing radiation therapy (Time 3). The State Anxiety Inventory was administered at Time 1 only. MAIN RESEARCH VARIABLES: The effect of use of guided imagery on comfort with anxiety as a control variable. FINDINGS: Pooled data indicated a significant overall increase in differences in comfort between the treatment and control group, with the treatment group having higher comfort over time. The data also revealed a significant linear trend in differences between groups. No significant interaction of group and time existed. CONCLUSIONS: Guided imagery is an effective intervention for enhancing comfort of women undergoing radiation therapy for early stage breast cancer. The intervention was especially salient in the first three weeks of therapy. IMPLICATIONS FOR NURSING PRACTICE: Guided imagery CDs specifically designed for this population were resource effective in terms of cost, personnel, and time.

Radiation Therapy | Immune System Imagery | Custom CDs | Top of Page


Chemotherapy:

Br J Cancer 1999 Apr; 80(1-2):262-8
Psychological, clinical and pathological effects of relaxation training and guided imagery during primary chemotherapy.

Walker LG, Walker MB, Ogston K, Heys SD, Ah-See AK, Miller ID, Hutcheon AW, Sarkar TK, Eremin O
Behavioural Oncology Unit, University of Aberdeen, Medical School, Foresterhill, UK.

The diagnosis and treatment of breast cancer are stressful, and stress may be associated with a poorer response to chemotherapy. There is a need, therefore, to develop and evaluate interventions that might enhance quality of life and, possibly, improve treatment response. The effects of relaxation combined with guided imagery (visualizing host defences destroying tumour cells) on quality of life and response to primary chemotherapy, to date, have not been adequately evaluated. Ninety-six women with newly diagnosed large or locally advanced breast cancer (T2 > 4 cm, T3, T4, or TxN2 and M0) took part in a prospective, randomized controlled trial. Patients were randomized following diagnosis to a control condition (standard care) or to the experimental condition (standard care plus relaxation training and imagery). Psychometric tests to evaluate mood and quality of life were carried out before each of the six cycles of chemotherapy and 3 weeks after cycle 6: tests of personality and coping strategy were carried out prior to cycles one and six. Clinical response to chemotherapy was evaluated after six cycles of chemotherapy using standard UICC criteria and pathological response was assessed from the tissue removed at surgery. As hypothesized, patients in the experimental group were more relaxed and easy going during the study (Mood Rating Scale). Quality of life was better in the experimental group (Global Self-assessment and Rotterdam Symptom Checklist). The intervention also reduced emotional suppression (Courtauld Emotional Control Scale). The incidence of clinically significant mood disturbance was very low and the incidence in the two groups was similar. Finally, although the groups did not differ for clinical or pathological response to chemotherapy, imagery ratings were correlated with clinical response. These simple, inexpensive and beneficial interventions should be offered to patients wishing to improve quality of life during primary chemotherapy.

Chemotherapy | Immune System Imagery | Top of Page 


STUDY: RELAXATION TECHNIQUES HELP CANCER PATIENTS LONDON (Reuters) April 15, 2000, 10:34 AM

Cancer patients can think themselves to a stronger immune system using relaxation and guided imagery techniques, a British researcher said on Saturday.

Professor Leslie Walker, the director of the Institute of Rehabilitation and Oncology Health at the University of Hull in northern England, said the psychological techniques can also help patients to cope better with the disease. "Our results show that relaxation and guided imagery can bring about measurable changes in the body's own immunological defences," he said in a statement. "However, the study provides strong evidence that, for some patients, relaxation and imagery have a very beneficial effect on quality of life," he said.

Walker and his colleagues tested relaxation techniques on 80 women suffering from breast cancer. They presented their findings to the annual meeting of the British Psychological Society. All of the women received standard medical treatments for breast cancer, but half were randomly selected for training in muscular relaxation, guided imagery and cue-controlled relaxation. Guided imagery involves imagining the body's natural defences battling the cancerous cells. In cue-controlled relaxation patients learn to relax by thinking of special words.

When the researchers tested all the women, they found that those practicing the relaxation techniques had higher numbers of important immune system cells.

Chemotherapy, Immune System Imagery, Radiation Therapy Top of page

Chemotherapy | Immune System Imagery | Radiation Therapy | Top of Page 


Eur J Cancer 1999 Dec; 35(13):1783-8
Psychological factors can predict the response to primary chemotherapy in patients with locally advanced breast cancer.

Walker LG, Heys SD, Walker MB, Ogston K, Miller ID, Hutcheon AW, Sarkar TK, Ah-See AK, Eremin O
Institute of Rehabilitation, University of Hull, U.K. l.g.walker@medschool.hull.ac.uk

This study evaluated the possible value of psychological variables in predicting clinical and pathological response to primary chemotherapy. 96 women with newly diagnosed large, or locally advanced, breast cancer (T2 > 4 cm, T3, T4, N2 and M0) participated in a prospective, randomised trial to evaluate the effects of relaxation training with guided imagery and L-arginine on response to primary chemotherapy. Before the first of six cycles of primary chemotherapy, women were assessed using the Hospital Anxiety and Depression Scale (HADS) and the Eysenck Personality Questionnaire (EPQ). The primary outcomes were clinical response (evaluated using standard International Union Against Cancer (UICC) criteria) and pathological response (graded by means of a previously published 5-point scale) following primary chemotherapy. Stepwise linear regressions were used to estimate the predictive value of age, menopausal status, clinical nodal status, tumour size at diagnosis, oestrogen receptor status, dietary supplementation (L-arginine versus placebo), personality (EPQ-L scores), mood (HADS scores) and a psychological intervention. HADS depression score was a significant independent predictor of pathological response to chemotherapy. HADS anxiety score was a significant independent predictor of clinical response. Because the original tumour size before chemotherapy (also a significant predictor of clinical and pathological responses) was taken into account in the analyses, the results cannot be explained in terms of psychobiological factors related to tumour size. This study supports the importance of psychological factors as independent predictors of response to primary chemotherapy in patients with breast cancer. If they can be replicated, these findings have major implications for the management of women with breast cancer. Psychological factors need to be assessed and evaluated in future trials of chemotherapy.

Chemotherapy | Immune System Imagery | Top of Page 


Annu Rev Nurs Res 1999; 17:57-84   (ISSN: 0739-6686)
Guided imagery interventions for symptom management. 

Eller LS

For the past several decades, papers in the nursing literature have advocated the use of cognitive interventions in clinical practice. Increasing consumer use of complementary therapies, a cost-driven health care system, and the need for evidence-based practice all lend urgency to the validation of the efficacy of these interventions. This review focuses specifically on guided imagery intervention studies identified in the nursing, medical and psychological literature published between 1966 and 1998. Included were 46 studies of the use of guided imagery for management of psychological and physiological symptoms. There is preliminary evidence for the effectiveness of guided imagery in the management of stress, anxiety and depression, and for the reduction of blood pressure, pain and the side effects of chemotherapy.

Chemotherapy | Relaxation and Balancing | Pain Management | Anxiety | Top of Page 


Efficacy of relaxation training and guided imagery in reducing the aversiveness of cancer chemotherapy

Affiliations: National Cancer Institute

Lyles JN, Burish TG, Krozely MG, et al.: Efficacy of relaxation training and guided imagery in reducing the aversiveness of cancer chemotherapy. Journal of Consulting and Clinical Psychology 50(4): 509-524, 1982.

Fifty cancer patients receiving chemotherapy, 25 by push injection and 25 by drip infusion, were assigned to one of three conditions for their chemotherapy treatments: (a) progressive muscle-relaxation training plus guided-relaxation imagery; (b) therapist control, in which a therapist was present to provide support and encouragement but did not provide systematic relaxation training; and (c) no-treatment control. Patients participated in one pretraining, three training, and one follow-up session. Results indicated that during the training sessions, patients who received relaxation training, relative to patients in either of the other two conditions, (a) reported feeling significantly less anxious and nauseated during chemotherapy, (b) showed significantly less physiological arousal (as measured by pulse rate and systolic blood pressure) and reported less anxiety and depression immediately after chemotherapy, and (c) reported significantly less severe and less protracted nausea at home following chemotherapy. The attending nurses' observations during chemotherapy confirmed patient reports. In general, patients in the therapist control condition and the no-treatment control condition did not differ significantly from each other. The differences among conditions generally remained significant during the follow-up session. The data suggest that relaxation training may be an effective procedure for helping cancer patients cope with the adverse effects of their chemotherapy. (28 Refs)

 Chemotherapy | Immune System Imagery | Top of Page  


All Surgery:

The Journal of Cardiovascular Management. March/April 1999. 
Tusek, Cwynar, Cosgrove:

Reported the results of a recent study at The Cleveland Clinic Foundation with patients undergoing cardiac surgery. Patients that listened to the guided imagery tape had a significant decrease in pain, stress and anxiety. Patients even left the hospital two days sooner than the patients that did not listen.

All Surgery | Cancer Surgery | Top of Page 


Advances in Mind-Body Medicine 14, 207-222, 1998.)
Mind-body interventions for surgery: evidence and exigency

Dreher H

In his recent review article, Henry Dreher, author and scholar, states that "several hundred studies involving thousands of patients confirm that relatively simple behavioral interventions prior to surgery can demonstrably improve postoperative outcomes in such measures as reduced need for pain medication, shorter hospital stays, less blood loss, and fewer surgical complications."

All Surgery | Cancer Surgery | Top of Page 


Dis Colon Rectum 1997 Feb; 40(2):172-8   (ISSN: 0012-3706)
Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery.

Tusek DL; Church JM; Strong SA; Grass JA; Fazio VW
Department of Colorectal Surgery, The Cleveland Clinic Foundation, Ohio 44195, USA.

PURPOSE: Guided imagery uses the power of thought to influence psychologic and physiologic states. Some studies have shown that guided imagery can decrease anxiety, analgesic requirements, and length of stay for surgical patients. This study was designed to determine whether guided imagery in the perioperative period could improve the outcome of colorectal surgery patients. METHODS: We conducted a prospective, randomized trial of patients undergoing their first elective colorectal surgery at a tertiary care center. Patients were randomly assigned into one of two groups. Group 1 received standard perioperative care, and Group 2 listened to a guided imagery tape three days preoperatively; a music-only tape during induction, during surgery, and postoperatively in the recovery room; a guided imagery tape during each of the first six postoperative days. Both groups had postoperative patient-controlled analgesia. All patients rated their levels of pain and anxiety daily, on a linear analog scale of 0 to 100. Total narcotic consumption, time to first bowel movement, length of stay, and number of patients with complications were also recorded. RESULTS: Groups were similar in age and gender distribution, diagnoses, and surgery performed. Median baseline anxiety score was 75 in both groups. Before surgery, anxiety increased in the control group but decreased in the guided imagery group (median change, 30; P < 0.001). Postoperatively, median increase in the worst pain score was 72.5 for the control group and 42.5 for the imagery group (P < 0.001). Least pain was also significantly different (P < 0.001), with a median increase of 30 for controls and 12.5 for the imagery group. Total opioid requirements were significantly lower in the imagery group, with a median of 185 mg vs. 326 mg in the control group (P < 0.001). Time to first bowel movement was significantly less in the imagery group (median, 58 hours) than in the control group (median, 92 hours; P < 0.001). The number of patients experiencing postoperative complications (nausea, vomiting, pruritus, or ileus) did not differ in the two groups. CONCLUSION: Guided imagery significantly reduces postoperative anxiety, pain, and narcotic requirements of colorectal surgery and increases patient satisfaction. Guided imagery is a simple and low-cost adjunct in the care of patients undergoing elective colorectal surgery.

All Surgery | Cancer Surgery | Top of Page 


AORN J 1997 Oct; 66(4):644-9 
Guided imagery as a coping strategy for perioperative patients.

Tusek D, Church JM, Fazio VW
Guided Imagery Program, Cleveland Clinic Foundation, USA.

Patients who undergo surgery usually experience fear and apprehension about their surgical procedures. Guided imagery is a simple, low-cost therapeutic tool that can help counteract surgical patients' fear and anxiety. The authors randomly assigned 130 patients undergoing elective colorectal surgical procedures into two groups. Members of one group received routine perioperative care. Members of the other group listened to guided imagery CDs for three days before their surgical procedures, during anesthesia induction, intraoperatively, in the postanesthesia care unit, and for six days after surgery. The authors measured patients' anxiety levels, pain perceptions, and narcotic medication requirements. The patients in the guided imagery group experienced considerably less preoperative and postoperative anxiety and pain, and they required almost 50% less narcotic medications after their surgical procedures than patients in the control group.

All Surgery | Cancer Surgery | Top of Page 


The Journal of Invasive Cardiology. April 1999 Vol 11. Number 4.

Tusek, Diane

This article emphasized the many uses of guided imagery in health care. It discusses how it can significantly reduce stress, pain, side effects of treatments, blood pressure, headaches and strength immune functioning. Patients are encouraged to be active participants in their care. Patients, family members, and staff have demonstrated positive benefits.

All Surgery | Cancer Surgery | Relaxation and Balancing | Pain Management | Top of Page


J Dev Behav Pediatr 1996 Oct; 17(5):307-10 
The effects of hypnosis/guided imagery on the postoperative course of children.


Lambert SA
University Hospitals of Cleveland, Rainbow Babies and Children's Hospital, Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio 44106, USA.

Hypnosis, guided imagery, and relaxation have been shown to improve the postoperative course of adult surgical patients. Children have successfully used hypnosis/guided imagery to significantly reduce the pain associated with invasive procedures and to improve selected medical conditions. The purpose of this study was to examine the effect of hypnosis/guided imagery on the postoperative course of pediatric surgical patients. Fifty-two children (matched for sex, age, and diagnosis) were randomly assigned to an experimental or control group. The experimental group was taught guided imagery by the investigator. Practice of the imagery technique included suggestions for a favorable postoperative course. Significantly lower postoperative pain ratings and shorter hospital stays occurred for children in the experimental group. State anxiety was decreased for the guided imagery group and increased postoperatively for the control group. This study demonstrates the positive effects of hypnosis/guided imagery for the pediatric surgical patient.

All Surgery | Cancer Surgery | Top of Page 


Bone Marrow & Stem Cell Transplant:

Cancer Nurs 2000 Aug; 23(4): 277-85 
The effectiveness of the comprehensive coping strategy program on clinical outcomes in breast cancer autologous bone marrow transplantation.

Gaston-Johansson F, Fall-Dickson JM, Nanda J, Ohly KV, Stillman S, Krumm S, Kennedy MJ
International and Extramural Programs, Johns Hopkins University School of Nursing, Baltimore, Maryland 21205-2110, USA.

Patients with breast cancer who undergo autologous bone marrow/peripheral blood stem cell transplantation (ABMT) cope not only with a life-threatening medical treatment, but also with multiple, interrelated symptoms including pain, fatigue, psychological distress, and nausea. The purpose of this study was to determine, in a randomized controlled clinical trial, whether a comprehensive coping strategy program (CCSP) was effective in significantly reducing pain, fatigue, psychological distress, and nausea in patients with breast cancer who underwent ABMT. The CCSP was composed of preparatory information, cognitive restructuring, and relaxation with guided imagery. Randomization placed 52 patients in the CCSP treatment group and 58 patients in the control group. The CCSP was found to be effective in significantly reducing nausea as well as nausea combined with fatigue 7 days after the ABMT when the side effects of treatment were most severe. These results are important given the high incidence of nausea and fatigue in the ABMT population. The CCSP-treated group experienced mild anxiety as compared with the control group who reported moderate anxiety. The greatest effectiveness of CCSP may correspond to the time of the greatest morbidity for patients with breast cancer who have undergone ABM.

Chemotherapy | Radiation Therapy | Bone Marrow-Stem Cell Transplant | Immune System Imagery | Pain Management | Top of Page


Can Oncol Nurs J 1996 Feb; 6(1): 20-5 
The research utilization process: the use of guided imagery to reduce anxiety.

Royle JA, Blythe J, Ingram C, DiCenso A, Bhatnager N, Potvin C
School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Ontario.

In the rapidly changing health care environment, nurses need to keep current with developments, assess their applicability to practice, and make changes where appropriate. There is evidence that nursing research is underutilized and that a considerable gap exists between nursing research and practice (Bostrum & Suter, 1993; Brett, 1987; Sokop & Coyle, 1990). The objectives of a study carried out on a bone marrow transplant unit in a teaching hospital were to: (1) by introducing a framework for research-based care, enhance research utilization in a selected setting, and (2) evaluate the outcomes of research utilization on a specific clinical nursing problem chosen by nurses and researchers. This paper describes the research utilization process and its outcomes, presents an evaluation of the participatory approach from the perspective of the participating nurses, and discusses facilitators and barriers to research utilization. Guided imagery was the intervention used to decrease patient anxiety.

Chemotherapy | Radiation Therapy | Bone Marrow-Stem Cell Transplant | Immune System Imagery | Pain Management | Top of Page


Pain 1995 Nov; 63(2): 189-98 
Relaxation and imagery and cognitive-behavioral training reduce pain during cancer treatment: a controlled clinical trial.

Syrjala KL, Donaldson GW, Davis MW, Kippes ME, Carr JE
Fred Hutchinson Cancer Research Center, Seattle, WA 98104, USA.

Few controlled clinical trials of psychological interventions for cancer pain relief exist in spite of frequent support for their importance as adjuncts to medical treatment. This study compared oral mucositis pain levels in 4 groups of cancer patients receiving bone marrow transplants (BMT): (1) treatment as usual control, (2) therapist support, (3) relaxation and imagery training, and (4) training in a package of cognitive-behavioral coping skills which included relaxation and imagery. A total of 94 patients completed the study which involved two training sessions prior to treatment and twice a week 'booster' sessions during the first 5 weeks of treatment. Results confirmed our hypothesis that patients who received either relaxation and imagery alone or patients who received the package of cognitive-behavioral coping skills would report less pain than patients in the other 2 groups. The hypothesis that the cognitive-behavioral skills package would have an additive effect beyond relaxation and imagery alone was not confirmed. Average visual analogue scale (VAS) report of pain within the therapist support group was not significantly lower than the control group (P = 0.103) nor significantly higher than the training groups. Patient reports of relative helpfulness of the interventions for managing pain and nausea matched the results of VAS reports. From these results, we conclude that relaxation and imagery training reduces cancer treatment-related pain; adding cognitive-behavioral skills to the relaxation with imagery does not, on average, further improve pain relief.

Chemotherapy | Radiation Therapy | Bone Marrow-Stem Cell Transplant Immune System ImageryTop of Page


Anxiety:

J Music Ther 1999; 36(1):39-55 
The Effects of Guided Imagery and Music Therapy on Reported Change in Normal Adults.


Maack C, Nolan P
Institut f&uulm;r k&oulm;rperorientierte Psychotherapie, Hamburg, Germany.


This study explores the main changes gained from Guided Imagery and Music (GIM) therapy as described by former clients. It also explores whether gains are integrated into the clients' lives and if those changes stabilize over periods of time after finishing GIM therapy. Questionnaires were sent to GIM therapists who forwarded them to former GIM clients. Twenty-five former GIM clients returned questionnaires directly to the researcher. Results show that the main gains reported by former clients of GIM therapy are (a) getting more in touch with one's emotions, (b) gaining insights into some problems, (c) spiritual growth, (d) increased relaxation, and (e) discovering new parts of oneself. Results also show that GIM therapy might be helpful for clients with symptoms of anxiety and/or fear, and for clients who want to increase their self-esteem. Changes gained during GIM therapy appear to stabilize over a period of time after finishing GIM therapy. They improved after termination of therapy, especially in the mental and transpersonal areas.

Anxiety | Empowerment | Relaxation and Balancing | Top of Page 


J Holist Nurs 1996 Sep; 14(3):196-205 
The effects of relaxation exercises on anxiety levels in psychiatric inpatients.

Weber S

The purpose of this study was to investigate the effects of relaxation exercises on anxiety levels in an inpatient general psychiatric unit. The conceptual framework used was holism. A convenience sample of 39 subjects was studied. Anxiety levels were measured prior to and post interventions with the state portion of the State-Trait Anxiety Inventory. Progressive muscle relaxation, meditative breathing, guided imagery, and soft music were employed to promote relaxation. A significant reduction in anxiety level was obtained on the post-test. The findings of this study can be incorporated by holistic nurses to help reduce anxiety levels of general psychiatric inpatients by using relaxation interventions.

Anxiety | Relaxation and Balancing | Top of Page


Annu Rev Nurs Res 1999; 17:57-84   (ISSN: 0739-6686) 
Guided imagery interventions for symptom management.

Eller LS

For the past several decades, papers in the nursing literature have advocated the use of cognitive interventions in clinical practice. Increasing consumer use of complementary therapies, a cost-driven health care system, and the need for evidence-based practice all lend urgency to the validation of the efficacy of these interventions. This review focuses specifically on guided imagery intervention studies identified in the nursing, medical and psychological literature published between 1966 and 1998. Included were 46 studies of the use of guided imagery for management of psychological and physiological symptoms. There is preliminary evidence for the effectiveness of guided imagery in the management of stress, anxiety and depression, and for the reduction of blood pressure, pain and the side effects of chemotherapy.

Anxiety | Relaxation and BalancingPain Management | ChemotherapyTop of Page 


Insomnia:

Web MD: Insomnia

Cognitive-Behavioral Techniques

Cognitive-behavioral techniques are helpful for retraining healthy sleep patterns. Such techniques combine sleep hygiene, relaxation techniques, and changing the habits and thought patterns that might cause wakefulness. Combinations may work best. A 1993 study reported that after only ten weeks, people with insomnia who used sleep restriction therapy, sleep hygiene, and relaxation techniques achieved a 75% reduction in the time taken to fall asleep (an average of 19 minutes). Such behavioral methods are also effective in elderly patients and, in fact, work better than drugs in this population as well as other age groups. If treating underlying problems and establishing proper sleep hygiene do not relieve sleeplessness, the patient may need to experiment with different behavioral approaches.

Anxiety | Insomnia | Relaxation and Balancing | Top of Page


MRI:

Holist Nurs Pract 1994 Jan;8(2): 59-69 
The effects of guided imagery on anxiety levels and movement of clients undergoing magnetic resonance imaging.

Thompson MB, Coppens NM

This randomized, experimental study examined the effects of guided imagery on anxiety levels and on movement of clients undergoing non-emergency magnetic resonance imaging (MRI). Subjects who listened to a guided imagery/relaxation tape (n = 20) before their MRI scan and used guided imagery during their scan had lower levels of state anxiety than the control group (n = 21). Based on subject report and operator report, the experimental group moved less frequently during the MRI than the control group. The results of this investigation support the use of guided imagery as a therapeutic intervention and Rogers' Science of Unitary Human Beings.

M.R.I. TestTop of Page 


J Music Ther 1999; 36(1):39-55 
The Effects of Guided Imagery and Music Therapy on Reported Change in Normal Adults.

Maack C, Nolan P
Institut f&uulm;r k&oulm;rperorientierte Psychotherapie, Hamburg, Germany.


This study explores the main changes gained from Guided Imagery and Music (GIM) therapy as described by former clients. It also explores whether gains are integrated into the clients' lives and if those changes stabilize over periods of time after finishing GIM therapy. Questionnaires were sent to GIM therapists who forwarded them to former GIM clients. Twenty-five former GIM clients returned questionnaires directly to the researcher. Results show that the main gains reported by former clients of GIM therapy are (a) getting more in touch with one's emotions, (b) gaining insights into some problems, (c) spiritual growth, (d) increased relaxation, and (e) discovering new parts of oneself. Results also show that GIM therapy might be helpful for clients with symptoms of anxiety and/or fear, and for clients who want to increase their self-esteem. Changes gained during GIM therapy appear to stabilize over a period of time after finishing GIM therapy. They improved after termination of therapy, especially in the mental and transpersonal areas.

Empowerment | Relaxation and Balancing | AnxietyTop of Page 


Custom CDs:

J Holist Nurs 1999 Dec; 17(4):317-30
Imagine this! Infinite uses of guided imagery in women's health.

Bazzo DJ, Moeller RA
Parma Community General Hospital, USA.

Guided imagery, the use of focused concentration of formed mental images, provides the mechanism of an independent nursing intervention to facilitate mind and body healing. Nurse healers can channel clients to personal restorative potentials and independent health through this powerful and inexpensive tool. In a variety of outpatient, inpatient, chronic care, and home care settings, nurses can introduce this treatment modality early on and for lifelong use for any number of nursing diagnoses. Specific conceptualizations for women's health are presented here. By unleashing your own and your client's imagination, the endless possibilities of guided imagery applications and resulting self-empowerment become apparent.

Custom CDs | Empowerment | Top of Page


Oncol Nurs Forum 1999 Jan-Feb; 26(1):67-72
The effects of guided imagery on comfort of women with early stage breast cancer undergoing radiation therapy.

Kolcaba K, Fox C
College of Nursing, University of Akron, Ohio, USA.

PURPOSE/OBJECTIVES: To measure the effectiveness of customized guided imagery for increasing comfort in women with early stage breast cancer. DESIGN: Experimental longitudinal, random assignment to groups. SETTING: Two urban radiation oncology departments. SAMPLE: 53 women (26 in the experimental group, 27 in the control group) aged 37-81; 80% European and 10% African American with stage I or II breast cancer about to begin radiation therapy. METHODS: The experimental group was to listen to a guided imagery audiotape once a day for the duration of the study. The Radiation Therapy Comfort Questionnaire was self-administered at three time points: prior to the introduction of intervention and the beginning of radiation therapy (Time 1), three weeks later (Time 2), and three weeks after completing radiation therapy (Time 3). The State Anxiety Inventory was administered at Time 1 only. MAIN RESEARCH VARIABLES: The effect of use of guided imagery on comfort with anxiety as a control variable. FINDINGS: Pooled data indicated a significant overall increase in differences in comfort between the treatment and control group, with the treatment group having higher comfort over time. The data also revealed a significant linear trend in differences between groups. No significant interaction of group and time existed. CONCLUSIONS: Guided imagery is an effective intervention for enhancing comfort of women undergoing radiation therapy for early stage breast cancer. The intervention was especially salient in the first three weeks of therapy. IMPLICATIONS FOR NURSING PRACTICE: Guided imagery CDs specifically designed for this population were resource effective in terms of cost, personnel, and time.

Custom CDs | Radiation Therapy | Immune System Imagery | Top of Page 


Empowerment:

J Holist Nurs 1999 Dec; 17(4):317-30
Imagine this! Infinite uses of guided imagery in women's health.

Bazzo DJ, Moeller RA
Parma Community General Hospital, USA.

Guided imagery, the use of focused concentration of formed mental images, provides the mechanism of an independent nursing intervention to facilitate mind and body healing. Nurse healers can channel clients to personal restorative potentials and independent health through this powerful and inexpensive tool. In a variety of outpatient, inpatient, chronic care, and home care settings, nurses can introduce this treatment modality early on and for lifelong use for any number of nursing diagnoses. Specific conceptualizations for women's health are presented here. By unleashing your own and your client's imagination, the endless possibilities of guided imagery applications and resulting self-empowerment become apparent.

Custom CDs | Empowerment | Top of Page


J Music Ther 1999; 36(1):39-55

The Effects of Guided Imagery and Music Therapy on Reported Change in Normal Adults.

Maack C, Nolan P
Institut f&uulm;r k&oulm;rperorientierte Psychotherapie, Hamburg, Germany.

This study explores the main changes gained from Guided Imagery and Music (GIM) therapy as described by former clients. It also explores whether gains are integrated into the clients' lives and if those changes stabilize over periods of time after finishing GIM therapy. Questionnaires were sent to GIM therapists who forwarded them to former GIM clients. Twenty-five former GIM clients returned questionnaires directly to the researcher. Results show that the main gains reported by former clients of GIM therapy are (a) getting more in touch with one's emotions, (b) gaining insights into some problems, (c) spiritual growth, (d) increased relaxation, and (e) discovering new parts of oneself. Results also show that GIM therapy might be helpful for clients with symptoms of anxiety and/or fear, and for clients who want to increase their self-esteem. Changes gained during GIM therapy appear to stabilize over a period of time after finishing GIM therapy. They improved after termination of therapy, especially in the mental and transpersonal areas.

Empowerment | Top of Page

 

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