A SYSTEMATIC REVIEW OF GUIDED IMAGERY AS AN ADJUVANT CANCER THERAPY
LIZ ROFFEa, KATJA SCHMIDTb,* and EDZARD ERNSTb
aSchool of Nursing and Midwifery, University of Southampton, Highfield, Southampton, S017 1BJ, UK bComplementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Institute of Health & Social Care, 25 Victoria Park Road, Exeter, EX2 4NT, UK
SUMMARY 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.
Jane Hart M.D. Alternative and Complementary Therapies. December 2008,
Guided imagery is a mind–body therapy that has been used for decades by individuals and in clinical settings to influence health outcomes. Guided imagery is particularly helpful for pain management and for reducing symptoms related to anxiety, stress, and other mental health conditions in which intruding thoughts play a role in the pathology. Guided imagery can be an important adjunctive therapy to a conventional treatment approach for various conditions. In patients with chronic pain, for instance, medications and standards of care may not be enough to reduce or eliminate the pain significantly. Complementary therapies, such as guided imagery, when practiced regularly, can decrease pain further and reduce the need for pain medications. Guided imagery can be practiced by individuals on their own, which leads to increased feelings of self-mastery and control, and at very low or no cost to persons, using the therapy. In addition, another benefit is that patients can practice the technique in virtually any location. Individuals may use an imagery practice during stressful medical testing such as getting magnetic resonance imaging (MRI), as well as at home, in the operating waiting room, or on a subway.Guided imagery has been practiced, written about, and researched for decades and has been used in religious, secular, and diverse cultural settings. From shamanism to psychotherapeutic settings, guided imagery has become a well-known complementary therapy. Increasingly, this imagery is utilized in clinical settings and is often encouraged and implemented by nurses. Blue Shield of California began offering guided imagery tapes to its presurgical patients due to increasing evidence that guided imagery may decrease surgical complications and reduce postoperative pain and pre- and postoperative anxiety.1 This article includes a description of guided imagery, a sampling of available research evidence on the topic, resources, and one woman’s experience with guided imagery.