Use of guided imagery for reduction of pain and anxiety and improved quality of sleep in patients undergoing surgery: a review and meta-analysis


Aurora Research Institute

Presentation Notes

Presented at 2014 Aurora Scientific Day, Milwaukee, WI


Background: While surgery is a very stressful event, patient factors are among the strongest predictors of recovery. Guided imagery is a collection of meditation and relaxation techniques used to reduce anxiety, stress and pain during and after surgical procedures. The use of guided imagery, a low- technology and low-cost approach to health care, is patient- centered in nature. However, skepticism in its use persists, possibly because it may not conform to the biomedical treatment model.

Purpose: The focus of this meta-analysis was to determine the effect sizes for the effectiveness of guided imagery in reducing pain and anxiety and improving quality of sleep for patients undergoing surgery.

Methods: A search through MEDLINE, Journals@OVID, PsycINFO, CINAHL and AltHealthWatch databases for studies published after 1985 that reported guided imagery and surgical procedures was done with the help of Aurora Libraries. A total of 113 publications were reviewed independently by two reviewers. Fifteen studies with randomized controlled trials and pre-post design comparing those receiving guided imagery intervention and a control group for outcomes such as anxiety, pain and quality of sleep were included for analysis. For anxiety, pain and quality of sleep, data was converted to visual analog scale.

Results: A total of 1,216 patients from 15 studies were analyzed. The point estimate for mean age was similar in both groups (P=0.72). Estimated mean difference in the anxiety (-0.93, PConclusion: We conclude guided imagery intervention is effective for reducing anxiety and pain in patients undergoing surgery. Guided imagery intervention does not improve the quality of sleep. Patients undergoing surgery should be given the option to have this low-cost, low-technology intervention.

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