Guided imagery provides key to better outcomes
Guided imagery provides key to better outcomes
In acute and chronic settings, patients heal faster
Soft music drifts down the hallway from the open doorway of the cardiac cath lab at a New Jersey hospital. A gentle voice urges the patient lying on a gurney to breathe deeply, find a safe place in her mind, relax, and release her anxieties about the invasive procedure about to take place.
In a hospital in Cleveland, post-surgical patients in the cardiac intensive care unit hear gentle messages of healing accompanied by calming music and nature sounds.
Both hospitals are part of a study on the healing power of the mind, assisted by guided imagery. The results so far are impressive: Patients leave the hospital two days earlier than similar patients who did not receive the powerful stress-relieving treatment, and have 33% fewer complications than the non-study patients. The study was published in the March/April 1999 issue of the Journal of Cardiovascular Management.
Guided imagery, a relaxation and stress reduction technique used for centuries, is increasingly being used in health care settings as an additional — and inexpensive — tool for enhancing patient care. Numerous studies have shown it has a profound impact on outcomes and patient satisfaction. The mind can be a powerful tool for reducing stress and anxiety, decreasing side effects, and speeding healing, according to experts in imagery and visualization.
"Guided imagery empowers a patient toward his own healing. It gives him a sense of accomplishment, comfort, and hope," says Diane Tusek, RN, BSN, president of Guided Imagery Inc., a Willoughby Hills, OH-based company that produces guided imagery tapes for hospital patients.
Helping patients cope
"Guided imagery is an adjunct to medical and surgical treatment that promotes healing," says Tusek. Her program of guided imagery tapes given to surgical and chronic disease patients is aimed at helping them find a way to cope with the physical conditions.
"I work a lot with patients with congestive heart failure," she says. "They feel isolated, depressed, and have that hopeless feeling that no one understands what is happening with them," says Tusek. "We know when you’re depressed, it depresses the immune system and can lead to even more physical problems."
When properly constructed, Tusek says, guided imagery has the built-in capacity to deliver multiple layers of complex, encoded messages by way of simple symbols and metaphors.
"You could say it acts like a depth charge dropped beneath the surface of the bodymind,’ where it can reverberate again and again," says Tusek, who points out that guided imagery is a "safe, nonthreatening" form of therapy. "The patient doesn’t have to talk or spill his guts. All he has to do is lie there and listen."
Over the past 25 years, the effectiveness of guided imagery was increasingly established by research findings that demonstrate its positive impact on health, creativity, and performance.
Studies have shown that in many instances, even 10 minutes of guided imagery can reduce blood pressure, lower cholesterol and glucose levels in the blood, and heighten short-term immune cell activity. It can considerably reduce blood loss during surgery and morphine use afterward. It lessens headaches and pain. The studies were published in the April 1999 issue of the Journal of Invasive Cardiology.
Tusek’s clinical studies bear out these theories. In studies on cardiac bypass patients at The Cleveland Clinic, Tusek found patients experienced 50% less anxiety in the operating room, 60% less anxiety on their first postoperative day, with diminishing anxiety to the fifth postoperative day. Among control patients, however, anxiety scores remained at a consistent high level during the five days following surgery.
Tusek’s results are of interest to the financial managers as well because patients who received a guided imagery tape five days prior to surgery experienced nearly 75% less postoperative pain than those who did not prepare with relaxation. Plus, the guided imagery participants consumed only about half the analgesic medications.
"Where else could you get these kinds of effects and these kinds of savings in health care costs for the cost of a $17 set of tapes?" asks Tusek.
Patricia Stanford, RN, BSN, manager of the EPS Electro-Physiology Studies department at Deborah Heart and Lung Center in Browns Mills, NJ, found a way to make guided imagery virtually free. For the price of five minutes of a nurse’s time to briefly talk a patient through a guided imagery session, Stanford finds that patients are far more relaxed and cooperative when they are about to undergo invasive procedures.
"It’s a wonderful modality for heart disease," she says, "because it reduces stress, helps patients feel more in control, and helps restore blood flow to coronary arteries."
Stanford, a certified hypnotherapist, asks her patients to visualize themselves in a pleasant and comforting place — on a beach, in a forest, even floating on a cloud. She uses a variety of images, including one where she suggests they put their cares and worries into a hot air balloon and simply let them float away.
"Many doctors call me to help when they have patients who are feeling stressed about a procedure, particularly if it is going to be painful and when sedation is not possible," says Stanford.
Those few minutes spent before a procedure, and often reinforced afterward with tapes or with repeated sessions with a nurse, are worth the time, says Stanford. That’s because they reduce the amount of postoperative care "because you have a more relaxed patient who doesn’t demand so much attention and so much medication," she adds.
An untapped value for insurers
While Stanford offers guided imagery on a rather informal basis at her hospital, she says she wishes insurance companies would see the value of guided imagery in the nonhospital setting and its value in helping patients cope with the depression and stress associated with chronic diseases.
Patricia McDonald, PhD, RN, assistant professor of nursing at Frances Payne Bolton School of Nursing at Case Western Reserve University in Cleveland, is creating a series of guided imagery tapes for patients with diabetes.
"People with diabetes tend to be very stressed, sometimes depressed, and even more often, they are in denial," says McDonald.
Once they learn to accept their conditions and cope with them, McDonald says, they will be able to better manage their disease and prevent complications.
She works with 40 patients in an assisted-living facility with more general tapes that employ guided imagery and muscle-by-muscle relaxation to help them find stress relief from a variety of chronic conditions, such as arthritis, heart disease, cancer, and diabetes.
"Acceptance is the key to better outcomes," says McDonald. "From that place of acceptance, they can move forward to a better quality of life, less pain, and better outcomes."
[Diane Tusek’s tapes can be obtained by calling (440) 944-9292. Or visit the Web site: www.guided imagery.com.]
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