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Original research: using guided imagery to manage pain in young children with sickle cell disease
Cassandra Elaine Dobson1, Mary Woods Byrne
1Cassandra Elaine Dobson is an assistant professor of nursing at Lehman College, the City University of New York, in New York City. Mary Woods Byrne is the Stone Foundation and Elise D. Fish Professor in Clinical Health Care for the Underserved at the Columbia University School of Nursing in New York City. The authors acknowledge Meghan D. Kelly, MSEd, CCLS, for providing training in guided imagery for child participants at the Children's Hospital at Montefiore Medical Center in New York City, and Songs of Love, a nonprofit organization, for creating and donating the original music CDs given to each child at the end of the study. Contact author: Cassandra Elaine Dobson, cassandra.dobson@lehman.cuny.edu. The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.
Background:
Despite innovations in treatment, disease-related pain is still the primary cause of hospitalization for children with sickle cell disease. Pharmacologic pain management relieves pain temporarily, but adverse effects are increasingly a concern. Cognitive behavioral therapies, which include the use of guided imagery, have shown promise in changing pain perception and coping patterns in people with chronic illnesses. Few studies have been done in children with sickle cell disease.
Objectives:
The purposes of this study were to test the effects of guided imagery training on school-age children who had been diagnosed with sickle cell disease, and to describe changes in pain perception, analgesic use, self-efficacy, and imaging ability from the month before to the month after training.
Methods:
A quasi-experimental interrupted time-series design was used with a purposive sample of 20 children ages six to 11 years enrolled from one sickle cell disease clinic, where they had been treated for at least one year. Children completed pain diaries daily for two months, and investigators measured baseline and end-of-treatment imaging ability and self-efficacy.
Results:
After training in the use of guided imagery, participants reported significant increases in self-efficacy and reductions in pain intensity, and use of analgesics decreased as well.
Conclusions:
Guided imagery is an effective technique for managing and limiting sickle cell disease-related pain in a pediatric population.
