Tusek, D.:  AACN Clinical Issues Advanced Practice in Acute and Critical Care.  Strategies for Implementing a Guided Imagery Program to Enhance Patient Experience.  February, 2000.

Patients in acute care settings often have emotional and physical stresses that are also experienced by family and significant others.  Guided imagery, one of the most well-studied integrative therapies, is used increasingly to improve patients' experiences and healthcare outcomes.  More and more, patients are relying on the use of guided imagery to provide a significant source of strength, support, and courage as they prepare for a procedure or manage the stresses of a hospital stay.  This article provides a brief review of the research base for guided imagery and broad indications for it's use. 
 

Comprehensive Neurofeedback Bibliography

Psychophysiological Coherence: A Proposed Link Among Appreciation, Cognitive Performance, and Health

Research on Guided Imagery to Stop Smoking
 

Ackerman CJ, Turkoski B. Using guided imagery to reduce pain and anxiety. Home Healthc Nurse 2000;Sep, 18(8):524-530;quiz, 531.
 

Antall GF, Kresevic D. The use of guided imagery to manage pain in an elderly orthopaedic population. Orthop Nurs 2004;23(5):335-340.
 

Gaston-Johansson F, Fall-Dickson JM, Nanda J, et al. The effectiveness of the comprehensive coping strategy program on clinical outcomes in breast cancer autologous bone marrow transplantation. Cancer Nurs 2000;Aug, 23(4):227-285.
 

Halpin LS, Speir AM, CapoBianco P, Barnett SD. Guided imagery in cardiac surgery. Outcomes in Management & Nursing Practice, 2002 Jul-Sep;6(3):132-7In 1998.

The  research team led by Linda Halpin at the Inova Heart Center of Inova Fairfax Hospital compared cardiac surgical outcomes between two groups of heart patients - with the use of Diane Tusek's guided imagery tapes. and the group receiving standard of care. 

Analysis of the data revealed that patients who completed the Tusek's guided imagery program had a shorter average length of stay, a decrease in average direct pharmacy costs, and a decrease in average direct pain medication costs while maintaining high overall patient satisfaction with the care and treatment provided.

Guided imagery is now used as a standard, complementary therapy to help reduce anxiety, pain, and length of stay among the cardiac surgery patients at all of the centers in Inova Hospital Center in Fairfax.
 

Huth MM, Broome ME, Good M. Imagery reduces children's post-operative pain. Pain. 2004 Jul;110(1-2):439-48. 

Investigators at Cincinnati Children's Hospital Medical Center conducted a randomized, controlled, clinical trial investigating the effectiveness of imagery, in addition to routine analgesics, in reducing tonsillectomy and/or adenoidectomy pain and anxiety after ambulatory surgery (AS) and at home.

The study concludes that imagery was affecting to reduce post-operative pain following tonsillectomy and/or adenoidectomy in ambulatory surgery.
 

Holden-Lund C “Effects of relaxation with guided imagery on surgical stress and wound healing.” Research in Nursing and Health 1998 11(4) 235-244. 
 

Mannix L, Tusek D., Solomon G.: Effect of Guided Imagery on Quality of Life for Patients with Chronic Tension-Type Headache. Headache: The Journal of Head and Face Pain. May 1999, Vol. 39, Number 5.

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.
 

Oz, M., M.D.  (2000). Quoted in the article, Healing From the Heart: A Leading Heart Surgeon Explores the Power of Complementary Medicine.  Dec. 12.  
 

Oz, M.C., Lemole, E.J., Oz, L.L., Whitworth, G.C., Lemole, G.M. (1996). Treating CHD with Cardiac Surgery Combined with Complementary Therapy. Medscape Womens Health, Oct;1(10):7.
 

Olness, K  “Imagery (self-hypnosis) as adjunct therapy in childhood cancer.” Am. Journal of Pediatric Hematology/Oncology 3 (3) 313-320 (1991). 
 

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

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.
 

Tusek, D.: Cath-Lab Digest: May 1999, Vol 7, Number 5.

Tusek, D, Church J., Fazio V.: AORN, October 1997. Vol. 66. No. 4.

Tusek D, Church J., Strong S., Grass J., Fazio V.: Diseases of the Colon and Rectum. February 1997, Vol. 49, No.2.

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

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.
 

Riner, R.: Guided Imagery and Other Forms of Alternative Medicine - Trend or Aberration? Where Does it Fit in Your Practice? The Journal of Invasive Cardiology. April 1999.

This article written by Dr. Riner, a clinical cardiologist and President and CEO of a professional advisory and healthcare management consulting firm. It discusses the use of guided imagery in clinical practice from the viewpoint of a physician.
 

Wachelka D, Katz RC. Reducing test anxiety and improving academic self-esteem with junior high, high school and college students with learning disabilities. J Behav Ther Exp Psychiatry 1999;Sep, 30(3):191-198.
 

Bennett H, Disbrow E. Mind Body Medicine: How to use your mind for better health. Yonkers New York: Consumer Report Books. 1999.
 

Dossey, B., Guzzetta C. Implications for bio-psycho-social-spiritual concerns in cardiovascular nursing. J. Cardiovasc Nurs 1994:8(4) 72-88.

Efficacy of Guided Imagery in Pediatric Surgical Preparation

Guided Imagery - Stress Journal Citations

Guided Imagery - Chemotherapy Journal Citations

Guided Imagery - Headache Journal Citations

Guided Imagery - Cancer Journal Citations

Guided Imagery - Coronary Journal Citations

Guided Imagery - GERD Journal Citations

Guided Imagery - Radiation Journal Citations

Guided Imagery - IBS Journal Citations
 

Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomized trial. Lang EV, Benotsch EG, Fick LJ, Lutgendorf S, Berbaum ML, Berbaum KS, Logan H, Spiegel D. PMID: 10801169
 

Behavioral interventions such as relaxation and guided imagery can have an impact on an individual’s health… Benson, H., (1983). The relaxation response and norepinephrine. Integrative Psychiatry. 1, 15-18.
 

Gruber, B.L., Hall, N.R., Hersh, S.P., & DuBois, P. (1988)
 

“Immune system and psychological changes in metastatic cancer patients while using ritualized relaxation and guided imagery”. Scandinavian Journal of behavior Therapy, 17, 25-46. This study demonstrated a positive correlation between behavioral interventions and increases in T-lymphocyte functions well as total levels of immunoglobulins G and M . There were also significant increases in mixed lymphocyte responsiveness, the ability of natural killer cells to lyse tumor cells, and the production of interleukin-2 by stimulated lymphocytes, Hall, N.R., & Goldstein, A.L., (1983) Endocrine regulation of host immunity.
 

The role of steroid and thymosins. In R.L. Fenichel & M. A. Chirigos (Eds.), Immune modulation agents and their mechanisms (pp.533-563). New York: Marcel Dekker.
 

Jasnosky, M.L., & Kugler, J. (1987). Relaxation, imagery, and neuroimmunomodulation. Annuls of the New York Academy of Sciences, 496, 722-730.
 

Relaxation training has been shown to reduce cortisol output. McGrady, A.V. Yonder, R., Tan, S.Y., Fine, T.H., & Woerner, M. (1981).
 

The effect of biofeedback-assisted relaxation training on blood pressure and selected biochemical parameters in patients with essential hypertension. Biofeedback & Self-Regulation, 10, 33-47.
 

Cortisol does have well-documented immunomodulatory effects with low doses stimulating and high doses inhibiting measures of immune system functioning.
 

Munch, A., & Guyre, P.M. (1991). Glucocorticoids and immune function. In R. Ader,D. L. Felten, & N. Cohn (Eds.), Psychoneuroimmunology. New York Academic Press.
 

Peavy, B.S., Lawlis, G.F., & Goven, A. (1985). Biofeedback-Assisted relaxation: Effects on phagocytic capacity. Biofeedback & Self Regulation, 10, 33-47.
 

Pennebaker, J.W., Kiecolt-Glaser, J.K., & Glaser, R., (1988). Disclosure of traumas and immune function. Health implication for psychotherapy. Journal of Consulting and Clinical Psychology, 56, 239-245.
 

Schwartz, G.E., (1975). Biofeedback, Self-regulation, and the patterning of physiological processes. American Scientist, 63, 314-324
 

Simon, H.B. (1991). Exercise and human immune function. In R. Ader, D. Felten, & N. Cohn (Eds), Psychoneuroimmunology. New York, Academic Press
 

Spiegel, D., Bloom, J.R., Kraimer, H.C., Gottheil, E. (1989). Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet, 2, 888-891.
 

Lancet 2000 Apr 29; 355(9214): 1486-90