Kwekkeboom Kristine L, Kneip Jenn, Pearson Laura
The University of Iowa College of Nursing, 314 Nursing Building, , Iowa City, IA 52242, USA.
Pain Manag Nurs. 2003 Sep;4(3):112-23. doi: 10.1016/s1524-9042(02)54213-2.
Guided imagery, as other nonpharmacologic strategies, has been demonstrated to be useful for some patients. However, no tested method exists to identify which patients are likely to benefit from this pain management strategy. This pilot study tested a model to predict success with guided imagery. Major concepts tested included imaging ability, outcome expectancy, history of imagery use, match with preferred coping style, and perceived credibility of the imagery provider. A one-group pretest-posttest design was used. A sample of 62 hospitalized cancer patients currently experiencing pain rated >/=3 on a 0 to 10 scale completed questionnaires and used an audiotaped imagery intervention. Pain outcomes examined included mean pain intensity and distress, positive and negative affect, and perceived control over pain. A path analysis was conducted using multiple regression to evaluate relationships proposed in the model. Previous history with imagery predicted outcome expectancy. Imaging ability predicted mean pain intensity, positive affect, and perceived control over pain. Outcome expectancy was not a significant predictor of any pain outcomes. Baseline status and concurrent symptoms, measured as covariates, also played a significant role in predicting outcomes. Variance explained in pain outcomes ranged from 10% to 52% (adjusted R(2) = 3% to 48%). Further exploration of model variables is warranted. Findings suggest that after considering current symptom experience, imaging ability may be a useful variable to assess in order to determine whether guided imagery is an appropriate intervention for individual patients.
与其他非药物治疗策略一样，引导式意象已被证明对一些患者有用。然而，目前尚无经过验证的方法来确定哪些患者可能从这种疼痛管理策略中获益。这项试点研究测试了一个预测引导式意象治疗成功率的模型。所测试的主要概念包括成像能力、结果预期、意象使用史、与首选应对方式的匹配度以及意象提供者的可信度。采用单组前后测设计。抽取了62名目前正在经历疼痛、在0至10分的量表上疼痛评分≥3分的住院癌症患者作为样本，他们完成了问卷调查并使用了一盘引导式意象治疗的录音带进行干预。所检查的疼痛结果包括平均疼痛强度和痛苦程度、积极和消极情绪以及对疼痛的控制感。使用多元回归进行路径分析，以评估模型中提出的关系。既往意象使用史可预测结果预期。成像能力可预测平均疼痛强度、积极情绪以及对疼痛的控制感。结果预期并非任何疼痛结果的显著预测因素。作为协变量测量的基线状态和并发症状在预测结果方面也发挥了重要作用。疼痛结果中所解释的方差范围为10%至52%（调整后的R² = 3%至48%）。有必要对模型变量进行进一步探索。研究结果表明，在考虑当前症状体验后，成像能力可能是一个有用的评估变量，以便确定引导式意象是否是适合个体患者的干预措施。
