Baird Carol L, Murawski Matthew M, Wu Jingwei
Indiana University School of Nursing, 1111 Middle Drive, NU 421, Indianapolis, Indiana 46202, USA.
Pain Manag Nurs. 2010 Mar;11(1):56-65. doi: 10.1016/j.pmn.2009.04.002. Epub 2010 Jan 4.
Supporting safe self-management interventions for symptoms of osteoarthritis (OA) may reduce the personal and societal burden of this increasing health concern. Self-management interventions might be even more beneficial if symptom control were accompanied by decreased medication use, reducing cost and potential side effects. Guided imagery with relaxation (GIR) created especially for OA may be a useful self-management intervention, reducing both symptoms and medication use. A longitudinal randomized assignment experimental design was used to study the efficacy of GIR in reducing pain, improving mobility, and reducing medication use. Thirty older adults were randomly assigned to participate in the 4-month trial by using either GIR or a sham intervention, planned relaxation. Repeated-measures analysis of variance revealed that, compared with those who used the sham intervention, participants who used GIR had a significant reduction in pain from baseline to month 4 and significant improvement in mobility from baseline to month 2. Poisson technique indicated that, compared with those who used the sham intervention, participants who used GIR had a significant reduction in over-the-counter (OTC) medication use from baseline to month 4, prescribed analgesic use from baseline to month 4, and total medication (OTC, prescribed analgesic, and prescribed arthritis medication) use from baseline to month 2 and month 4. Results of this study support the efficacy of GIR in reducing symptoms, as well as in reducing medication use. Guided imagery with relaxation may be useful in the regimen of pain management for clinicians.
支持针对骨关节炎(OA)症状的安全自我管理干预措施,可能会减轻这一日益严重的健康问题给个人和社会带来的负担。如果症状得到控制的同时药物使用减少,从而降低成本和潜在副作用,那么自我管理干预措施可能会更有益。专门为OA设计的引导式意象放松法(GIR)可能是一种有用的自我管理干预措施,既能减轻症状,又能减少药物使用。采用纵向随机分配实验设计来研究GIR在减轻疼痛、改善活动能力和减少药物使用方面的疗效。30名老年人被随机分配,通过使用GIR或假干预措施(计划放松)参与为期4个月的试验。重复测量方差分析显示,与使用假干预措施的人相比,使用GIR的参与者从基线到第4个月疼痛显著减轻,从基线到第2个月活动能力显著改善。泊松技术表明,与使用假干预措施的人相比,使用GIR的参与者从基线到第4个月非处方(OTC)药物使用显著减少,从基线到第4个月处方镇痛药使用显著减少,从基线到第2个月和第4个月总药物(OTC、处方镇痛药和处方关节炎药物)使用显著减少。本研究结果支持GIR在减轻症状以及减少药物使用方面的疗效。引导式意象放松法可能对临床医生的疼痛管理方案有用。