Institute of Allied Health Sciences, College of Medicine, National Cheng-Kung University, Tainan, Taiwan.
Biol Res Nurs. 2010 Oct;12(2):188-97. doi: 10.1177/1099800409347556. Epub 2010 May 7.
Dyspnea is a frequent and devastating symptom among advanced cancer patients for which improved and low-cost palliative techniques are needed.
A one-group repeated measures research design investigated the efficacy of guided imagery (GI) with theta music (M) on dyspnea in advanced cancer patients. The intervention consisted of four periods: (a) pretest; (b) intervention with peaceful non-M; (c) intervention with 10 min of GI with M (GI/M), with the first and last 3 min being M only (i.e., the middle 4 min was GI/M); and (d) posttest. Dyspnea outcome was measured with the Modified Borg Scale (MBS) for self-reported evaluation of dyspneic symptoms. Physiological parameters measured were pulse oxygen saturation (SpO(2)), end-tidal CO( 2) (EtCO(2)), heart rate (HR), and respiratory rate (RR). Posttest qualitative data were obtained via interview for subjective patient experience.
Participants included 53 patients, 33% with lung cancer. GI/M produced a significant decrease in MBS scores; 90% of the subjects gave positive qualitative reviews of GI/M. SpO(2) did not change significantly over time. GI/M significantly increased EtCO(2), decreased RR, and decreased HR.
This study demonstrates that GI/M is a useful intervention for palliative care of patients with dyspnea. M alone was demonstrated to be effective, while soothing non-M was not effective. GI/M was more effective than M alone. GI/M should be considered low-cost end-of-life palliative care for dyspnea.
呼吸困难是晚期癌症患者常见且具有破坏性的症状,需要改进和降低成本的姑息治疗技术。
采用单组重复测量研究设计,调查引导意象(GI)与θ 音乐(M)对晚期癌症患者呼吸困难的疗效。干预措施包括四个阶段:(a)预测试;(b)使用平静的非-M 进行干预;(c)使用 10 分钟的 GI 与 M(GI/M)进行干预,前 3 分钟和后 3 分钟仅使用 M(即中间 4 分钟是 GI/M);(d)后测试。呼吸困难的结果通过改良的 Borg 量表(MBS)进行自我报告评估。测量的生理参数包括脉搏血氧饱和度(SpO₂)、呼气末二氧化碳(EtCO₂)、心率(HR)和呼吸频率(RR)。后测试的定性数据通过访谈获得,用于主观患者体验。
参与者包括 53 名患者,其中 33%患有肺癌。GI/M 显著降低了 MBS 评分;90%的受试者对 GI/M 给予了积极的定性评价。SpO₂在时间上没有显著变化。GI/M 显著增加了 EtCO₂,降低了 RR,并降低了 HR。
本研究表明,GI/M 是一种有效的姑息治疗呼吸困难的方法。单独使用 M 被证明是有效的,而舒缓的非-M 则无效。GI/M 比单独使用 M 更有效。GI/M 应被视为呼吸困难的低成本临终姑息治疗方法。