Cassandra 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,
Am J Nurs. 2014 Apr;114(4):26-36; test 37, 47. doi: 10.1097/01.NAJ.0000445680.06812.6a.
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.
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.
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.
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.
Guided imagery is an effective technique for managing and limiting sickle cell disease-related pain in a pediatric population.
尽管治疗方法有所创新，但与疾病相关的疼痛仍然是导致镰状细胞病儿童住院的主要原因。药物止痛可暂时缓解疼痛，但不良反应日益令人担忧。认知行为疗法包括使用引导想象，已显示出在改变慢性疾病患者的疼痛感知和应对模式方面的潜力。在镰状细胞病儿童中进行的研究很少。
本研究旨在测试引导意象训练对已被诊断患有镰状细胞病的学龄儿童的影响，并描述从训练前一个月到训练后一个月疼痛感知、镇痛药使用、自我效能和成像能力的变化。
采用准实验性中断时间序列设计，从一家镰状细胞病诊所中选择了 20 名年龄在 6 至 11 岁之间的儿童作为目的样本，他们在该诊所接受治疗至少一年。儿童在两个月内每天填写疼痛日记，研究者测量基线和治疗结束时的成像能力和自我效能。
在接受引导意象训练后，参与者报告自我效能显著提高，疼痛强度降低，镇痛药使用减少。
引导意象是一种有效的技术，可用于管理和限制儿科镰状细胞病相关疼痛。
