The effect of guided imagery on physiological and psychological outcomes of adult ICU patients: A systematic literature review and methodological implications
| Autor: | Maria Hadjibalassi, Elizabeth Papathanassoglou, Evridiki Papastavrou, Ekaterini Lambrinou |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Relaxation Imagery Psychotherapy Blinding Critical Illness CINAHL Emergency Nursing Critical Care Nursing Medical and Health Sciences law.invention 03 medical and health sciences 0302 clinical medicine Patient satisfaction Randomized controlled trial law Health Sciences medicine Humans 030212 general & internal medicine Intensive care medicine Psychiatry Guided imagery 030504 nursing business.industry Repeated measures design Intensive Care Units Systematic review Anxiety Complementary alternative therapies medicine.symptom 0305 other medical science business Critical illness |
| Popis: | Objectives Guided imagery (GI) is a relaxation technique that is being increasingly explored in various patients’ populations. We systematically reviewed evidence on the effects of GI on physiological and psychological outcomes of adult critically ill patients and extracted implications for future research. Review method used Systematic literature review of published studies based on the Cochrane Guidelines. Data sources Studies were located through literature searches of CINAHL, PubMed, Embase, Cochrane Database of Systematic Reviews and Psych-Info. Review methods We explored effects of GI in critically illness. The outcome measures included pain, anxiety, hemodynamic measurements, stress neuropeptides, length of stay, sleep quality, inflammatory markers, patient satisfaction and cost of care. The Cochrane Collaboration’s tool for assessing risk of bias was employed. Extracted data included pathophysiological framework, sample, diagnoses of participants, specifics of intervention, design, experimental groups, analyses and main outcomes. Results Based on the selection criteria, 10 studies were identified, involving N = 1391 critically ill patients. The main limitations include incomplete outcome data and selective reporting, incomplete blinding and lack of experimental group allocation concealment. Due to heterogeneity and incomplete reporting, a meta-analysis was not feasible. Our findings included: (a) favourable effects of the intervention with regard to decrease of pain, anxiety and LOS; (b) many studies employing randomised controlled trial designs; (c) a predominant focus on patients with cardiac surgery; (d) large heterogeneity in measurement of outcomes. Moreover, the evidence suggests that improvements in sleep quality, patient satisfaction and cost of care merit further investigation. Methodological implications include the need to clarify the underlying physiological framework, the use of repeated measure designs and the adjustment for confounders. Conclusions On the basis of these results, and of the absence of reported side-effects, we conclude that GI is a promising patient-centered approach for the improvement of a number of patients’ outcomes that merits further investigation in critical care. |
| Databáze: | OpenAIRE |
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