ABSTRACT
Imagery has been used as a healing practice since ancient times. Its reemergence in modern medicine began in the second half of the 20th century, when research suggested that imagery could help reduce patients' pain and anxiety and improve their quality of life and outlook on their illness. While current evidence is insufficient to support claims that imagery affects disease progression, research suggests that this method of inducing relaxation encourages patients' healing process and gives them a greater sense of autonomy in relation to disease and its management. Because imagery is noninvasive, the risks associated with its use are minimal and it is now widely used in integrative nursing. The author discusses imagery's uses and benefits, as well as the potential pitfalls in its use, and describes an imagery technique she has found effective in practice, providing a sample script and explaining how the technique might be used to help patients in various settings.
Subject(s)
Amputation, Surgical/psychology , Anxiety Disorders/nursing , Imagery, Psychotherapy/methods , Integrative Medicine/methods , Pain Management/nursing , Self Care/methods , Aged , Amputation, Surgical/adverse effects , Amputation, Surgical/nursing , Anxiety Disorders/psychology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/surgery , Humans , Leg/surgery , Male , Nursing Care/methods , Oxygen Consumption , Pain Management/methods , Pain Management/psychology , Personal Autonomy , Pulmonary Disease, Chronic Obstructive/psychology , Self Care/psychologyABSTRACT
OBJECTIVE: To determine whether nurse case management with a therapeutic algorithm could effectively improve rates of control for hypertension, hyperglycemia, and hyperlipidemia compared with usual care among veterans with diabetes. RESEARCH DESIGN AND METHODS: A randomized controlled trial of diabetic patients that had blood pressure (BP) >140/90 mmHg, hemoglobin A(1c) (HbA(1c)) >9.0%, or LDL >100 mg/dL. Intervention patients received case management (n = 278) versus usual care (n = 278) over a 1-year period. The primary outcome was the percentage of patients achieving simultaneous control of all three parameters (defined by BP <130/80 mmHg, HbA(1c) <8.0%, and LDL <100 mg/dL) at 1 year. Secondary outcomes included improvements within each individual component of the composite primary outcome. Differences between groups were analyzed using t tests, Pearson χ(2) tests, and linear and logistic regression. RESULTS: A greater number of individuals assigned to case management achieved the primary study outcome of having all three outcome measures under control (61 [21.9%] compared with 28 [10.1%] in the usual care group [P < 0.01]). In addition, a greater number of individuals assigned to the intervention group achieved the individual treatment goals of HbA(1c) <8.0% (73.7 vs. 65.8%, P = 0.04) and BP <130/80 mmHg (45.0 vs. 25.4%, P < 0.01), but not for LDL <100 mg/dL (57.6 vs. 55.4%, P = 0.61), compared with those in the usual care group. CONCLUSIONS: In patients with diabetes, nurse case managers using a treatment algorithm can effectively improve the number of individuals with control of multiple cardiovascular risk factors at 1 year.
