A holistic technique to lower anxiety: relaxation with guided imagery

A 6-Week Worksite Positivity Program Leads to Greater Life Satisfaction, Decreased Inflammation, and a Greater Number of Employees With A1C Levels in Range

OBJECTIVE

To determine whether a 6-week Positivity Program could impact employee cardiovascular inflammation, blood sugars, cortisol, dehydroepiandrosterone (DHEA), and/or life satisfaction.

METHODS

Pre- and post-study blood draw and life satisfaction questionnaire tracked changes in 10 cardiovascular and inflammatory biomarkers for 63 employees who participated in a 6-week Positivity Program comprised of three interventions: gratitude, HeartMath's Heart Lock-In, and yoga stretches with guided imagery.

RESULTS

Improvements were recorded in life satisfaction as well as in seven of 10 cardiovascular and inflammatory biomarkers, including high sensitivity C-reactive protein (HsCRP) (-27%), hemoglobin A1c (HbA1c) (-1%), glucose (-2%), myeloperoxidase (MPO) (-5%), lipoprotein-associated phospholipase-A2 (Lp-PLA2) (-9%), apolipoprotein B (ApoB) (-6%), and DHEA (1%). No improvements were recorded in cortisol (11%), small-dense LDL (sdLDL) (0%), or oxidized LDL (OxLDL) (7%).

CONCLUSIONS

Data suggest that engaging in 6 weeks of a workplace Positivity Program may improve employee life satisfaction, blood sugar levels, and some markers of cardiovascular inflammation.

Stress management during pregnancy: designing and evaluating a mind-body intervention

The objective of this 12-week study was to determine whether a relaxation-guided imagery (R-GI) intervention designed as a primary prevention strategy for stress management was perceived as beneficial to African American women during the second trimester of pregnancy. All participants documented perceived benefits of the R-GI intervention that included the following: (1) improved breathing; (2) ability to relax, clear one's mind, and become calm; (3) ability to channel and decrease stress; (4) release of anxiety; (5) use of R-GI throughout the day helped control anger and state of mind, leading to a smoother day; and (6) improved ability to fall and stay asleep.

A descriptive study of the interactive guided imagery experience

The purpose of this Study was to describe the experience of participating in Interactive Guided Imagery (IGI) from the perspective of clients. A qualitative descriptive design guided the research. Ten clients who had engaged in IGI, each with an R.N., IGI-certified practitioner, composed the sample. To explore participants' perceptions of their IGI experience, data were gathered through semistructured, in-depth interviews. Data analysis was carried out through data coding, categorizing, and subcategorizing; thematic synthesis; and structuring of relationships. Six primary themes emerged to compose the description of the experience of participating in IGI: the client's lived experience, use of a nonordinary state of consciousness, the guide, the guide-client relationship, influencing factors, and the results of IGI use. Based on the primary themes and their interrelationships, a model of the IGI experience was developed. The description and the model of the IGI experience provide the basis for further nursing knowledge development of the IGI modality.

Chronic Functional Abdominal Pain (CFAP)

Patients with chronic functional abdominal pain (CFAP) present particularly challenging management issues for primary care physicians and gastroenterologists. A major objective in the care of patients with CFAP is to develop an understanding of this condition as a biopsychosocial disorder where symptoms can be attributed to "brain-gut" dysfunction rather than to a missed structurally based condition. The foundation of any therapeutic strategy is the patient-physician partnership, probably the hardest element of treatment for most physicians. All treatment programs should be based on a multi-component strategy, with the patient as a full partner. Realistic expectations should be agreed upon for "care" rather than "cure." The patient's preferences should be a major factor in the decision as to whether to recommend pharmacologic or psychological treatment, or a combination of the two. Antidepressant drugs are increasingly being used in CFAP, and well-designed studies are emerging to confirm their clinical effectiveness. Patients' understanding of the indications for and effects of antidepressants must be reframed in order to address barriers and achieve adherence to therapy. The clinical effectiveness of antidepressants can often only be assessed after 3 to 6 weeks of therapy. The side effects, which appear early, are usually transient and often disappear within 1 to 2 weeks. There is no conclusive evidence that one antidepressant drug is more effective than others, although most studies have tested tricyclic agents. The most important factors in the choice of antidepressant medication are side-effect profile, physician familiarity and comfort with the drug, and cost.

Reducing distress in first level and student nurses: a review of the applied stress management literature

Following recent evidence of continuing high levels of distress in both trained and student nurses, a critical review of the stress reduction and stress management literature targeting both trained and student nurses is presented. Using a systematic approach, some 36 studies dating from 1980 until the present day were identified adopting either pre-experimental, quasi-experimental or experimental designs. While many work-site programmes in this series were successful in terms of adaptive changes in problem-solving, self-management skills including relaxation and interpersonal skills, affective well-being, and work performance, a number of design and evaluation inadequacies were identified. The relative lack of home-work interface or organizational level programmes to reduce work-related distress, and the scarcity of interventions targeting aspects of the work environment likely to contribute to such outcomes may have contributed to continuing high levels of distress in trained and student nurses. Recommendations regarding the future design, provision and evaluation of such work-site interventions include the further clarification of the structure of perceived stressors, and development of causal models of the stress process to identify the job characteristics 'causing' work-related distress. Such an approach would inform the design and implementation of evidence-based organizational level interventions augmenting strategies to target the health behaviour, lifestyle/risk factors and self-management skills of practitioners and students with attempts to amend problematic elements of the psychosocial work environment.

Imagine this! Infinite uses of guided imagery in women's health

Guided imagery, the use of focused concentration of formed mental images, provides the mechanism of an independent nursing intervention to facilitate mind and body healing. Nurse healers can channel clients to personal restorative potentials and independent health through this powerful and inexpensive tool. In a variety of outpatient, inpatient, chronic care, and home care settings, nurses can introduce this treatment modality early on and for lifelong use for any number of nursing diagnoses. Specific conceptualizations for women's health are presented here. By unleashing your own and your client's imagination, the endless possibilities of guided imagery applications and resulting self-empowerment become apparent.

Effect of relaxation with guided imagery on anxiety, depression, and self-esteem in primiparas

A pretest-posttest experimental design with a convenience sample of 60 subjects was used to examine the effects of a relaxation with guided imagery protocol on anxiety, depression, and self-esteem in primiparas during the first 4 weeks of the postpartum period. The results showed that the experimental group had less anxiety and depression and greater self-esteem than did the control group at the end of the period. Positive correlations were obtained between anxiety and depression; negative correlations between self-esteem and anxiety and depression. All findings were significant at the .05 level.

An exploratory study of the effectiveness of a relaxation with guided imagery protocol

An exploratory study was done to examine the effectiveness of a relaxation with guided imagery protocol in reducing anxiety and depression and increasing self-esteem in new mothers during the first 4 weeks postpartum. The results indicate that anxiety and depression declined and self-esteem increased in subjects in both the experimental and control groups over the 4-week period. However, the decline in anxiety and the increase in self-esteem was greater in the experimental group than in the control group. The decline in depression was about the same in both groups. Further study, using more precise methodology and instrumentation, needs to be done to verify the results.

Imagery: A Treatment for Nursing Student Anxiety

This study examined the effectiveness of audiotaped imagery in reducing anxiety and improving test performance among first-year nursing students. Volunteer subjects were randomly assigned to three groups, imagery-only, imagery/relaxation, and a no-treatment control group. Pottest state anxiety scores in these groups were significantly lower (p = .001) than in the no-treatment control group. Test performance did not differ significantly (p = .067). Subjects using the audiotaped imagery reported an increased sense of well-being, improved ability to sleep, greater energy, and improved self-confidence.

Using relaxation with guided imagery to assist primiparas in achieving maternal role attainment

A framework has been developed that provides nurses with a theoretical basis for using relaxation with guided imagery with primiparas (first-time mothers) to reduce anxiety and depression and to increase self-esteem, thereby promoting maternal role attainment and expected infant behavior during the postpartum period. Although relaxation with guided imagery (RGI) has been used clinically in many situations, no research studies were found that reported using RGI with new mothers. However, because RGI has been effective in altering the responses of adults and children in diverse settings, it is inferred that RGI could be effectively used in helping primiparas adapt to the pressure of parenthood. An RGI protocol for use with new mothers is presented.

Relaxation imagery used for stress reduction in the prevention of smoking relapse

Many ex-smokers fail to remain abstinent after the completion of a formal cessation programme, and relapse rates of 60% to 80% are common. Smokers identify stress as a major factor in relapse. Healthy coping skills are required to prevent a return to smoking. The effectiveness of relaxation imagery was investigated for reducing stress and prolonging abstinence in adult ex-smokers. Volunteer subjects (n = 76) were solicited after completing a local smoking cessation programme, and participants were randomly assigned to an experimental imagery group (n = 39) and to a control group (n = 37). Both groups met for a 3-month period, and experimental group members received instruction in imagery techniques. A 2 x 3 repeated-measures MANOVA with post hoc procedures demonstrated significant changes in variables over time, resulting in enhanced imagery effectiveness, reduced stress, and greater abstinence for the group receiving imagery training. Additionally, discriminant analysis revealed that higher stress and lower imagery effectiveness were prevalent in smoking recidivists. Results indicate that as guided relaxation imagery is learned and practised, effectiveness of imagery is increased, perceived stress is reduced, and smoking abstinence is maintained.