Keywords

cognitive behavioral therapy, guided imagery, pain, pain diary, pediatric, self-efficacy, sickle cell disease

 

Authors

  1. Dobson, Cassandra Elaine PhD, RN-BC, PHc
  2. Byrne, Mary Woods PhD, RN, FAAN

Abstract

Background: 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.

 

Objectives: 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.

 

Methods: 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.

 

Results: 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.

 

Conclusions: Guided imagery is an effective technique for managing and limiting sickle cell disease-related pain in a pediatric population.