Gerontological Nursing Interventions Research Center (GNIRC)

Title: Predicting Success with Guided Imagery for Cancer Pain
Principal Investigator: Kristine Kwekkeboom, PhD, RN
Study Site: The University of Iowa

Abstract
Recommendations for treatment of cancer pain call for both analgesic medications and nonpharmacologic interventions (AHCPR, 1994). While nurses have several nonpharmacologic interventions in their repetoir, those interventions don't work equally well for all patients. To date, there is no systematic method to help nurses choose the best intervention for an individual patient. Kwekkeboom (1999) proposed a model of factors that may influence success with cognitive-behavioral interventions. Applied to guided imagery, the model suggests that the effect of imagery on pain outcomes is moderated by imaging ability (the ability to create and experience vivid mental images) and by outcome expectancy. Outcome expectancy may be influenced by previous experiences with imagery, preferred coping style, and perceived credibility of the provider. The purpose of this study is to test relationships proposed in this model and estimate their magnitude, to test study procedures, and assess feasibility of conducting the study on a larger scale. A quasi-experimental design will be used to assess relationships between the predictor variables and pain outcomes. A sample of forty hospitalized breast cancer patients who are experiencing pain rated ³ 3 on a 0 to 10 scale will complete measures and use an audiotaped imagery intervention. Pain outcomes will include changes in pain intensity and distress, perceived control over pain, positive and negative affect, and evaluation of the imagery experience. This study is a first step in documenting predictors of success with guided imagery and developing a clinically useful method of identifying persons likely to benefit from specific cognitive-behavioral interventions.