Analysis of recent literature concerning relaxation and imagery interventions for cancer pain

Abstract

A review of literature concerning relaxation and imagery interventions for cancer pain is necessary because major review articles have excluded nursing research or were written prior to the publication of controlled studies in cancer pain conducted by nurses. This review of published nursing/medical/psychological literature of adults with cancer pain conducted over the past 14 years (1982-95) revealed few controlled studies, weak theoretical frameworks, few complete descriptions of the nature of the pain problem, and lack of control over the interventions. Most had very small sizes and could not demonstrate significant effects. Additionally, the intervention methods and length of the interventions were highly variable. Despite these design shortcomings, relaxation and imagery appear to reduce the sensory experience of pain, have equivocal effects on affective measures, and appear to have no effect on functional status. Suggestions for improvement include the need for more experimental studies, more complete descriptions of pain, improved statistical reporting, controls over adequacy of and compliance to the interventions, use of single interventions, and use of more complex measures of affective outcomes. Additionally, the paper contains a discussion of the problems of measuring selected outcome variables in this type of research.

Progressive Muscle Relaxation: An adjuvant therapy for reducing pain and fatigue among hospitalized cancer patients’ receiving radiotherapy.

“…But the findings of other studies on P.M.R are ambiguous. An analysis of Literature review on P.M.R and imagery interventions for cancer pain reported that interventions reduced sensory experience of pain but had no effect on functional status of patients [26]. One study done on individual difference variables and the effects of P.M.R and analgesic imagery on cancer pain among 40, hospitalized cancer patients in U.S.A, revealed that only half of the participants achieved a clinically meaningful improvement in pain with each intervention [21].…”

A systematic review of guided imagery as an adjuvant cancer therapy

“…Relaxation is not always thought to be necessary for guided imagery (Post-White, 2002) although many relaxation or guided imagery sessions incorporate elements of each practice and use similar techniques. Previous reviews of guided imagery trials have included combined interventions (Wallace, 1997;Luebert et al, 2001) but did not include all randomised-controlled trials of guided imagery with cancer patients available to date. We would argue that the therapeutic effects of guided imagery as a sole adjuvant intervention should be evaluated in order to clarify its role in other therapeutic regimens.…”

Effects of Electromyography Biofeedback-Assisted Relaxation on Pain in Patients With Advanced Cancer in a Palliative Care Unit

“…10 Few controlled studies have examined the effect of relaxation interventions on the management of cancer pain, in particular, or end-oflife symptoms, in general. Previous systematic reviews revealed that there was insufficient evidence to support the efficacy of relaxation for the relief of cancer-related pain 11 or chronic pain at large. 12 On the contrary, a meta-analysis found significant beneficial effects of relaxation in cancer patients for reducing cancer treatmentYrelated pain, with an average effect size of 0.44.…”