Guided imagery for pain management by children with sickle cell disease ages 6 to 11 years

Despite current treatment innovations, disease related pain continues to be the number one cause of hospitalization in children with sickle cell disease (SCD). Pharmacologic modalities of pain management have helped to relieve sickle cell pain temporarily but side effects are an increasing concern. Cognitive behavioral therapies have been promising in changing pain perception and coping patterns with chronic illnesses but few studies have been done with children with SCD.;The purpose of this study is to provide a descriptive profile of daily pain perception and to measure changes in medication used for pain control; self-efficacy and imaging ability during the month prior to and the month following training in guided imagery. A quasi-experimental interrupted time series design was conducted with a purposive sample of 21 children aged 6-11 years following Institutional Review Board approval and informed consent and assent. Study participants were enrolled from one SCD clinic where they had been treated an average of 6.3 years. Mean age was 8.4 years; 60% were girls; 72% were African-American; and 95% had sickle cell anemia.;Children completed the Pain Assessment Tool at study outset and Kids Imaging Ability Questionnaire (KIAQ) and Sickle Cell Self-Efficacy Scale (SCSES) pre and post intervention. Diaries including pain episodes and daily activities were completed daily during two months by twenty participants. Following the guided imagery training, children had greater self-efficacy (t=5.46, p<0.000, reported fewer pain episodes (t=3.379, p=0.003) and scored pain intensity lower on the FACES scale (t=4.951, p=0.000): Baseline imaging ability was not associated with number of times guided imagery was actually used but baseline self-efficacy had a modest and inverse relationship to use of guided imagery: r=-0.481, p=0.032.;The findings of this study demonstrate that school aged children can effectively learn guided imagery through brief training. Guided imagery significantly increases both disease specific self efficacy and imaging ability. During the first month following training, guided imagery was an effective adjunct to pain management with resulting decreased pain reported and decreased use of opioid medication.