The Effect of Pleasant Imagery Instruction on the Control of Postsurgical Pain

Abstract

Although analgesics are universally used for pain control after surgery, thousands of patients still suffer from incomplete pain relief. Cu.i·rent nursing practic'e does not adequately address the management of postoperative pain in preoperative teaching plans; a gap exi~ts in the psy~hological preparation of the surgical patient. Pleasant imagery, a cognitive coping skill, was identified as ~ poteritial process to manage acute postsurgical pain. The purpose of this study w~s to explore the e~fects of preoperative pleasant imagery instruction on the control of postsurgical pain •. The randomized post-test only control group design tested the following hypotheses:

Surgical patients who are taught pleasant imagery skills along with procedural information preoperativ~ly will require a fewer number of analgesic doses postoperatively than· those. _patients· who receive procedural information only, 2) Surgical patients who are taught pleasant imagery skills along with procedural information preoperatively will report less pain (have a lower visual analogue score) postoperatively than those· ·patients who receive procedural information only. The sample consisted of 32 subjects admitted to the· hospital. for elective gynecological or urological abdominal surgery .over an 11 week period. The subjects were randomly assigned to the control group (N=l6) or study group (N=l6). Preoperatively the study group_rec~ived procedural ~nformation and instructions on the use of pleasant imagery to control ~pain.. The control group received procedural information only~ .The visual analogue scale was used to m~asure postoperative pain p~rception. In addition, the frequenc~ of analgesic use (total doses) was recorded. Group m~ans were computed for each dependentva;r:iable, visual analogue .scores, and doses of analgesics. The t-test for independent means was used to test for significant difference at the .QS level of pro~ability~ Patients that usedJ pleasant imagery, perceived significantly less pain and consumed sig~i~icaritly less pain.med~cation than the control group. These findings stiggest that nurses can enhance ,the management of postoperative pain by teaching their patients to use pleasant imagery •.