Effects of guided imagery on dyspnea, medication usage, airway obstruction, and human field image in children with asthma
Asthma is the most common pulmonary condition in childhood affecting as many as five million children in the United States. Traditional medical and nursing protocols rely on asthma education and medications to relieve bronchospasm and control inflammation. Despite these efforts, morbidity and mortality rates have increased, especially in the minority population. With this chronic condition, an interest in complimentary or alternative therapy has grown to control and relieve symptoms. According to Rogers' (1970) nursing framework, a child can experience change from a “pragmatic” wave pattern with asthma patterning to an “imaginative” wave pattern with no asthma patterning.
This quasi-experimental study investigated the effects of guided imagery on the perception of dyspnea, medication usage, pulmonary function tests, and human field image in children with asthma. Dyspnea was assessed using a visual analog scale. Medication usage was assessed from data on the home journal. Airway obstruction was assessed by pulmonary function testing. Human field image was assessed using Johnston's Human Field Image Metaphor Scale (Johnston, 1994). The imagery protocol, consisting of three sessions, elicited perceptions of asthma with either word descriptions or drawings. These data formed the basis of the imagery exercises. Children from 7 to 18 (n = 58) were recruited from two urban clinics.
Although not statistically significant with ANOVA testing, of the 31 children in the imagery group, five children reported less medication usage. Those five, an older subset of the sample, experienced changes in pattern from a less restricted and pragmatic human field wave pattern to one more imaginative in nature with increased potential. This is in keeping with Rogers' postulate of resonancy. Scores from the Human Field Image Metaphor Scale increased for both groups. This is in keeping with Rogers' postulate of helicy. Both groups evolved over time and the patterns created and experienced were different than a previous point in time. Results of this study also provide descriptive data regarding the children's artwork and word descriptions of asthma. Further research is needed to assess the benefits of guided imagery as a complimentary, adjunct therapy for asthma care.
Children & youth