Purpose/Objectives: To better understand the common themes of women participating in an imagery program designed to improve quality of life (QOL).
Research Approach: Qualitative.
Setting: Classroom setting at Alaska Regional Hospital in Anchorage.
Participants: 10 women with a confirmed diagnosis of breast cancer who had completed conventional care participated in a six-class, eight-week-long imagery program titled Envision the Rhythms of Life© (ERL).
Methodologic Approach: Focus group audio recordings and notes were interpreted with the Krueger focus group method and confirmed by an outside evaluator.
Main Research Variables: Breast cancer survivors' descriptions of imagery practice and experience as they created passive, active, and targeted imagery.
Findings: Participants reported the importance of engaging passive and active imagery, letting targeted imagery take on a life of its own, performing homework, understanding the science, practicing, hearing imagery stories, engaging all the senses, trusting imagery, and group interaction. Imagery practice improved mood state.
Conclusions: When delivered by expert imagery trainers in collaboration with oncology nurses, ERL can improve breast cancer survivors' QOL. The present study is one of few reports that evaluated survivors' imagery experiences from a clinical trial and produced significant QOL improvements.
Interpretation: The present study provides oncology nurses understanding of the psychological risks faced by breast cancer survivors after completion of primary care and explains the critical need for post-treatment programs for survivors dealing with post-traumatic stress disorder, depression, anxiety, or high levels of stress.
References
Ahsen, A. (1968). Basic concepts in eidetic psychotherapy. New York: Brandon House.
Bakke, A. C., Purtzer, M. Z., & Newton, P. (2002). The effect of hypnotic-guided imagery on psychological well-being and immune function in patients with prior breast cancer. Journal of Psychosomatic Research, 53(6), 1131-1137.
Ball, T. M., Shapiro, D. E., Monheim, C. J., & Weydert, J. A. (2003). A pilot study of the use of guided imagery for the treatment of recurrent abdominal pain in children. Clinical Pediatrics, 42(6), 527-532.
Benson, H., Frankel, F. H., Apfel, R., Daniels, M. D., Schniewind, H. E., Nemiah, J. C., et al. (1978). Treatment of anxiety: A comparison of the usefulness of self-hypnosis and a meditational relaxation technique. Psychotherapy and Psychosomatics, 30(3-4), 229-242.
Blalock, J. E., & Smith, E. M. (2007). Conceptual development of the immune system as a sixth sense. Brain, Behavior, and Immunity, 21(1), 23-33.
Brittenden, J., Heys, S. D., Ross, J., & Eremin, O. (1996). Natural killer cells and cancer. Cancer, 77(7), 1226-1243.
Crawford, J. J. (1982). Hypnotizability, daydreaming styles, imagery vividness and absorption: A multidimensional study. Journal of Personality and Social Psychology, 42(5), 915-926.
Farragher, B. (1998). Psychiatric morbidity following the diagnosis and treatment of early breast cancer. Irish Journal of Medical Science, 167(3), 166-169.
Freeman, L. W. (2004). Imagery. In Mosby's complementary and alternative medicine: A research-based approach (2nd ed., pp. 275-304). St. Louis, MO: Mosby.
Freeman, L. W., Cohen, L., Stewart, M., White, R., Link, J., Palmer, J. L., et al. (2008). An imagery intervention for recovering breast cancer patients: Clinical trial of safety and efficacy. Journal of the Society for Integrative Oncology, 6(2), 67-75.
Freeman, L. W., & Dirks, L. (2006). Mind-body imagery practice among Alaska breast cancer patients: A case study. Alaska Medicine, 48(3), 74-84.
Goleman, D. J., & Schwartz, G. E. (1976). Meditation as an intervention in stress reactivity. Journal of Consulting and Clinical Psychology, 44(3), 456-466.
Gruber, B. L., Hersh, S. P., Hall, N. R., Waletzky, L. R., Kunz, J. F., Carpenter, J. K., et al. (1993). Immunological responses of breast cancer patients to behavioral interventions. Biofeedback and Self-Regulation, 18(1), 1-22.
Gurevich, M., Devins, G. M., & Rodin, G. M. (2002). Stress response syndromes and cancer: Conceptual and assessment issues. Psychosomatics, 43(4), 259-281.
Hewitt, M., Greenfield, S., & Stovall, E. (Eds.) (2006). From cancer patient to cancer survivor: Lost in transition. Washington, DC: National Academies Press.
Holden-Lund, C. (1988). Effects of relaxation with guided imagery on surgical stress and wound healing. Research in Nursing and Health, 11(4), 235-244.
Kiecolt-Glaser, J. K., & Glaser, R. (1992). Psychoneuroimmunology: Can psychological interventions modulate immunity? Journal of Consulting and Clinical Psychology, 60(4), 569-575.
Krueger, R. A. (1998a). Analyzing and reporting focus group results. Thousand Oaks, CA: Sage.
Krueger, R. A. (1998b). Developing questions for focus groups. Thousand Oaks, CA: Sage.
Krueger, R. A. (1998c). Moderating focus groups. Thousand Oaks, CA: Sage.
Krueger, R. A., & Casey, M. A. (2000). Focus groups: A practical guide for applied research (3rd ed.). Thousand Oaks, CA: Sage.
Levy, S., Herberman, R., Lippman, M., & D'Angelo, T. (1987). Correlations of stress factors with sustained depression of natural killer cell activity and predicted prognosis in patients with breast cancer. Journal of Clinical Oncology, 5(3), 348-353.
Levy, S., Herberman, R., Lippman, M., D'Angelo, T., & Lee, J. (1991). Immunological and psychosocial predictors of disease recurrence in patients with early-stage breast cancer. Behavioral Medicine, 17(2), 67-75.
Locke, S., Kraus, L., Leserman, J., Hurst, M., Heisel, J. S., & Williams, R. M. (1984). Life change stress, psychiatric symptoms and natural killer cell activity. Psychosomatic Medicine, 46(5), 441-453.
Longman, A., Braden, C., & Mishel, M. (1999). Side-effects burden, psychological adjustment, and life quality in women with breast cancer: Pattern of association over time. Oncology Nursing Forum, 26(5), 909-915.
Manyande, A., Chayen, S., Priyakumar, P., Smith, C. C., Hayes, M., Higgens, D., et al. (1992). Anxiety and endocrine responses to surgery: Paradoxical effects of preoperative relaxation training. Psychosomatic Medicine, 54(3), 275-287.
Miller, G., & Cohen, S. (2001). Psychological interventions and the immune system: A meta-analytic review and critique. Health Psychology, 20(1), 47-63.
Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow-up and clinical implications of the mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17(3), 192-200.
Oktay, J. (1998). Psychosocial aspects of breast cancer. Lippincott's Primary Care Practice, 2(2), 149-159.
Payne, D., Hoffman, R., Theodoulou, M., Dosik, M., & Massie, M. J. (1999). Screening for anxiety and depression in women with breast cancer. Psychiatry and medical oncology gear up for managed care. Psychosomatics, 40(1), 64-69.
Post-White, J. (2002). Clinical indication for use of imagery in oncology practice. In D. M. Edwards (Ed.), Voice massage: Scripts for guided imagery (p. 3). Pittsburgh, PA: Oncology Nursing Society.
Scherwitz, L. W., McHenry, P., & Herrero, R. (2005). Interactive guided imagery therapy with medical patients: Predictors of health outcomes. Journal of Alternative and Complementary Medicine, 11(1), 69-83.
Solberg, E. E., Halvorsen, R., Sundgot-Borgen, J., Ingjer, F., & Holen, A. (1995). Meditation: A modulator of the immune response to physical stress? A brief report. British Journal of Sports Medicine, 29(4), 255-257.
