An ICU nurse asks if there are any studies establishing the positive impact of guided imagery on relaxing patients and easing the distress of extubation (being weaned off a ventilator, a normally anxiety-producing procedure.. Hello,
I am putting together a presentation of non-pharmacological methods to decrease anxiety during extubation (weaning from a ventilator) in a major hospital ICU unit. Do you know of research related directly to this topic or have experience in the use of guided imagery for extubation? I appreciate your feedback. We use your CD''s regularly in many other areas of the hospital. Thank you. Joel T, RN

Dear Joel,
I know that weaning patients off the ventilator in the ICU is a classically distressing procedure, and, yes, there are a number of studies, some specific to ventilator weaning, along with and other research, also relevant, that relates in a more general way to helping patients relax during yucky procedures.

Just to get you started, let me offer you two citations, and then I’ll tell you how you can find more yourself:

Tiernan PJ. Independent nursing interventions: relaxation and guided imagery in critical care. Critical Care Nurse. 1994 Oct;14 (5): pages 47-51.
Heath AH. Imagery: helping ICU patients control pain and anxiety. Dimens Crit Care Nurs. 1992 Jan-Feb;11 (1): pages 57-62.

Now the way to find more of these is to go to the amazing archives of our National Library of Medicine - otherwise known as pubmed - your tax dollars at work - and in the search box, enter: weaning, guided imagery , and then click on GO. (you can also enter extubation, guided imagery, or weaning, relaxation - feel free to fiddle with the search terms because sometimes you can get a whole new cache of articles) . But just with that first combo of ‘weaning’ and ‘guided imagery’ you’ll find a whole humongous list of 138 articles (at least as of this morning - they’re always being updated so this is always subject to change). Some directly relate to your query and some are a bit more general or tangential. But there’s a great deal there that answers your question.

Many of these citations are abstracted, so if you click on the link of the specific article, you’ll be taken to the page that has a brief summary of the study. To get the whole article, you’ll need a subscription - at least most of the time - and no doubt your hospital system has one.

Better yet, after each citation listed, there’s a link for ‘related articles’, which you can click on and get even more studies - some overlapping and some not. It’s a treasure trove of data, over there at pubmed!! Sometimes I get lost over there for hours, wandering among the related links!

Now, if you’re interested, we do have a CD for people who are required to be awake during unpleasant or anxiety-producing procedures - extubation comes to mind, as does colonoscopy, angiography and closed MRI’s too - it''s called Relaxed and Awake for Medical Procedures and we''re told all the time that it helps a lot. It would be great if you did a study on its efficacy and your name and article could join that roster on pubmed! ).

Good luck and I hope this helps.