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Effectiveness of Guided Imagery Relaxation on Levels of Pain and Depression in Patients Diagnosed With Fibromyalgia

Onieva-Zafra, María Dolores PhD; García, Laura Hernandez MSc; del Valle, Mayte Gonzalez RN

doi: 10.1097/HNP.0000000000000062

Aim: The aim of this study was to evaluate the effects of guided imagery as a nursing intervention for pain management and depression in patients diagnosed with fibromyalgia.

Background: Many studies support the use of guided imagery to improve patient outcomes. Guided imagery has been used for different purposes and it is thought to be an effective intervention for people suffering from nonmalignant pain.

Design: A 2-group quasi-experimental study was conducted during 8 weeks by the University of Nursing in Almeria (Spain).

Methods: Patients diagnosed with fibromyalgia aged 18 to 70 years (n = 60) were randomly assigned to a guided imagery group (n = 30) or a control group (n = 30). The outcomes measures were scores for pain with the McGill Pain Questionnaire long form (MPQ-LF) and the Visual Analogue Scale (VAS) and depression with the Beck Depression Inventory and the VAS for depression. The effects were examined at baseline, postintervention (4th week), and at the end of the study (8th week).

Results: Treatment efficacy was analyzed by using a t test for paired samples. Temporal changes in the scores were examined by using a 2-way repeated-measures analysis of variance. The treatment group reported statistically significantly lower levels of pain (P < .046) and depression (P < .010) than the control group at the week 4 evaluation. A statistically significant effect on pain as measured by the daily VAS diary was also found in the experimental group. At week 8, no significant differences were found for pain.

Conclusion: Patients diagnosed with fibromyalgia may benefit from this nursing intervention in terms of relieving pain and depression. Guided imagery relaxation therapy could be incorporated as part of fibromyalgia treatment to promote health among people with fibromyalgia.

Relevance to clinical practice: Guided imagery as a nursing intervention can alleviate pain and depression in patients diagnosed with fibromyalgia

Department of Nursing and Physical Therapy, University of Almeria, Almeria, Spain (Dr Onieva-Zafra and Ms García); and Poniente Hospital, El Ejido, Almería, Spain (Ms del Valle).

Correspondence: María Dolores Onieva-Zafra, PhD, Carretera de Sacramento s/n, Departamento de Enfermería y Fisioterapia, Universidad de Almería, 04120 Almería (Spain) (

The authors gratefully acknowledge the participation of the FM patients and support of their families in the study. This research received no specific grant from any funding agency in the public, commercial, or non–profit-based sectors.

No conflict of interest is declared by the authors.

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