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Journal of Pediatric Psychology Advance Access published online on April 22, 2009
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsp030
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© The Author 2009. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Enhancing Pain Management in the PICU by Teaching Guided Mental Imagery: A Quality-Improvement Project

William H. Kline, PhD1, Ayme Turnbull, PsyD2, Victor E. Labruna, PhD2, Laurie Haufler, RN3, Susan DeVivio, RN, NP3 and Peter Ciminera, MD3

1Division of Child Psychiatry, North Shore-LIJ Health System, 2Division of Trauma Psychiatry, North Shore-LIJ Health System and 3Department of Pediatrics, Nassau University Medical Center

All correspondence concerning this article should be addressed to William Kline, PhD, 103 Huntington Rd, Port Washington, NY 11050, USA. E-mail: billkline9{at}aol.com


  Abstract

Objective This quality-improvement study, following the PDCA methodology, compared the effectiveness of teaching mental imagery (MI) for pain management versus conducting a detailed inquiry (DI) about pain-related experiences with acutely injured PICU patients. Methods Participants included 44 hospitalized children and adolescents assigned to one of two intervention groups, MI (N = 24) or DI (N = 20). Pain was assessed pre- and post-intervention using the Wong-Baker Faces Pain Rating Scale and a 0–10 Likert pain rating scale, and the Pediatric Trauma Score was utilized to assess the severity of each child's injuries. Results Boys in the MI condition exhibited a significant decrease in average pain ratings [t(38) = 3.41, p = .0015]. Girls in the MI condition exhibited a non-significant decrease in average pain ratings. Conclusions Teaching children the use of MI for pain management in an intensive-care setting was supported; the use of DI with boys was not supported.

Key words: accidents and injuries; children; coping; pain..

Received August 30, 2008; revision received March 20, 2009; accepted March 21, 2009


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