Guided imagery for symptom management of patients with life-limiting illnesses: A systematic review of randomized controlled trials.

Abstract

Background: Patients with life-limiting illnesses receiving palliative care have a high symptom burden that can be challenging to manage. Guided imagery, an alternative therapy in which patients are induced to picture mental images with sensory components, has proven in quasi-experimental studies to be effective as a complementary therapy for symptom management. Objective: To systematically review randomized controlled trials that report evidence of guided imagery for symptom management in patients with life-limiting illnesses. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed for this review and the search strategy was applied in Medline, CINHAL, and Web of Science. The quality of the articles was evaluated using the Cochrane Collaboration’s Risk-of-Bias Tool 2 (RoB 2). The results are presented using the Guidance on the Conduct of Narrative Synthesis in Systematic Reviews. Results: A total of 8822 studies were initially identified through the search strategy, but after applying exclusion criteria, 24 randomized controlled trials were included in this review. The quality assessment revealed that 11 studies had a high risk of bias, 11 had some concerns, and 2 had a low risk of bias. Out of the 24 included studies, 14 evaluated oncological diagnosis, while the remaining 9 focused on non-oncological diagnoses across 6 different diseases. Guided imagery was found to be effective in managing symptoms in 20 out of the 24 studies. Regardless of the disease stage, patients who received guided imagery experienced relief from anxiety, depression, pain, nausea, vomiting, sleep disturbances, and fatigue. Conclusion: Guided imagery therapy has shown promising results regarding symptom management in palliative care patients with life-limiting illnesses.