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How We Go About Making Guided Imagery – a Question From a Dialysis Center

31 Jan

We got a query about our Dialysis Guided Imagery from a PhD nurse and health manager representing a large health system that delivers hemodialysis treatment. It was a good occasion to go over how we research our guided imagery to ensure we’re giving accurate information, delivered in a clinically and emotionally sensitive way. It’s a lot of front-loaded work, but always essential to do. Here it is.

Question:

Hi, Belleruth.

Thank you for developing the Dialysis Health Journeys Guided Meditation.

Can you assist me a little regarding the guide? On your website it states "A clinically tested segment of guided imagery for dialysis also contains specific hypnotic suggestions to help keep blood pressure stable and support motivation for necessary dietary and lifestyle changes. Carefully researched with the help of scores of renal health professionals and dialysis patients, this popular, effective meditation for dialysis comes in CD or MP3 download format, and can be listened to before, during or after treatments".

Can you point to any studies/publications that describe, summarize or detail this research?

Kind Regards,

Paul B, RN PhD 

Answer:

Paul,

Thanks for your interest. Happy to answer as fully as I can.. 

Yes, there is good evidence for the efficacy of guided imagery (including, but not exclusively ours) for diabetes, medical procedures, pain, behavior change to healthier habits, adherence to medical regimens, surgery, chemotherapy, anxiety over diagnostic and medical procedures, and mood/quality of life. 

There are few studies to show efficacy of mind-body therapies for hemodialysis, but there are these:

The descriptive copy on our Dialysis product page refers to the way I have gone about creating our guided imagery over the past 25 years. These are steps I always take in my preliminary research before writing the first draft of a guided imagery narrative: 

Specifically for the Dialysis imagery, I first interviewed medical specialists - in this case, it was an internist, a nephrologist and a diabetes nurse educator, as well as the nurse-director of a local dialysis center system (CDC, now called Centers for Dialysis Care), to ensure I had a correct picture of the way dialysis works, the physiology of renal disease, and a sense of what processes in the body and what medicines and behavioral habits. might slow disease down or make it worse.

I also got critical feedback on the impact of dialysis treatment has over time on the patient, from a professional perspective.

Then I spoke with nursing and tech staff who deal directly with dialysis patients, to learn about the issues and problems they see, and what their primary concerns are for the people in their care. CDC was kind enough to hold two different staff meetings for me, so I could grill the staff and get a good sense of what they felt were the most important concerns and challenges.

I then was given the opportunity to speak with patients, before, during and after their treatment, to hear directly from them what their experience of dialysis felt like, and what it did to their sense of self, their mood, and living their lives. (I am a psychotherapist by training). I learned a lot about their symptoms and worries, and what gave them heart.

Then I wrote a preliminary narrative and tested it with two support groups of patients, as well as by having staff offer the sample audio to various patients willing to bring an audio home with them and test it there.

I made sure they understood that I wasn't looking for praise - that the very best thing they could do for me and this effort was to tell me the truth - what was helpful on the audio and what was jarring or irrelevant, so I could fix it. (I've created 63 health-related audios, and still there are always blind spots.)

Then I rewrote the narrative and tested it with a fresh group of patients.

Finally I recorded it and worked with our sound engineer and composer to edit, score and mix the master copy. 

We immediately began distributing these recordings, and they were quickly picked up and used by DaVita and Fresenius, two large dialysis chains, as well as several hospitals (Mayo, Johns Hopkins, Columbia Presbyterian, and UCSF are a few of the hospitals that use our materials.)

I hope this answers your question, but happy to supply you with more information and specific citations of studies with Health Journeys guided imagery, as well as some sample audio downloads (for dialysis, surgery, medical procedures, pain, anxiety, etc) to see if this might be a fit with your health system.

All best,

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Belleruth Naparstek, ACSW, BCD

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Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award