Abstract
D. Litt et Phil.
It is well known that high levels of anxiety and/or depression often accompany the diagnosis and treatment of cancer. Literature from various sources, but in particular from the fairly new field of research, Psychoneuroimmunology, also provides ample evidence that excessive anxiety and/or depression can be immunosuppressive. It makes sense, therefore, that any intervention restoring balance to the immuno-regulatory system, thereby allowing the body’s innate healing processes to focus on eliminating cancer, is highly desirable.
In line with current thinking based on the mind-body connection as well as cognitive behavioural techniques utilised in many therapeutic settings, various psychological interventions have been found to help the patient gain a better sense of control over distressing symptoms and side-effects of cancer. Some of these include: basic cognitive restructuring, hypnotherapy, relaxation-meditation techniques, art and music therapy, and guided imagery.
Substantial international research illustrates the beneficial effect that relaxation and/or guided imagery provides in such diverse settings including work, sport and health. In this regard, it was decided to run a pilot study to ascertain whether a customised tape recording with a relaxation and guided imagery dialogue aimed at helping patients manage and cope with negative symptoms of cancer, could significantly reduce anxiety levels in patients with cancer receiving radiotherapy.
To operationalise the above, 30 men and women, aged between 20 and 80, with Stages 1, 2 or 3 breast, prostrate, gynaecological cancers, and head and neck cancers, who were about to commence radical (minimum 25 fractions) radiotherapy, were randomly selected to an experimental and a control group.
A consecutive sample, pre-test post-test experimental design was applied to this study in which the experimental and control groups were subjected to pre- and post radiotherapy Hospital Anxiety & Depression (HAD) Scale, Institute for Personality Assessment and Training (IPAT) Anxiety Scale and blood pressure measurements during their 1st, 3rd, 6th week cycle of treatments, as well as a final measurement 12 weeks after commencement of therapy.
The main hypothesis of this pilot study was that there would be statistically significant decreases in levels of anxiety as a result of the intervention of guided imagery tape recording in patients with non-metastatic cancer undergoing curative radiotherapy.
For the intervention, each experimental participant was taught a relaxation technique and then following an interview a customised guided imagery dialogue developed for the participant’s sole use. The participant was requested to listen to this tape at least once a day.
The control group had the same pre- and post tests as the experimental group, but did not receive any intervention.
Statistical analysis of the data revealed that the experimental group showed a tendency towards decreased blood pressure and anxiety over the course of radiotherapy. The most significant change, however, was noted in terms of diastolic blood pressure, suggesting that the intervention corresponded to a physiological decrease in anxiety. There was not a statistically significant difference in terms of the measured psychological variables. A general conclusion to this pilot study suggests that whilst guided imagery may contribute to a lowering of anxiety, additional cognitive intervention would probably affect a more substantial and sustained change in the patient.
Although this pilot study revealed some methodological weaknesses the results are sufficiently encouraging to warrant further in-depth research regarding the use of guided imagery as a cost-effective, easy method for individuals to learn and utilise as part of their integrative cancer treatment programme.