The effect of using guided mental imagery for patients receiving knee or hip replacement

Background/significance: Guided mental imagery has been described to create a sensory experience to achieve clinical goals such as to slow heart rate, stimulate immune function, reduce pain, stress, and promote physical and psychological well-being. Purpose: The aim of this study is to assess whether the use of guided mental imagery as a therapeutic tool reduces the length of stay in inpatient care for the patients undergoing knee or hip replacement surgery. Methods: After approval by Aurora IRB in this retrospective study, a de-identified data for all the patients who had undergone surgical procedure for knee or hip replacement performed at Aurora Sinai Medical Center from January 2009 through December 2011 were collected. Included in the study were the patients who had more than one day stay in the hospital. The study sample comprised of two groups. The guided imagery (GI) group comprised of 614 patients who used guided imagery before, during and after the surgery, in addition to the standard of care. The guided imagery intervention included the use of earphones and one of the several ways – either by CD, skylight interactive TV system, or by the download from the web site. The second group of 869 patients who received only standard of care was matched by age and gender to the GI group. Data collected included: age, length of stay, type of surgery, discharge outcome (home care, home health, skilled nursing home, and rehab facility), and the total cost for the patients. Results: There were 924 (62.31%) female and 559 (37.69%) male patients who had undergone either hip (n=559, 38.37%)or knee surgery (n=914, 61.63). Out of the 1,483 patients, only 614 (41.40%) opted for the use of the GI techniques along with standard of care. The proportion of patients opting for the use of GI was higher among females (0.44) compared to male patients (0.37, p=0.015). Mean number of days for the GI group were lower compared to the control group (3.21 vs. 3.36 days with p=0.047). The total cost was higher (p=.0001) for the patients transferred to rehab facility ($22,788.95) compared to patients transferred either to skilled nursing facility ($17,628.73), home care ($16,921.93), or to home health facility ($16,793.86). Conclusion: The study shows that the use of guided imagery as a complimentary therapeutic tool is associated with speedy recovery of patients and with the reduction of cost