A Systematic Review of Relaxation, Meditation, and Guided Imagery Strategies for Symptom Management in Heart Failure.
Kristine L Kwekkeboom, Lisa C Bratzke
PMID 26065388WHAT IT FOUND
Relaxation, meditation, and guided imagery sometimes eased breathlessness, sleep problems, fatigue, or symptom burden in adults with heart failure, but findings were mixed and no strategy worked consistently.
Key findings
01The review included 9 unique studies: 5 tested relaxation, 3 tested meditation, 1 tested guided imagery, and none tested distraction alone.
02Four of five relaxation studies showed at least some benefit, but effects varied: progressive muscle relaxation reduced breathlessness without improving fatigue or quality of life related to symptoms, and biofeedback improved sleep in one comparison but not another.
03Meditation showed beneficial effects in 2 of 3 trials, while the guided imagery study found no benefit versus exercise, though within-group quality of life related to symptoms improved from pre- to post-treatment.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 9 unique studies were included, and 5 had fewer than 50 participants, so the review cannot give a firm answer. The studies used different strategies, controls, and symptom measures, so the review could not combine them into a single estimate of benefit. Most studies did not have symptom management as their main aim, and none included class IV heart failure, so this says little about advanced symptomatic patients. Study quality scores ranged from 9 to 24 out of 35, and three studies scored below the scale midpoint. Many lacked treatment manuals, did not keep outcome assessors unaware of group assignment, did not calculate sample size in advance, or did not analyse all participants as assigned. The search was limited to English and did not contact authors, so relevant studies may have been missed.
Declared interests
No funding or conflict-of-interest declaration appears in the supplied text.
The easy way to misread this
Do not read this review as proof that relaxation, meditation, or guided imagery reliably relieve heart failure symptoms. The studies were small and mixed, some benefits were only within-group, and several interventions combined techniques so the effect of any single strategy cannot be isolated.