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J Pediatr Psychol. 2010 Jan-Feb;35(1):25-31. doi: 10.1093/jpepsy/jsp030. Epub 2009 Apr 22.

Enhancing pain management in the PICU by teaching guided mental imagery: a quality-improvement project.

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  • 1Division of Child Psychiatry, North Shore-LIJ Health System, USA.



This quality-improvement study, following the PDCA methodology, compared the effectiveness of teaching mental imagery (MI) for pain management versus conducting a detailed inquiry (DI) about pain-related experiences with acutely injured PICU patients.


Participants included 44 hospitalized children and adolescents assigned to one of two intervention groups, MI (N = 24) or DI (N = 20). Pain was assessed pre- and post-intervention using the Wong-Baker Faces Pain Rating Scale and a 0-10 Likert pain rating scale, and the Pediatric Trauma Score was utilized to assess the severity of each child's injuries.


Boys in the MI condition exhibited a significant decrease in average pain ratings [t(38) = 3.41, p = .0015]. Girls in the MI condition exhibited a non-significant decrease in average pain ratings.


Teaching children the use of MI for pain management in an intensive-care setting was supported; the use of DI with boys was not supported.

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