Implementation of Bonny Method of Guided Imagery and Music (BMGIM) to complement care provided in selected cancer interim homes in Gauteng province

Abstract

With a projected global increase in incidence of cancer the need for supportive cancer care is also on an increase. Nurses are tasked to care for the psychological and social needs of the patients. However, patients and nurses do not always perceive that these needs are being fulfilled. Bonny Method of Guided Imagery and Music (BMGIM) has physical, psychological, social and spiritual effects which can enhance supportive cancer care. However, no research could be found on the use of BMGIM in the care of cancer patients receiving chemo- or radiotherapy. The aim of this study was to implement and evaluate the complementary effect of the BMGIM on the physical, psychological and spiritual wellbeing of patients in selected cancer interim homes in Gauteng, South Africa. The objectives: 1. To conduct a systematic review to identify methods that have been used to implement the BMGIM in other health care settings, and evaluate the reported effectiveness of the BMGIM in cancer care contexts; 2. To implement the BMGIM in selected cancer interim homes in order to introduce an existing music therapy method into a new setting; 3. To evaluate cancer patients experiences during BMGIM therapy, as well as to evaluate the effects of the BMGIM on patients physical, psychological and spiritual wellbeing for the duration of their stay in the cancer interim home. Within the research design of intervention research a prospective intervention study supported by a simultaneous qualitative approach, phenomenology, was conducted. The population of the study was cancer patients receiving chemo- or radiotherapy while living in a cancer interim home or in their private home. Through a purposive sampling, a sample size of 24 was achieved. In phase one a systematic review was conducted. Evidence gathered informed the implementation of BMGIM in phase two. Phase three involved evaluation of the effect of BMGIM through administration of a demographic questionnaire, Symptom Distress Scale, Psychological General Well Being Index and Spiritual Index of Well Being. Qualitative data in the form of session summary forms, photographs of the mandala and unstructured interviews were also used to collect data. Data analysis in the quantitative domain included adoption of descriptive and inferential statistical methods. While the process of coding and the development of constituents and the essence of the findings were used in the qualitative domain. Throughout the study ethical principles were adhered to. Measures of validity, reliability and trustworthiness ensured quality assurance. The intervention of BMGIM was found to bring about improvements in the physical, psychological and spiritual wellbeing of the participants. The quantitative domain indicated significant improvements in fatigue and quality of pain. Improvements were also found in psychological and spiritual wellbeing though the small sample size influenced the significance of the findings. The qualitative domain findings were encapsulated in six constituents namely Underlying mechanism of action of the BMGIM, Development of coping strategies, Juxtaposition of images and their meaning, Experience of physical wellbeing, Experience of psychological wellbeing, and Experience of spiritual wellbeing and in the essence. The BMGIM was found to be a method through which patients experienced holistic care. Recommendations in nursing practice, education, administration, research were made.