Table 2. Summary of studies selected for this review.

Author/year	Study location	Design	n	Age	Main findings
Elias et al.4	Campinas (SP)	Qualitative approach - clinical case study, longitudinal	5	37-75 years	Cancer patients who received two to four relaxation, mental image and spirituality sessions achieved better quality of life within the process of dying. It was observed that application of this technique was important for resignification of the symbolic pain of these patients’ deaths.
Elias8	Campinas (SP)	Qualitative approach	7	From 22 months to 17 years	In a qualitative study, four children and three adolescents with cancer that was beyond the possibilities of cure, each received three to ten sessions of relaxation, mental images and spirituality. After the visits, it was observed that the intervention gave new meaning to the symbolic pain of death and provided quality of life within the process of dying for these patients.
Elias et al. 5	Campinas (SP)	Qualitative/quantitative	6	**	Development of a training course to instruct healthcare professionals about the use of RIME intervention. Qualitative results were analyzed through content analysis, semi-structured interviews and a diary; the quantitative data were analyzed through a descriptive method, using the Wilcoxon test. The program proved to be effective in preparing healthcare professionals to using RIME intervention, enabling them to care and to provide spiritual assistance from an academic perspective.
Elias et al.10	Campinas (SP)	Quantitative/qualitative	11	27-76 years	A study conducted among cancer patients who received RIME intervention. Through a qualitative approach, six categories and eleven subcategories were found, among which the most prevalent were: fear of death due to denial of the severity of the clinical picture; fear of death due to perceiving the severity of the clinical picture; and fear of disintegration of feeling and of being affectively forgotten after death. Through a quantitative analysis, a statistically significant difference was observed (P < 0.0001). The results suggested that RIME promoted quality of life within the process of dying, with serenity and dignity before death.
Ribeiro et al.11	São Paulo (SP)	Quantitative/qualitative	21	61.3 years*	Patients using intestinal ostomies during an immediate postoperative period marked a visual analogue scale regarding wellbeing before and after RIME application: the respective mean scores were 3.33 and 1.38. Through asking the patients how they felt emotionally before the surgery and after the RIME intervention, the following context units emerged: feelings, emotions, sensations and expectations of action, which generated four distinct categories that represented the transformation relating to mental wellbeing. RIME was the only variable that presented statistical significance, which led to the affirmation that it contributed to improvement of the patients’ emotional wellbeing.
Elias et al.12	São Paulo (SP)	Randomized controlled study/quantitative/qualitative	28	33-59 years	The women were screened and randomized through five draw groups. In each group, half of the patients went to the control group to receive up to twelve sessions of brief psychotherapy (BP) and the other half went to the RIME group to receive three sessions of this plus twelve BP sessions. The qualitative data were treated using branched content analysis into thematic analysis; the quantitative data were collected using the WHOQOL brief scale, Rosenberg’s self-esteem scale, Beck’s hopelessness scale and a visual analogue wellbeing scale. The results showed that RIME promoted a significant improvement in quality of life perception (38.3%), compared with the control group (12.5%), along with a significant improvement in the patients’ self-esteem (14.6%).
Espinha13	Marília (SP)	Randomized controlled study	44	57-63 years	A study conducted among patients with head-and-neck cancer, using the performance scale instrument (ECOG) the QOL questionnaire EORTC-QLQ-C30 and the QLQ-H&N35 questionnaire for patients with head-and-neck neoplasia. The results suggested that the RIME intervention led to quality-of-life benefits for patients with head-and-neck cancer, regardless of the toxicity of the radiotherapy treatment.
Elias et al.14	São Paulo (SP)	Comparative exploratory, quantitative/qualitative approach	28	33-59 years	Implementation of the RIME brief psychotherapeutic intervention among women with breast cancer who were undergoing treatment, with the possibility of cure. The main focus of the study was to present the qualitative results, for which the instruments used were recorded semi-structured interviews and graphic representations from before the first and after the third RIME session. The results showed that RIME promoted empowerment for higher libido and constructive strength among women with breast cancer with the potential for cure.
Pereira15	Fortaleza (CE)	Qualitative research	4	16-17 years	The RIME intervention was used to resignify the pain of symbolic loss among four adolescents who were in a context of vulnerability. The analysis from the RIME brief psychotherapeutic intervention was done through observation of the spiritual pain and its intensity, as manifested by the research subjects, along with their experiences of pain resignification. For this, two instruments were used: a visual analogue scale of wellbeing and content analysis through the thematic analysis technique. The RIME intervention promoted resignification of the spiritual pain of these young mourners, thus offering a satisfactory return from mourning and providing possibilities for working to break ties and recurrence of pain.

*Average age; **unspecified age.

RIME = relaxation, mental images and spirituality (relaxamento, imagens mentais e espiritualidade); WHOQOL = World Health Organization Quality of Life; ECOG = Eastern Cooperative Oncology Group; QOL = Quality of Life; EORTC = European Organization for Research and Treatment of Cancer.