The effect of guided imagery pre-cesarean section on the perceived preoperative anxiety, surgical fear, and physiological parameters of women: A randomized controlled trial

Introduction

Guided imagery (GI) helps patients feel happy, relaxed, calm, and safe while ensuring positive thinking. This study was conducted to investigate the impact of GI applied before cesarean section (CS) on preoperative anxiety, surgical fear, and physiological parameters.

Methods

Participants were randomized into the GI (n = 29) or control (n = 28) groups in this randomized controlled trial. Participants in the GI group were given a 15-minute GI audio recording three days before their CS and were allowed to listen to it every night for 3 days until the CS. Finally, they listened on the day of the CS, immediately after preparing for the CS. Anxiety levels were evaluated using the State Anxiety Inventory-S (STAI-S) 3 days before the CS (STAI-S1) and 15 min after the preparations on the CS morning (STAI-S2); while surgical fear was evaluated using the Surgical Fear Questionnaire (SFQ) 3 days before the CS (SFQ1-Total) and 15 min after the preparations on the CS morning (SFQ2-Total). Blood pressure, temperature, heart rate, respiratory rate, and fetal heart rate were also evaluated.

Results

A significant difference in the mean STAI-S scores was observed 15 min after the preparations for the CS between the GI and control groups (mean difference (MD) -4.51, 95 % confidence intervals (CIs) [-7.71, -1.31]). However, no significant difference was found in the mean SFQ scores between the groups (MD -5.53, 95 %CIs [-16.69, 5.63]). In the within group comparison of GI and the control group, no statistically significant difference was observed in the score means of the GI group (STAI-S1 with STAI-S2 and SFQ1-Total with SFQ2-Total). However, the score means of the control groups STAI-S2 was higher than STAI-S1 (MD -5.82, 95 %CIs [-8.16, -3.48]), and SFQ2-Total was higher than SFQ1-Total (MD -6.71, 95 %CIs [-10.97, -2.46]). No significant difference was found in physiological parameters between the groups.

Conclusion

This study revealed the effectiveness of GI during the period before CS in reducing preoperative anxiety and keeping surgical fear under control. Nurses and other healthcare professionals involved in preoperative care can utilize GI to reduce preoperative anxiety and manage surgical fear before a CS.

Clinical trial registration

NCT05790954