Hosseini, M., Tirgari, B., Forouzi, M. A., & Jahani, Y. (2016). Guided imagery effects on chemotherapy induced nausea and vomiting in Iranian breast cancer patients. Complementary Therapies in Clinical Practice, 25, 8–12. 

To evaluate the effects of guided imagery on chemotherapy-induced nausea and vomiting (CINV) among patients with breast cancer

Women who experienced nausea and vomiting within 24 hours after the first course of chemotherapy were assessed before and after the second course of chemotherapy. For the third course of therapy, participants listened to two audio recorded guided imagery scripts. One had mixed nature sounds as background and the other track instructed listeners to imagine feeling better within a pleasant setting of their choice. Patients listened to the first track the night before the third course of treatment. Prior to chemotherapy, severity and frequency of nausea and vomiting were measured.

• N = 55   
• MEAN AGE = 57.5 years (SD = 8.43)
• FEMALES: 100%
• CURRENT TREATMENT: Chemotherapy
• KEY DISEASE CHARACTERISTICS: All had breast cancer.

• SITE: Single site   
• SETTING TYPE: Not specified    
• LOCATION: Iran

PHASE OF CARE: Active antitumor treatment

Quasiexperimental

Morrow Assessment of Nausea and Vomiting

Pre- and post nausea and vomiting scores were lower in the third treatment cycle compared to those in the second cycle of chemotherapy (p = 0.0001).

Guided imagery may be helpful for reducing CINV.

• Small sample (< 100)
• Risk of bias (no control group)
• Risk of bias (no blinding)
• Risk of bias (no random assignment)
• Measurement validity/reliability questionable
• The type of chemotherapy was not identified.
• No information is provided regarding any use of antiemetics.  
• Apparently, CINV was evaluated immediately pre- and postchemotherapy, so it may not have picked up actual time in which the symptoms were experienced.
• It is unclear how scores were determined based on description of the items on the instrument.  
• The article is not clearly written, making it difficult to determine exact study procedures and timing of measurement.

The findings suggest that guided imagery might be helpful to reduce CINV symptoms. This study and report do not provide strong evidence because of multiple limitations. Additional research is needed to determine efficacy. Guided imagery is a very low-risk intervention that might be helpful to some patients, but the appropriate timing of such an intervention related to timing of chemotherapy administration needs to be determined in future research.