Troesch, L.M., Rodehaver, C.B., Delaney, E.A., & Yanes, B. (1993). The influence of guided imagery on chemotherapy-related nausea and vomiting. Oncology Nursing Forum, 20, 1179-1185.

Guided imagery was added to a standard antiemetic regimen; subjects in the experimental group listened to a 20-minute audiotape during chemotherapy administration, and the control group received standard antiemetic regimen alone. The intervention was done over three cycles of chemotherapy. The 20-minute tape was listened to 60 minutes prior to cisplatin, the following morning before breakfast, and the following evening at bedtime.

• The study consisted of 28 newly diagnosed chemotherapy-naive patients with cancer who were receiving cisplatin.
• Ages ranged from 33–80 years, and the mean age was 63 years for the control and experimental groups.
• Patients with gastric cancer, malignancies in the upper gastrointestinal (GI) system, or pre-existing disease states of GI tract were excluded.

Subjects were recruited from one oncologist’s practice (inpatients and outpatients) in a large, Midwestern teaching center.

The study included a convenience sample and was nonrandomized.

• The Rhodes Index of Nausea and Vomiting, form 2 (eight-item, five-point, Likert-type, self-report tool) was used to determine each patient's total experiences score.
• The Chemotherapy Experience Survey, which was designed by the researchers, was used to evaluate overall perceptions of the chemotherapy experience. It consists of two parts. The first is a five-point, Likert-type tool with eight word pairs ranging from negative to positive; the second is a rating of overall chemotherapy experience (10 = most negative, 100 = most positive).

• No statistical significance was demonstrated with symptom occurrence and distress.
• Guided imagery did not have a statistically significant effect on patients’ perceptions of the frequency of nausea, vomiting, and retching, as well as associated distress.
• Patients who participated in the guided imagery felt significantly more in control, powerful, relaxed, and prepared than the control group.
• The guided imagery group described their overall experience more positively than the control group.

• Only adult patients receiving cisplatin were included.
• Only one physician's office was used for recruiting the sample (could control antiemetic regimen).
• The scope of the study was limited.
• The study had a small sample size.
• Other limitations include complex monitoring required over three cycles of chemotherapy, communication difficulties, and inability to control hospital setting and activities.