The effects of guided imagery on state and trait anxiety and sleep quality among patients receiving hemodialysis: A randomized controlled trial

Objective: This study aimed to investigate the effects ofguided imagery on state and trait anxiety and sleep quality among hemodial ysis patients. Design: This was a randomized controlled trial. A total of seventy hemodialysis patients were assigned through block randomization to either an intervention group to receive guided imagery or a control group to receive routine care services. Setting: The study was performed in the hemodialysis unit of Akhavan teaching hospital, Kashan, Iran. Intervention: In addition to routine care services, patients in the intervention group received guided imagery six times a week for four successive weeks via listening to a guided imagery instructional compact disk and following the instructions. Primary outcomes: Before and four weeks after the intervention, state and trait anxiety and sleep quality were measured via Spielberger's State-Trait Anxiety Inventory and Pittsburgh Sleep Quality Index. Results: The results of analysis of covariance showed that the intervention and the control groups significantly differed from each other respecting the posttest mean scores of state anxiety (adjusted mean difference: -9.11; 95% CI = -10.26 to -7.96; P < 0.001), trait anxiety (adjusted mean difference: -8.94; 95% CI = -10,31 to -7.57; P < 0.001), and sleep quality (adjusted mean difference: -0.877; 95% CI = -1.51 to -0.24; P < 0.007). Conclusions: Guided imagery can significantly alleviate anxiety and improve sleep quality among hemodialysis patients. Nurses are recommended to use guided imagery to alleviate hemodialysis patients' anxiety and improve their sleep quality.