Effects of guided imagery, and breathing exercise device on nausea-vomiting, and anxiety in hyperemesis gravidarum

This study aimed to compare the effects of guided imagery, and diaphragmatic breathing exercise using a breathing exercise device on nausea-vomiting severity and anxiety levels in pregnant women with hyperemesis gravidarum (HG), considering their implementation alongside routine antiemetic treatment.

This randomised controlled experimental study was conducted between August 2022 and August 2023 at the pregnant women's follow-up service. Participants were assigned to three groups: Breathing Exercise (n = 60), Guided Imagery (n = 60), and Control (n = 60). Data were collected using the Personal Information Form, the Pregnancy-Unique Quantification of Emesis and Nausea (PUQE) test, and the Pregnancy-Related Anxiety Scale-Revision-2 (PRAQ-R2). Statistical analyses included the Shapiro - Wilk test, paired t-test, repeated-measures ANOVA, one-way ANOVA, and multiple regression. Significance was set at p < 0.05. The study is registered with ClinicalTrials.gov (NCT05829473).

While there were no significant baseline differences among the groups, the Breathing Exercise Group (BEG) showed the most substantial improvements in PRAQ-R2 and PUQE scores. Significant reductions were also observed in the Guided Imagery Group (GIG) compared to the Control Group (CG) (p < 0.05). On the first day, post-test PUQE scores were significantly lower in the BEG compared to the GIG and CG (p < 0.001 and p < 0.05, respectively). Although pre-test PRAQ-R2 fear of childbirth scores were similar across groups (p = 0.069), post-test scores differed significantly in favour of both intervention groups (p < 0.001).

The results show that guided imagery and diaphragmatic breathing exercises reduce nausea, vomiting, and pregnancy-related anxiety in women with HG.