Guided imagery effects on chemotherapy induced nausea and vomiting in Iranian breast cancer patients Mahboobehsadat Hosseini a , Batool Tirgari b, * , Mansooreh Azizzadeh Forouzi c , Yunes Jahani d a Department of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran b Kerman Neuroscience Research Center and Neuropharmacology Institute, Kerman, Iran c Kerman Neuroscience Research Center and Neuropharmacology Institute, Kerman, Iran d Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran article info Article history: Received 10 April 2016 Received in revised form 27 July 2016 Accepted 27 July 2016 Keywords: Guided imaginary Chemotherapy Nausea Vomiting Breast cancer abstract Background: The objective of this study was to examine the effect of guided imagery on chemotherapy induced nausea and vomiting in breast cancer patients. Design: This was a quasi-experimental study in which a group of sample was evaluated pre and post intervention. A convenience sample of 55 eligible breast cancer patients enrolled to participate in this study after giving informed consent. They completed the Morrow Assessment of Nausea and Vomiting, before and after the intervention. The intervention consisted of listening to the two guided imagery tracks. Findings: After the intervention, patients at the third session of chemotherapy had significantly lower mean scores in the frequency and severity of nausea and vomiting pre and post chemotherapy (p < 0.05). Conclusions: Guided imagery, as an inexpensive and noninvasive method, is particularly appealing op- tion to alleviate chemotherapy induced nausea and vomiting. It can be used in addition to pharmaco- logical strategies and can be implemented by patients independently with sufficient training. Therefore, this therapy will considerably improve severity and frequency of chemotherapy induced nausea and vomiting. © 2016 Elsevier Ltd. All rights reserved. 1. Introduction Breast cancer incidences are increasing worldwide. Approxi- mately one in eight American women will develop breast cancer during her lifetime [1]. Breast cancer also is the most common cancer in Iranian women and mainly affects them about a decade earlier than western countries [2]. Currently, chemotherapy re- mains the first option to control the postoperative progression of cancer to increase the survival rate [1]. Chemotherapy-induced nausea and vomiting (CINV) are the most problematic and serious side effects among patients with cancer [3e5] and its prevalence has been reported between 54% and 96% [4]. Despite numerous advances in the treatment, CINV continues to remain a challenge and distressing side effect to a proportion of patients undergoing systemic anti-cancer treatment [6,7]. On the other hand, standard pharmacological methods of antiemetic therapy are inadequate for dealing with these side effects [3,8,9]. According to Karagozoglu et al. (2013) [3] although antiemetic agents are widely used today, approximately 40% of the patients receiving chemotherapy still suffer from nausea and 75% from vomiting. Vanbockstael et al. (2015) [5] concluded that, despite improvements in pharmacological antiemetic treatment, 52.4% of patients experience CINV during the first cycle of chemotherapy [4]. If CINV is not controlled properly, it leads to further complica- tions including effects on food intake [10], anorexia and metabolic imbalances [3,4] weight loss, social interactions, dehydration, dif- ficulty sleeping [10] and anxiety [4,10]. These complications can have significant negative impact on patients' quality of life [3,4,10]. Some of the important recent approaches used for controlling * Corresponding author. E-mail addresses: M_hosseiny_85@yahoo.com (M. Hosseini), batool.tirgary@ gmail.com (B. Tirgari), forozy@gmail.com (M.A. Forouzi), yonesjahani@yahoo.com (Y. Jahani). Contents lists available at ScienceDirect Complementary Therapies in Clinical Practice journal homepage: www.elsevier.com/locate/ctcp http://dx.doi.org/10.1016/j.ctcp.2016.07.002 1744-3881/© 2016 Elsevier Ltd. All rights reserved. Complementary Therapies in Clinical Practice 25 (2016) 8e12