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

OBJECTIVE: 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. MATERIALS AND METHODS: 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). RESULTS: 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). CONCLUSION: The results show that guided imagery and diaphragmatic breathing exercises reduce nausea, vomiting, and pregnancy-related anxiety in women with HG.