Journal List > Korean J Women Health Nurs > v.17(2) > 1037273

Bae, Chang, Kim, and Kang: Effects of Guided imagery on Stress and Anxiety of Women Receiving in Vitro Fertilization



The purpose of this study was to identify effects of guided imagery on stress including cognitive, affective, marital and social, and anxiety among women receiving in vitro fertilization (IVF).


Data were collected between April, 21 and June, 17, 2008. The participants in this study were 57 women (26 for the experimental group, 31 for the control group) receiving IVF for primary or secondary infertility in one of the outpatient infertility centers in Seoul. The guided imagery (Suk, 2001) was provided through audio CD to the experimental group by themselves 8 minutes per day for 2 weeks. Data were analyzed by SPSS 12.0 windows program.


After guided imagery, the experimental group showed significantly lower affective stress and total stress scores. Anxiety scores increased significantly in the control group, but not in the experimental group after treatment.


The findings suggest that guided imagery is an effective nursing intervention for reducing stress especially affective stress and anxiety among infertile women receiving IVF in outpatient infertility center.

Figures and Tables

Table 1
Research Design

Yc1=infertility stress scale, VAS-A; Yc2=infertility stress scale, VAS-A; Ye1=infertility stress scale, VAS-A; X=guided imagery; Ye2=infertility stress scale, VAS-A

Table 2
Homogeneity Test for General & Infertile Characteristics

Exp.=experimental group; Cont.=control group.

Table 3
Homogeneity Test for Research Variables

Exp.=experimental group; Cont.=control group.

Table 4
Comparison of Research Variables between Experimental Group and Control Group

Exp.=experimental group; Cont.=control group.


1. Bazzo D.J., Moeller R.A. Imagine this! Infinite uses of guided imagery in women's health. Journal of Holistic Nursing. 1999. 17:317–330.
2. Boivin J. A review of psychosocial interventions in infertility. Social Science & Medicine. 2003. 57:2325–2341.
3. Collins A., Freeman E.W., Boxer A.S., Tureck R. Perceptions of infertility and treatment stress in females as compared with males entering in vitro fertilization treatment. Fertility and Sterility. 1992. 57:350–356.
4. Connolly K.J., Edelmann R.J., Bartlett H., Cooke I.D., Lenton E., Pike S. An evaluation of counselling for couples undergoing treatment for in-vitro fertilization. Human Reproduction. 1993. 8:1332–1338.
5. Cousineau T.M., Domar A.D. Psychological impact of infertility. Best Practice and Research Clinical Obstetrics and Gynaecology. 2007. 21(2):293–308.
6. Covington S.N., Burns L.H. Infertility counselling. 2006. 2nd ed.New York: Cambridge University Press.
7. Devine K.S. Caring for the infertile woman. MCN. The American Journal of Maternal Child Nursing. 2003. 28(2):100–105.
8. Domar A.D., Clapp D., Slawsby E., Kessel B., Orav J., Freizinger M. The impact of group psychological interventions on distress in infertile women. Health Psychology. 2000. 19:568–575.
9. Eugster A., Vingerhoets A.J. Psychological aspects of in vitro fertilization: a review. Social Science & Medicine. 1999. 48:575–589.
10. Gift A.G. Visual analog scales: Measurement of subjective phenomena. Nursing Research. 1989. 38:286–288.
11. Hatler C.W. Using guided imagery in the emergency department. Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association. 1998. 24:518–522.
12. Kim C.J. The psychological causes and therapy of anxiety. Journal of Education Research. 1996. 14:67–95.
13. Kim E.A. The relationship between the reproductive rights of women and the biomedical science and technology. Korean Journal of Law Philosophy. 2009. 12(1):121–150.
14. Kim S.H., Park Y.J., Chang S.O. A study on the development of an infertility stress scale. The Journal of Nurses Academic Society. 1995. 25(1):141–155.
15. Klonoff-Cohen H., Chu E., Natarajan L., Sieber W. A prospective study of stress among women undergoing in vitro fertilization or gamate intrafallopian transfer. Fertility and Sterility. 2001. 76:675–687.
16. Lee G.H., Oh E.H. Effect of guided imagery program on patients depression and anxiety receiving cancer chemotherapy. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2004. 13(2):125–134.
17. McCarthy M.P. Women's lived experience of infertility after unsuccessful medical intervention. Journal of Midwifery & Women's Health. 2008. 53(4):319–324.
18. Park H., Ha N.S., Choi J. The effects of guided imagery on the stress and anxiety of nursing students in clinical practice. Journal of Korean Academy of Nursing Administration. 2004. 10(3):311–316.
19. Park J.M. The effect of the relaxing technique on the degree of stress of infertile women during in vitro procedure. 2000. Seoul: Hanyang University;Unpublished master's thesis.
20. Park Y.J. The stress of the infertile women. Korean Journal of Women Health Nursing. 1995. 1(2):209–221.
21. Pelletier K.R. Mind-body health: research, clinical and policy applications. American Journal of Health Promotion. 1992. 6:345–357.
22. Pengelly P., Inglis M., Cudmore L. Couples' experiences and the use of counselling in treatment centers. Psychodynamic Counselling. 1995. 1:507–524.
23. Suk M.H. Effects of guided imagery on psychological resourses and stress responses of adolescents. 2001. Seoul: Yonsei University;Unpublished doctoral dissertation.
24. Suk M.H., Kil S.Y., Park H.J. The effects of guided imagery on nursing students performing intramuscular injections. Journal of Korean Academy of Nursing. 2002. 32(6):784–791.
25. Verhaak C.M., Smeenk J.M., Evers A.W., Kremer J.A., Kraaimaat F.W., Braat D.D. Women's emotional adjustment to IVF: A systematic review of 25 years of research. Human Reproduction Update. 2007. 13(1):27–36.
26. Vogelsang J. The visual analog scale: An accurate and sensitive method for self-reporting preoperative anxiety. Journal of Post anesthesia Nursing. 1988. 3:235–239.
27. Wallace L.M. Psychological preparations a method of reducing the stress of surgery. Journal of Human Stress. 1984. 10:62–77.
28. Wirtberg I., Möller A., Hogström L., Tronstad S.E., Lalos A. Life 20 years after unsuccessful infertility treatment. Human Reproduction. 2007. 22:598–604.
29. Yong P., Martin C., Thong J. A comparison of psychological functioning in women at different stages of in vitro fertilization treatment using the mean affect adjective checklist. Journal of Assisted Reproduction and Genetics. 2000. 17:553–556.
30. Zimmerman M. Using principles of relaxation, visualization, and guided imagery in the care of persons recovering from addictions. Addictions Nursing Network. 1989. 1(3):9–11.
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