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Effects of Guided Imagery on Blood Pressure in Pregnant Women with Hypertension: A Pilot Randomized Controlled Trial

Authors

  • Faith Wight Moffatt RN, PhD,

    1. Faith Wight Moffatt is an Assistant Professor in the School of Nursing, Dalhousie University, Halifax, Nova Scotia; Ellen Hodnett is Professor and Heather M. Reisman Chair in Perinatal Nursing Research, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Mary Jane Esplen is a CIHR Scientist at the Toronto General Research Institute and Professor in the Department of Psychiatry, Faculty of Medicine and in the Lawrence S. Bloomberg Faculty of Nursing University of Toronto, Toronto; Judy Watt-Watson is a Professor in Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
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  • Ellen Hodnett RN, PhD, FCAHS,

    1. Faith Wight Moffatt is an Assistant Professor in the School of Nursing, Dalhousie University, Halifax, Nova Scotia; Ellen Hodnett is Professor and Heather M. Reisman Chair in Perinatal Nursing Research, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Mary Jane Esplen is a CIHR Scientist at the Toronto General Research Institute and Professor in the Department of Psychiatry, Faculty of Medicine and in the Lawrence S. Bloomberg Faculty of Nursing University of Toronto, Toronto; Judy Watt-Watson is a Professor in Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
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  • Mary Jane Esplen RN, PhD,

    1. Faith Wight Moffatt is an Assistant Professor in the School of Nursing, Dalhousie University, Halifax, Nova Scotia; Ellen Hodnett is Professor and Heather M. Reisman Chair in Perinatal Nursing Research, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Mary Jane Esplen is a CIHR Scientist at the Toronto General Research Institute and Professor in the Department of Psychiatry, Faculty of Medicine and in the Lawrence S. Bloomberg Faculty of Nursing University of Toronto, Toronto; Judy Watt-Watson is a Professor in Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
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  • Judy Watt-Watson RN, PhD

    1. Faith Wight Moffatt is an Assistant Professor in the School of Nursing, Dalhousie University, Halifax, Nova Scotia; Ellen Hodnett is Professor and Heather M. Reisman Chair in Perinatal Nursing Research, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto; Mary Jane Esplen is a CIHR Scientist at the Toronto General Research Institute and Professor in the Department of Psychiatry, Faculty of Medicine and in the Lawrence S. Bloomberg Faculty of Nursing University of Toronto, Toronto; Judy Watt-Watson is a Professor in Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
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  • The research was funded through: an Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) Canada/Johnson & Johnson Canada Award, Ottawa, Ontario; the Atlantic Region of the Association of Canadian Schools of Nursing, Antigonish, Nova Scotia; the Nursing Research Fund, Dalhousie University, Halifax, Nova Scotia; the IWK Health Centre, Halifax, Nova Scotia; and the Canadian Nurses Foundation Nursing Care Partnership, Ottawa, Ontario. During the time of this study, Faith Wight Moffatt also received student funding from: AWHONN, Washington, DC; the Nova Scotia Health Research Foundation, Halifax, Nova Scotia; the University of Toronto, Toronto, Ontario; and the Canadian Institutes of Health Research Strategic Training Initiative in Research in Reproductive Health Sciences, Ottawa, Ontario, Canada.

Address correspondence to Faith Wight Moffatt, RN, PhD, School of Nursing, Dalhousie University, 5869 University Avenue, Halifax, Nova Scotia, Canada B2T 1G4.

Abstract

Abstract:  Background:  Hypertension occurs in nearly 10 percent of pregnancies, and is associated with higher risk of infant and maternal morbidity and mortality than in normal pregnancies. Previous studies have suggested that relaxation therapies reduce blood pressure in nonpregnant adults. The objectives of this pilot randomized trial were to provide preliminary evidence of whether relaxation by means of guided imagery would reduce blood pressure in hypertensive pregnant women, and to assess the feasibility of a larger trial.

Methods:  A total of 69 pregnant women with hypertension were randomized to periods of guided imagery or of quiet rest, twice daily for 4 weeks or until delivery, whichever came first. Daytime ambulatory mean arterial pressure, systolic and diastolic blood pressure, and anxiety were measured weekly for up to 4 weeks.

Results:  Women allocated to guided imagery had lower mean arterial pressure elevations over time than those allocated to quiet rest (guided imagery: M = 1.58 mmHg, SD = 7.63; quiet rest: M = 5.93 mmHg, SD = 6.55; t = 2.36, p = 0.02). However, when adjusted for baseline mean arterial pressure and gestation, the effect was not significant (p = 0.14). Numbers of women prescribed antihypertensive medication postrandomization were similar (guided imagery: n = 16; quiet rest: n = 13, χ= 0.74, p = 0.46). There was also no evidence of an effect on women’s anxiety. Nearly 90 percent (n = 26) of the guided imagery group indicated that they would use it again.

Conclusions:  Further rigorous study is warranted to determine effects of guided imagery on maternal blood pressure and perinatal health outcomes. (BIRTH 37:4 December 2010)

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