Effect of Guided Imagery on Sleep Quality, State Anxiety, and Comfort in Patients With Acute Coronary Syndrome

The goal of this randomized controlled trial is to determine whether guided imagery, when added to routine care, can reduce state anxiety and improve sleep quality and comfort in adults with acute coronary syndrome who are being treated in a cardiac intensive care unit. The main questions this study aims to answer are: Does guided imagery reduce state anxiety compared with routine care alone? Does guided imagery improve sleep quality compared with routine care alone? Does guided imagery improve comfort compared with routine care alone? A total of 64 participants will be randomly assigned to either a guided imagery group or a routine care group using block randomization. Participants in the guided imagery group will receive routine care and listen to a standardized guided imagery audio recording through headphones twice a day for two consecutive days. Each guided imagery session will last approximately 15 minutes. Participants in the routine care group will receive the standard treatment and nursing care provided in the cardiac intensive care unit without guided imagery. Researchers will assess participants' anxiety, sleep quality, and comfort and compare the changes between the two groups.

Inclusion Criteria: * Age 18 years or older. * Diagnosed with acute coronary syndrome, specifically ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI). * Admitted to and monitored in the cardiac intensive care unit. * Expected to remain in the cardiac intensive care unit for at least two nights and to be transferred to a ward or discharged after the two-day study period. * Clinically and hemodynamically stable, with no ongoing or increasing chest pain, significant respiratory distress, unstable vital signs, symptomatic serious arrhythmia, or need for urgent invasive intervention. * Conscious, oriented to person, place, and time, and able to communicate verbally. * Able to understand and speak Turkish. * No hearing impairment that would prevent listening to the guided imagery audio recording through headphones. * Sufficient cognitive ability to understand and respond to the study questionnaires. * Willing to participate and able to provide written informed consent. Exclusion Criteria: * Diagnosis of unstable angina pectoris. * Confusion, delirium, or any alteration in consciousness that interferes with communication. * Diagnosed dementia or cognitive impairment that prevents understanding study instructions. * Hearing loss that prevents following the audio instructions through headphones. * Inability to communicate verbally. * Clinical or hemodynamic instability, including ongoing chest pain, significant dyspnea, hemodynamic instability, symptomatic serious arrhythmia, or need for urgent intervention. * Receiving invasive mechanical ventilation or respiratory support that interferes with communication. * Receiving sedative treatment at a level that interferes with consciousness or communication. * Active psychosis, severe agitation, or an active psychiatric disorder that prevents following the guided imagery instructions. * Expected cardiac intensive care unit stay of less than two nights. * Refusal to participate or inability to provide informed consent.