Guided imagery with a spiritual approach combined with lavender
oil aromatherapy on anxiety and well-being in adults and the elderly: a mixed
methods study.
adult, aged, anxiety, nursing care, sleep, well-being, health Services.
Anxiety disorders are a major public health problem and represent a growing challenge,
associated with a significant impact on the quality of life and well-being of the population.
Evidence points to a bidirectional relationship between anxiety and subjective well-being,
especially in adults and the elderly. In the context of primary care and integrative
practices in Brazil, there is a need for complementary interventions that address
emotional, sensory, and spiritual dimensions, going beyond exclusively biomedical
approaches. Integrative Nursing presents itself as a possibility for the development of
person-centered interventions, with an emphasis on safe practices, such as Integrative
and Complementary Practices (ICP), which are less invasive and oriented towards
strengthening well-being. The objective is to evaluate the effects of an intervention
consisting of Guided Imagery with a spiritual approach, combined with aromatherapy
using Lavandula angustifolia essential oil, on the levels of anxiety and well-being of adults
and elderly people in the community, in light of the principles of Integrative Nursing. The
specific objectives are to measure and compare anxiety and well-being levels before and
after the intervention, as well as to understand the experiences, meanings, reactions, and
effects perceived by the participants, integrating quantitative and qualitative data. This is
a quasi-experimental intervention study without a control group, structured using a mixed
method with a quantitative predominance and incorporated qualitative collection (QUAN-
qual). In the quantitative phase, a before-and-after design will be adopted, with the
application of validated scales (Beck Anxiety Inventory and WHO-5 for well-being) before
and after the intervention. The sample calculation indicated an initial need for 34
participants for this study. The qualitative phase will use brief semi-structured interviews,
with intentional sampling by maximum variation, covering age diversity and differences in
response to the intervention. It is estimated that approximately 10 participants will be
involved, with the possibility of adjustment according to theoretical saturation. The study
will be conducted at the Laboratory of Integrative and Complementary Practices
(LAPICS/UFRN). The choice of this location is justified by LAPICS' relevance in
promoting and developing Integrative and Complementary Health Practices, its
connection to UFRN, and its encouragement of scientific production in the area. The
population of this study will be adults and elderly people who have a history of mild to
moderate anxiety, whether diagnosed or self-reported. People diagnosed with severe
anxiety or a history of psychiatric disorders will not be able to participate in the study,
considering risks that cannot be circumvented. The intervention will consist of guided
imagery with a spiritual approach, accompanied by inhalation aromatherapy, lasting
approximately 5 minutes, totaling about 15 minutes considering preparation for the intervention. The guided imagery script will be based on previous literature. The guided image audio will be pre-recorded to standardize the technique.
A pilot study will beconducted with four participants to test the applicability, logistics, and clarity of the script, allowing for adjustments before the quasi-experimental stage. The pilot will follow the same inclusion criteria, but its data will not be included in the main sample. Data collection will involve two stages: (1) application of pre- and post-intervention scales; (2) qualitative interviews after completion of the post-test. Quantitative analysis will include descriptive statistics and the Wilcoxon test to compare pre- and post-intervention scores (p<0.05). The qualitative analysis will follow the guidelines of Creswell and Clark (2013), using coding, categorization, and identification of themes. Subsequently, the quantitative and qualitative findings will be integrated through a joint comparison of the results.