The Effect of Guided Imagery on Bariatric Surgery Patients

Primary outcomes

1. Personal Information Form

   Time frame: up to 24 hours

   The Personal Information Form, developed by the researcher based on a review of the relevant literature, consists of a total of 16 questions. It includes items related to gender, age, education level, marital status, and previous surgical history.

2. The Surgical Fear Scale

   Time frame: up to 24 hours

   Developed by Theunissen et al. in 2014 to assess the fear levels of patients scheduled for surgical procedures, this 8-item Likert-type scale evaluates short-term surgical fears with items 1-4 and long-term surgical fears with items 5-8. Each item is scored on a scale from 0 ("not afraid at all") to 10 ("very afraid"), resulting in a total score ranging from 0 to 80. Higher scores indicate greater levels of surgical fear (Theunissen et al., 2014). The Turkish validity and reliability study conducted by Bağdigen and Özlü (2018) reported a Cronbach's alpha coefficient of 0.93.

3. Richard-Campbell Sleep Questionnaire

   Time frame: up to 24 hours

   The Richard-Campbell Sleep Questionnaire was developed by Richards in 1987 and its Turkish validity and reliability study was conducted by Özlü and Özer in 2015 . The scale consists of 6 items that assess various aspects of nighttime sleep, including sleep depth, sleep latency, frequency of awakenings, duration of awakening after sleep onset, sleep quality, and noise level in the environment. Each item is scored on a scale from 0 to 100. However, when calculating the total score, the 6th item (noise level) is excluded, and the evaluation is based on the first 5 items. Higher scores indicate better sleep quality. The total score is obtained by dividing the sum of the item scores by the number of items. Scores ranging from 0 to 25 indicate very poor sleep quality, while scores between 76 and 100 indicate very good sleep quality.

4. Visual Analog Scale for Pain (VAS)

   Time frame: up to 24 hours

   Developed by Price et al. (1983), this scale measures the intensity of pain using a 10 cm vertical or horizontal line with endpoints labeled as "no pain" (0) and "worst possible pain" (10). The patient marks a point corresponding to their perceived pain intensity, and the distance from the "no pain" end to the marked point is measured in centimeters, representing the pain score. Higher scores indicate greater pain intensity.

5. State-Trait Anxiety İnventory (STAI-I, STAI-II)

   Time frame: up to 24 hours

   It is a test developed by Spielberger et al. that measures state and trait anxiety levels. Its validity and reliability in Turkey was done by Oner and Le Compte. The scale consists of two parts, the 'state anxiety scale', which is created with the aim of determining the instantaneous feelings, and the 20-item 'trait anxiety scale', which was created to determine the feelings in general. It is a four degree scale ranging from 'Nothing' to 'All'. Scores range from 20 (low anxiety) to 80 (high anxiety).

6. Parameter Tracking Form

   Time frame: up to 24 hours

   Before and after bariatric surgery, patients' heart rate, blood pressure, and oxygen saturation will be measured and recorded in this form. In addition, to assess stress levels, blood cortisol measurements will be performed. Blood samples for cortisol will be collected in the morning (between 07:30-08:30) in appropriate tubes, promptly transported to the laboratory, and analyzed under cold chain conditions. Serum or plasma will be separated and analyzed using standard devices. All procedures will be carried out in the Erzurum City Hospital laboratory according to existing standard protocols and high-quality criteria, and results will be recorded.