Predictors of Adherence to Relaxation Guided Imagery During Pregnancy in Women with Preterm Labor.

Objectives: To examine adherence to relaxation guided imagery in women experiencing preterm labor as well as predictors influencing adherence.

Methods: This study used a longitudinal follow-up approach. Each of the 57 participating women received a mini-MP3 player containing a 13-minute relaxation guided imagery audio program that they were instructed to follow daily until giving birth. Follow-up interviews were conducted weekly. A generalized estimating equation was used to predict adherence.

Results: The total adherence rate was 58%. Higher adherence was predicted by the presence of at least a college degree (p=0.006), greater perceived stress (p=0.006), a higher risk of preterm delivery (p<0.001), and greater relaxation effects (p=0.028). Older maternal age was associated with lower adherence (p=0.001). In addition, adherence decreased significantly over time (p<0.001). Adherence was not related to marital status, employment, parity, the baseline level of anxiety, or hospitalization.

Conclusions: Pregnant women with a high risk for preterm birth and greater perceived stress showed higher adherence to relaxation guided imagery. For women with a lower adherence to relaxation guided imagery, health care professionals may consider individual preferences regarding relaxation techniques.