The Effect of Guided Imagery Based on the Health Promotion Model on the Quality of Life in Breast Cancer Patients: An Integrative Study

İntroduction Breast cancer; It is an important public health problem because it is the most common cancer type globally and is closely associated with mortality. Breast cancer, which is a chronic disease and continues throughout life; It negatively affects many aspects of life with its individual, familial and social dimensions. Due to both the disease and a long and difficult treatment process, many individual and social changes are experienced in the process after the active treatment of breast cancer is completed, physical discomforts such as fatigue and pain continue, and many problems such as fear of recurrence of the disease and changes in body image occur in life quality and well-being are significantly affected. In addition, in this process, patients; They may experience many problems such as permanent side effects of the treatment, stress and depression, and they need to be informed about lifestyle changes.

Despite that; When the literature is examined, while the problems of cancer patients during the treatment process are considered more important, they are not given enough attention after the treatment process and there are limited number of studies on the problems experienced in this period. At this point, studies based on the Health Promotion Model, which include the processes of acquiring health promoting behaviors in detail and which is one of the most widely used models in nursing research, are of great importance. According to the literature, healthy lifestyle behaviors prevent late problems, chronic disease risks, recurrences, secondary cancers and reduce mortality in cancer patients; on the other hand, it is stated that it increases individual coping and quality of life, supports the individual holistically, and reduces health expenditures. One of the most used integrative/holistic applications in cancer patients today is guided imagery. In addition to contributing to the development of targeted behavior, guided imagery; by making the patient's mind get away from disturbing emotions and negative thoughts in daily life and feel relaxed, happy and peaceful; positively affects well-being, self-efficacy and quality of life. As it is known, the quality of life is one of the United Nations Sustainable Development Goals and is considered internationally important. When the literature is examined, guided imagery has been applied in cancer patients, especially for the management of symptoms such as pain, fatigue, nausea-vomiting, insomnia, stress and anxiety, in individuals whose treatment process is ongoing. No study was found that evaluated the simultaneous effects of the health promotion model and guided imagery. A guided imagery method that positively supports individuals' well-being and quality of life by providing mind-body harmony.

Keywords: Breast Cancer, Health Promotion Model, Guided Imagery, Nursing, Quality of Life, Healthy Lifestyle Behaviors

Research Hypotheses H1a: After the training and counseling supported guided imagery application based on the health promotion model in the experimental group, the healthy lifestyle behaviors mean scores of the participants were higher than before the application (within group) and control group (between groups).

H1b: After the training and counseling supported guided imagery application based on the health promotion model in the experimental group, the health-related quality of life score averages of the participants were higher than before the application (within group) and control group (between groups).