<![CDATA[Background: Pain and anxiety are common in patients with fractures and delay recovery. Guided imagery is a low-cost, non-pharmacological nursing intervention, but evidence for its use in fracture patients has not been synthesized. This review aimed to synthesize evidence on the effectiveness of guided imagery in reducing pain and anxiety in patients with fractures. Methods: This literature review was reported according to PRISMA 2020. PubMed, Google Scholar/Garuda-indexed journals, trial registers, and reference lists were searched from inception to October 2026. Experimental and quasi-experimental studies evaluating the effect of guided imagery, alone or combined with other techniques, on pain and/or anxiety in fracture patients were included and synthesized narratively. Results: Nine studies with 269 participants (15–74 per study) were included: eight from Indonesia and one from Iran. Three were non-randomized controlled studies and six were one-group pretest–posttest studies. Guided imagery was delivered alone in six studies and combined with music, deep breathing, or aromatherapy in three. All eight studies measuring pain reported a significant reduction in at least one pain measure (mean decrease 0.55–3.37 points on 0–10 scales in one-group studies and 4.80 points in one controlled study). The only study measuring anxiety found a greater reduction in preoperative anxiety than in the control group. Conclusion: Guided imagery may reduce pain in patients with fractures and can be offered by nurses as a low-risk adjunct to analgesics. However, the evidence comes from small, non-randomized studies, and randomized controlled trials using standardized protocols are needed.]]>
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