ABSTRACT THE EFFECTIVENESS OF GUIDED IMAGERY IN REDUCING PSYCHOLOGICAL DISTRESS AND ANXIETY SCORES IN PATIENTS UNDERGOING BRONCHOSCOPY Alfi Luthfiani1, Aris Sudiyanto2, Budhi Hami Seno2, Yusup Subagio Sutanto31Psychiatry Resident, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi General Hospital2Teaching Staff, Department of Psychiatry, Faculty of Medicine, Sebelas Maret University / Dr. Moewardi General Hospital2Teaching Staff, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Sebelas Maret University / Dr. Moewardi General Hospital Introduction: Bronchoscopy is considered the gold standard diagnostic tool and is crucial in diagnosing pulmonary neoplasms and interstitial lung diseases. However, the procedure is often perceived as uncomfortable by nearly 60% of patients due to topical anesthesia, leading to discomfort, anxiety, and pain, primarily due to experienced side effects. This condition also instills anxiety and fear experienced before the procedure. Non-pharmacological therapy utilizing relaxation methods can alleviate stress, one of which is guided imagery, proven to reduce pre-procedural anxiety. As bronchoscopy serves as a referral, research is warranted to ascertain the effectiveness of guided imagery in reducing anxiety and psychological distress before bronchoscopy.Method: This study employed a double-blind randomized controlled trial design, dividing 36 patients scheduled for bronchoscopy into two groups: control and intervention. For intervention group, 20-minute MP3 audio recording is applied twice a day in 3 days before bronchoscopy. Instruments used to measure anxiety symptoms included the APAIS questionnaire (Amsterdam Preoperative Anxiety and Information Scale) and VAS-A (Visual Analogue Scale for Anxiety), while psychological distress was assessed using the Kessler-10 scale. Assessments were conducted upon hospital entry, before bronchoscopy, and after bronchoscopy.Results: Statistical analysis revealed that guided imagery significantly and substantially (Cohen’s d > 0.8) reduced APAIS levels from hospital entry to before bronchoscopy (p < 0> 0.8) in reducing anxiety levels from inpatient entry to before bronchoscopy (p < 0> 0.8) from hospital entry to before bronchoscopy (p < 0>.Conclusion: Guided imagery proves to be an effective intervention in reducing psychological distress and anxiety score in patients undergoing bronchoscopy.Keywords: guided imagery, anxiety, psychological distress, bronchoscopy, randomized controlled trial.