The Effect of Breathing Exercises on Pain, Sleep, and Symptom Management in Patients Undergoing Hemodialysis: A Randomized Controlled Trial

Abstract

Purpose This study was conducted to determine the effect of breathing exercises on pain, sleep, and symptom management in patients undergoing hemodialysis. Methods The randomized controlled study was conducted with patients undergoing hemodialysis at a private dialysis center in the northern Black Sea region. Data were collected using the Descriptive Information Form, the Visual Analog Scale (VAS), the Richards-Campbell Sleep Questionnaire (RCSQ), the Dialysis Symptom Index (DSI), and the Vital Signs Form. According to the power analysis performed in the study, a total of 70 participants, 35 in each group, needed to be included in the study in order to conduct an independent t-test with a confidence level of 95%, a test power of 95%, and an effect size of d = 0.80. The study was conducted with a total of 69 patients divided into two groups: the experimental group (n = 35) and the control group (n = 34). Patients in the experimental group performed breathing exercises (Diaphragmatic breathing, Agni S & amacr;r, Nadi Shodhana, and the 4-7-8 breathing technique) on dialysis days for eight weeks. During this period, patients in the control group continued to receive routine nursing care in the hemodialysis unit. Results Following the application, the average pain intensity in the control group (4.06 +/- 3.1) was found to be statistically significantly higher than the average in the experimental group (0.4 +/- 1.19) (p < 0.001). The average sleep score in the control group (48.56 +/- 22.35) was found to be statistically significantly lower than the average in the experimental group (80.21 +/- 16.46) (p < 0.001). The average DSI in the control group (92 +/- 22.05) was found to be statistically significantly higher than the average in the experimental group (41.37 +/- 7.15) (p < 0.001). Conclusion Breathing exercises in patients undergoing hemodialysis were found to reduce pain, improve sleep quality, and have a positive impact on symptom management. In light of this, it is recommended that nurses include breathing techniques as part of the care provided to hemodialysis patients. Using complementary methods such as breathing therapy supports the physical, psychological, psychosocial, and holistic care of patients, thus increasing patient satisfaction and quality of life. Training health professionals in breathing therapy will ensure a broader use of this complementary method in a larger patient population.