Anxiety, Breathing Exercises, Dyspnea, Heart Failure
Conditions
Brief summary
Heart failure is a leading cause of emergency department admissions, with dyspnea and psychological distress being among the most common presenting symptoms. This randomized controlled trial aims to evaluate the effect of nurse-guided diaphragmatic breathing and pursed-lip breathing exercises on dyspnea and psychological distress in patients presenting to the emergency department with heart failure. A total of 112 eligible participants will be randomly assigned in a 1:1 ratio to either an intervention group receiving breathing exercises in addition to standard care or a control group receiving standard care alone. Dyspnea severity will be assessed using the Modified Borg Dyspnea Scale, and psychological distress will be assessed using the Distress Thermometer at predefined time points. The findings are expected to provide evidence for the effectiveness of a simple, low-cost, nurse-led non-pharmacological intervention in improving symptom management in patients with heart failure.
Detailed description
Heart failure is a major public health problem associated with frequent emergency department admissions due to symptoms such as dyspnea and anxiety. Dyspnea is one of the most distressing symptoms experienced by patients with heart failure and is often accompanied by increased anxiety, which may further worsen respiratory distress. Although pharmacological treatment remains the cornerstone of acute management, non-pharmacological interventions, including breathing exercises, may provide additional symptom relief. The aim of this randomized controlled trial is to evaluate the effect of diaphragmatic breathing and pursed-lip breathing exercises on dyspnea and anxiety in patients presenting to the emergency department with heart failure. A total of 112 eligible patients will be randomly assigned to either an intervention group or a control group. Participants in the intervention group will receive standard emergency department care in addition to nurse-guided diaphragmatic breathing and pursed-lip breathing exercises. The control group will receive standard emergency department care alone. Clinical parameters, including pulse rate, blood pressure, respiratory rate, oxygen saturation, and distress level, will be assessed according to the study protocol. Dyspnea severity will be evaluated using the Modified Borg Dyspnea Scale, and anxiety-related distress will be assessed using the Distress Thermometer. Outcome measurements will be obtained at baseline and at predefined time points following the intervention. The primary objective is to determine whether breathing exercises reduce dyspnea severity and anxiety compared with standard care. The findings of this study are expected to provide evidence regarding the effectiveness of a simple, low-cost, and nurse-led non-pharmacological intervention that may improve symptom management in patients with heart failure treated in emergency departments.
Interventions
OTHERDiaphragmatic and Pursed-Lip Breathing Exercises
Participants received standard emergency department care plus nurse-guided diaphragmatic breathing and pursed-lip breathing exercises. The intervention consisted of three cycles of breathing exercises with rest periods between cycles. Participants were observed and supported throughout the intervention.
Sponsors
Istanbul University - Cerrahpasa
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Masking description
Due to the nature of the breathing exercise intervention, participants and the investigator delivering the intervention could not be blinded. To minimize bias, data were coded as Group A and Group B, and statistical analyses were performed by an independent statistician who was blinded to group allocation.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Applicants must be 18 years of age or older. Volunteer to participate in the study. Present to the emergency department of the hospital where the study is planned to be conducted. Having been diagnosed with NYHA stage III-IV heart failure by a physician. Being able to understand and speak Turkish.
Exclusion criteria
Being under 18 years of age Not being a volunteer to participate in the study Using narcotic analgesics to a degree that affects understanding questions and communication, Having a diagnosis of serious mental illness Not having been diagnosed with NYHA stage III-IV heart failure by a physician \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in psychological distress measured by the Distress Thermometer | Baseline (before intervention), and at 5, 10, 15, 30, 45, and 60 minutes after initiation of the intervention. | Psychological distress will be assessed using the Distress Thermometer |
| Change in dyspnea severity measured by the Modified Borg Dyspnea Scale | Baseline (before intervention), and at 5, 10, 15, 30, 45, and 60 minutes after initiation of the intervention. | Dyspnea severity will be assessed using the Modified Borg Dyspnea Scale |
Countries
Turkey (Türkiye)
Outcome results
None listed