Evaluate Breathing Exercises on Improvement in Respiratory Status among Patients with Respiratory Diseases
1Tutor, Pratiksha Institute of Nursing, Guwahati, Assam.
2Assistant Professor, Army Institute of Nursing, Guwahati, Assam.
*Corresponding Author Email:
Background: Respiratory diseases are typical issue of the airway that hampers the normal airflow and leads to airway inflammation. The impacts of breathing exercises on respiratory diseases have been concentrated to discover its role on improvement of respiratory status. Objective: To estimate breathing exercises on improvement in respiratory status among patients with respiratory diseases. Material and method: A pre experimental, one group pre-test post-test design was adopted on 50 samples with respiratory diseases selected by convenient sampling technique from Medicine (male and female), Pulmonary Medicine, CTVS ward of Guwahati Medical College and Hospital, Assam. Data collected through structured interview schedule for demographic and clinical variables and “modified respiratory status scale” for assessing respiratory status. The group received intervention for 3 minutes one time daily for 7 days. Post-test was done on 7th day. In this study, deep breathing exercise and pursed lip breathing exercise were used. Data were analyzed by using the software package SPSS 2.0 version. Results: the pre-test respiratory status mean was 7.6 and post-test respiratory status mean was 4.98 mean difference was 2.62. The difference in mean scores shows a significant improvement of Respiratory status among patients with Respiratory Diseases. The t’ value of the breathing capacity by using modified respiratory status scale (13.55) was much higher than the ‘p’ value at 0. 05 level of significance. So, Breathing Exercises (Deep Breathing Exercise and Pursed Lip Breathing Exercise) was effective which improve the respiratory status among Respiratory Disease patients. Respiratory status is associated with Gender, History of previous hospitalization and no association with clinical variables. Conclusion: The study concluded that breathing exercises is effective in improvement of respiratory status among patients with respiratory diseases.
KEYWORDS: Evaluate, Breathing exercises, Respiratory status, Respiratory diseases.
Respiratory system is one in all the vital system of our body. There are various diseases which might affect the system due to various causes. Respiratory illnesses are driving reasons for death and ailment on the earth.
These diseases, whether acute or chronic, communicable or non-communicable, impose a significant global burden and affect immeasurable people.1 This study mainly focused on six respiratory diseases which include Chronic Asthma, COPD, pulmonary TB, Pleural Effusion, Pneumonia, Empyema.
Over 80% of asthma-related deaths occur in low-and lower-middle income countries2. Globally COPD was the fourth leading reason for death (5.1%) in 2004 and is projected to occupy the third position (8.6%) in 2030.3 Breathing exercise is an exercise intended to push effective and healthy breathing and breath control. Breathing exercises may assist the patient during rest and activity by decreasing dyspnea, improving oxygenation, and slowing the vital sign.4
Ubolnuar N, Tantisuwat A, Thaveeratitham P, Lertmaharit S, Kruapanich C, Mathiyakom W (2019) conducted a study on to assess effects of Breathing Exercises in Patients With Chronic Obstructive Pulmonary Disease. Randomized controlled trial techniques utilized investigating the outcomes of BEs in COPD sufferers posted thru May 2018, have been retrieved from 5 digital databases (MEDLINE, CINAHL, Cochrane, Scopus, and ScienceDirect). When in contrast to the manage groups, respiratory charge extensively (p≤0.001) improved in the pursed-lip breathing (PLB), ventilatory feedback (VF) plus exercise, diaphragmatic respiratory workout (DBE), and mixed BEs. Additionally, PLB substantially extended tidal extent (p<0.001), inspiratory time (p=0.007), and complete respiratory time (p<0.001). VF plus workout extensively increased inspiratory capacity (p<0.001), All Breathing Exercises did no longer drastically enhance dyspnea, compared to the controls (p>0.05).5
· To evaluate effectiveness of breathing exercises on improvement in respiratory status among patients with respiratory diseases in Tertiary care center, Guwahati, Assam.
· To determine the association between pre-test score of respiratory status with selected demographic variables.
· To determine the association between pre-test score of respiratory status with selected clinical variables.
Hypothesis was tested at 0.05 level of significance.
· H1: There is significant difference between pre-test and post-test score of respiratory status among patients with respiratory diseases.
· H2: There is significant association of pre-test score of respiratory status among patients with respiratory diseases with selected demographic variables.
· H3: There is significant association of pre-test score of respiratory status with selected clinical variables.
The study was conducted after obtaining permission from institutional and hospital ethical committee. It was a pre-experimental pre-test post-test research design study where data collected from 50 samples by convenient sampling technique starting with collecting demographic and clinical variables through Structured Interview Method and did pretest with “modified respiratory status scale” to determine respiratory status.
After pre-test intervention given for 3 minutes for continuous 7 days. and did post-test done on 7th day of data collection with the help of modified respiratory status scale. Data collected from 25.06.2020 To 08.07.2020 In medicine (male and female), CTVS, pulmonary medicine ward of GMCH. In this research study two breathing exercises (deep breathing exercise and pursed lip breathing exercise) were used. Data were analyzed by using the software package SPSS 2.0 version.
Distribution of patients with Respiratory diseases according to their demographic variables and clinical variables. The findings of the study reveal that majority of samples 16(32%) are belongs to 51-60 years where 30(60%) samples were male, 22(44%) samples were belongs to daily worker among which 17(34%) belongs to Rs 50001-10000 monthly income. About history of substance abuse 27(54%) had a positive history and among them 14(28%) had history of smoking. Majority 19(38%) had a history of previous hospitalization and among them 10(20%) samples belongs to respiratory disease. In regarding to number of previous hospitalization 31(62%) had no history of previous hospitalization.
In this study clinical variables are, among 50 samples with regards to History of Co morbid condition 29(58%) had no history. Among 58%, 10(20%) belongs to HTN. Regarding, Family History of Respiratory Diseases 32(64%) had no Family history of Respiratory Diseases. About Type of Relation, 5(10%) belongs to parents, 4(8%) belongs to siblings, 7(14) belongs to grand- parents and 2(4%) belongs to Relatives. About Ongoing Treatment Regimen, 27(54%) belongs to Medications like bronchodilator, 3(6%) belongs to Meter Dose Inhaler, 7(14%) belongs to Supplemental Oxygen, 13(26%) were using Spirometry.
Table-1: Paired ‘t’ test to evaluate the Breathing Exercises among patients with Respiratory Disease N=50
|
|
Mean |
SD |
Mean difference |
‘t’ test |
|
Pre-test |
7.6 |
3.14 |
2.62 |
13.55 |
|
Post-test |
4.98 |
2.96 |
|
The above table reveals that the pre-test of respiratory status mean was 7.6, standard deviation was 3.14 and post-test respiratory status mean was 4.98 and standard deviation was 2.96. The mean difference was 2.92. The t’ value of the breathing capacity by using modified respiratory status scale (13.55) was much higher than the ‘p’ value at 0. 05 level of significance.
So, Breathing Exercises (Deep Breathing Exercise and Pursed Lip Breathing Exercise) was effective which improve the respiratory status among patients with Respiratory Diseases.
There was significant difference between pre-test and post-test score of respiratory status among patients with respiratory diseases. Hence H1 was accepted.
There was significant association of pre-test score with Gender and History of previous hospitalization with respiratory status. Other demographic variables are not significant with respiratory status. Hence, H2 was accepted.
There was no significant association between patients with respiratory diseases with clinical variables. Hence H3 was rejected.
To evaluate the breathing exercises on improvement in respiratory status:
To evaluate breathing exercises, the present study used paired “t” test. The result showed that The ‘t’ value of the breathing capacity by using modified respiratory status scale (13.55) was much higher than the ‘p’ value at 0. 05 level of significance and the mean difference (pre-test and post-test score of respiratory status) was 2.62.
So, Breathing Exercises (Deep Breathing Exercise and Pursed Lip Breathing Exercise) was effective which improve the respiratory status among patients with Respiratory Diseases.
This study findings can be compatible with Ramos EMC, Vanderlei LCM, Ramos D, Teixeira LM, Pitta C, Veloso M (2009) was directed an examination to evaluate the impacts of pursed lip breathing exercise on the conduct of pulse and its inconstancy, and on varieties in blood pressure, respiratory rate and heartbeat oxygen immersion in subjects with chronic obstructive pulmonary disease. Sixteen subjects were taken with ten minutes of normal breathing without PLB (R1), eight minutes with Pursed Lip Breathing Exercise (R2) and ten minutes of normal breathing again (R3). Pulse was recorded, beat-to-pulsate, by methods for a Polar S810 heart screen. The RMSSD list (root mean square of the contrast between progressive R-R spans) was decided. The pulse variety among motivation and lapse was 8.98 bpm, and the variety between pulse very still and pulse with Pursed Lip Breathing Exercise was 8.25 bpm. During R2, respiratory rate diminished and beat oxygen saturation expanded essentially in examination with R1 and R3. Examination of the RMSSD record indicated that pursed lip breathing exercise expanded parasympathetic movement in these subjects, hence showing that this method affected the autonomic cardiovascular balance.6
Regarding association between demographic variables and respiratory status, that most of the demographic variables are not significant with respiratory status. Only Gender and History of previous hospitalization has a significant association with respiratory status. Hence the H2: There is significant association of pre-test score of respiratory status among patients with respiratory diseases with selected demographic variables is accepted.
The study findings can be compatible with Karthika K, (2017) conducted a quasi experimental study to evaluate the effectiveness of deep breathing exercise among patients with chronic obstructive pulmonary disease who are aged between 50-60 years of age. The study included 60 samples patients who were selected by purposive sampling technique. The study was done by using pre experimental (one group pre and post-test) design. The study revealed that there was a significant association between dyspnea with age and family history of COPD among patients with chronic obstructive pulmonary disease. The subjects in experimental group had decreased level of breathing pattern after giving deep breathing exercise compared to control group.4
Regarding association between clinical variables and respiratory status, result shows that there is no significant association between any of the clinical variables with respiratory status.
Hence the H3: There is significant association of pre-test score of respiratory diseases with selected clinical variables is rejected.
The present study was done to assess the effectiveness of breathing exercises (deep breathing exercise and pursed lip breathing exercise) on improvement in respiratory status among patients with respiratory diseases. The study reveals that breathing exercises were effective in improvement of respiratory status.
1. https://www.erswhitebook.org/chapters/respiratory research
2. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390: 1211–59.
3. World health organization. World health statistics 2008. Geneva: World health organization, 2008
4. Karthika K. A quasi experimental study to evaluate the effectiveness of deep breathing exercise among patients with chronic obstructive pulmonary disease who are aged between 50- 60 years in selected hospitals at dindigul district. degree of masters in science of nursing, sakthi college of nursing, oddanchatram. 2017.Chennai.
5. Ubolnuar N, Tantisuwat A, Thaveeratitham P, Lertmaharit S, Kruapanich C, Mathiyakom W. Effects of Breathing Exercises in Patients With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis. Annals of rehabilitation medicine. 2019; 43(4): 509-23
6. Ramos EMC, Vanderlei LCM, Ramos D, Teixeira LM, Pitta C, Veloso M. Influence of pursed lip breathing on heart rate variability and cardiorespiratory parameters in subjects with chronic obstructive pulmonary disease (COPD). 2009; 13(4): 288- 93
Received on 24.03.2021 Modified on 26.04.2021
Accepted on 21.05.2021 ©AandV Publications All right reserved
Asian J. Nursing Education and Research. 2021; 11(4):495-498.
DOI: 10.52711/2349-2996.2021.00118