Breathing Exercises for Dyspnea and Anxiety in Heart Failure

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.

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

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