Decreasing degrees of dyspnea in chronic obstructive pulmonary disease patients through combination of breathing exercises and relaxation

https://doi.org/10.22146/jcoemph.66492

Juliana G.E.P Massie(1*), Muhamad Adam(2), Tuti Herawati(3), I Made Kariasa(4)

(1) Universitas Indonesia
(2) 1. Universitas Indonesia 2. Universitas Indonesia Hospital
(3) 1. Universitas Indonesia 2. Universitas Indonesia Hospital
(4) 1. Universitas Indonesia 2. Universitas Indonesia Hospital
(*) Corresponding Author

Abstract


Shortness of breath (dyspnea) is a common symptom that accompanies patients with Chronic Obstructive Pulmonary Disease (COPD). Management of dyspnea in patients with COPD is not only using pharmacological therapy but also non-pharmacological therapy. Non-pharmacological therapy for patients with COPD covers three main aspects: breath, mind, and functional processing. Along with the development of complementary therapy in nursing science, nursing interventions that can be done at home begin to be in great demand because of their low cost and time effectiveness. One of the interventions is providing breathing exercises and relaxation for patients with COPD to reduce the dyspnea complaints, increase the strength of breathing muscles and prevent the hospital re-admission due to acute exacerbation. This study aimed to see the effectiveness of the combination of Pursed Lip Breathing (PLB) and Progressive Muscle Relaxation (PMR) on the degree of dyspnea. This quasi-experimental study was conducted with a pre and post-test design approach with 20 respondents in each group. The results showed significant differences in the degree of dyspnea after the combination of PLB and PMR (p < 0.05). The results from this study recommend improving the development of complementary therapy programs in nursing education and services by modifying nursing care standards with the combinations of PLB and PMR for patients with COPD.


Keywords


COPD; Dyspnea; Progressive Muscle Relaxation; Pursed Lip Breathing

Full Text:

PDF


References

1.Bourdet SV, Williams DM. Chapter 27: Chronic Obstructive Pulmonary Disease Pharmacotherapy: A Pathophysiologic Approach. 10th ed. New York: McGraw-Hill Education / Medical; 2015. p. 537-54.

2.Huriah T, Ningtias DW. Pengaruh Active cycle of breathing technique terhadap peningkatan nilai VEP1, jumlah sputum, dan mobilisasi sangkar thoraks pasien PPOK. Indonesian Journal of Nursing Practices. 2017;1(2):44-54.

3.World Health Organization. Chronic Respiratory Diseases. Jenewa: World Health Organization; 2019 [updated 2019 Dec 27; cited 2020 Jan 12]. Available from: https://www.who.int/respiratory/copd/en/.

4.World Health Organization. Chronic Obstructive Pulmonary Disease (COPD) . Jenewa: World Health Organization; 2017 [updated 2017 Dec 1; cited 2019 Feb 20]. Available from: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd).

5.Irianti EC, Arsin AA, Abdullah MT. Quality of life in patients with chronic obstructive pulmonary disease at Pulmonary Community Health Centre Makassar. International Journal of Community Medicine and Public Health. 2018;5(9):3753-9.

6.Quaderi SA, Hurst JR. The unmet global burden of COPD. Glob Health Epidemiol Genom. 2018;3:e4-e.

7.Grigsby M, Siddharthan T, Chowdhury MA, Siddiquee A, Rubinstein A, Sobrino E, et al. Socioeconomic status and COPD among low- and middle-income countries. Int J Chron Obstruct Pulmon Dis. 2016;11:2497-507.

8.Global Initiative for Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease 2019 report USA: GOLD; 2021 [updated 24 March 2021; cited 2021 June 10]. Available from: https://goldcopd.org/wp-content/uploads/2019/12/GOLD-2020-FINAL-ver1.2-03Dec19_WMV.pdf.

9.Singh VP, Rao V, Prem V, Sahoo RC, Keshav Pai K. Comparison of the effectiveness of music and progressive muscle relaxation for anxiety in COPD: a randomized controlled pilot study. Chron Respir Dis. 2009;6(4):209-16.

10.Marciniuk DD, Goodridge D, Hernandez P, Rocker G, Balter M, Bailey P, et al. Managing dyspnea in patients with advanced chronic obstructive pulmonary disease: a Canadian Thoracic Society clinical practice guideline. Can Respir J. 2011;18(2):69-78.

11.Danvers L. Managing breathlessness and chest clearance 2017 [cited 2019 January 21]. Available from: https://www.educationforhealth.org/wp-content/uploads/Day-2-Managing-Breathlessness-and-Chest-Clearance-Laura-Danvers.pdf.

12.Ramadhani R, Sitorus R, Yona S. Peningkatan self efficacy dalam mengelola kesulitan bernafas melalui edukasi manajemen dispnea pada pasien PPOK. Jurnal Aisyah : Jurnal Ilmu Kesehatan. 2018;3(2):125-33.

13.Ramdhani N, Putra AA. Pengembangan multimedia relaksasi 2008 [Available from: http://neila.staff.ugm.ac.id/wordpress/wp-content/uploads/2008/05/relaksasi-otot.pdf.

14.Rini IS, Sitorus R, Sabri L. Hubungan antara efikasi diri dengan kualitas hidup pasien Penyakit Paru Obstruktif Kronis dalam konteks asuhan keperawatan di RS Paru Batu dan RSU Dr. Saiful Anwar Malang Jawa Timur [Tesis]. Depok: Universitas Indonesia; 2011.

15.Broekhuizen BD, Sachs AP, Hoes AW, Moons KG, van den Berg JW, Dalinghaus WH, et al. Undetected chronic obstructive pulmonary disease and asthma in people over 50 years with persistent cough. Br J Gen Pract. 2010;60(576):489-94.

16.Tsiligianni I, Kocks J, Tzanakis N, Siafakas N, van der Molen T. Factors that influence disease-specific quality of life or health status in patients with COPD: a review and meta-analysis of Pearson correlations. Prim Care Respir J. 2011;20(3):257-68.

17.Jones PW, Brusselle G, Dal Negro RW, Ferrer M, Kardos P, Levy ML, et al. Health-related quality of life in patients by COPD severity within primary care in Europe. Respir Med. 2011;105(1):57-66.

18.Persatuan Dokter Paru Indonesia. Pedoman diagnosis dan penatalaksanaan Penyakit Paru Obstruktif Kronis (PPOK) di Indonesia Jakarta: PDPI; 2016 [cited 2019 March 14]. Available from: https://www.klikpdpi.com.

19.Achadi A. Regulasi pengendalian masalah rokok di Indonesia. Jurnal Kesehatan Masyarakat Nasional. 2008;2(4):161-5.

20.Finkelstein J, Cha E, Scharf SM. Chronic obstructive pulmonary disease as an independent risk factor for cardiovascular morbidity. Int J Chron Obstruct Pulmon Dis. 2009;4:337-49.

21.Divo M, Cote C, de Torres JP, Casanova C, Marin JM, Pinto-Plata V, et al. Comorbidities and risk of mortality in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012;186(2):155-61.

22.Hanania NA, O'Donnell DE. Activity-related dyspnea in chronic obstructive pulmonary disease: physical and psychological consequences, unmet needs, and future directions. Int J Chron Obstruct Pulmon Dis. 2019;14:1127-38.

23.Donohue JF, Maleki-Yazdi MR, Kilbride S, Mehta R, Kalberg C, Church A. Efficacy and safety of once-daily umeclidinium/vilanterol 62.5/25 mcg in COPD. Respir Med. 2013;107(10):1538-46.

24.Bateman ED, Ferguson GT, Barnes N, Gallagher N, Green Y, Henley M, et al. Dual bronchodilation with QVA149 versus single bronchodilator therapy: the SHINE study. Eur Respir J. 2013;42(6):1484-94.

25.Buhl R, Maltais F, Abrahams R, Bjermer L, Derom E, Ferguson G, et al. Tiotropium and olodaterol fixed-dose combination versus mono-components in COPD (GOLD 2-4). Eur Respir J. 2015;45(4):969-79.

26.Martinez FJ, Rabe KF, Ferguson GT, Fabbri LM, Rennard S, Feldman GJ, et al. Efficacy and Safety of glycopyrrolate/formoterol metered dose inhaler formulated using co-suspension delivery technology in patients with COPD. Chest. 2017;151(2):340-57.

27.Mete B, Pehlivan E, Gulbas G, Gunen H. Prevalence of malnutrition in COPD and its relationship with the parameters related to disease severity. Int J Chron Obstruct Pulmon Dis. 2018;13:3307-12.

28.Baig MMA, Hashmat N, Adnan M, Rahat T. The relationship of dyspnea and disease severity with anthropometric indicators of malnutrition among patients with chronic obstructive pulmonary disease. Pak J Med Sci. 2018;34(6):1408-11.

29.Artana IB, Rai IN. Tingkat ketergantungan nikotin dan faktor-faktor yan gberhubungan pada perokok di Desa Penglipuran 2009. Jurnal Penyakit Dalam. 2010;11(1):1-9.

30.Borné Y, Ashraf W, Zaigham S, Frantz S. Socioeconomic circumstances and incidence of chronic obstructive pulmonary disease (COPD) in an urban population in Sweden. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2019;16(1):51-7.

31.Kanervisto M, Vasankari T, Laitinen T, Heliovaara M, Jousilahti P, Saarelainen S. Low socioeconomic status is associated with chronic obstructive airway diseases. Respir Med. 2011;105(8):1140-6.

32.Eisner MD, Blanc PD, Omachi TA, Yelin EH, Sidney S, Katz PP, et al. Socioeconomic status, race and COPD health outcomes. Journal of Epidemiology and Community Health. 2011;65(1):26.

33.Gershon AS, Dolmage TE, Stephenson A, Jackson B. Chronic obstructive pulmonary disease and socioeconomic status: a systematic review. Copd. 2012;9(3):216-26.

34.Pampel FC, Krueger PM, Denney JT. Socioeconomic disparities in health behaviors. Annu Rev Sociol. 2010;36:349-70.

35.Sakhaei S, Sadagheyani HE, Zinalpoor S, Markani AK, Motaarefi H. The Impact of pursed-lips breathing maneuver on cardiac, respiratory, and oxygenation parameters in COPD patients. Open Access Maced J Med Sci. 2018;6(10):1851-6.

36.Garzon-Perez LV. Reactivation of the parasympathetic system with pursed lips after physical exercise [Thesis]. France: Université de Franche-Comté; 2017.

37.Rossi RC, Pastre CM, Ramos EMC, Vanderlei LCM. Pursed-lip breathing in chronic obstructive pulmonary disease: a literature review. Fisioterapia e Pesquisa. 2012;19(3):282-9.

38.Roberts SE, Schreuder FM, Watson T, Stern M. Do COPD patients taught pursed lips breathing (PLB) for dyspnoea management continue to use the technique long-term? A mixed methodological study. Physiotherapy. 2017;103(4):465-70.

39.Seyedi Chegeni P, Gholami M, Azargoon A, Hossein Pour AH, Birjandi M, Norollahi H. The effect of progressive muscle relaxation on the management of fatigue and quality of sleep in patients with chronic obstructive pulmonary disease: a randomized controlled clinical trial. Complement Ther Clin Pract. 2018;31:64-70.

40.Volpato E, Banfi P, Nicolini A, Pagnini F. A quick relaxation exercise for people with chronic obstructive pulmonary disease: explorative randomized controlled trial. Multidiscip Respir Med. 2018;13:13.



DOI: https://doi.org/10.22146/jcoemph.66492

Article Metrics

Abstract views : 920 | views : 788

Refbacks

  • There are currently no refbacks.


Copyright (c) 2022 Journal of Community Empowerment for Health

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.