The Effect of Slow Deep Breathing Relaxation Exercise on Pain and Anxiety Levels during and Post Chest Tube Removal after Coronary Artery Bypass Graft Surgery in Nablus Hospitals رسالة ماجستير

Abstract

Background: Chest tube removal has been described by patients undergoing coronary artery bypass grafting procedures as a very stressful and unpleasant process. This emphasizes how important it is to put in place measures that successfully lessen discomfort both during and after chest tube removal. Researchers have looked into the effects of many non-pharmacological techniques. One method that nurses could use to help patients undergoing chest tube removal is slow deep breathing relaxation exercises. Purpose: To evaluate the effect of slow deep breathing relaxation exercises on pain levels and anxiety levels during and post chest tube removal following coronary artery bypass grafting in Nablus hospitals Methods: Experimental design was conducted to compare between scores of pain and anxiety levels during and post chest tube removal among the intervention and control groups. A convenient sample had been selected from two hospitals in Nablus city (n=80). By randomization method the sample was divided into intervention group (n=40) and control group (n=40). slow deep breathing relaxation exercises was used for intervention group while standard care was used for the control. Data were collected through a questionnaire which composed of three parts. The first part gathered demographic and medical information. The second part assessed pain using the Numeric Pain Scale. The third part evaluated anxiety using the Visual Anxiety Scale. Data analysis was utilized to evaluate descriptive statistics, statistical inference, and correlations. The data were collected from the beginning of March to October 2024. Results: There were significant differences in pain scores during chest tube removal between the intervention (M = 5.325, SD = 0.997) and the control (M = 7.125, SD = 0.939) (p = 0.000). Intervention group had a lower score of pain. There were significant differences in pain scores after chest tube removal between the intervention (M = 2.125, SD = 0.723) and the control (M = 3.575, SD = 0.903) (p = 0.000). Intervention group had a lower score of pain. There were significant differences in anxiety scores during chest tube removal between the intervention (M = 4.650, SD = 1.350) and the control (M = 6.100, SD = 1.008) (p = 0.000). Intervention group had a lower score of Anxiety. There were significant differences in anxiety scores after chest tube removal between the intervention (M = 1.400, SD = 1.105) and the control (M = 2.825, SD = 1.279) (p = 0.000). Intervention group had a lower score of Anxiety. The effects of slow deep breathing relaxation exercises on pain and anxiety levels did not significantly correlate with medical characteristics including BMI, smoking status, or the number of drains. The type of operation performed, and the degree of pain experienced during chest tube IV removal had a significant relationship (p = 0.000), with more complex surgeries (such as coronary artery bypass grafting with multiple grafts) being linked to higher degrees of pain. Higher degrees of pain during removal (p = 0.01) and anxiety following removal (p = 0.007) were significantly associated with longer chest tube insertion times. Conclusion: The intervention group outperformed the control group, evidenced by significant differences in pain and anxiety scores. This study demonstrates the effectiveness of slow deep breathing relaxation exercises in reducing anxiety and pain during and after chest tube removal. The findings support the usefulness of relaxation techniques as a complement approach to postoperative care. Implementing targeted strategies taking that consider the type of operation and drain duration could improve patient outcomes