The effect of relaxation breathing exercise on chemotherapy induced nausea and vomiting in patients with hematological malignancies

Pınar Ekşi; Sıdıka Oğuz

doi:10.18203/2349-3259.ijct20262507

Authors

Pınar Ekşi Institute of Health Sciences, Marmara University, Kartal, Istanbul, Turkey
Sıdıka Oğuz Department of Medical Nursing, Faculty of Health Sciences, Marmara University, Maltepe, Istanbul, Turkey https://orcid.org/0000-0002-1101-1923

DOI:

https://doi.org/10.18203/2349-3259.ijct20262507

Keywords:

Relaxation breathing exercise, Hematological malignancies, Chemotherapy, Nausea and vomiting

Abstract

Background: Chemotherapy is widely used in the treatment of hematological malignancies despite it has important and difficult side effects in patients. Chemotherapy induced nausea and vomiting are among the most common side effects in patients and antiemetic drugs may not be always curative. This research aimed to determine the effectiveness of relaxation breathing exercise on managing chemotherapy induced nausea and vomiting in patients with hematological malignancies undergoing chemotherapy.

Methods: A randomized controlled trial design was conducted with a total of selected sixty-eight patients with hematological malignancies (34 intervention and 34 control participants) undergoing chemotherapy hospitalized in the hematology clinic of a training and research hospital. The intervention group implemented relaxation breathing exercise three times a day with a standard treatment protocol and the control group only received routine drug treatment for chemotherapy induced nausea and vomiting. Nausea and vomiting were assessed by filling Rhodes ındex of nausea vomiting and retching (RINVR) for the first six days after the start of the chemotherapy. Data collection process ended. Data analysis process is in progress.

Conclusions: In this study the effectiveness of relaxation breathing exercise on chemotherapy related nausea and vomiting will be examined in patients with hematological malignancies.

Trial Registration: The study was registered at clinicaltrials. gov.tr (Registration No: NCT07456982).

References

Badr EA, Abdalla HM, Gaafer YA, Kamel MY. Effect of peppermint inhalation versus Swedish massage on chemotherapy induced-nausea and vomiting in children with leukemia: Multi-arm randomised trial. J Pediatr Nurs. 2024;77:140-51.

Haider A, Azhar A. Symptom Management and Palliative Care in Hematologic Malignancies. Manual of Hematopoietic Cell Transplantation and Cellular Therapies. 2024;549-60.

Sheng L, Zhu Y, Liu Y, Hua H, Zhou J, Ye L. Fear of cancer recurrence and associated factors in family caregivers of patients with hematologic malignancy receiving chemotherapy: A latent profile analysis. Asia-Pacific J Oncol Nurs. 2024;11(4):100382. 2

Sommariva S, Pongiglione B, Tarricone R. Impact of chemotherapy-induced nausea and vomiting on health-related quality of life and resource utilization: A systematic review. Crit Rev Oncol/Hematol. 2016;99:13-36.

Esser P, Kuba K, Mehnert A, Johansen C, Hinz A, Lordick F, Gotze H. Quality of life in survivors of hematological malignancies stratified by cancer type, time since diagnosis and stem cell transplantation. Eur J Haematol. 2018;101(3):340-8.

Aapro M. CINV: Still troubling patients after all these years. Supportive Care in Cancer. 2018;26(1):5-9.

Gupta K, Walton R, Kataria SP. Chemotherapy-induced nausea and vomiting: pathogenesis, recommendations, and new trends. Cancer Treat Res Commun. 2021;26(100278):1-8.

Namazinia M, Mazlum SR, Mohajer S, Abdullah KL, Salehian M. Structered laughter yoga therapy program on patients with chemotherapy-induced nausea and vomiting: A randomized clinical trial. Asia-Pacific J Oncol Nurs. 2024;11(1):100337.

Luo S, Zhao H, Gan X, He Y, Wu C, Ying Y. Nomogram model for predicting frailty of patients with hematologic malignancies – A cross-sectional survey. Asia-Pacific J Oncol Nurs. 2023;10(11):100307.

Jordan K, Azambuja E, Barrio MAG, Jahn F, Di Palma M, Scotte F, et al. Going beyond the 2023 MASCC and ESMO guideline update for the prevention of chemotherapy- and radiotherapy-induced nausea and vomiting. Eur J Cancer. 2025;222:115451.

Li MY, Yao LQ, Liu XL, Tan JY, Wang T. Effects of nonpharmacological interventions on symptom clusters in breast cancer survivors: A systematic review of randomized controlled trials. Asia-Pacific J Oncol Nurs. 2024;11(3):100380.

Nelwati N, Noviyani D. The effect of diaphragmatic breathing on nausea, vomiting and functional status among breast cancer patients undergoing chemotherapy. Eur J Oncol Nurs. 2024;70:102548.

Mulhaeriah AY, Achmad EK, Sangkala MS. Effectiveness of relaxation breathing exercise on fatigue in gynecological cancer patients undergoing chemotherapy. Int J Nurs Sci. 2018;5(4):331-5.

Saoji AA, Raghavendra BR, Manjunath NK. Effects of yogic breath regulation: A narrative review of scientific evidence. J Ayurved Integr Med. 2019;10(1):50-8.

Hamasaki H. Effects of Diaphragmatic Breathing on Health: A Narrative Review. Medicines. 2020;7(10):65.

Kim S.D, Kim HS. Effects of a relaxation breathing exercise on fatigue in haemopoietic stem cell transplantation patients. J Clin Nurs. 2005;14(1):51-5.

Aybar DO, Kılıç SP, Çınkır HY. The effect of breathing exercise on nausea, vomiting and functional status in breast cancer patients undergoing chemotherapy. Compl Ther Clin Pract. 2020;40:101213.

Molassiotis A, Aapro M, Dicato M, Gascon P, Novoa SA, Isambert N, et al. Evaluation of risk factors predicting chemotherapy-related nausea and vomiting: results from a European prospective observational study. J Pain Symptom Manag. 2014;47(5):839-48.

Tian X, Tang RY, Xu LL, Xie W, Chen H, Pi YP, et al. Progressive muscle relaxation is effective in preventing and alleviating of chemotherapy-induced nausea and vomiting among cancer patients: a systematic review of six randomized controlled trials. Supportive Care in Cancer. 2020;28(9):4051-8.

Genç F, Tan M. The effect of acupressure application on chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer. Cambridge University Press. Palliative and Supportive Care. 2014;13(2):275-84.

Turan GB, Özer Z, Sariköse A. The effects of progressive muscle relaxation exercise applied to lung cancer patients receiving chemotherapy on dyspnea, pain and sleep quality: A randomized controlled trial. Eur J Oncol Nurs. 2024;70:102580.

Wang H, Kwok WH, Yao L. An evidence-based breathing exercise intervention for chronic pain management in breast cancer survivors: A phase II randomized controlled trial. Eur J Oncol Nurs. 2024;71:102625.

Navari RM. Management of Chemotherapy-Induced Nausea and Vomiting. Focus on Newer Agents and New Uses for Older Agents. Drugs. 2013;73:249-62.

Navari RM. Olanzapine for the prevention and treatment of chronic nausea and chemotherapy-induced nausea and vomiting. Eur J Pharmacol. 2014;722:180-6.

Harris M, Keane M. Random coin tossing. Probability Theory Related Fields. 1997;109:27-37.

Rhodes VA, McDaniel RW. The index of nausea, vomiting, and retching: A new format of the index of nausea and vomiting. Oncol Nurs Forum. 1999;26(5):889-94.

Isenring E, Cross G, Kellett E, Koczwara B, Daniels L. Nutritional Status and İnformation Needs of Medical Oncology Patients Receiving Treatment at an Australian Public Hospital. Nutr Cancer. 2010;62(2):220-8.

Montazeri AS, Raei M, Ghanbari A, Dadgari A, Hamidzadeh A. Effect of Herbal Therapy to Intensity Chemotherapy-Induced Nausea and Vomiting in Cancer Patients. Iran Red Crescent Med J. 2013;15(2):101-6.

Sahebi AE, Elyasi F, Charati JY, Shahhosseini Z. Psychological Interventions for Nausea and Vomiting of Pregnancy: A Systematic Review. Taiwanese J Obstet Gynecol. 2018;57(5):644-9.

Ülger Ö, Yağlı NV. Effects of Yoga on the Quality of Life in Cancer Patients. Complement Ther Clin Pract. 2010;16(2):60-3.