Benefits of a Holistic Breathing Technique in Patients on Hemodialysis

Headnote

Copyright 2011 American Nephrology Nurses' Association

Stanley, R., Leither, T.W., & Sindelir, C. (2011). Benefits of a holistic breathing technique in patients on hemodialysis. Nephrology Nursing Journal, 38(2), 149-153.

Health-related quality of life and heart rate variability are often depressed in patients on hemodialysis. This pilot program used a simple holistic, self-directed breathing technique designed to improve heart rate variability, with the hypothesis that improving heart rate variability would subsequently enhance health-related quality of life. Patient self-reported benefits included reductions in anxiety, fatigue, insomnia, and pain. Using holistic physiologic techniques may offer a unique and alternative tool for nurses to help increase health-related quality of life in patients on hemodialysis.

Goal

To provide an overview of the benefits of a holistic breathing technique for patients with end stage renal disease on hemodialysis.

Objectives

1. Identify impairments to health-related quality of life in patients with end stage renal disease on hemodialysis.

2. Explain the process of a simple holistic, self-directed breathing technique.

Health-related quality of life (HRQOL) may be the single most important outcome for patients undergoing chronic hemodialysis. Patients with end stage renal disease (ESRD) suffer significant impairments in HRQOL (Weisbord & Kimmel, 2008) related to physical symptoms (Morsch, Gonclaves, & Barros, 2006), fatigue (Jhamb, Weisbord, Steel, & Unruh, 2008), sleep disorders (Koch, Nagtegaal, Kerkhof, & ter Wee, 2009; Kosmadakis & Medcalf, 2008), depression (Chilcot, Wellsted, Silva- Gane, & Farrington, 2008; Kimmel & Peterson, 2005), and psychosocial issues (Lew & Patel, 2007). Although improved HRQOL has been independently associated with lower risk for hospitalization, mortality, and morbidity, there remains a paucity of simple or effective interventions to consistently improve overall well being and HRQOL in this population. Heart rate variability (HRV) is a suspected marker of autonomic nervous system (ANS) flexibility and function. Low HRV is associated with poor outcomes in many disease states (Lehrer, 2007). HRV is markedly reduced in the ESRD population (Ranpuria, Hall, Chan, & Unruh, 2008). The goal of this pilot study was to determine if a simple holistic breathing technique known to improve HRV would have a beneficial impact on patient-reported HRQOL.

Methods

Two-hundred seventy-four (274) patients with ESRD from nine outpatient hemodialysis units were screened by social workers and charge nurses for eligibility in the pilot study. Patients...