[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100655123":3},{"organization":4,"outcomesModule":7,"designInfo":36,"detailedDescription":42,"studyPopulation":35,"armGroups":43,"interventions":54,"overallOfficials":60,"centralContacts":64,"locations":72,"responsibleParty":88,"collaborators":35,"id":91,"slug":92,"hasResults":93,"nctId":94,"briefTitle":95,"officialTitle":96,"acronym":35,"eligibilityCriteria":97,"healthyVolunteers":93,"sex":98,"minAge":99,"maxAge":35,"enrollmentInfo":100,"targetDuration":35,"studyType":103,"phases":104,"briefSummary":106,"conditions":107,"keywords":109,"overallStatus":117,"whyStopped":35,"lastUpdateSubmitDate":118,"lastUpdatePostDateStruct":119,"startDateStruct":122,"completionDateStruct":124,"leadSponsor":126,"locationsCount":127},{"fullName":5,"class":6},"Mersin University","OTHER",{"primaryOutcomes":8,"secondaryOutcomes":13,"otherOutcomes":35},[9],{"measure":10,"description":11,"timeFrame":12},"Pain Intensity","Pain intensity will be assessed using a 10-cm Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst possible pain). Higher scores indicate greater pain intensity.","Before the intervention, immediately after chest tube removal, and 5, 15, and 30 minutes after chest tube removal.",[14,17,20,23,26,29,32],{"measure":15,"description":16,"timeFrame":12},"Anxiety Level","Anxiety will be assessed using the 10-cm Visual Analog Scale for Anxiety (VAS-A), ranging from 0 (no anxiety) to 10 (highest possible anxiety). Higher scores indicate greater anxiety.",{"measure":18,"description":19,"timeFrame":12},"Dyspnea Level","Dyspnea will be assessed using the 10-cm Visual Analog Scale for Dyspnea (VAS-D), ranging from 0 (no dyspnea) to 10 (worst imaginable dyspnea). Higher scores indicate greater dyspnea.",{"measure":21,"description":22,"timeFrame":12},"Systolic Blood Pressure","Systolic blood pressure will be measured using a bedside patient monitor and recorded in millimeters of mercury (mmHg).",{"measure":24,"description":25,"timeFrame":12},"Diastolic Blood Pressure","Diastolic blood pressure will be measured using a bedside patient monitor and recorded in millimeters of mercury (mmHg).",{"measure":27,"description":28,"timeFrame":12},"Heart Rate","Heart rate will be measured using a bedside patient monitor and recorded as beats per minute (beats\u002Fmin).",{"measure":30,"description":31,"timeFrame":12},"Respiratory Rate","Respiratory rate will be assessed by the researcher by observing and counting chest movements for one minute and will be recorded as breaths per minute.",{"measure":33,"description":34,"timeFrame":12},"Peripheral Oxygen Saturation (SpO2)","Peripheral oxygen saturation (SpO2) will be measured using a bedside patient monitor and recorded as a percentage (%).",null,{"allocation":37,"interventionModel":38,"interventionModelDescription":35,"primaryPurpose":39,"observationalModel":35,"timePerspective":35,"maskingInfo":40},"RANDOMIZED","PARALLEL","SUPPORTIVE_CARE",{"masking":41,"maskingDescription":35,"whoMasked":35},"NONE","Chest tube removal is a routine procedure following open-heart surgery; however, it may cause pain, anxiety, dyspnea, and changes in hemodynamic parameters. Nonpharmacological interventions that are simple, safe, and easy to apply may contribute to symptom management during this procedure.\n\nThis prospective, two-arm, parallel-group randomized controlled trial will evaluate the effects of box breathing performed before chest tube removal in patients undergoing open-heart surgery. A total of 86 eligible patients will be randomly assigned in a 1:1 ratio to the intervention group (n=43) or control group (n=43) using block randomization.\n\nParticipants assigned to the intervention group will receive routine care and perform the box breathing technique approximately five minutes before chest tube removal. The technique consists of four phases of equal duration: inhaling for 4 seconds, holding the breath for 4 seconds, exhaling for 4 seconds, and holding after exhalation for 4 seconds. Participants will perform 15 consecutive cycles for approximately five minutes under the verbal guidance of the researcher. The exercise will be completed immediately before chest tube removal. Participants in the control group will receive routine clinical care without an additional nonpharmacological intervention.\n\nPain intensity will be assessed using the Visual Analog Scale (VAS), anxiety using the Visual Analog Scale for Anxiety (VAS-A), and dyspnea using the Visual Analog Scale for Dyspnea (VAS-D). Hemodynamic parameters will include systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, and peripheral oxygen saturation (SpO2).\n\nAssessments will be performed at five time points: before the box breathing intervention (T0), immediately after chest tube removal (T1), and at 5 minutes (T2), 15 minutes (T3), and 30 minutes (T4) after chest tube removal. Both groups will continue to receive routine medical treatment and nursing care throughout the study.\n\nThe primary outcome is pain intensity associated with chest tube removal. Secondary outcomes are anxiety, dyspnea, systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, and peripheral oxygen saturation.",[44,50],{"label":45,"type":46,"description":47,"interventionNames":48},"Box Breathing Group","EXPERIMENTAL","Participants in this group will perform the box breathing technique in addition to routine care. Approximately five minutes before chest tube removal, participants will perform 15 cycles of the 4-4-4-4 box breathing technique, consisting of inhaling for 4 seconds, holding the breath for 4 seconds, exhaling for 4 seconds, and holding after exhalation for 4 seconds.",[49],"Behavioral: Box breathing",{"label":51,"type":52,"description":53,"interventionNames":35},"Control Group","NO_INTERVENTION","Participants in this group will receive routine medical treatment and nursing care without any additional nonpharmacological intervention related to chest tube removal.",[55],{"type":56,"name":57,"description":58,"armGroupLabels":59,"otherNames":35},"BEHAVIORAL","Box breathing","Participants will perform the 4-4-4-4 box breathing technique approximately five minutes before chest tube removal. The technique consists of inhaling through the nose for 4 seconds, holding the breath for 4 seconds, exhaling for 4 seconds, and holding after exhalation for 4 seconds. Participants will perform 15 consecutive cycles for approximately five minutes under the verbal guidance of the researcher. The intervention will be completed immediately before chest tube removal. Routine medical treatment and nursing care will continue throughout the intervention.",[45],[61],{"name":62,"affiliation":5,"role":63},"Tuğba ÇAM YANIK","PRINCIPAL_INVESTIGATOR",[65,70],{"name":66,"role":67,"phone":68,"phoneExt":35,"email":69},"Tuğba ÇAM YANIK, PHD","CONTACT","05067703216","tugbacam@mersin.edu.tr",{"name":71,"role":67,"phone":68,"phoneExt":35,"email":69},"TUGBA ÇAM YANIK, PHD, RN",[73],{"facility":74,"status":35,"city":75,"state":76,"zip":77,"country":78,"countryCode":35,"cosmosGeoPoint":79,"geoPoint":84,"contacts":85},"Turkey, Mersin University Hospital","Yenişehir","Mersin","33120","Turkey (Türkiye)",{"type":80,"coordinates":81},"Point",[82,83],34.56667,36.8,{"lat":83,"lon":82},[86],{"name":87,"role":67,"phone":68,"phoneExt":35,"email":69},"Tuğba ÇAM YANIK, PhD",{"type":63,"investigatorFullName":89,"investigatorTitle":90,"investigatorAffiliation":5,"oldNameTitle":35,"oldOrganization":35},"Tugba CAM YANIK","Assistant Professor of Surgical Diseases Nursing","100655123","effect-of-box-breathing-before-chest-tube-removal-after-open-heart-surgery-100655123",false,"NCT07808658","Effect of Box Breathing Before Chest Tube Removal After Open-Heart Surgery","The Effect of Box Breathing Before Chest Tube Removal After Open-Heart Surgery on Pain, Anxiety, Dyspnea, and Hemodynamic Parameters: A Randomized Controlled Trial","Inclusion Criteria:\n\n* Patients who have undergone open-heart surgery and have a chest tube\n* Aged 18 years or older\n* Willing to participate in the study and providing written informed consent\n* Conscious, oriented, and cooperative\n* Able to read and understand Turkish\n* Clinically and hemodynamically stable\n* Having no more than three chest tubes (up to two mediastinal and one thoracic chest tube)\n* No diagnosed psychiatric disorder\n* Not receiving psychiatric medications and\u002For local neuromuscular blocking agents\n\nExclusion Criteria:\n\n* Patients who have not undergone open-heart surgery\n* Unconscious, disoriented, or uncooperative patients\n* Unable to read and understand Turkish\n* Intubated patients\n* Receiving additional analgesic medication other than routine analgesia\n* Receiving local anesthesia at the chest tube insertion site\n* Having four chest tubes (two mediastinal and two thoracic)\n* Unwilling to participate in the study\n* Having a diagnosed psychiatric disorder or mental health condition","ALL","18 Years",{"count":101,"type":102},86,"ESTIMATED","INTERVENTIONAL",[105],"NA","This randomized controlled trial aims to evaluate the effects of box breathing performed before chest tube removal on pain, anxiety, dyspnea, and hemodynamic parameters in patients undergoing open-heart surgery. A total of 86 patients will be randomly assigned in a 1:1 ratio to either the box breathing group or the control group. Participants in the intervention group will perform the 4-4-4-4 box breathing technique for approximately five minutes before chest tube removal in addition to routine care, while participants in the control group will receive routine care only. Pain, anxiety, dyspnea, and hemodynamic parameters will be assessed before and at specified time points after chest tube removal.",[108],"Open-Heart Surgery",[110,111,108,112,113,114,115,116],"Box Breathing","Chest Tube Removal","Pain","Anxiety","Dyspnea","Hemodynamic Parameters","Nonpharmacological Intervention","NOT_YET_RECRUITING","2026-09-10",{"date":120,"type":121},"2026-09-11","ACTUAL",{"date":123,"type":102},"2026-10-01",{"date":125,"type":102},"2027-10-30",{"name":5,"class":6},1]