Chronic obstructive pulmonary disease (COPD) ranks third among the leading causes of death worldwide. It causes a variety of symptoms resulting from irreversible obstruction of the airways. In addition to pharmacological methods, nonpharmacological methods are also used to alleviate these symptoms. A review of the methods used for this purpose reveals that yoga and breathing exercises are among them. Accordingly, the aim of this study is to investigate the effects of pranayama breathing exercises performed to the sound of rain on dyspnea, self-efficacy, and respiratory function in individuals with chronic obstructive pulmonary disease (COPD). The study, designed as a randomized controlled pre-test/post-test trial, will be conducted at the Turgut Özal Medical Center of İnönü University between April 2026 and September 2027 among patients visiting the Pulmonology Outpatient Clinic. The study will consist of two experimental groups and one control group. Prior to the start of the study, informed consent will be obtained from the patients, and the Patient Demographic Form, COPD Self-Efficacy Scale, Dyspnea 12 Severity Scale, Visual Analog Scale, and Pulmonary Function Test will be administered. The intervention will be administered twice daily for 15-20 minutes over a 6-week period. 1. Patients in the experimental group will have a pranayama breathing exercise video and the sound of rain downloaded to their phones so they can practice at home. 2. Patients in the control group will have only the pranayama breathing exercise video downloaded to their phones so they can practice at home. No intervention will be performed on patients in the control group. Throughout the study, patients will receive daily reminder messages urging them to continue the exercises for 6 weeks. At the end of the 6 weeks, patients will be called to the outpatient clinic, where they will complete the COPD Self-Efficacy Scale, the Dyspnea 12 Severity Scale, the Visual Analog Scale, and a pulmonary function test. To be able to administer the pranayama breathing exercise, the researcher will receive training prior to the study. Based on the results of the study, it is believed that, thanks to the ease of practice of pranayama breathing exercises, they can be performed by nurses on the ward and by patients at home, leading to a reduction in their symptoms.
• 18 years of age and older
Diagnosed with COPD at least 6 months prior based on pulmonary function test results
Stage 1 (FEV1 > 80%), Stage 2 (50% ≤ FEV1 < 80%), and Stage 3 (30% ≤ FEV1 < 50%) patients meeting GOLD 2021 criteria
No nasal breathing obstruction
• Those who do not wish to continue the practice
Those who experience difficulties during the practice
Those who begin using any alternative treatment in addition to standard care other than pranayama breathing exercises
Crossover
pranayama breathing exercises
Other interventionNadhi sodhana/Nadhi Shudi, also known as alternate nostril breathing, is used to help calm the nervous system, soothe the mind, reduce stress, and improve concentration. Because it can be applied to different patient groups with various diagnoses and has no complications, Nadhi sodhana Pranayama practice will be conducted. To ensure patients can perform Nadhi sodhana Pranayama correctly and completely, a video demonstrating the practice will be prepared and uploaded to their phones. Additionally, patients will receive a pranayama training and practice guide. In a suitable room, the pranayama practice and its steps will be repeated through explanation and demonstration until the patient learns, and any difficulties will be corrected. Once patients are observed to be performing the practice correctly, they will be asked to practice pranayama breathing exercises twice a day for 15-20 minutes for 6 weeks. The researcher will also send a daily text message reminding them to practice the bre
A group will perform pranayama breathing exercises accompanied by the sound of rain.
Other interventionNadhi sodhana/Nadhi Shudi, also known as alternate nostril breathing, is used to help calm the nervous system, soothe the mind, reduce stress, and improve concentration. Because it can be applied to different patient groups with various diagnoses and has no complications, Nadhi sodhana Pranayama practice will be conducted. To ensure patients can perform Nadhi sodhana Pranayama correctly and completely, a video demonstrating the practice will be prepared and uploaded to their phones. Additionally, patients will receive a pranayama training and practice guide. In a suitable room, the pranayama practice and its steps will be repeated through explanation and demonstration until the patient learns, and any difficulties will be corrected. Once patients are observed to be performing the practice correctly, they will be asked to practice pranayama breathing exercises twice a day for 15-20 minutes for 6 weeks, accompanied by the sound of rain. The researcher will also send a daily text message
COPD Self-Efficacy Scale
COPD Self-Efficacy Scale: The COPD Self-Efficacy Scale was developed by Wigal et al. in 1991. In Turkey, its validity and reliability were established by Kara and Mirci (2002). The COPD Self-Efficacy Scale is a 5-point Likert-type scale consisting of 34 items and 5 sub-dimensions that determine the degree of confidence COPD patients have in managing or avoiding shortness of breath during certain activities. The Negative Impact sub-dimension measures the degree of confidence in managing shortness of breath in stressful situations. The Emotional State sub-dimension determines the degree of confidence in coping with shortness of breath in situations of anger, fear, and life-related distress. The Physical Effort sub-dimension measures the level of ability to manage shortness of breath during physical activities such as climbing stairs very quickly and walking. The Weather/Environmental Conditions sub-dimension evaluates coping with situations that may cause shortness of breath, such as co
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