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Home-based deep breathing for depression in patients with coronary heart disease: a randomised controlled trial
Chung L, Tsai P, Liu B, Chou K, Lin W, Shyu Y, Wang M
International Journal of Nursing Studies 2010 Nov;47(11):1346-1353
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: The primary aim of this study was to examine the effect of a home-based deep-breathing training programme on depressive symptoms as compared with a control condition (ie, weekly telephone support) in patients with coronary heart disease (CHD). DESIGN: This efficacy trial used a randomised controlled, parallel group design. PARTICIPANTS AND METHODS: A total of 62 CHD patients with a Beck Depression Inventory-II (BDI-II) > 10 were randomised to receive either home-based deep-breathing training (experimental group, n = 28) or weekly telephone support (control group, n = 34). Both participants and data assessors were blinded to the study hypothesis. The primary outcome measure was the change in the self-reported depressive symptom severity, measured by the BDI-II. The secondary outcome was the change in the Patient Health Questionnaure-9 (PHQ-9)-assessed depressive symptom severity. Depressive symptoms were assessed at baseline and post-test in both groups. For the experimental group, depressive symptoms were also assessed at the end of the first 2 weeks of training. RESULTS: The post-test BDI-II and PHQ-9 were significantly lower in the experimental group than in the control group (p < 0.001 and p < 0.001, respectively). The decreases in BDI-II, from baseline, at post-test were significantly greater in the experimental group as compared with the control group (95% confidence interval (CI) -12.554 to -5.408, p < 0.001). Similarly, the pre-test-to-post-test change in PHQ-9 scores was significantly greater in the experimental group as compared with the control group (95% CI -5.59 to -0.092, p = 0.007). Examining the changes in BDI-II and PHQ-9 within the experimental group by the repeated-measures analysis of variance (ANOVA) revealed that both measures of depressive symptoms decreased significantly over time (both p < 0.001). The percentage of participants with a BDI-II >= 17 decreased over time from 28.6% at baseline, and 17.9% during treatment, to 10.7% post-test. CONCLUSIONS: Home-based deep-breathing training is effective in reducing depressive symptoms as compared with telephone support in patients with CHD.
With permission from Excerpta Medica Inc.

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