BACKGROUND: Chronic kidney disease (CKD) patients undergoing hemodialysis (HD) commonly experience elevated levels of depression, anxiety, and stress. Non-pharmacological interventions, like breathing and physical exercises, may offer psychological benefits. OBJECTIVES: To evaluate the efficacy of diaphragmatic breathing and range of motion exercises on reducing depression, anxiety, and stress in CKD patients on hemodialysis. METHODS: A total of 116 HD patients were randomly assigned to intervention (n = 58) and control (n = 58) groups in a pre-test/post-test design. The Depression Anxiety Stress Scale (DASS-21) was used for assessment. The intervention group received diaphragmatic breathing exercises three times weekly before dialysis and range of motion exercises during dialysis for six weeks. The control group received routine care. Statistical analysis was performed using t-tests. RESULTS: Baseline DASS-21 scores showed no significant difference between groups (intervention: 12.05 +/- 3.39; control: 12.97 +/- 3.51; t 1.424, p = 0.1571). Post-intervention, the intervention group demonstrated significantly lower scores (10.39 +/- 3.91) compared to the control group (13.62 +/- 3.24; t 4.833, p < 0.05). CONCLUSIONS: Diaphragmatic breathing and range of motion exercises significantly reduce depression, anxiety, and stress levels in CKD patients undergoing hemodialysis, supporting their use as effective adjunct therapies.

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