The Effect of Deep Breathing Exercise and 4–7-8 Breathing Techniques Applied to Patients After Bariatric Surgery on Anxiety and Quality of Life

Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature

“…Thus, human-guided training does not appear necessary beyond the first session, after which breathing practices can be carried out individually at home. Nonetheless, interventions incorporating at-home practices should motivate and assess practice compliance, as our three ineffec-tive interventions with at-home practice [39,50] reported either inconsistent or unknown practice compliance.…”

“…Although 41 of the 44 effective multi-session interventions included at least one human-guided session, having multiple sessions alone appears to support breath practice effectiveness. Three of the four effective unguided interventions included multiple sessions [39,80,106]; and significant associations between effectiveness, intervention duration, and number of sessions suggest that breathing practices are more beneficial when performed repeatedly. Nevertheless, some single-session interventions were, in fact, effective, with 10 of 23 providing stress reduction benefits.…”

“…Among these, however, four incorporated no core component, and the remaining two included other factors that may have influenced effectiveness. Regarding the latter, stress reduction may have also been hindered by fast-only breathing in Watson and colleague's intervention and by the discomfort of doing deep diaphragmatic breathing after abdominal surgery in Aktas and colleagues' intervention [39,105]. The presence of core components in the three effective interventions [39,105,106] suggests that such short sessions may be particularly sensitive to practice implementation, such that human guidance, multiple sessions, or long-term practice are required for effective stress reduction.…”

“…In some cases, lack of human-guided training may be made up for by multiple sessions that allow participants to learn these nuances themselves over time. Of the four effective interventions that lacked such training, three included multiple sessions [39,80,106], and the other [79] may have incorporated some unreported and unintentional human guidance due to the investigator's presence during the practice.…”

“…Although existing literature confirms the widespread benefits of slow breathing practices for stress/anxiety reduction [23][24][25][35][36][37][38], null or negative results are reported in some studies [39][40][41][42][43][44][45][46][47][48][49][50]. Discerning the distinguishing features between effective and ineffective interventions is of interest.…”