<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec>
<h3>Objective</h3>
<p>This study aimed to determine the effect of the relaxation breathing exercise (RBE) on fatigue and cortisol levels among Indonesian women with gynecological cancer undergoing chemotherapy.</p>
</sec>
<sec>
<h3>Methods</h3>
<p>This pilot study consecutively recruited 44 gynecological cancer patients to receive RBE (22) or usual care (22). Cortisol level was measured before and after completion of the intervention (day 8). Fatigue was measured using the Piper Fatigue Scale (PFS). Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) at the baseline days of the study for days 1, 4, and 8. The obtained data were analyzed using Fisher’s exact test, the independent <italic>t</italic>-test, and the Mann–Whitney <italic>U</italic> test.</p>
</sec>
<sec>
<h3>Results</h3>
<p>There were significant increases in cortisol levels within the groups, either the intervention or control groups, respectively (<italic>P</italic>-value = 0.0003 and 0.001). Despite there being no statistical significance between the intervention and control groups, there were noticeable differences in the cortisol levels, indicating the extreme increase in cortisol levels in the control group (Median [IQR1– IQR3]: 2.30 [0.99–9.09]; Min–Max: 0.43–23.38) compared with the intervention group (Median [IQR1–IQR3] = 2.97 [1.26–5.18]; Min–Max = 0.39–6.91).</p>
</sec>
<sec>
<h3>Conclusions</h3>
<p>RBE helps prevent a significant increase in cortisol levels that can alleviate fatigue for women with gynecological cancer. Further research was recommended to compare several intervention modalities for fatigue and cancer-related symptom management based on cortisol level changes.</p>
</sec>
</abstract>

Objective
This study aimed to determine the effect of the relaxation breathing exercise (RBE) on fatigue and cortisol levels among Indonesian women with gynecological cancer undergoing chemotherapy.


Methods
This pilot study consecutively recruited 44 gynecological cancer patients to receive RBE (22) or usual care (22). Cortisol level was measured before and after completion of the intervention (day 8). Fatigue was measured using the Piper Fatigue Scale (PFS). Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) at the baseline days of the study for days 1, 4, and 8. The obtained data were analyzed using Fisher’s exact test, the independent t-test, and the Mann–Whitney U test.


Results
There were significant increases in cortisol levels within the groups, either the intervention or control groups, respectively (P-value = 0.0003 and 0.001). Despite there being no statistical significance between the intervention and control groups, there were noticeable differences in the cortisol levels, indicating the extreme increase in cortisol levels in the control group (Median [IQR1– IQR3]: 2.30 [0.99–9.09]; Min–Max: 0.43–23.38) compared with the intervention group (Median [IQR1–IQR3] = 2.97 [1.26–5.18]; Min–Max = 0.39–6.91).


Conclusions
RBE helps prevent a significant increase in cortisol levels that can alleviate fatigue for women with gynecological cancer. Further research was recommended to compare several intervention modalities for fatigue and cancer-related symptom management based on cortisol level changes.

Effects of relaxation breathing exercise on fatigue and cortisol level among Indonesian gynecological cancer patients undergoing chemotherapy: a pilot study<xref ref-type="fn" rid="j_fon-2024-0022_fn_001"><sup>†</sup></xref>

Frontiers of Nursing

This work is licensed under the Creative Commons Attribution 4.0 International License.

Effects of relaxation breathing exercise on fatigue and cortisol level among Indonesian gynecological cancer patients undergoing chemotherapy: a pilot study

Objective
This study aimed to determine the effect of the relaxation breathing exercise (RBE) on fatigue and cortisol levels among Indonesian women with...

Variables	Intervention (n = 17)		Control (n = 16)		P-value
Variables	n	%	n	%	P-value
Age in years (mean, SD)	47.06	8.45	45.31	9.81	0.587
Educational level					1.000
High	10	30.30	10	30.30
Low	7	21.20	6	18.20
Cancer type					0.656
Ovarian	4	12.10	2	6.10
Cervical	13	39.40	14	42.40
Cancer stage					0.296
Early	8	24.20	11	33.30
Advanced	9	27.30	5	15.20
Chemo cycle					1.000
≤3	12	36.40	12	36.40
>3	5	15.10	4	12.10
Regimen					1.000
Platinum	15	45.50	15	45.50
Non-platinum	2	6.00	1	3.00
PFS Score day 1 (mean, SD)	4.29	1.75	3.54	1.68	0.220
HADS day 1 (mean, SD)	1.37	0.29	1.42	0.38	0.622

Variables/groups	Time			P-value	Effect size (ES)
Variables/groups	Day 1 (pretest)	Day 4	Day 8 (posttest)	P-value	Effect size (ES)
PFS Score (mean, SD)
Intervention (n = 17)	4.29 ± 1.75	5.03 ± 1.99	3.52 ± 1.52	0.012*	0.443
Control (n = 16)	3.54 ± 1.68	4.65 ± 2.01	3.57 ± 1.90	0.152	-
HADS Score (mean, SD)
Intervention (n = 17)	1.37 ± 0.29	1.34 ± 0.25	1.28 ± 0.36	0.767	-
Control (n = 16)	1.42 ± 0.38	1.42 ± 0.35	1.46 ± 0.35	0.793	-

Variable	Intervention (n = 17)		Control (n = 16)		P-valuea
Variable	Median (IQR1-IQR3)	Min–Max	Median (IQR1-IQR3)	Min–Max	P-valuea
Cortisol level
Day 1	0.38 (0.31–0.64)	0.25–0.88	0.51 (0.38–0.70)	0.20–2.35	0.15
Day 8	2.97 (1.26–5.18)	0.39–6.91	2.30 (0.99–9.09)	0.43–23.38	0.83
P-value^b	0.0003*		0.001*

Effects of relaxation breathing exercise on fatigue and cortisol level among Indonesian gynecological cancer patients undergoing chemotherapy: a pilot study^†

Article Category: Original article

Pubblicato online: 26 giu 2024

Pagine: 201 - 208

Ricevuto: 20 gen 2024

Accettato: 23 mar 2024

DOI: https://doi.org/10.2478/fon-2024-0022

Parole chiave
anxiety, cortisol, fatigue, gynecological cancer, relaxation breathing exercise

© 2024 Mulhaeriah Mulhaeriah et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

Socio-demographic and medical characteristic bases (n = 33).

Difference in PFS and HADS mean scores within the 2 groups (n = 33).

Comparison of median cortisol level within and between the 2 groups (n = 33).

Effects of relaxation breathing exercise on fatigue and cortisol level among Indonesian gynecological cancer patients undergoing chemotherapy: a pilot study†

Article Category: Original article

Pubblicato online: 26 giu 2024

Pagine: 201 - 208

Ricevuto: 20 gen 2024

Accettato: 23 mar 2024

DOI: https://doi.org/10.2478/fon-2024-0022

Parole chiaveanxiety, cortisol, fatigue, gynecological cancer, relaxation breathing exercise

© 2024 Mulhaeriah Mulhaeriah et al., published by Sciendo

This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

Socio-demographic and medical characteristic bases (n = 33).

Difference in PFS and HADS mean scores within the 2 groups (n = 33).

Comparison of median cortisol level within and between the 2 groups (n = 33).

Effects of relaxation breathing exercise on fatigue and cortisol level among Indonesian gynecological cancer patients undergoing chemotherapy: a pilot study^†

Parole chiave
anxiety, cortisol, fatigue, gynecological cancer, relaxation breathing exercise