{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:01:40Z","timestamp":1780635700229,"version":"3.54.1"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,10,18]],"date-time":"2013-10-18T00:00:00Z","timestamp":1382054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Caring Sciences"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:p>Chronic stress is among the most common diagnoses in <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>weden, most commonly in the form of exhaustion syndrome (<jats:styled-content style=\"fixed-case\">ICD<\/jats:styled-content>\u201010 classification \u2013 F43.8). The majority of patients with this syndrome also have disturbed breathing (hyperventilation). The aim of this study was to investigate the association between hyperventilation and exhaustion syndrome. Thirty patients with exhaustion syndrome and 14 healthy subjects were evaluated with the <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>ijmegen <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>ymptom <jats:styled-content style=\"fixed-case\">Q<\/jats:styled-content>uestionnaire (<jats:styled-content style=\"fixed-case\">NQ<\/jats:styled-content>). The participants completed questionnaires about exhaustion, mental state, sleep disturbance, pain and quality of life. The evaluation was repeated 4\u00a0weeks later, after half of the patients and healthy subjects had engaged in a therapy method called \u2018<jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>rounding\u2019, a physical exercise inspired by African dance. The patients reported significantly higher levels of hyperventilation as compared to the healthy subjects. All patients\u2019 average score on <jats:styled-content style=\"fixed-case\">NQ<\/jats:styled-content> was 26.57\u00a0\u00b1\u00a010.98, while that of the healthy subjects was 15.14\u00a0\u00b1\u00a07.89 (<jats:italic>t<\/jats:italic>\u00a0=\u00a0\u22123.48, df\u00a0=\u00a042, p\u00a0&lt;\u00a00.001). The <jats:styled-content style=\"fixed-case\">NQ<\/jats:styled-content> scores correlated strongly with two measures of exhaustion (<jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>arolinska <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>xhaustion <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>cale <jats:styled-content style=\"fixed-case\">KES <\/jats:styled-content><jats:italic>r<\/jats:italic>\u00a0=\u00a00.772, p\u00a0&lt;\u00a00.01; <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>hirom <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>elamed <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>urnout <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>easure <jats:styled-content style=\"fixed-case\">SMBM <\/jats:styled-content><jats:italic>r<\/jats:italic>\u00a0=\u00a00.565, p\u00a0&lt;\u00a00.01), mental status [Hospital Anxiety and Depression Score (HADS) depression <jats:italic>r<\/jats:italic>\u00a0=\u00a00.414, p\u00a0&lt;\u00a00.01; HADS anxiety <jats:italic>r<\/jats:italic>\u00a0=\u00a00.627, p\u00a0&lt;\u00a00.01], sleep disturbances (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.514, p\u00a0&lt;\u00a00.01), pain (<jats:italic>r<\/jats:italic>\u00a0=\u00a0\u2212.370, p\u00a0&lt;\u00a00.05) and poor well\u2010being (<jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>edical <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>utcomes <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>urvey <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>hort <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>orm 36 questionnaire\u2010 <jats:styled-content style=\"fixed-case\">SR<\/jats:styled-content> Health <jats:italic>r<\/jats:italic>\u00a0=\u00a0\u22120.529, p\u00a0&lt;\u00a00.05). In the logistic regression analysis, the variance in the scores from <jats:styled-content style=\"fixed-case\">NQ<\/jats:styled-content> were explained to a high degree (<jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.752) by scores in <jats:styled-content style=\"fixed-case\">KES<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">HADS<\/jats:styled-content>. The brief Grounding training contributed to a near significant reduction in hyperventilation (<jats:italic>F<\/jats:italic>\u00a0=\u00a02.521, p\u00a0&lt;\u00a00.124) and to significant reductions in exhaustion scores and scores of depression and anxiety. The conclusion is that hyperventilation is common in exhaustion syndrome patients and that it can be reduced by systematic physical therapy such as <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>rounding.<\/jats:p>","DOI":"10.1111\/scs.12090","type":"journal-article","created":{"date-parts":[[2013,10,18]],"date-time":"2013-10-18T11:19:46Z","timestamp":1382095186000},"page":"657-664","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Hyperventilation and exhaustion syndrome"],"prefix":"10.1111","volume":"28","author":[{"given":"Heli","family":"Ristiniemi","sequence":"first","affiliation":[{"name":"Stress Clinic Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksander","family":"Perski","sequence":"additional","affiliation":[{"name":"Stress Research Institute Stockholm University Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugene","family":"Lyskov","sequence":"additional","affiliation":[{"name":"The Centre for Musculoskeletal Research G\u00e4vle University G\u00e4vle Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margareta","family":"Emtner","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Neuroscience Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,10,18]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Swedish National Social Insurance Board.2012 http:\/\/www.fk.se(last accessed 15 September 2012)."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1108\/13620430910966406"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1037\/10474-012"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/08964289.1992.9935172"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.132.3.327"},{"key":"e_1_2_8_7_1","volume-title":"The Burnout Companion to Study and Practice: A Critical Analysis","author":"Schaufeli W","year":"1998"},{"key":"e_1_2_8_8_1","volume-title":"Utmattningssyndrom\u2013 Stressrelaterad Psykisk Oh\u00e4lsa","author":"Socialstyrelsen","year":"2003"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0b013e318222b1dc"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-0417"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2008.04743.x"},{"key":"e_1_2_8_12_1","first-page":"1295","article-title":"Behandling av l\u00e5ngtidssjukskrivna patienter med stressdiagnoser \u2013 Resultat fr\u00e5n en interventionsstudie (Treatment of patients on long\u2010term sick leave because of stress\u2010related problems. 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