{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:47:08Z","timestamp":1787071628603,"version":"build-2736575974"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 3","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9]]},"abstract":"\n A\n BSTRACT<\/jats:sc>\n <\/jats:title>\n \n Background:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Objectives:<\/jats:title>\n To evaluate the efficacy of diaphragmatic breathing and range of motion exercises on reducing depression, anxiety, and stress in CKD patients on hemodialysis.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n A total of 116 HD patients were randomly assigned to intervention (\n n<\/jats:italic>\n = 58) and control (\n n<\/jats:italic>\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\n t<\/jats:italic>\n -tests.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Baseline DASS-21 scores showed no significant difference between groups (intervention: 12.05 \u00b1 3.39; control: 12.97 \u00b1 3.51;\n t<\/jats:italic>\n = 1.424,\n P<\/jats:italic>\n = 0.1571). Post-intervention, the intervention group demonstrated significantly lower scores (10.39 \u00b1 3.91) compared to the control group (13.62 \u00b1 3.24;\n t<\/jats:italic>\n = 4.833,\n P<\/jats:italic>\n < 0.05).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jpbs.jpbs_916_25","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T16:01:28Z","timestamp":1753372888000},"page":"S2566-S2568","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy of Deep Breathing Exercise and Range of Motion Exercise on Depression, Anxiety, and Stress in Patients with Chronic Kidney Disease Undergoing Hemodialysis"],"prefix":"10.4103","volume":"17","author":[{"given":"Sameer K.","family":"Choudhary","sequence":"first","affiliation":[{"name":"Department of Nursing, Krishna Institute of Nursing Sciences, Krishna Vishwa Vidyapeeth \u201cDeemed to be University\u201d, Satara, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tukaram B.","family":"Zagade","sequence":"additional","affiliation":[{"name":"Department of Nursing, Krishna Institute of Nursing Sciences, Krishna Vishwa Vidyapeeth \u201cDeemed to be University\u201d, Satara, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"R1-20250930","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1186\/s12888-023-05312-8","article-title":"The impact of anxiety and depression on the quality of life of hemodialysis patients in a sample from Somalia","volume":"23","author":"Mohamed","year":"2023","journal-title":"BMC Psychiatry"},{"key":"R2-20250930","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1080\/0886022X.2022.2077761","article-title":"Prevalence of depression and anxiety and their predictors among patients undergoing maintenance hemodialysis in Northern China:A cross-sectional study","volume":"44","author":"Meng","year":"2022","journal-title":"Ren Fail"},{"key":"R3-20250930","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s41100-021-00331-1","article-title":"Depression among end-stage renal disease patients undergoing hemodialysis:A cross-sectional study from Palestine","volume":"7","author":"Al-Jabi","year":"2021","journal-title":"Ren Replace Ther"},{"key":"R4-20250930","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1590\/1516-3180.2018.0272280119","article-title":"Depression and anxiety among patients undergoing dialysis and kidney transplantation:A cross-sectional study","volume":"137","author":"Brito","year":"2019","journal-title":"Sao Paulo Med J"},{"key":"R5-20250930","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.comppsych.2010.10.009","article-title":"Factors associated with risk of suicide in patients with hemodialysis","volume":"52","author":"Martiny","year":"2011","journal-title":"Compr Psychiatry"},{"key":"R6-20250930","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1186\/s40359-021-00678-4","article-title":"The impact of stress management training on stress-related coping strategies and self-efficacy in hemodialysis patients:A randomized controlled clinical trial","volume":"9","author":"Bahraseman","year":"2021","journal-title":"BMC Psychol"},{"key":"R7-20250930","first-page":"11","article-title":"Intradialytic exercise:A feasibility study","volume":"6","author":"Henson","year":"2010","journal-title":"Ren Soc Australas J"},{"key":"R8-20250930","doi-asserted-by":"crossref","first-page":"85","DOI":"10.11113\/sh.v13n2-3.1920","article-title":"Anxiety and depression in chronic kidney disease (CKD) patients in the initial phase of hemodialysis therapy","volume":"13","author":"Suparti","year":"2021","journal-title":"Sains Humanika"},{"key":"R9-20250930","first-page":"1855","article-title":"Effectiveness of physical activity on depression, anxiety, stress and quality of life of patients on hemodialysis","volume":"29","author":"Samson","year":"2018","journal-title":"Biomed Res"}],"container-title":["Journal of Pharmacy and Bioallied Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jpbs.jpbs_916_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:49:51Z","timestamp":1787068191000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jpbs.jpbs_916_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,24]]},"references-count":9,"journal-issue":{"issue":"Suppl 3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jpbs.jpbs_916_25","relation":{},"ISSN":["0976-4879","0975-7406"],"issn-type":[{"value":"0976-4879","type":"print"},{"value":"0975-7406","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,24]]},"assertion":[{"value":"2025-05-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-10","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}