Deep-Breathing Relaxation as an Adjunct to Acute Pain Management in Patients with Acute Myocardial Infarction: A Two-Patient Case Study in an Intensive Cardiac Care Unit
Abstract
Acute myocardial infarction (AMI) is a cardiovascular emergency frequently accompanied by severe acute chest pain, discomfort, and psychological distress, requiring timely and comprehensive management. Although pharmacological therapy remains central to acute pain management, non-pharmacological interventions may provide complementary support during nursing care. However, evidence describing the practical integration of deep-breathing relaxation into comprehensive pain management for patients with AMI in Indonesian intensive cardiac care settings remains limited. This study aimed to describe the implementation of deep-breathing relaxation as an adjunct to comprehensive pain management and to describe changes in pain intensity and patient comfort among patients with AMI admitted to an Intensive Cardiac Care Unit (ICCU). A descriptive prospective two-patient case study was conducted in the ICCU of Dr. Moh. Soewandhie Regional General Hospital, Surabaya. Two purposively selected patients with AMI and acute pain received routine nursing care, physician-prescribed pharmacological treatment, and deep-breathing relaxation for approximately 10 minutes per session, three times daily for three consecutive days when clinically and hemodynamically stable. Data were collected using the Numeric Rating Scale, nursing assessments, clinical observations, interviews, physical examinations, and medical-record reviews. Both patients demonstrated progressive reductions in pain intensity, with NRS scores decreasing from 9 to 3 in Patient 1 and from 9 to 2 in Patient 2. Reduced nonverbal pain behaviours and improved comfort were also observed. Nevertheless, because the intervention was delivered concurrently with pharmacological therapy and other comprehensive care and no control group was used, the observed improvement cannot be attributed specifically to deep-breathing relaxation. Deep-breathing relaxation may therefore be considered a feasible adjunct to comprehensive pain management in clinically stable patients with AMI. Larger controlled studies with standardized intervention protocols and detailed monitoring of concurrent treatments are required to establish its independent effectiveness and safety.
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References
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