Effect of Mindfulness-Based Breathing Exercise Combined with Lavender Aromatherapy on Anxiety and Sleep Quality among Hemodialysis Patients: A Quasi-Experimental Study Open Access

Authors

  • 1 Trisno Yuwono Universitas STRADA Indonesia, Kediri, East Java, Indonesia
  • 2 Agusta Dian Ellina Universitas STRADA Indonesia, Kediri, East Java, Indonesia
  • 3 Joko Prasetyo Universitas STRADA Indonesia, Kediri, East Java, Indonesia
  • 4 Atik Setiawan Wahyuningsih Universitas STRADA Indonesia, Kediri, East Java, Indonesia
  • 5 Agustin Widyowati Universitas STRADA Indonesia, Kediri, East Java, Indonesia

https://doi.org/10.55018/ihc.v12.12 Published: 2025-12-21

Downloads

Abstract

Background: Patients with chronic kidney failure report the sight of blood-filled dialysis tubes, the burden of routine therapy costs, fear of invasive measures, and the uncertainty of recovery triggers their anxiety. This anxiety also carries over into the home, causing difficulty sleeping at night and ongoing feelings of restlessness. Purpose. The Effect of the Combination of Mindfulness based on Breathing Exercise with Lavender Aromatherapy on Anxiety and Sleep Quality in Hemodialysis Patients

Methods: This study employed a quasi-experimental pretest–posttest control-group design and was reported in accordance with the TREND guidelines for non-randomized intervention research. The target population comprised 90 hemodialysis patients at Bhayangkara Kediri Hospital, of whom 40 were selected using purposive sampling. The intervention consisted of a combination of mindfulness-based breathing exercises and lavender aromatherapy, with anxiety and sleep quality as outcome variables. Anxiety was measured using the Self-Rating Anxiety Scale (SAS), and sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), both of which have demonstrated acceptable validity and reliability in prior research. Data analysis included descriptive statistics and the Wilcoxon signed-rank test to determine pre-post differences between intervention and control groups, with a significance level set at p < 0.05.

Result: The general characteristics of respondents were comparable between the intervention and control groups with respect to age, sex, duration of hemodialysis, and comorbid conditions. Specific baseline characteristics related to anxiety levels and sleep disturbances were also similar across groups, indicating initial equivalence. The Wilcoxon signed-rank test showed a statistically significant improvement in anxiety (p < 0.001) and sleep quality (p < 0.001) following the intervention. These findings suggest that combining mindfulness-based breathing exercises with lavender aromatherapy may reduce anxiety and enhance sleep quality among hemodialysis patients.

Conclusion: The combination of mindfulness-based breathing exercises with Lavender Aromatherapy reduces Anxiety and improves Sleep Quality in hemodialysis patients. This intervention is very easy to implement, so it can be used as a nursing intervention in the hemodialysis unit to advance nursing science.

Keywords:

Breathing Exercises, Aromatherapy, Mindfulness, Anxiety, Sleep, Renal Dialysis

References

Alfikrie, F., Purnomo, A., & Selly, R. (2020a). Pengaruh Relaksasi Napas Dalam Terhadap Kecemasan Pada Pasien Gagal Ginjal Kronis Yang Menjalani Hemodialisa. BORNEO NURSING JOURNAL (BNJ), Vol. 2 No.(n1), 18–24. https://doi.org/10.24198/jkp.v3n1.3
Anisah, I. N., & Maliya, A. (2021). Efektivitas Relaksasi Benson Terhadap Kecemasan Pasien Yang Menjalani Hemodialisa. Jurnal Berita Ilmu Keperawatan, 14(1), 57–64.
Arifah, N. N., Yusuf, A., & Kartini, Y. (2019). The Influence of Spiritual Guided Imaginary on Anxiety to Hemodialysis Patients in The Syarifah Ambami Ratu Ebu Bangkalan Regional General Hospital. Surabaya International Health Conference.
Barrett, B., Harden, C. M., Brown, R. L., Coe, C. L., & Irwin, M. R. (2020). Mindfulness meditation and exercise both improve sleep quality: Secondary analysis of a randomized controlled trial of community dwelling adults. Sleep Health, 6(6), 804–813. https://doi.org/10.1016/j.sleh.2020.04.003
Cahyanti, L., & Jamaludin. (2021). Mindfulness Meditasi Meningkatkan Kualitas Tidur Pasien HIV. Jurnal Keperawatan Dan Kesehatan Masyarakat STIKES Cendekia Utama Kudus.
Damanik, H. (2020). Tingkat Kecemasan Pasien Gagal Ginjal Kronik. Jurnal Ilmiah Keperawatan Imelda, 6(1), 80–85.
Davari, H., Ebrahimian, A., Rezayei, S., & Tourdeh, M. (2021). Effect of Lavender Aromatherapy on Sleep Quality and Physiological Indicators in Patients after CABG Surgery: A Clinical Trial Study. Indian Journal of Critical Care Medicine, 25(4), 429–434. https://doi.org/10.5005/jp-journals-10071-23785
Dewanti, G. S., & Supratman. (2020). Relaksasi Otot Progresif Terhadap Tingkat Kecemasan Pada Pasien Hemodialisa. Seminar Nasional Keperawatan Universitas Muhammadiyah Surakarta (SEMNASKEP), 93–98.
Donelli, D., Antonelli, M., Bellinazzi, C., Gensini, G. F., & Firenzuoli, F. (2019). Effects of lavender on anxiety: A systematic review and meta-analysis. In Phytomedicine (Vol. 65). Elsevier GmbH. https://doi.org/10.1016/j.phymed.2019.153099
Haghshenas, M., Assarian, F., Omidi, A., Razaghof, M., & Rahimi, H. (2019). Efficacy of Mindfulness-based Stress Reduction in Hemodialysis Patients with Anxiety and Depression: a randomized, double-blind, parallel-group trial. Electronic Physician, 11(1), 7370–7377. https://doi.org/10.19082/7370
Hayajneh, A. A., Al-Younis, M. O., & Rababa, M. (2024). The effect of a mindfulness intervention (MI) on sleep disturbance (SD) among nurses. Scientific Reports, 14(1), 5084. https://doi.org/10.1038/s41598-024-55748-5
Khoshkhatti, N., Majd, M. A., Bazzazian, S., & Yazdinezhad, A. (2020). The Effectiveness of Mindfulness-Based Cognitive Therapy on Symptoms of Anxiety, Depression and Stress in Renal Patients Under Hemodialysis. Iranian Journal of Nursing Research, 14(6). https://doi.org/10.21859/ijnr-140602
Kurniawan, A. D., Sunarno, I., Miftachul Ulum, M., & Blitar Poltekkes Kemenkes Malang, K. (2022). A Literature Review: The Effect of Giving Lavender Aromatherapy On Sleep Quality In The Elderly. JOSAR, 8(2).
Larasati, R. (2018). Hubungan Dukungan Keluarga Dengan Tingkat Kecemasan Pasien Gagal Ginjal Kronik Yang Menjalani Hemodialisa Di Rumah Sakit Dr Moewardi Surakarta. Unuversitas Muhammadiyah Surakarta.
Listiana, D. (2020). Hubungan Komunikasi Terapeutik Perawat Dengan Tingkat Kecemasan Pada Pasien Yang Menjalani Hemodialisa. Jurnal Keperawatan Muhammadiyah Bengkulu, 08(April), 34–42.
Mahyuvi, T. (2021). Buku Panduan: Intervensi Spiritual Breathing Relaxation dalam menurunkan Skala Kecemasan Penderita Gagal Ginjal Kronik yang mejalani tindakan Hemodialisa (Edisi 1). Lembaga Mutiara Hidup Indonesia.
Mahyuvi, T., & Sari, N. (2023). Overcoming Anxiety Chronic Kidney Failure Patients with Spiritual Mindfulness Intervention: A Case study. Nursing Sciences Journal, 7(2).
Mahyuvi, T., & Sari, N. (2024). Reducing Anxiety in Patients Undergoing Hemodialysis with Spiritual Mindfulness Based On Breathing Exercise. Journal Of Nursing Practice, 7(2), 252–261. https://doi.org/10.30994/jnp.v7i2.385
Mahyuvi, T., & Tukirahmawati, D. (2022). Spiritual Benson Relaxation in Pre-Dialysis Chronic Kidney Failure Patients with Anxiety Problems: Case Study. Journal of Applied Nursing and Health, 4(2). https://doi.org/10.55018/janh.v4i2.109
Nisa, F., Yusuf, A., Diyan Rachmawati, P., Sufyanti Arief, Y., Efendi, F., & Basuki Notobroto, H. (2021). The Effect of Spiritual Mindfulness-Based Cognitive Therapy on Self-Concept and Risk of Depression in Adolescent at Islamic Boarding School. In Journal Of Health Science Community (Vol. 2, Issue 1).
Nursalam, N., Kurniawati, N. D., Putri, I. R. P., & Priyantini, D. (2020). Automatic reminder for fluids management on confidence and compliance with fluid restrictions in hemodialysis patients. Systematic Reviews in Pharmacy, 11(5), 226–233. https://doi.org/10.31838/srp.2020.5.34
Rahmadhani, R. (2022). Effect of lavender aromatherapy on sleep quality and anxiety levels: A review of neurophysiological mechanisms. Journal of Complementary Nursing Care, 5(2), 101–108.
Razzera, B. N., Nickel Adamoli, A., Freitas Ranheiri, M., da Silva Oliveira, M., Maria Pandolfo Feoli, A., & Nunes Razzera, B. (2022). Impacts of mindfulness-based interventions in people under-going hemodialysis: a systematic review. Artigo de Revisão. https://doi.org/10.1590/2175-8239
Rikos, N., Kassotaki, A., Frantzeskaki, C., Fragiadaki, M., Mpalaskas, A., Vasilopoulos, G., & Linardakis, M. (2023). Investigation of Perception of Quality of Life and Psychological Burden of Patients Undergoing Hemodialysis - Quality of Life of Hemodialysis Patients. Nursing Reports.
Rikos, N., Kassotaki, A., Frantzeskaki, C., Fragiadaki, M., Mpalaskas, A., Vasilopoulos, G., & Linardakis, M. (2023). Psychological burden, anxiety, and sleep quality among patients undergoing hemodialysis. Nursing Reports, 13(1), 45–56. https://doi.org/10.3390/nursrep13010005
Riskesdas. (2018). Riset kesehatan dasar. Badan penelitian dan pengembangan kesehatan. Kementrian kesehatan RI.
Rokhyati, Dwidiyanti, M., & Padmasari, S. (2019). Non-Pharmacological Intervention On Stress Levels Of Chronic Kidney Disease Patients That Have Hemodialisa ; Literature Review. Jurnal Ilmu Keperawatan Jiwa, 2(1).
Rusch, H. L., Rosario, M., Levison, L. M., Olivera, A., Livingston, W. S., Wu, T., & Gill, J. M. (2019). The effect of mindfulness meditation on sleep quality: a systematic review and meta‐analysis of randomized controlled trials. Annals of the New York Academy of Sciences, 1445(1), 5–16. https://doi.org/10.1111/nyas.13996
Salsabila, N. (2020). The effect of mindfulness-based breathing exercises on anxiety reduction in patients with chronic kidney disease. Jurnal Keperawatan Klinis Indonesia, 4(1), 22–29.
Sitoresmi, H., Irwan, A. M., & Sjattar, E. L. (2020). Nursing Intervention for Patients With Chronic Renal Failure Who Undergoing Hemodialysis : A Systemtic Review. Jurnal Ilmiah Keperawatan.
Talley, G., & Shelley-Tremblay, J. (2020). The Relationship between Mindfulness and Sleep Quality is Mediated by Emotion Regulation. Psychiatry International, 1(2), 42–66. https://doi.org/10.3390/psychiatryint1020007
Tamarah, E., Soleha, U., Santy, W. H., & Hasina, S. N. (2024). The Effect of Deep Breathing Exercise Therapy Combination of Aromatherapy Based on Orem’s Self Care Theory on Fatigue and Sleep Quality in Chronic Kidney Disease Patients Hemodialysis. Indonesian Journal of Global Health Research, 7(1), 247–256. https://doi.org/10.37287/ijghr.v7i1.4198
Tanoto, W., & Zaenal B., Moch. (2022). Therapy Compliance Level of Chronic Kidney Failure Patients With Hemodialization In The Hemodialization Room. Journal of Applied Nursing and Health, 4(1), 112–129. https://doi.org/10.55018/janh.v4i1.65
Veronica, S. Y., & Dwiningrum, R. (2023). The effect of giving lavender aromatherapy on anxiety level in final stage students of DIII midwifery at Aisyah University of Pringsewu. Jurnal Aisyah : Jurnal Ilmu Kesehatan, 8(S1), 339–342. https://doi.org/10.30604/jika.v8is1.1727
Wiyono, H., & Putra, P. P. (2021). Penurunan Tingkat Kecemasan Melalui Breathing Exercise. Jurnal Ilmu Keperawatan Jiwa, 4, 481–486.
Yonata, A., Islamy, N., Taruna, A., & Pura, L. (2022). Factors Affecting Quality of Life in Hemodialysis Patients. International Journal of General Medicine, Volume 15, 7173–7178. https://doi.org/10.2147/IJGM.S375994

Permission is granted subject to the terms of the License under which the work was published. Permission will be required if your reuse is not covered by the terms of the License.

How to Cite

Yuwono, T., Ellina, A. D. ., Prasetyo, J. ., Wahyuningsih, A. S. ., & Widyowati, A. . (2025). Effect of Mindfulness-Based Breathing Exercise Combined with Lavender Aromatherapy on Anxiety and Sleep Quality among Hemodialysis Patients: A Quasi-Experimental Study. International Journal of Health Concord, 1(2), 42-56. https://doi.org/10.55018/ihc.v12.12

Downloads

Download data is not yet available.

Share.

Scrollspy Example