Effects of breathing exercise techniques on the pain and anxiety of burn patients: A systematic review and meta‐analysis

This systematic review and meta‐analysis aim to summarise the effect of breathing exercise techniques (BET) on the pain and anxiety of burn patients during burn care. A systematic search was performed on international electronic databases such as Scopus, PubMed, and Web of Science, as well as on Iranian electronic databases such as Iranmedex and Scientific Information Database (SID) with keywords extracted from Medical Subject Headings such as ‘Burns’, ‘Bandages’, ‘Pain’, ‘Pain management’, ‘Anxiety’, ‘Breathing’, and ‘Breathing exercise’, which were performed from the earliest to 4 April 2022. The Joanna Briggs Institute (JBI) critical appraisal checklist assessed the quality of randomised control trials (RCTs) and quasi‐experimental studies. The current meta‐analysis was performed using STATA V.14.0 software. A 95% confidence interval (CI) was used to determine significance levels. Random effect model was used to calculate the weighted mean difference (WMD). A total of 469 burn patients participated in 10 studies. Exactly 58.60% of burn patients were male, and the number of people in the intervention and control groups was equal. The mean age of burn patients was 32.84 (SD = 10.39). Exactly 78.05% of patients had second‐degree burns. The mean study duration was 19 weeks. Results of analysis of RCT studies showed BET decreased insignificantly pain severity (WMD: −1.17, 95%CI: −2.54 to 0.21, Z = 1.66, P = .096, I (2):97.1%) in the intervention group than control group. However, the results of non‐RCTs studies indicated BET significantly decreased pain (WMD: −1.38, 95%CI: −2.16 to −0.61, Z = 3.49, P < .001, I (2):88.4%) and anxiety (WMD: −4.91, 95%CI: −9.35 to −0.47, Z = 2.71, P = .03 0.001, I (2):88.4%) in the intervention group than control group. Overall, the results of RCTs found BET intervention decreased pain in the intervention group when compared with the control group; however, it was statistically insignificant. Also, results of non‐RCT studies showed intervention of BET significantly decreased pain and anxiety in burns patients. More RCTs studies are required for better judgement of the effectiveness of BET intervention in clinical settings.