The effect of the 4-7-8 breathing technique applied during chemotherapy on anxi ety, symptom load , and sleep quality

This randomized controlled experimental study evaluated the effects of the 4-7-8 breathing technique on anxiety, symptom burden, and sleep quality in patients receiving chemotherapy. The study was conducted between March 2025 and June 2026 at the Gaziantep City Hospital Outpatient Chemotherapy Unit and Oncology 1–2 wards. Based on G*Power analysis, 64 patients were randomly assigned to an experimental group (n=32) and a control group (n=32) using simple randomization. In addition to routine care, the experimental group practiced the 4-7-8 breathing technique twice daily for 21 days. Data were collected using a Demographic Information Form, the State Anxiety Inventory (STAI), the Edmonton Symptom Assessment Scale (ESAS), and the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using IBM SPSS Statistics 22.0. Following the intervention, the experimental group had significantly lower STAI scores than the control group (p=0.016; d=0.62). Total ESAS symptom scores also improved significantly in the experimental group (p=0.009; d=0.67). At the symptom level, fatigue and loss of appetite showed significantly greater improvement in the experimental group than in the control group. Although worry, insomnia, and shortness of breath decreased significantly from baseline in the experimental group, these improvements were not significantly different from those in the control group. PSQI scores improved in both groups, with no significant between-group difference (p=0.889). The findings indicate that the 4-7-8 breathing technique is an effective, low-cost, and easy-to-apply non-pharmacological intervention for reducing anxiety and symptom burden in patients receiving chemotherapy and may be integrated into oncology nursing care.