Highlights
- •Healthcare intervention requires evidence-based practice.
- •The development process of an evidence-based breathing exercise intervention protocol for chronic pain management following the MRC framework has been thoroughly reported.
- •The study provided an example for other researchers in the development of healthcare intervention.
- •This developed breathing exercise intervention protocol will be further evaluated in future clinical studies.
Abstract
Background
Breathing exercise has been utilized as a promising approach to pain management in
cancer survivors. However, the development process of the breathing exercise intervention
protocol was rarely reported.
Aim
To develop an evidence-based breathing exercise intervention protocol for chronic
pain management in breast cancer survivors and to provide a detailed account of the
intervention development process.
Methods
The study design was guided by the Medical Research Council Framework for Developing
and Evaluating Complex Intervention. The breathing exercise intervention development
process adopted phase one of the Medical Research Council Framework for Developing
and Evaluating Complex Intervention framework. The content validity index was applied
to determine the consensus of the appropriateness of the breathing exercise intervention
protocol among the panel experts.
Results
The preliminary breathing exercise intervention protocol was developed based on fight-or-flight
theory and vagus nerve theory, and the best available research evidence identified
from seven systematic reviews, three clinical trials, and four practice recommendations.
The breathing exercise intervention was designed as slow deep pursed-lip breathing
with a time ratio of inspiration to expiration 1:2-3. The intensity of the breathing
exercise was determined as 3 to 5 sessions a day, 5 minutes per session, for 4 weeks.
The content validity of the breathing exercise intervention protocol was excellent
as consensus was achieved among all panel experts with both the item-level and scale-level
CVIs reaching 1.0.
Conclusions
This study developed an evidence-based breathing exercise intervention protocol for
chronic pain management in breast cancer survivors. The protocol is well-supported
by the relevant theories, research evidence, practice recommendations, and experts’
consensus.
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Article info
Publication history
Published online: November 15, 2022
Accepted:
September 24,
2022
Received in revised form:
August 16,
2022
Received:
May 6,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
