NON-PHARMACOLOGICAL MANAGEMENT OF CHF PATIENTS USING A COMBINATION OF ALTERNATE NOSTRIL BREATHING EXERCISES AND THE SEMI FOWLER POSITION TO IMPROVE RESPIRATORY PATTERNS
DOI:
https://doi.org/10.47701/c32n4d85Keywords:
Alternate Nostril Breathing Exercise, Semi-Fowler Position, Non-Pharmacological Management, Breathing Pattern, Congestive Heart Failure (CHF)Abstract
Congestive Heart Failure (CHF) is a clinical condition in which the heart is unable to pump enough blood to meet the metabolic needs of the body. The most common clinical manifestations in CHF patients are abnormal breathing patterns, including shortness of breath and increased respiratory rate due to excessive pulmonary blood volume and decreased ventilation efficiency. A non-pharmacological management approach that can be applied to improve the breathing pattern of CHF patients is the practice of Alternate Nostril Breathing combined with a semi Fowler's position. The aim of this study is to determine the effectiveness of Alternate Nostril Breathing and the semi-Fowler's position in improving the breathing pattern in CHF patients. The research method used is a Pre Experimental design through a One-Group Pretest-Posttest model with a sample of 35 respondents. The results indicate that H? is rejected and Ha is accepted, leading to the conclusion that the implementation of Alternate Nostril Breathing Exercise with the Semi Fowler position affects changes in the breathing pattern of CHF patients. The conclusion of this study is that the application of Alternate Nostril Breathing Exercise with the Semi Fowler position has a significant effect on changes in the breathing pattern of CHF patients. This intervention can be considered as one of the non-pharmacological complementary therapies in nursing care for CHF patients to improve their breathing patterns.
References
Hinkle, J. L., & Cheever, K. H. (2018). Brunner & Suddarth's textbook of medical-surgical nursing (14th ed.). Wolters Kluwer.
Coppiano, J., Carrasco, M., & Asif, I. (2026). Cardiomyopathy: A guide for primary care. American Family Physician, 113(2).
Malik, A., dkk. (2022). Karakteristik dyspnea dan tekanan darah pasien congestive heart failure. Jurnal Keperawatan Bunda Delima, 8(1). https://journal.bundadelima.ac.id/index.php/jkbd/article/download/276/18
Rahmawati, E., dkk. (2026). Penerapan posisi semi-fowler untuk meningkatkan keefektifan pola napas pada pasien congestive heart failure (CHF). Journal of Emergency and Critical Care (JOECY), 4(1). https://joecy.org/index.php/joecy/article/download/9133/7373/26694
Gauer, L. R., Rifaat, A., & Foulkrod, A. M. (2025). Heart failure with reduced ejection fraction: Medical management. American Family Physician, 112(2).
Muzaki, A. (2020). Posisi semi fowler untuk meningkatkan saturasi oksigen pada pasien Congestive Heart Failure (CHF) dengan sesak napas. Jurnal Ilmiah Kesehatan, 2(1), 45–52.
Yuliani, Y. (2020). Pengaruh pemberian posisi semi fowler terhadap ekspansi paru dan pola pernapasan pasien gagal jantung. Jurnal Keperawatan, 8(2), 112-118.
Aini, N., Padila, P., & Pratiwi, I. N. (2018). Pengaturan posisi semi fowler terhadap penghematan konsumsi oksigen pasien gagal jantung. Jurnal Keperawatan Silampari, 2(1), 15–28.
Majampoh, S., dkk. (2020). Pengaruh pemberian posisi semi fowler terhadap penurunan derajat sesak napas pada pasien penyakit jantung. Jurnal Keperawatan, 8(2), 34-41.
Anisa, L. K. (2025). Penerapan teknik alternate nostril breathing exercise untuk menurunkan sesak napas pada pasien congestive heart failure di RSUP Dr. Sardjito [Tugas Akhir Ners, Poltekkes Kemenkes Yogyakarta].
Wijayati, S., dkk. (2019). Pengaturan posisi tidur semi fowler terhadap pemenuhan kebutuhan oksigenasi pada pasien kardiopulmonari. Jurnal Ilmiah Keperawatan, 14(2), 85-92.
Villani, G. J. (2023). Alternate nostril breathing: Uses, benefits, & how to practice. Choosing Therapy
Permata, F., dkk. (2021). Penurunan tekanan darah pada pasien hipertensi menggunakan teknik alternate nostril breathing exercise. Jurnal Kesmas Asclepius, 3(2), 60-69.
Sari, D., dkk. (2023). Pengaruh alternate nostril breathing exercise terhadap frekuensi napas pada pasien gangguan sistem pernapasan. Jurnal Keperawatan Ners, 7(1), 112-120.
Lakatta, E. G. (2015). Age-associated changes in cardiovascular structure and function: A fertile milieu for future disease. Heart Failure Reviews, 20(4), 481–497.
Strait, J. B., & Lakatta, E. G. (2012). Aging-associated cardiovascular changes and their relationship to heart failure. Heart Failure Clinics, 8(1), 143–164.
Murda, A., Listyarini, A. D., Aprilia, N., & Dinindya, N. L. (2023). Literature Review: Faktor Yang Berkaitan Dengan Kejadian Congestive Heart Failure (CHF). 2(2), 44–55.
Rahawarin, H. E. F., Irwan, & Jolanda, D. (2025). Karakteristik pasien gagal jantung di Poliklinik Jantung RSUD Dr. M. Haulussy Kota Ambon Maret 2022. Quantum Wellness: Jurnal Ilmu Kesehatan, 2(3), 177–189. https://doi.org/10.62383/quwell.v2i3.2289
Setianingsih, M. P., & Hastuti, Y. D. (2022). Kelelahan pada Pasien Congestive Heart Failure. Holistic Nursing and Health Science, 5(2), 178–187. https://doi.org/10.14710/hnhs.5.2.2022.34-43
Utami, F., & Pratiwi, A. (2021). Gambaran karakteristik personal pada pasien gagal jantung: A narrative review article. Jurnal Ilmu Kesehatan, 5(1), 45–57. http://jurnal.umt.ac.id/index.php/jik/index45
Novitasari, M., Sabri, R., & Huriani, E. (2023). Pengaruh alternate nostril breathing exercise terhadap frekuensi napas pada pasien congestive heart failure. Jurnal Ners, 7(1), 110–115. https://doi.org/10.31004/jn.v7i1.12109
Misyadi, Ardiansyah, F., & Baedlawi, A. (2023). Congestive Heart Failure di Ruang Ruai Rumah Sakit Umum Jurnal Keperawatan Medika. Jurnal Keperawatan Medika, 2(1), 185–191.
Bozkurt, B., Coats, A. J., Tsutsui, H., Abdelhamid, M., Adamopoulos, S., Albert, N., Anker, S. D., Atherton, J., Böhm, M., Butler, J., Drazner, M. H., Felker, G. M., Filippatos, G., Fonarow, G. C., Fiuzat, M., Gomez-Mesa, J. E., Heidenreich, P., Imamura, T., Januzzi, J., … Zieroth, S. (2021). Universal definition and classification of heart failure: A report of the Heart Failure Society of America, Heart Failure Association of the European Society of Cardiology, Japanese Heart Failure Society and Writing Committee of the Universal Definition of Heart Failure. Journal of Cardiac Failure, 27(4), 387–413. https://doi.org/10.1016/j.cardfail.2021.01.022
