الفهرس 
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Abstract
Summary
Bronchial asthma is one of the most prevalent chronic inflammatory disorders of the airway. It negatively affects patients, their families and the community, represents a major economic and social burden both in developed and developing countries. Improved self-management of asthma relies upon several behavioral factors that may be influenced by asthma self-efficacy, which reflects a patient’s confidence in their ability to carry out the necessary self-management behaviors required to control asthma symptoms and prevent exacerbations (Mandhana, 2022).
Buteyko method is a combination therapy or alternative that promotes the use of breathing exercises primarily as a treatment for asthma and other respiratory conditions. It mainly focuses on breathing through nose, holding of breath and relaxation (Hunter et al., 2019). Nurses play an important role in evaluating and systematically reviewing how well patients manage their condition. A nurse can apply a variety of skills to develop care and management regimes that are appropriate for each individual patient (Rixsi& Alikulovа, 2022).
Aim of the study
The present study was conducted to fulfill the following aim to assess the effect of buteyko breathing technique on Symptoms Burden and Self-efficacy for Patients with Bronchial Asthma through the following:
• Assessing symptoms burden and self-efficacy for patients with bronchial asthma.
• Appling of buteyko breathing technique for patients with bronchial asthma.
• Evaluating the effectiveness of buteyko breathing technique on symptom burden, and self-efficacy for patients with bronchial asthma.
Research hypotheses:
This study hypothesized that;
1- The Buteyko breathing technique will relieve Symptoms Burden for patients with bronchial asthma.
2- The Buteyko breathing technique will improve self-efficacy for patients with bronchial asthma.
Subjects and Method:
Study design
A Quasi-experimental research design was used to conduct this study.
Setting
This study was conducted at chest department at Ain Shams University Hospital affiliated to Ain Shams University Cairo, Egypt.
Subjects
Purposive sample of (40) patients with bronchial asthma (study group) selected according to certain criteria.
Tools of data collection:
1) Asthma patients, interview questionnaire
It was developed by the researcher in Arabic language and it included three parts: Part (1) Patients’ demographic characteristics assessment, Part (2): Patients clinical data assessment and Part (3) Patients’ knowledge assessment.
2) Asthma control questionnaire (ACQ)
It was adapted from (Juniper.1999; Jia et al., 2013; Alpizar et al., 2021; American thoracic socity, 2022). The ACQ assesses 5 items.
3) Severity of bronchial asthma symptoms assessment questionnaire
It was developed and designed in English language by (Dupont et al., 1998; Fitzpatrick et al., 2020). It assesses 6items.
4) Dyspnea -12 questionnaire
This tool adopted from (Yorke et al., 2011). It provides an overall score for breathlessness severity that incorporates seven physical items and five affective items.
5) Fatigue symptoms inventory
This tool adapted from (Hann et al., 2000). It includes 12-items.
6) Perceived control asthma questionnaire
This tool adopted from (Katz et al., 1997; Burgess, 2015; Courtney et al., 2019). Is an 11 item questionnaire.
Results:
The results of the study showed that:
• In relation to age, the mean ± SD of age of the studied patients was 43.75 ± 14.58 years.
• Females were more prevalent and constituted 55.0% of the studied patients.
• 60% of the studied patients live in urban areas.
• 67.5% of the studied patients were diagnosed with bronchial asthma ≥ 5 years with mean ± SD 9.91 ± 3.07 years and 72.5% of them use nebulizer.
• 57.5% of the studied patients were nonsmokers.
• 65.0% of the studied patients had satisfactory level of total knowledge regarding bronchial asthma.
• There was a highly statistically significant improvement in patients’ total severity of fatigue symptoms, dyspnea severity and increasing in perceived control of asthma symptoms after compared pre and post implementation BBT with p value (P < 0.01).
• There was a highly statistically significant reduction in asthma severity and increasing in asthma control between pre and post implementation BBT with P-value (P < 0.01).
• All patients’ socio-demographic data had no statistically significant relation with total dyspnea severity and total severity of fatigue symptoms post implementation BBT except age that was statistically significant relation post implementation at P value < 0.05.
• Regarding the relation between socio-demographic data of the studied patients and their total perceived control of asthma symptoms and their total asthma severity this result displayed that, there was no statistically significant relation post implementation at (P= > 0.05).
• There were no statistically significant relation between total asthma control among the studied patients at post-implementation and age, gender, occupation, monthly income and residence.
• There were highly statistically significant positive correlation between patients’ severity of fatigue symptoms, total dyspnea severity and total asthma severity at pre and post implementation.
• Also, there were highly statistically significant positive correlation between patients’ total perceived control of asthma symptoms and total asthma control at pre and post implementation at p < 0.01.
• There were highly statistically significant negative correlation between patients’ total perceived control of asthma symptoms, total asthma control and at pre and their total patients’ severity of fatigue symptoms, total dyspnea severity and total asthma severity post implementation at p < 0.01.
Conclusion:
Based on the findings of the present study, it can be concluded that:
The results of the current study supported all hypotheses. There was a positive effect for practicing BBT on improving total asthma severity, dyspnea level, total asthma control, total fatigue level, and self-efficacy for patients with bronchial asthma. As there was a statistically significant improvement of daily Asthma Control, Asthma severity, level of fatigue and patients’ self-efficacy.
Recommendations:
Based on the results of the present study, the following recommendations are suggested:
Application and Early conduction of BBT beside traditional treatment modalities should be provided for patients with asthma as a safe and cost less method of improving symptoms of asthma.
Ongoing and regular educational programs about benefits and how to apply BBT for asthmatic patients.
Developed BBT booklet to be distributed in all chest departments and should be available for all asthmatic patient admitted to chest department.
Further research studies are needed to focus on studying new modalities to reduce symptoms of asthma and decrease use of asthma medications as possible.
Replication of the current study on a larger probability sample to obtain more generalized findings in relation to this problem.