Pursed-Lip Breathing as a Belief-Based Nursing Intervention to Reduce Respiratory Rate in Patients with Pulmonary Tuberculosis: A Narrative Literature Review

Main Article Content

Fernando Da Costa Fernandes
Indah Sri Wahyuningsih
Dwi Heppy Rochmawati
Erna Melastuti

Abstract

Background: Pulmonary tuberculosis remains a major global health concern and is frequently accompanied by increased respiratory rate due to impaired lung function. Non-pharmacological nursing interventions that incorporate patients’ belief systems may enhance physiological and psychological outcomes.


Objective: This review aims to examine the effectiveness of pursed-lip breathing as a belief-based nursing intervention in reducing respiratory rate among patients with pulmonary tuberculosis.


Methods: A narrative literature review was conducted by analyzing studies published between 2020 and 2026. Literature was obtained from PubMed, Google Scholar, ScienceDirect, DOAJ, and Garuda using relevant keywords. Articles were selected based on predefined inclusion criteria, and a total of 7 studies were analyzed using a descriptive approach.


Results: The findings show that pursed-lip breathing consistently contributes to a reduction in respiratory rate by improving ventilation efficiency and prolonging the expiratory phase. When integrated with belief-oriented nursing care, such as spiritual support or culturally relevant practices, patients demonstrated better adherence, reduced anxiety, and more stable breathing patterns. Several studies reported significant improvements in respiratory parameters following the intervention.


Discussion: The effectiveness of pursed-lip breathing is strengthened when aligned with patients’ beliefs, as it addresses both physiological and psychological dimensions of care. This integrative approach supports patient-centered nursing practice and enhances overall therapeutic outcomes.


Conclusion: Pursed-lip breathing, when applied as a belief-based nursing intervention, shows promising potential in reducing respiratory rates among patients with pulmonary tuberculosis, although further rigorous studies are needed to confirm its long-term effectiveness.

Article Details

How to Cite
Fernandes, F. D. C. ., Wahyuningsih, I. S. ., Rochmawati, D. H. ., & Melastuti, E. . (2026). Pursed-Lip Breathing as a Belief-Based Nursing Intervention to Reduce Respiratory Rate in Patients with Pulmonary Tuberculosis: A Narrative Literature Review. International Journal of Pharmaceutical and Bio Medical Science, 6(08), 1231–1237. https://doi.org/10.47191/ijpbms/v6-i8-10
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Articles

References

I. World Health Organization. Tuberculosis. World Heal Organ 2025. https://www.who.int/news-room/fact-sheets/detail/tuberculosis (accessed March 22, 2025).

II. Salsabila S, Patimah I. Implementation of Pursed Lips Breathing Technique on patient with Tuberculosis: Case Study. Nurs Case Insight J 2025;3:9–12. https://doi.org/10.63166/wdjkna51.

III. Abdul Wahid Siokona, Zainar Kasim, Rahmat Hidayat Djalil. Pengaruh Latihan Pursed Lips Breathing Terhadap Respiratory Rate Pada Pasien TB Paru Di Ruangan Anggrek RS TK II Robert Wolter Mongisidi Manado. J Vent 2023;1:270–83. https://doi.org/10.59680/ventilator.v1i4.756.

IV. Afifah Delfia Putri, Nuraeni A. Application of Pursed Lip Breathing Exercises to Reduce Fatigue in Pulmonary Tuberculosis Patients. J Heal Med Nurs 2025;2:63–8. https://doi.org/10.59613/jhmn.v2i2.9.

V. Bhakti Permana, Nunung Nurhayati, Eva Supriatin, Linlin Lindayani. Effect Of Diaphragmatic Breathing And Pocketed Lip Breathing Techniques On The Management Of Breathlessness In Patients Ineffective Respiratory Pattern Disorders With Mycobacterium Tuberculosis (Pulmonary Tuberculosis). J Ilm Keperawatan (Scientific J Nursing) 2021;7:8–17. https://doi.org/10.33023/jikep.v7i3.808.

VI. Wiratama RD, Rochmah AF, Puspita UN, Muhith A, Zahro C, Muthoharoh A, et al. Combination of Tripod Position and Pursed Lip Breathing to Reduce Shortness of Breathing in Patients with Respiratory System Disorders. J Appl Nurs Heal 2024;6:121–7. https://doi.org/10.55018/janh.v6i1.183.

VII. Silvia AB, Kurniasih D, Yulendasari R. Efektivitas posisi semi fowler modifikasi modifikasi pursed lips breathing terhadap peningkatan saturasi oksigen pada pasien tb paru. J Qual Heal Res Case Stud Reports 2024;4:114–22. https://doi.org/10.56922/quilt.v4i2.411.

VIII. Aytaç S, Ovayolu Ö, Dogru S. The effect of breathing exercises on fatigue in tuberculosis patients: a randomized controlled trial. Rev Assoc Med Bras 2024;70. https://doi.org/10.1590/1806-9282.20240888.

IX. Bates ML. Respiratory diseases are whole body diseases: opportunities for growth in respiratory physiology. Am J Physiol Cell Mol Physiol 2021;321:L628–30. https://doi.org/10.1152/ajplung.00326.2021.

X. Stana M, Grambozov B, Gaisberger C, Karner J, Ruznic E, Berchtold J, et al. Carbon Monoxide Diffusing Capacity (DLCO) Correlates with CT Morphology after Chemo-Radio-Immunotherapy for Non-Small Cell Lung Cancer Stage III. Diagnostics 2022;12:1027. https://doi.org/10.3390/diagnostics12051027.

XI. Vuust P, Heggli OA, Friston KJ, Kringelbach ML. Music in the brain. Nat Rev Neurosci 2022;23:287–305. https://doi.org/10.1038/s41583-022-00578-5.

XII. Cai Y, Ren X, Wang J, Ma B, Chen O. Effects of Breathing Exercises in Patients With Chronic Obstructive Pulmonary Disease: A Network Meta-analysis. Arch Phys Med Rehabil 2024;105:558–70. https://doi.org/10.1016/j.apmr.2023.04.014.

XIII. Cazorla S, Busegnies Y, D’Ans P, Héritier M, Poncin W. Breathing Control Exercises Delivered in a Group Setting for Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial. Healthcare 2023;11:877. https://doi.org/10.3390/healthcare11060877.

XIV. Pandini I, Lahdji A, Noviasari NA, Anggraini MT. The Effect of Family Social Support and Self Esteem in Improving the Resilience of Tuberculosis Patients. Media Keperawatan Indones 2022;5:14. https://doi.org/10.26714/mki.5.1.2022.14-21.

XV. Feng X, Gao Y, Hu H, Zhang L, Zhang L, Cui L, et al. The effects of music therapy on patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis. Physiother Theory Pract 2025;41:1478–94. https://doi.org/10.1080/09593985.2024.2420010.

XVI. Cooper KL, Chang E. Implementing a Spiritual Care Subject for Holistic Nursing Practice: A Mixed Method Study. J Holist Nurs 2023;41:233–45. https://doi.org/10.1177/08980101221088081.

XVII. Ribeiro R, Oliveira H, Goes M, Gonçalves C, Dias A, Fonseca C. The Effectiveness of Nursing Rehabilitation Interventions on Self-Care for Older Adults with Respiratory Disorders: A Systematic Review with Meta-Analysis. Int J Environ Res Public Health 2023;20:6422. https://doi.org/10.3390/ijerph20146422.

XVIII. Kader M, Hossain MA, Reddy V, Perera NKP, Rashid M. Effects of short-term breathing exercises on respiratory recovery in patients with COVID-19: a quasi-experimental study. BMC Sports Sci Med Rehabil 2022;14:60. https://doi.org/10.1186/s13102-022-00451-z.