Effectiveness of Progressive Muscle Relaxation as an Effort to Reduce Anxiety in Asthma Patients in Emergency Departments: Implications for Health Policy and Nursing Practice

Maria Kurni Menga; Lenny Gannika

doi:10.61099/jakespol.v1i2.388

Authors

Maria Kurni Menga Department of Nursing, Politeknik Sandi Karsa, South Sulawesi, Indonesia, Indonesia https://orcid.org/0000-0001-5679-3001
Lenny Gannika Department of Nursing, Sam Ratulangi University, Universitas Sam Ratulangi, North Sulawesi, Indonesia, Indonesia https://orcid.org/0000-0003-2172-0077

DOI:

https://doi.org/10.61099/jakespol.v1i2.388

Keywords:

Anxiety, Asthma, Emergency Service, Hospital, Muscle Relaxation, Nursing Care

Abstract

Introduction: Anxiety is a common and clinically significant comorbidity among asthma patients in emergency departments (EDs), potentially worsening respiratory symptoms and complicating management. Non-pharmacological interventions such as Progressive Muscle Relaxation (PMR) remain underutilized in acute care. This study aimed to evaluate the effectiveness of PMR in reducing anxiety among asthma patients in ED settings.

Methods: A quasi-experimental pretest–posttest control group design was employed. The study included 70 adult asthma patients (35 intervention, 35 control) recruited using purposive sampling in an ED setting over three months. The intervention group received a structured 15-minute PMR session in addition to standard care, while the control group received standard care only. Anxiety levels were measured using the State-Trait Anxiety Inventory (STAI). Data were analyzed using paired and independent t-tests, followed by multivariate linear regression to control for potential confounders.

Results: The intervention group demonstrated a significantly greater reduction in anxiety scores compared to the control group (mean difference: -14.2 vs -4.4; p < 0.001). Multivariate analysis confirmed that PMR was an independent predictor of anxiety reduction (β = -9.85; 95% CI: -12.40 to -7.30; p < 0.001), after adjusting for age, sex, and asthma severity. Asthma severity was also significantly associated with anxiety levels (β = 1.75; 95% CI: 0.30 to 3.20; p = 0.018).

Conclusion: PMR is an effective, low-cost, and feasible intervention for reducing anxiety among asthma patients in ED settings. Integrating PMR into emergency nursing protocols may enhance patient-centered care and improve clinical outcomes. Policymakers should consider incorporating non-pharmacological interventions into acute care guidelines to support holistic and sustainable health service delivery.

Downloads

Download data is not yet available.

References

[1] S. Abuhammad, “Celebrating five decades of pediatric nursing progress: Achievements, persistent challenges and future directions,” J. Pediatr. Nurs., vol. 85, pp. 69–74, Nov. 2025, doi: https://doi.org/10.1016/j.pedn.2025.07.007.

[2] J. Baumbusch, I. Sloan Yip, and N. A. Bandara, “Always on duty - Fostering climate resilience in the nursing profession: A discussion paper,” Int. J. Nurs. Stud., vol. 172, p. 105227, 2025, doi: https://doi.org/10.1016/j.ijnurstu.2025.105227.

[3] J. D. Bennetts et al., “Evaluation of a Nurse-Pharmacist Post-Discharge Telehealth Model of Care for People With Heart Failure,” Hear. Lung Circ., 2026, doi: https://doi.org/10.1016/j.hlc.2025.12.025.

[4] V. Binnie and A. N. B. Johnston, “Exploring clinicians’ knowledge and attitudes toward the care needs of complex adult users of an Emergency Department: A descriptive mixed methods study,” Int. Emerg. Nurs., vol. 75, p. 101481, 2024, doi: https://doi.org/10.1016/j.ienj.2024.101481.

[5] L. Y. Choo et al., “Morbidity, mortality, and health outcomes following emergency department visits for fentanyl-related overdoses: A retrospective cohort study,” Drug Alcohol Depend. Reports, vol. 18, p. 100405, 2026, doi: https://doi.org/10.1016/j.dadr.2025.100405.

[6] R. Coleman, B. Snuggs, and S. Jones, “Enhancing nursing education through the implementation of an unfolding case study: Addressing maternal substance use disorders via experiential learning,” Clin. Simul. Nurs., vol. 114, p. 101943, 2026, doi: https://doi.org/10.1016/j.ecns.2026.101943.

[7] M. A. Q. Curley et al., “Call to action: Blueprint for change in acute and critical care nursing,” Nurs. Outlook, vol. 72, no. 6, p. 102271, 2024, doi: https://doi.org/10.1016/j.outlook.2024.102271.

[8] M. M. El-Sayed et al., “Climate change-induced eco-anxiety and asthma control in pediatric patients: A cross-sectional nursing study,” J. Pediatr. Nurs., vol. 85, pp. 285–293, 2025, doi: https://doi.org/10.1016/j.pedn.2025.08.009.

[9] A. J. Gallant et al., “Co-designing interventions to improve emergency department discharge communication with youths, parents and healthcare providers: a process evaluation,” Int. J. Nurs. Stud. Adv., vol. 9, p. 100362, 2025, doi: https://doi.org/10.1016/j.ijnsa.2025.100362.

[10] H. Kemble, M. Foster, J. Blamires, and R. Mowat, “Children and young people’s self-reported experiences of asthma and self-management nursing strategies: An integrative review,” J. Pediatr. Nurs., vol. 77, pp. 212–235, 2024, doi: https://doi.org/10.1016/j.pedn.2024.03.029.

[11] D. Kuhn, L. Lemen, M. Ramirez, K. T. Gleason, O. Mazurenko, and E. Ramly, “Implementing Patient-Reported Measures into Emergency Care Workflows: A Scoping Review,” J. Emerg. Med., vol. 85, pp. 56–84, 2026, doi: https://doi.org/10.1016/j.jemermed.2026.01.018.

[12] D. F. Lillvis et al., “Interpersonal Factors in the Emergency Care of Injured Children and Youth With Special Health Care Needs,” Acad. Pediatr., vol. 25, no. 8, p. 102796, 2025, doi: https://doi.org/10.1016/j.acap.2025.102796.

[13] R. Lyons, “The Nurse Practitioner’s Role in Pediatric Acute Care for Climate-Related Illness,” J. Nurse Pract., vol. 22, no. 2, p. 105665, 2026, doi: https://doi.org/10.1016/j.nurpra.2025.105665.

[14] İ. Yazıcıoğlu, G. Bağçivan, and A. Kolic, “The Cost-Effectiveness of Nursing Interventions in Cancer Care: Systematic Review,” Semin. Oncol. Nurs., vol. 41, no. 4, p. 151907, Aug. 2025, doi: https://doi.org/10.1016/j.soncn.2025.151907.

[15] R. Mackle et al., “Implementing enhanced paediatric asthma care in rural Australia: Qualitative insights from healthcare professionals,” Respir. Med., vol. 249, p. 108444, 2025, doi: https://doi.org/10.1016/j.rmed.2025.108444.

[16] D. Xu, E. Garcia, and G. Arling, “Care Trajectories for a Cohort of First-Time Nursing Home Admissions: A 5-Year Longitudinal Study in Minnesota,” J. Am. Med. Dir. Assoc., vol. 26, no. 12, p. 105885, 2025, doi: https://doi.org/10.1016/j.jamda.2025.105885.

[17] A. Mahmoud, R. Mullen, P. E. Penson, and C. Morecroft, “Patient experiences of their current asthma care and their views toward providing support for patients with asthma in community pharmacy: A Qualitative study,” Explor. Res. Clin. Soc. Pharm., vol. 14, p. 100454, 2024, doi: https://doi.org/10.1016/j.rcsop.2024.100454.

[18] X. Wang, W. T. Chien, and Y. Y. Chong, “Acceptance and Commitment Therapy-based empowerment intervention for asthma management in parent-child dyads: A pilot randomised controlled trial,” Int. J. Nurs. Stud. Adv., vol. 9, p. 100381, 2025, doi: https://doi.org/10.1016/j.ijnsa.2025.100381.

[19] H. Martínez-Barros et al., “[Translated article] Designing a patient onboarding in a multidisciplinary severe asthma unit,” Farm. Hosp., vol. 50, no. 1, pp. T16–T22, 2026, doi: https://doi.org/10.1016/j.farma.2025.10.009.

[20] M.-R. Narcisse, R. Moise, P. A. McElfish, H. C. Felix, T. Kirkland, and G. Jean-Louis, “Sleep duration associated with acute care utilization: Revisiting Andersen’s Behavioral Model of Health Services Use,” Sleep Heal., vol. 11, no. 5, pp. 691–701, 2025, doi: https://doi.org/10.1016/j.sleh.2025.06.007.

[21] M. Özsavran, C. Karakaya, and S. A. Kılıç, “The challenging care journey: A qualitative study of the experiences of mothers with children diagnosed with asthma,” J. Pediatr. Nurs., vol. 86, pp. 125–135, 2026, doi: https://doi.org/10.1016/j.pedn.2025.11.006.

[22] V. Pavedahl, I. K. Holmström, M. Summer Meranius, U. von Thiele Schwarz, and Å. Muntlin, “Guidelines for patient care used by registered nurses in the emergency room: Mapping of Swedish governing documents,” Int. Emerg. Nurs., vol. 77, p. 101536, 2024, doi: https://doi.org/10.1016/j.ienj.2024.101536.

[23] S. Rashkovich et al., “Independent and joint associations between patient characteristics and the triaging process for a telepsychiatry consultation-liaison service,” J. Psychiatr. Res., vol. 190, pp. 449–456, 2025, doi: https://doi.org/10.1016/j.jpsychires.2025.07.013.

[24] Suprapto, “Stunting Policy Implementation in Indonesia: A Primary Health Care Perspective,” J. Ilm. Kesehat. Sandi Husada, vol. 15, no. 1, pp. 347–361, Apr. 2026, doi: https://doi.org/10.35816/jiksh.v15i1.302.

[25] C. Shenvi, E. Gottesman, and T. Rosen, “The Importance of Addressing Social Drivers of Health and Unmet Social Needs in Optimizing Geriatric Emergency Care,” Emerg. Med. Clin. North Am., vol. 43, no. 2, pp. 281–301, 2025, doi: https://doi.org/10.1016/j.emc.2024.08.009.

[26] J. Stasinopoulos, M. T. Y. Leung, A. S. J. Yong, J. Ilomaki, and J. S. Bell, “Rates and Reasons for Recurrent Emergency Hospitalizations Among Frail Residents With Diabetes Following First Admission to Long-Term Care Facilities,” J. Am. Med. Dir. Assoc., vol. 26, no. 12, p. 105920, 2025, doi: https://doi.org/10.1016/j.jamda.2025.105920.