THE EFFECT OF A COMBINATION OF DEEP BREATHING TECHNIQUES AND POSITIVE SELF-TALK THERAPY ON ANXIETY IN HYPERTENSIVE PATIENTS

Aulya Nurazizah; Iwan Somantri; Ridwan Kustiawan; Peni Cahyati; Ristrini Ristrini

doi:10.34035/jk.v17i2.2109

Authors

Aulya Nurazizah Applied Bachelor's Degree Program in Nursing, Department of Nursing, Politeknik Kesehatan Tasikmalaya, Tasikmalaya, Indonesia
Iwan Somantri Applied Bachelor's Degree Program in Nursing, Department of Nursing, Politeknik Kesehatan Tasikmalaya, Tasikmalaya, Indonesia
Ridwan Kustiawan Applied Bachelor's Degree Program in Nursing, Department of Nursing, Politeknik Kesehatan Tasikmalaya, Tasikmalaya, Indonesia
Peni Cahyati Applied Bachelor's Degree Program in Nursing, Department of Nursing, Politeknik Kesehatan Tasikmalaya, Tasikmalaya, Indonesia
Ristrini Ristrini Center for Public Health and Nutrition Research, Health Research Organization, National Research and Innovation Agency peni_poltekestsm@yahoo.com

DOI:

https://doi.org/10.34035/jk.v17i2.2109

Keywords:

anxiety, deep breathing techniques, high blood pressure

Abstract

Background: Hypertension is a major global health issue that frequently triggers psychological distress, such as anxiety, which can further destabilize blood pressure. Deep breathing techniques promote physiological relaxation by activating the parasympathetic nervous system, whereas positive self-talk therapy helps reduce anxiety by modifying negative thoughts into more adaptive and positive ones. As these interventions target complementary physiological and psychological mechanisms, their combination is expected to provide a more comprehensive effect in reducing anxiety among patients with hypertension. This study aims to determine the effect of combining deep breathing techniques and positive self-talk therapy on anxiety scores among hypertensive patients within the Kersanegara Community Health Center working area, Tasikmalaya City.
Methods: This quantitative study employed a quasi-experimental approach with a pretest-posttest control group design. A total of 42 respondents were selected via purposive sampling and divided equally into an intervention group (n = 21) and a control group (n = 21). The intervention group received the combined therapy for 5 days (15–20 minutes per session), while the control group received standard care and health education. Anxiety levels were measured using the Hamilton Anxiety Rating Scale (HARS) and analyzed using dependent and independent t-tests.
Results: The average anxiety score in the intervention group significantly decreased from 22.05 to 13.71 (p = 0.000). Meanwhile, the control group showed no significant reduction, changing from 21.05 to 20.29 (p = 0.217). The post-intervention independent t-test confirmed a significant difference in anxiety levels between the two groups (p = 0.000).
Conclusion: The combination of deep breathing techniques and positive self-talk therapy is highly effective in reducing anxiety among hypertensive patients and can serve as an alternative non-pharmacological nursing intervention. This intervention may be incorporated into routine nursing care and community-based hypertension management programs, particularly in primary healthcare settings, to help nurses manage anxiety among hypertensive patients.

References

Adam, M., Wijayanti, E., & Mudzakkir, M. (2025). Overview of the Characteristics of Hypertension Sufferers in Kemiri Hamlet, Kedungsari Village, Tarokan District, Kediri Regency in 2025. National Seminar on Science, Health, and Learning 5, 0008, 245–259.

Bura, A. S. N., Mahmud, N. U., & Masriadi. (2023). Overview of the Behavioral Characteristics of Elderly Hypertension in the Working Area of the Antara Makassar Health Center. Journal of Public Health, 72(2), 161–177. http://philstat.org.ph

Fadli, A., Azmi, A., & Haryatno, P. (2023). Comparison of the Effect of Resistance Exercises and Sports Education on Blood Pressure Control in Hypertensive Patients at the PT. Telkom Regional IV Semarang. Physiotherapy Health Science (PhysioHS), 6(2).

Faijurahman, A. N. (2022). An overview of the anxiety of the elderly who suffer from hypertension in the working area of the Sukaraja Health Center. Tambusai Health Journal, 3 (September), 479–486.

Febiola, S., & Hudiawati, D. (2024). The Effect of Health Education on Anxiety Levels in Hypertensive Patients in the Purwantoro Health Center Area. Prepotif: Journal of Public Health, 8(April), 1281–1287.

Fernandes, J. S. A., Alves, G. C., & Milani, R. G. (2024). Arterial Hypertension and Anxiety: Literature Review and Relevance in Primary Health Care. Revista de Gestão Social e Ambiental, 18(12), e010181. https://doi.org/10.24857/rgsa.v18n12-019

Gaol, H. L., Berna, I., & Br, I. (2021). Overview of the level of anxiety in the elderly with hypertension on the Jalan Pembangunan Usu Lingukungan 14 Kecematan Medan Baru in 2021. 184–189.

Harkomah, I., Maulani, M., AZ, R., & Dasuki, D. (2022). Breathing Relaxation Techniques in Reducing Anxiety of the Elderly with Hypertension at the Putri Ayu Health Center, Jambi City. JUKESHUM: Journal of Community Service, 2(2), 184–190. https://doi.org/10.51771/jukeshum.v2i2.305

Irawan, E., Tania, M., Fadillah, A., & Suwignjo, P. (2023). The Effect of Positive Self Talk Therapy on Anxiety in Hypertensive Patients at the Babakan Sari Health Center, Bandung City. BSI Journal of Nursing, 11(2), 141–153.

Kario, K., Okura, A., Hoshide, S., & Mogi, M. (2024). The WHO Global report 2023 on hypertension warning the emerging hypertension burden in globe and its treatment strategy. Hypertension Research, 47(5), 1099–1102. https://doi.org/10.1038/s41440-024-01622-w

Kurniawan, I., Rosyidah, I., & Maunaturrohmah, A. (2018). The relationship between anxiety and the incidence of hypertension in the elderly. https://repository.itskesicme.ac.id/id/eprint/1487/2/143210102 Indra Kurniawan Artikel.pdf

Lani, T. (2021). Anxiety Levels of the Elderly with Hypertension Diploma Study Program Diploma Three Nursing Stikes Intan Martapura, Indonesia 97–100.

Muharram, F. R., Widyahening, I. S., & Danaei, G. (2025). Hypertension care performance in Indonesia: evidence from three waves of nationally representative cross-sectional surveys. BMJ Open, 15(12), 1–9. https://doi.org/10.1136/bmjopen-2025-109588

Nurhidayat Ento, M. H., Djamaluddin, N., Antu, M. S., & Dumar, B. (2025). The Relationship Between Anxiety Levels and Blood Pressure in Patients with Hypertension at Kabila Community Health Center. Jurnal Kolaboratif Sains, 8(8), 5239–5249. https://doi.org/10.56338/jks.v8i8.8452

Pathan, F. K. M., Pandian, J. S., Shaikh, A. I., Ahsan, M., Nuhmani, S., Iqbal, A., & Alghadir, A. H. (2023). Effect of slow breathing exercise and progressive muscle relaxation technique in the individual with essential hypertension: A randomized controlled trial. Medicine (United States), 102(47), E35792. https://doi.org/10.1097/MD.35792

Pragholapati, A., Ardiana, F., & Nurlianawati, L. (2021). Overview of Cognitive Function in the Elderly (Elderly). Journal of Pearl Ners, 4(1), 14–23. https://doi.org/10.51544/jmn.v4i1.1269

Ridho, M.; Mariana, E. R. M. (2022). Differences in Progressive Muscle Relaxation Techniques and Deep Breathing Relaxation Techniques for Reducing Anxiety in Hemodialysis Patients: 2. https://doi.org/https://doi.org/10.36086/jkm.v2i2.1438

Rizal, H., Rizani, A., Banjarmasin, P., & Nursing, J. (2019). 106-Article text-337-1-10-20191029 (1). 6(1), 18–24.

Suciana, F., Agustina, N. W., & Zakiatul, M. (2020). Long correlation of suffering hypertension with background levels. Journal of Nursing and Public Health STIKES Cendekia Utama Kudus, 9, 146–155.

Utami, A. G., Kurniawan, W. E., & Wirakhmi, I. N. (2024). Effect of Benson Relaxation Therapy on Blood Pressure in Hypertensive Patients. Journal of Professional Nursing Research, 6(2), 743–752. https://doi.org/10.37287/jppp.v6i2.2154