Research and Publication Ethics: Necessary permission to conduct the research was obtained from the Fırat University non-interventional research ethics committee (2021/02 -27). At all stages of the research, the articles of the Helsinki declaration were taken into account. Informed written consent was obtained from each study participant. They were also informed of their full right to refuse, withdraw, or completely reject their part in the study. Confidentiality was guaranteed by keeping the secret of personal identification and keeping questionnaires and results in a well-secured area.
Research Design and Sampling: This descriptive research was carried out between February 2021 and May 2021 at the Fırat University Hospital General Surgery Clinics. All adult patients who underwent surgery in the hospital's surgical clinics formed the population of the research. All patients were included, regardless of the type of surgery. In general surgery clinics, approximately 375 operations are performed in a year. By power analysis with 0.08 effect size, 0.05 error level, and 0.95 ability to represent the population, the sampling amount of the study was assigned as 200. The data were collected by the researchers by face-to-face interview technique on the 2nd postoperative day from patients who were hospitalized in general surgery wards for at least 72 hours. The data were selected by random sampling. Based on the inclusion criteria patients were selected and were randomly allocated into two groups; Preoperative the status of learning the breathing exercises, postoperative the status of learning the breathing exercises.
Breathing exercise: 'Sit on the edge of the bed or lie on your back and bend your knees to relax your abdominal muscles. Place your hands on the sides of your abdomen. Continue breathing through your nose until your upper abdomen bulges outward. Slowly blow air through your mouth, contracting your abdominal muscles.' It is a routine practice taught in the form of
Data Collection: A Personal Data Form, The State-Trait Anxiety Inventory (STAI), and The Richards-Campbell Sleep Questionnaire (RCSQ) were used to collect data.
Personal Data Form: It was developed to collect introductory information about patients who volunteered to take part in this research. It includes information about age, gender, profession, marital status, level of education, the state of learning the breathing exercises, who teaches breathing exercises, and how breathing exercises are taught.
The Richards-Campbell Sleep Questionnaire (RCSQ): The scale, originally called the Richard-Campbell Sleep Questionnaire (RCSQ), was revealed in 1987by Richards. RCSQ refers to a 6-item scale that assesses the time to fall asleep, the depth of night sleep, the time to stay awake when you wake up, the frequency of waking up, the level of noise in the environment, and the quality of sleep. Using the visual analog scale technique, each item is scored from 0 to 100 on a chart. A score of "0-25" on the scale indicates very poor sleep, while a score of "76-100" suggests excellent sleep. The scale's total score is calculated using 5 items; the sixth item, which assesses the noise level in the surroundings, is removed from the total score calculation. Patients' sleep quality improves as their scores on the scale rise. The scale created by Richards was found to have a Cronbach's alpha value of 0.8214. But, Cronbach's alpha was found 0.94 in the present study. Its reliability and validity investigation was carried out by Karaman Özlü and Özer15.
The State-Trait Anxiety Inventory (STAI): The Turkish reliability and validity of the scale created by Spielberger et al16 were made by Öner and Le Compte17. This scale consists of 40 items, the first twenty questions measure the patient's level of state anxiety, and the other twenty questions measure the level of trait anxiety. Reliability values were observed to range from 0.83 to 0.87 for trait anxiety and from 0.83 to 0.92 for state anxiety in the Turkish-adapted scale. Cronbach's alpha value of this study was found to be 0.79 for state anxiety and 0.89 for trait anxiety. Eighty and above points taken from the scale are evaluated as panic, 60-79 points as severe anxiety, 40-59 points as moderate anxiety, 20-39 points as mild anxiety, and 0-9 points as no anxiety16,17.
Statistical Analysis: The Statistical Package for Social Science 22.00 (SPSS) program was used to analyze the study's data. When reviewing study data, the normality test was performed using the Shapiro-Wilk test in addition to descriptive statistical methods (percentage, number, standard deviation, average). In comparisons between the two independent groups, the Mann-Whitney U test was employed since the normal distribution was not observed in the collected data. The significance level was accepted as p<0.05.
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