الفهرس 
Introduction and Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Respiratory system is one of the main parts of body, which takes air into the lungs .Lower respiratory tract infections are being the most prevalent disorders requiring nursing attention with significant considerable morbidity and mortality in children. Pharmacotherapy alone has limited role in improving the respiratory function, therefore the complementary and alternative approaches that can use for lower respiratory tract infection management as breathing exercise which make breathing more effective , it can be achieved through training of nurses to use appropriate complementary approaches and conducting more researches at this point to improve care provided. Complementary and alternative medicine as buteyko and diaphragmatic breathing techniques play an effective role in managing lower respiratory tract infections through implementation of buteyko and diaphragmatic breathing techniques offers a non-pharmacological strategy to improve clearance of airway and expansion of parenchyma by the effectiveness of respiratory muscles that requires simple inexpensive equipment and can easily be used by the children themselves or their parents assistant after educating and training them . The current study was aimed to evaluate the effect of buteyko breathing technique versus diaphragmatic breathing on clinical outcomes for children with lower respiratory tract infection. A quasi-experimental research design was utilized in the present study. The study was conducted at Pediatric Medical Department of Tanta Main University Hospital which is affiliated to the Ministry of Higher Education and Scientific Research. A convenience sampling consisted of 90 children with lower respiratory tract infection was collected from the above previously mentioned settings. They were divided into three equal groups namely: 1- group (I): Thirty children implemented buteyko breathing technique. 2- group (II): Thirty children who implemented diaphragmatic breathing technique . 3- group (lll): Thirty children who were received routine day hospital care. Inclusion criteria of children included the following: Both sexes, age from 6-12 years, children with lower respiratory tract infection (asthma, pneumonia, bronchitis-bronchiolitis). Tools of data collection: Five tools were used in the current study as the following: Tool I: Structured interview Schedule: It was developed by the researchers to collect the required data and it includes the following two parts:- Part (1): Socio demographic characteristics of the studied children: as age, sex, educational level, residence, date and duration of admission. Part (2): Medical History of the child related to lower respiratory tract infection: Prescribed medication, history of the disease, triggering factors for symptoms, duration, treatment, complications, duration of last admission. Tool II: Control Pause breathing Test (CP) It was adapted from (Buteyko International, 2014). Buteyko breathing exercise to assess the consequent retention of carbon dioxide and breathing depth, result oxygenation and health by using special breathing hold manner, it was used before and immediately after the technique by using stopwatch . Tool III: Physiological measurement and oxygen saturation Part (1): Basic physiologic measurement such as Measuring temperature, heart and respiratory rate. Part (2): Measurement of oxygen saturation using pulse oximeter Tool IV: Peak expiratory flow rate:- It measured with mini wright peak flow meter device to display child capacity to expire out air through the bronchi, the meter test the ability to force out of the lung . (139,149) -Tool V: Children clinical outcomes: It was used to assess clinical outcome for both study groups (I, II) and control group (III) at pre and immediately after technique procedure it included: - Physiological measurement: Improved temperature, respiratory, pulse rate. Oxygen saturation: Using pulse oximeter, higher oxygen indicated good breathing and prognosis . Peak expiratory flow rate: improvement in child capacity to expire out air through the bronchi. The main results of the present study: - It was evident that 53.3% , 46.7% and 40% were between 6-8 years old with the mean age were (8.16 ± 2.19 , 7.95 ± 1.82 and 8.36 ± 1.85) years respectively in buteyko, diaphragmatic and control group. - It was clear that 60% , 53.3% and 56.7% of children were males respectively in buteyko, diaphragmatic and control group. - It was observed that, 53.3% , 50% and 66.7 % of children respectively were from urban areas in each of the buteyko, diaphragmatic and control group - It was evident that, there were a highly statistically significant differences regarding level of control pause breathing score among children ( P=0.0001, P= 0.001) before and after breathing technique respectively in buteyko, diaphragmatic group. where there was statistically significant differences among children( P=0.037) in control group. - It was observed that before and after buteyko technique, there were a statistically significant differences in heart rate measurement (P =0.017) in group (I) . - It was found that before and after breathing technique regarding respiratory rate measurement, there were highly statistically significant differences (P =0.0001) amongst the studied children of buteyko and diaphragmatic group. - There were highly statistically significant differences regarding oxygen saturation measurement before and after procedure where (P=0.0001, 0.002 and 0.001) among the studied children respectively in buteyko, diaphragmatic and control group. - It was noticed that , there were a highly statistically significant differences regarding level of peak expiratory flow rate between children in group (I) ( P=0.005) .where there were no statistically significant differences among studied children in other two groups (P= 0.086and P =0.305) respectively in diaphragmatic and control group. - There was a negative significant correlation between heart rate and control pauses breathing test after buteyko breathing technique where (P=0.001) of group (I). - There was a negative highly significant correlation amongst heart rate and rate of peak expiratory flow where (P=0.0001) among children of group (I) after buteyko breathing technique. - There was a negative significant correlation between respiratory rate and of peak expiratory flow rate where( P=0.015) among children of after buteyko breathing technique and there was a negative significant correlation between respiratory rate and rate of peak expiratory flow respectively among children before and after diaphragmatic breathing technique where( P= 0.016 , 0.032). - There was positive significant correlation where (P=0.022) between peak expiratory flow rate and control pauses breathing test before and, positive highly significant correlation where (p=0.007) after buteyko breathing technique between children of group (I). - There was a positive highly significant correlation among peak expiratory flow rate and control pauses breathing test where ( P=0.0001, 0.003) respectively among children of group (II) before and after diaphragmatic breathing technique.