PhD student earns Dean’s Emmons Dissertation Research Award to study breathwork and surgical recovery

Devon E. Cobos Garcia, a PhD candidate and registered nurse, has received the College of Nursing’s Dean’s Emmons Dissertation Research Award for her dissertation research, “A Box Breathing Intervention and the Surgical Stress Response in Older Adults Undergoing Total Knee Arthroplasty: A Randomized Controlled Feasibility Trial.” The award supports doctoral students conducting innovative, high-impact dissertation research with strong potential to advance nursing science and patient care.

Her research examines how breathwork may improve surgical recovery among older adults undergoing knee replacement, a population particularly vulnerable to complications arising from the body’s physiological response to surgery. The research questions emerged directly from Cobos Garcia’s clinical experience as a preoperative and post-anesthesia care unit nurse. By observing differences in patient recovery, Cobos Garcia began exploring how stress physiology, surgical factors, and personal history influence outcomes.

“Devon Cobos Garcia’s research exemplifies the innovative, patient-centered work we strive to support at the College of Nursing,” said Brian Ahn, PhD, dean of the College of Nursing. “We are proud to help fund this work, which is essential to educating the next generation of nurse scientists and to providing students with opportunities to develop as researchers while advancing patient care.”

“This dissertation addresses an important gap in geriatric and perioperative nursing by examining how a structured, nonpharmacological intervention can help regulate physiological and psychological stress in older adults recovering from surgery,” said Juyoung Park, PhD, interim nursing and health science division chair and PhD program director. “Devon’s work exemplifies the innovative, student-led research we aim to cultivate in our PhD program.”

At the center of Cobos Garcia’s dissertation is an investigation of whether a structured breathwork intervention, specifically Box Breathing, a technique involving slow, rhythmic breathing with equal-length phases of inhalation, breath holding, exhalation, and breath holding, can support autonomic nervous system balance following surgery. Her study will also examine whether breathwork can be feasibly integrated into routine surgical care, as well as its potential effects on stress hormones, pain, mental health, and overall recovery, compared with an attention control task (an active comparison task that provides the same time commitment, engagement, and attention as the breathwork intervention, helping determine if any observed benefits are from the intervention itself rather than the experience of study participation alone).

The project introduces several important innovations in perioperative research. It collects serial cortisol samples over two days to better understand physiological stress patterns surrounding surgery and expands the examination of breathwork in surgical settings to include broader measures of well-being. In addition, the use of a virtual, self-paced intervention with a nationwide sample of older adults demonstrates how this approach could be scaled and applied across diverse surgical environments.

By focusing on a low risk, nonpharmacologic intervention and examining the intricacies of the surgical stress response, this research addresses a critical challenge in perioperative care, where prolonged recovery and postoperative complications are common among older adults. The findings may inform more supportive recovery approaches that complement existing standards of care.

“Receiving this award enables me to take an important first step toward my research goals by funding a feasibility study that will help inform future randomized controlled trials,” Cobos Garcia said. “I’m deeply appreciative of the College of Nursing’s mentorship and commitment to student research that has the potential to meaningfully improve patient care. This support will extend beyond my dissertation and into the lives of older adults undergoing surgery.”

Guiding the dissertation is an interdisciplinary mentorship team comprising College of Nursing faculty advisors Ruth Taylor-Piliae, PhD, RN, FAHA, FAN, and Tad Pace, PhD, along with dissertation committee members Pamela Reed, PhD, MA, RN, FAAN, and Rina Fox, PhD, MPH.

Through this award, the College of Nursing continues to invest in student-led research that bridges clinical practice and scientific discovery. Cobos Garcia’s work exemplifies the college’s commitment to fostering innovative, interdisciplinary scholarship that informs more integrative, personalized approaches to patient care.