EFFECTIVENESS OF YOGASANA THERAPY ON LEVELS OF STRESS .

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EFFECTIVENESS OF YOGASANA THERAPY ONLEVELS OF STRESS AMONG WOMEN WITHHYPERTENSION AT SELECTED AREA, VELLOREM.Sc (NURSING) DEGREE EXAMINATIONBRANCH IV - COMMUNITY HEALTH NURSINGSRI NARAYANI COLLEGE OF NURSING,VELLORE 55.A Dissertation submitted toTHE TAMIL NADU DR. M. G. R. MEDICAL UNIVERSITY,CHENNAI 600 032.In partial fulfilment of the requirement for the degree ofMASTER OF SCIENCE IN NURSING.APRIL - 2016

CERTIFICATEThis is to certify that this dissertation entitled ³EFFECTIVENESSOF YOGASANA THERAPY ON LEVELS OF STRESS AMONGWOMEN WITH HYPERTENSION AT SELECTEDRURAL AREA.VELLORE is a bonafide work done by Ms. ARCHANA.V, Sri NarayaniCollege of Nursing, Vellore 55, in the partial fulfilment of therequirement for the award of the degree of Master of Science in Nursing,Branch IV Community health nursing, under my guidance andsupervision during the academic period from April 2014-16.Prof. Mrs. Lalitha Purushothaman, M.Sc.,(N),M.Phil.Administrative cum Liaison Officer,HOD of Nursing Research Department,Sri Narayani College of Nursing,Thirumalaikodi,Vellore-55.

EFFECTIVENESS OF YOGASANA THERAPY ONLEVELS OF STRESS AMONG WOMEN WITHHYPERTENSION AT SELECTED RURALAREA,VELLORE.Approved by dissertation committee on July 2015RESEARCH GUIDE:Prof. Mrs. Sujatha.V, M.Sc (N).,Principal and Research Co-ordinator,HOD of Community Health Nursing,Sri Narayani College of Nursing,Vellore-55.SPECIALITY GUIDE:Mrs.S.Gandhimathi, M.Sc (N).,Research guide,Reader,Department of Community Health Nursing,Sri Narayani College of Nursing,Vellore-55.A Dissertation submitted toTHE TAMIL NADU DR. M. G. R. MEDICAL UNIVERSITY,CHENNAI 600 032.In partial fulfilment of the requirement for the degree ofMASTER OF SCIENCE IN NURSING.APRIL 2016

EFFECTIVENESS OF YOGASANA THERAPY ONLEVELS OF STRESS AMONG WOMEN WITHHYPERTENSION AT SELECTED AREA, VELLOREBY301427601M.SC (NURSING) DEGREE EXAMINATIONBRANCH IV - COMMUNITY HEALTH NURSINGSRI NARAYANI COLLEGE OF NURSING,VELLORE 55.A Dissertation submitted toTHE TAMILNADU DR. M. G. R. MEDICAL UNIVERSITY,CHENNAI 600 032.In partial fulfilment of the requirement for the Degree ofMASTER OF SCIENCE IN NURSING.Internal ExaminerExternal Examiner

ACKNOWLEDGEMENTThe satisfaction and pleasure that accompany the successful completion of anytask would be incomplete without mentioning the people who made it a success. Iconsider it a privilege to express my gratitude and respect to all those who guided andinspired me in the completion of this project.With sincere gratitude and humility. I bow before the Almightily God andGnana Guru BELOVED SRI SAKTHI AMMA, for his abundant grace, love,compassion, immense showers of blessings and guidance, which enabled me to reachup to his step and to complete my study.I am very much thankful to our beloved, Director Dr.N.BALAJI, Ph.D,MACE, FISMA, FACSc., MBA., Sri Narayani Hospital and Research centre andSNCON for giving this opportunity to conduct the study.I would also like to express my deep sense of gratitude and sincere thanks toProf. Mrs. LALITHA PURUSHOTHAMAN, M.Sc (N), M.Phil., AdministrativeCum Liaison officer, Sri Narayani College of Nursing as she gave me the emotionalsupport and the strength to make my dreams come true.My sincere thanks to Prof. Mrs. SUJATHA.V, M.Sc (N) Principal & HODcommunity Health Nursing Dept, SNCON for providing scholarly touch,encouragement and her inspiring guidance in providing skilful and compassionate spiritof support throughout my study.i

My faithful thanks to my guide Mrs.S.GANDHIMATHI, M.Sc (N)., SriNarayani college of Nursing, for her constant ,support, patience, encouragement andsupport to complete my study.My faithful thanks to Prof. Mr. S. MUTHURATHIAM, M.Sc., Biostatisticanfor his help in the statistical analysis of the data.Ithankrespected madam Prof. Mrs. ARUNA, M.Sc.,(N).,Ph.D.,HOD Dept of Community Health Nursing Sri Ramachandhra college of Nursing,Mrs. LISY JOSEPH, M.Sc(N)., Lecturer, Sri Ramachandra college of Nursing,Prof. Mrs. BEULAH PREMKUMAR, M.Sc(N), Ph.D., Department of Medical andSurgical Nursing Christian Medical College, Vellore, Prof. Mrs. SUJA SURESH,M.Sc(N) Billorth College of Nursing.I wish to express my thanks to all the teaching faculty of Sri Narayani Collegeof Nursing who helped me in the successful completion of this study.I extend my sincere thanks and gratitude to the Mrs. MAHALAKSHMI,B.B.A., PGDCA., and Miss. ARCHANA, B.Sc., Zoology, Mr. SUDHAGAR, B.Sc.,MCA., our librarians Mr. SUNDARRAJALU, MLIS Mrs. GEETHA LAKSHMI,MLIS and Mr. SARAVANAN, MLIS of Sri Narayani College of Nursing for timelyhelp in Photostat, typing and printout.It is great pleasure to acknowledge my deepest thanks and gratitude toDr.K.POONGODI, MBBS., DPH., Deputy Director, Vellore who gave thepermission to conduct the study, Dr.KAILASAM, Block Medical OfficerDr.NIVEDHINI Medical officer of primary Health Centre, Anacuit, Vellore forpermitting me to conduct the study.ii

I especially render my sincere thanks Mr. SUNDHRAMOOTHY and to all thestudy participants for their sincere co-operation and interest which shown upon thesuccessful completion of the study. I would like to express my extreme sinceregratitude and appreciation to Mr.A.J.THEODORE RAJKUMAR, M.A.,M.Phil.,Assistant Professor for his valuable suggestions for Tamil and Mrs.S.CHRISTINAYAKKALSOROJINI, M.A.,M.Phil., Assistant ProfessorEnglish editing of thedissertation.My hearty thanks to my Uncle Mom, Dad, and Sister for their support in allthe ways to finish my dissertation. I am indebted to my lovable family membersMr. Karthik, Mrs. Sharlin Tamilselvan who were the backbone of my happiness andhurdles throughout my life.V.ARCHANAiii

ABSTRACTThe global burden of high blood pressure supports predictions of a world wideepidemic of cardio- vascular disease. Hypertension is directly responsible for 57% ofdeaths in India. (WHO 2015). Stress is an altered state of body and mind from normalhomeostatic conditions that is caused due to extrinsic or intrinsic factors. In the world200 million women are suffering from stress. Yogasana is an economical, noninvasive practice that has become increasingly popular as a means of relievingstress, enhancing health, and improving fitness with no appreciable side effects andmultiple collateral lifestyle benefits.STATEMENTEffectiveness of yogasana therapy reduces levels of stress among women withhypertension at selected rural area, Vellore.OBJECTIVES1.To assess the pre-test levels of stress among women with hypertension beforeyogasana therapy.2.To assess the effectiveness of yogasana therapy on levels of stress amongwomen with hypertension.3.To find out the association between the post test levels of stress among womenwith hypertension and selected demographic variables.iv

METHODS:The research approach is quantities and the research design selected was preexperimental one group pre and post test design. Purposive sampling technique wasadopted to selected 30 women with hypertension at Unai Vaniyambadi, Village. TheISMA stress questionnaire. The conceptual frame work used in the present study isbased on Kolcaba theory of comfort was developed by Katherine Kolcaba 1990.Descriptive statistics and inferential statistics were used for analysis and interpretation.Results and interpretation:The pretest levels of stress among women with hypertension mean value is 22.2and SD 0.574. After yogasana therapy the post test mean value is 5.53 the SD 2.05.0HDQ GLIIHUHQFH ZDV 7KH FDOFXODWHG SDULHG ³W WHVW YDOXH ZKLFK LV JUHDWHU than the table value (3.66) which was statistically significant at P 0.001. Hence H1was accepted. The demographic variable number of children was associated at P 0.05level. Hence H2 was accepted.CONCLUSION:The majority of the women with hypertension had significant improvement inthe levels of stress after yogasana therapy.Key words:Effectiveness, Yogasana therapy, Levels of stress, Women with hypertension.v

TABLE OF CONTENTSCHAPTER NOICONTENTSPAGE NO.1INTRODUCTIONxNeed for the study6xStatement of the problem9xObjectives of the study9xOperational definitions9xHypotheses9xConceptual framework10xDelimitations11IIREVIEW OF LITERATURE15IIIRESEARCH METHODOLOGY23xResearch approach23xResearch design23xSetting of the study24xPopulation of the study24xSample24xSampling technique24vi

CHAPTER NOCONTENTSx Sample size24x Criteria for sample selection24xDescription of tool25xScoring interpretation26xValidity26xReliability26xPilot study26xData collection procedure27x Data analysis planIVPAGE NO.27DATA ANALYSIS AND29INTERPRETATIONVVIVIIRESULTS AND DISCUSSION52SUMMARY AND RECOMMENDATIONSxSummary56xConclusion58xNursing Implications58xRecommendations5960REFERENCESvii

LIST OF TABLESTABLENOTITLEPAGE NOFrequency and percentage distribution of women with1hypertension according to age group30Frequency and percentage distribution of women with2hypertension according to marital status31Frequency and percentage distribution of women with3hypertension according to education32Frequency and percentage distribution of women with4hypertension according to occupation33Frequency and percentage distribution of women with5hypertension according to monthly family income34Frequency and percentage distribution of women with6hypertension according to Co-morbid condition35Frequency and percentage distribution of women with7hypertension according to number of children36Frequency and percentage distribution of women with8hypertension according to duration of hypertension37Frequency and percentage distribution of women with9hypertension on regular treatmentviii38

TABLENOTITLEPAGE NOFrequency and percentage distribution of women according1039to family history of hypertensionFrequency and percentage distribution of women according1140to family history of hypertension if yes.Frequency and percentage distribution of women with1241hypertension practicing exercises.Frequency and percentage distribution of women with1342hypertension according to daily salt intakeFrequency and percentage distribution of women with1443hypertension sleeping pattern at nightFrequency and percentage distribution of women with1544hypertension according to leisure time activitiesFrequency and percentage distribution of levels of stress1645among women with hypertension0HDQ VWDQGDUG GHYLDWLRQ SDLUHG µW¶ YDOXH RI 3UH 3RVW 1746test levels of stress among women with hypertension.Association of selected demographic variables and post test1847levels of stress among women with hypertensionix

LIST OF FIGURESFIGURENO.TITLEPAGE NO1Conceptual framework of the study142Schematic representation of research plan28Column graph showing percentage distribution of the330women with hypertension according to age groupColumn graph showing percentage of women with431hypertension according to marital statusColumn graph showing percentage of women with532hypertension according to educationColumn graph showing percentage of women with633hypertension according to occupationColumn graph showing percentage of women with734hypertension according to monthly family incomeColumn graph showing percentage of women with835hypertension according to Co Morbid conditionColumn graph showing percentage of women with936hypertension according to no of childrenx

FIGURETITLENO.PAGE NOColumn graph showing percentage of women with1037hypertension according to duration of hypertensionPie graph showing percentage of women with1138hypertension according to on regular treatmentColumn graph showing percentage of women with12hypertension according to family history of39hypertensionPie graph showing percentage of women with13hypertension according to family history of40hypertension (If yes related)Column Graph showing percentage of women with1441hypertension daily salt intakeColumn Graph showing percentage of women with1542hypertension sleeping pattern at nightColumn Graph showing percentage of women with1643hypertension according to leisure time activitiesxi

FIGURETITLENO.PAGE NOColumn Graph showing percentage distribution of1744levels of hypertension among womenColumn graph showing percentage distribution of pre18and post test scores for stress among women with45hypertension.Column graph showing percentage distribution ofPHDQ VWDQGDUG GHYLDWLRQ SDLUHG µW¶ YDOXH RI SUH 1946post test levels of stress among women withhypertension.xii

LIST OF APPENDICESAPPENDIXTITLEPAGENOa.Certificate of Yoga for Human Excellenceib.Letter seeking permission to conduct main studyiic.Certificate of validationiiid.Letter requesting participation in the studyive.List of experts for tool validationvf.Certification of English editingvig.Certification of Tamil Editingviih.Demographic Variables (English)viiiiStress Questionnaire (English)ixjDemographic Variables (Tamil)xvkStress Questionnaire (Tamil)xixlLesson plan-EnglishxxiimLesson plan-Tamilxxxvixiii

LIST OF ABBREVENTIONSWHOWorld health organisation.JAPIJournal of associated physicians of India.CRESSAHISMANSSChennai Rural Epidemiology study.Arterial Hypertension.International Stress Management Association.Non Significant.Significant.xiv

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CHAPTER IINTRODUCTION³ RJD V\QFKURQLVHV WKH PLQG ERG\ DQG WKH VRXO - (Narendra Modi 2015)Human being must be leisure from stress to lead a normal healthy life.If they have sustained stress they are at the high risk of getting hypertension.Hypertension commonly called high blood pressure is sustained arterial pressure. Itremains as an important health challenge.Chronic disease is an impairment of bodily structure and/ or function thatnecessitates a modification of the patients normal life and has persisted even anextended period of time. The problem of chronic non-communicable disease isassuming increasing importance among the women population in both developedand developing countries.(Williams -2012)Hypertension is a major risk factor for cardiovascular diseases, which arestill the leading causes of death inEu

Effectiveness of yogasana therapy reduces levels of stress among women with hypertension at selected rural area, Vellore. OBJECTIVES 1. To assess the pre-test levels of stress among women with hypertension before yogasana therapy. 2. To assess the effectiveness of yogasana therapy on levels of stress among women with hypertension. 3. To find out the association between the post test levels of