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DISSERTATION VIVA-VOCE

Guided By,

Prof. Mrs.Rani . P , M.ScN!,

Princi"a#,

Sru$%i Co##e&e of Nursin&, Gun$ur.

Co-Guided By,

Mr. Se#'ara(, M.ScN!,

Reader,

Sru$%i Co##e&e of Nursin&, Gun$ur.

Presen$ed )y

Re& No* +//0

Ms. B. Siris%a,

II-1ear, M.ScN!,

Sru$%i Co##e&e of Nursin&,

Gun$ur.

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 Anxiety does

not emptytomorrow ofits sorrows,

but onlyempties

today of its

strength. 

Charles

S ur eon

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• Everyone experience anxiety about the future is part of being human and helps us plan ahead and make better

decisions. Some anxiety is normal and even productive.

However, when anxiety becomes disruptive and disabling to

a person’s life, it is considered an unhealthy psychiatricdisorder.

•  National Health nterview Survey shows that 39% of people

over 65 years of age suffer from some limitation of activitydue to chronic conditions and 11% are unable to carryout

major activities because of their anxiety towards illness and

also they suffer from some kind of anxiety disorders.

INTROD2CTION

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•

!any researchers have stated that 3An4ie$y isuncon$ro##a)#e and a5)i&ui$y is 5ore s$ressfu# for a

&eria$ric, 6%ic% can )e "redic$ed, 5odified or

$er5ina$ed. Nurses )ein& $%e cen$ra# fi&ure in a

&eria$ric care can %e#" $o iden$ify $%e #e'e# of an4ie$y

and "ro'ide o""or$uni$y for $%ese "eo"#e $o co"e 6i$%

$%e s$ressfu# si$ua$ion.7

• "he researcher personally felt from the experience that old

age people that need to be relieved from the anxiety by

using "ro&ressi'e 5usc#e re#a4a$ion $ec%ni8ue which is

effective in reducing anxiety by a#$erna$e#y $ensin& and

re#a4in& $%e 5usc#es. So the researcher is interested to

conduct this study which may mutually benefit the old age

 people and also the society.

NEED 9OR T:E ST2D1

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STATEMENT O9 T:E PROB;EM

 3A s$udy $o e'a#ua$e $%e effec$i'eness of

"ro&ressi'e 5usc#e re#a4a$ion $ec%ni8ue on

an4ie$y a5on& o#d a&e "eo"#e in se#ec$ed

co55uni$y areas, Ponnur7.

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OB

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OPERATIONA; DE9INITIONS

 Anxietyt refers to mental or emotional tension associated

with feelings of uncertainty and helplessness.

 Effectiveness

n this study it refers to the extent to which

 progressive muscle relaxation exercise reduces the

anxiety among old age people.

 Evaluate

t refers to assess or determine the effectiveness of

 progressive muscle relaxation exercise.

OPERATIONA; DE9INITIONS

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OPERATIONA; DE9INITIONS

 Progressive muscle relaxation t refers to a techni#ue for reducing anxiety by

alternately tensing and relaxing the muscles.

Ol age !eo!le

$ld age people refers to individuals whose age is %&

years and above of both sex.

OPERATIONA; DE9INITIONS

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:1POT:ESIS

• :+* "here will be a statistically significant

difference in anxiety level after giving progressive

muscle relaxation exercise among experimentalgroup.

• :-* "here will be a statistically significant association

 between anxiety with selected demographic variables

among experimental and control group.

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• $ld age people will have certain level of anxiety

• 'rogressive muscle relaxation techni#ue will help to reduce

the level of anxiety

ASS2MPTIONS

DE;IMITATIONS

S$udy is de#i5i$ed $o*

• $ld age people who are available at data collection only.

• $ld age people who are willing to participate in the study only.

• $ld age people who can understand "elugu and English only.

• Sample si(e of %& $ld age people with %& years and above only.

•

% weeks of data collection procedure.

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CONCEPT2A; 9RAME=OR> 

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"he review of literature is systematic and

critical review of the most important published

and unpublished data based on the material found

in print and non ) print forms. "he related

literature for the present study has been discussedunder following sections

 – "ection A# $iterature related to anxiety disorders

among elderly.

 – "ection # $iterature related to efficacy of progressive

muscle relaxation technique.

REVIEW OF LITERATURE

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 MET:ODO;OG1

Researc% A""roac%* * #uantitative research approach

Researc% Desi&n* +uasi experimental Non e#uivalent control

group design.

• >ey*

 – $- 'retest level of anxiety among samples.

 – - 'rogressive muscle relaxation techni#ue teaching and

demonstration.

 – $/- 'ost test level of anxiety among samples.

GROUP PRETEST INTERVENTION POSTTEST

Experimental

Group

01 X 02

Control Group 01 -- 02

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Se$$in&* 0ommunity Health 0entre, located at 'onnur. 'onnur is anurban slum area which is located % kilometres away from 1untur withthe population of 2&&&.

Po"u#a$ion*

•"he population in the present study includes old age people above %&years in 'onnur.

Sa5"#e*

• Samples of the study are aged %& and above %& years who are available

during the data collection in 'onnur.

Sa5"#e Si?e @ Sa5"#in& Tec%ni8ue*

• "he sample si(e of the study is %& old age people 3experimental

group42&, control group42&5 from selected community areas,'onnur by using non probability purposive sampling techni#ue

 MET:ODO;OG1

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Cri$eria for Sa5"#e Se#ec$ion*

Inc#usion cri$eria

• $ld age people who are available at the time of data collection.

• $ld age people who are willing to participate in the study.

• $ld age people who can understand "elugu and English

• $ld age people with %& years and above of both sex.

E4c#usion cri$eria

• "he old age people who are unable to hear.

• "he old age people who are not willing to participate in the study.

•  "he old age people who are practicing other relaxation techni#ue.

• "he old age people who have muscular disorders.

 MET:ODO;OG1

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• VARIAB;ES*

 – De"endan$ 'aria)#e * 6evel of anxiety.

 – Inde"enden$ 'aria)#e * 'rogressive muscle relaxation

techni#ue.

 – E4$raneous 'aria)#es * *ge, gender, income, religion,

marital status, type of family, dietary pattern

 MET:ODO;OG1

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DESCRIPTION O9 T:E TOO;

Par$ I*t consists of Socio demographic 7ariables such as age,gender, income, religion, marital status, type of family, dietary

 pattern

Par$ II* :a5i#$on An4ie$y Ra$in& Sca#e.

t is used to assess the level of anxiety among old age

 people from selected community areas, 'onnur. 

Scorin& ey* Each item is scored independently based on a five8point,

ratio scale. Sum the scores from all 9 parameters

0 Not Present

1 Mild

2 Moderate

3 Severe

4 Very Severe

Score Level of n!iety

14"1# Mild n!iety

1$"24 Moderate n!iety

2%"30 Severe n!iety

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• PART III* PROGRESSIVE M2SC;E RE;AATION TEC:NI2E

I$ consis$s of +/ s$e"s.

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• "he reliability of the present study tool wasestablished by split half method by using thespear brown prophecy formula 4 /r:;r and the

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*fter getting permission from the medical officer to conduct study in

'onnur and consent from participants, the pilot study was conducted

among % old age people. "he sub>ects were selected by using

 purposive sampling techni#ue. 2 sub>ects were assigned to

experimental group and 2 sub>ects to control group. 're test was done by administering Hamilton anxiety rating scale for both in

experimental and control group. "he intervention 'rogressive muscle

relaxation techni#ue was given for week from ?::? to &::? in

the experimental group, without intervention in control group. 'osttest was conducted on @th  day to assess the effectiveness of

 progressive muscle relaxation techni#ue on anxiety. *fter conducting

the pilot study, the study was found to be feasible. "ool was found to

 be reliable.

PI;OT ST2D1

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DATA COLLECTION PROCEDUREAata collection for the study was done in Selected community areas, 'onnur.

Besearcher got permission from the concerned authority.

'opulation were identified 3%& C above %& old age people5 by non probability

convenient sampling techni#ue.

$n day83&2:&/:?5, 're8test level of anxiety among samples were assessed.

$n day83&2:&/:?5, 'rogressive muscle relaxation techni#ue teaching C

demonstration was given 3@ days 3&2:&/:? to &=:&/:?52follow up was done5.

$n day8/D3&/:&2:?5, 'ost test level of anxiety was assessed

DATA CO;;ECTION PROCED2RE

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DATA ANA;1SIS AND INTERPRETATION

"he data has been analy(ed and presented under the following

heading-• Sec$ion I*  re#uency and percentage distribution of selected

demographic variables.

• Sec$ion II*  !ean and Standard deviation to determine the

effectiveness of progressive muscle relaxation techni#ue onreducing the level of anxiety among old age people in experimental

and control group.

• Sec$ion III*  Belationship between pre and post test effectiveness of

 progressive muscle relaxation techni#ue on reducing the level of

anxiety among old age people in experimental and control group.

• Sec$ion IV* *ssociation between the pre and post test effectiveness

of progressive muscle relaxation techni#ue on reducing the level of

anxiety among old age people in experimental and control group

with selected demographic variables.

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0

10

20

30

40

%0

&0

#0

60

53.3

3033.4

1013.3

AGE

60-65 years

66-70 years

71-75 yearsPERCENTAGE

Sec$ion I* De5o&ra"%ic C%arac$eris$ics

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0

10

20

30

40

%0

&0

#0

$0

23'2 6.7#&'# #3'3

GENDER

!ALE

FE!ALE

PERCENTAGE

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E"PERI!ENTAL GROUP0

%

10

1%

20

2%

30

3%

40

4%43.4

6.7

6.7

0

16.6

00

33.3

13.3

0

INCO!E

# Rs 5000

Rs 5001-7000Rs 7001-$000

Rs $001-11000

% 11000PERCENTAGE

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E"PERI!ENTAL GROUP0

10

20

30

40

%0

&0

#0

$0

(0

100

&3.3

$3.4

3.3

0

13.4

3.3

0

3.3

RELIGION

'INDU

C'RI(TIAN

!U(LI!

OT'ER(PERCENTAGE

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E"PERI!ENTAL GROUP0

10

20

30

40

%0

&0

#0

$0

(0

&0

$0

10

3.36.7 6.7

3'3

0

!ARITAL (TATU(

!ARRIED

UN!ARRIED

WIDOW)WIDOWER

DIVORCEDPERCENTAGE

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E"PERI!ENTAL GROUP0

10

20

30

40

%0

&0

#0

$073.3

70

23'4

30

3.3

0

T*PE OF FA!IL* 

NUCLEAR +OINT

E"TENDEDPERCENTAGE

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0

10

20

30

40

%0

&0

#0

40

33'3

&0

&&'#

DIETAR* PATTERN

V)*)+,-N

N.N V)*)+,-N

PERCENTAGE

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Sec$ion II* Effec$i'eness of "ro&ressi'e 5usc#e

re#a4a$ion $ec%ni8ue on an4ie$y a5on& o#d "eo"#e in

e4"eri5en$a# &rou"

S.No e!el o" anxiet# Experimental $roup

Pre te%t Po%t te%t

" &'( " &'(

1 )il* + 1,., 20 .

2 )o*erate 2 /. 10 ,,.,

, Se!ere 0 0 0 0

Total ,0 100 ,0 100

N, 30

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!ILD !ODERATE (EVERE0

10

0

30

40

50

60

70

&0

$0

13.3

&6.7 0

66.7

33.3 0

LEVEL OF AN"IET*- E"PERI!ENTAL GROUP

PRE TE(T

PO(T TE(T

PERCENTAGE

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Sec$ion II* Effec$i'eness of "ro&ressi'e 5usc#e

re#a4a$ion $ec%ni8ue on an4ie$y a5on& o#d "eo"#e in

Con$ro# &rou"

S.No e!el o" anxiet# Control $roup

Pre te%t Po%t te%t

" &'( " &'(

1 )il* 1. , 10

2 )o*erate 2 /,.+ 2 0

, Se!ere 0 0 0 0

Total ,0 100 ,0 100

N, 30

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!ILD !ODERATE (EVERE0

10

0

30

40

50

60

70

&0

$0

16.6

&3.4 0

10

$0 0

LEVEL LOF AN"IET* CONTROL GROUP

ND DA* 

3RD DA* 

PERCENTAGE

S i C i f f

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Sec$ion III* Co5"arison of "re-$es$ and "os$-$es$ #e'e# of

an4ie$y of o#d a&e "eo"#e in e4"eri5en$a# and con$ro#

&rou"

N, 60

S.No Group Pre te%t Po%t te%t Paire* t3

te%t)ean Stan*ar*

*e!iation

)ean Stan*ar*

*e!iation

1 Experimental

Group

20.1, ,., 12.1, .0+ C 4 .2

t 4 1.

%5

2 Control Group 1., ,./ 20.1 ,.,+ C 4 1.+

t 4 1.

NS

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PRE TE (T PO(T TE(T PRE TE(T PO(T TE(T0

5

10

15

0

5

0.13

1.13

3.63

6.04

1$.3

3.&

0.16

3.34

!EAN - (TANDARD DEVIATION OF PRETE(T - PO(TTE(T LEVEL OF AN"IET* OF OLD AGE PEOPLE IN E"PERI!ENTAL - CONTROL GROUP

E"PERI!ENTAL

GROUP

CONTROL GROUP

!EA

N

(TANDAR

D

DEVIATIO

N

Sec$ion IV* Associa$ion )e$6een $%e effec$i'eness of

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• Con$ro# Grou"*

 – "here is si&nifican$ associa$ion between a&e and 5ari$a#

s$a$us

 – "here is no si&nifican$ associa$ion between &ender,

inco5e, re#i&ion, $y"e of fa5i#y, die$ary "a$$ern.

•

E4"eri5en$a# &rou"* – "here is no si&nifican$ associa$ion between a&e, &ender,

re#i&ion $y"e o fa5i#y, die$ary "a$$ern, inco5e and

5ari$a# s$a$us.

Sec$ion IV* Associa$ion )e$6een $%e effec$i'eness of

"ro&ressi'e 5usc#e re#a4a$ion $ec%ni8ue on an4ie$y

a5on& o#d a&e "eo"#e 6i$% $%eir se#ec$ed de5o&ra"%ic

'aria)#es

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DISC2SSION

  t has been discussed based on the tabulation of

the data which is based on ob>ectives of the

study.

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De5o&ra"%ic C%arac$eris$ics

+. A&e, in experimental group + F/! and in control group +F

.!were between F/ F years.. Gender, in experimental group HF.H! and in control group

H.! 6ere fe5a#e.

. Inco5e, in experimental group + 0.0! earn Rs./// and

in control group +/ .! earn Rs. J//+- ++,///0. Re#i&ion, in experimental group .! and in control group,

J.0! are :indus.

. Mari$a# s$a$us, in experimental group 0 /! and in control

group H J/! are 5arried.F. Ty"e of fa5i#y, in experimental group H.! and in control

group + H/! #i'e in Nuc#ear fa5i#y.

H. Die$ary "a$$ern, in experimental group + F/! and in control

group /FF.H! were non 'e&e$arians

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Effec$i'eness of "ro&ressi'e 5usc#e re#a4a$ion $ec%ni8ue on

reducin& $%e #e'e# of an4ie$y a5on& o#d a&e "eo"#e in

e4"eri5en$a# and con$ro# &rou".

•

In e4"eri5en$a# &rou"• Pre-$es$

 – 0 +.! had 5i#d #e'e# of an4ie$y

 – F F.H! had 5odera$e #e'e# of an4ie$y

• Pos$ $es$

 – / FF.H! have 5i#d #e'e# of an4ie$y

 – +/ /! have 5odera$e #e'e# of an4ie$y.

• In con$ro# &rou"

• Pre-$es$ 

 – +F.F! had 5i#d #e'e# of an4ie$y

 – .0! had 5odera$e #e'e# of an4ie$y

• Pos$ $es$

 – +/! have 5i#d #e'e# of an4ie$y

 – H J/! have 5odera$e #e'e# of an4ie$y.

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Co5"arison of "re-$es$ and "os$-$es$ #e'e# of an4ie$y of o#d

a&e "eo"#e in e4"eri5en$a# and con$ro# &rou"

• In E4"eri5en$a# Grou",

 –'re test mean is &'(13 and standard deviation is 3(63 

 –'ost test mean is 1&(13 and standard deviation is 6(')(

 –0alculated value of paired FtG test is *(&*  and the tabulate value is 1(69(

 –"he calculated value is greater than tabulated value. hence the researchhypothesis is accepted.

• In Con$ro# &rou",

 –'re test mean is 19(3 and standard deviation is 3(+

 –'ost test mean is &'(16  and standard deviation is 3(3)

 –0alculated value of paired

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• Con$ro# Grou"*

 – "here is si&nifican$ associa$ion between a&e and 5ari$a#

s$a$us

 – "here is no si&nifican$ associa$ion between &ender,

inco5e, re#i&ion, $y"e of fa5i#y, die$ary "a$$ern.

•

E4"eri5en$a# &rou"* – "here is no si&nifican$ associa$ion between a&e, &ender,

re#i&ion $y"e o fa5i#y, die$ary "a$$ern, inco5e and

5ari$a# s$a$us.

Associa$ion )e$6een $%e effec$i'eness of "ro&ressi'e 5usc#e

re#a4a$ion $ec%ni8ue on an4ie$y a5on& o#d a&e "eo"#e 6i$% $%eir

se#ec$ed de5o&ra"%ic 'aria)#es

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•  -ursing !ractice#

 – 'rogressive muscle relaxation techni#ue is effective incontrolling the progression of anxiety disorder.

 – "he progressive muscle relaxation techni#ue #uality of

care and the old age people life.

 – "he study helps nurses to take care of old age people with*nxiety

 – "he interventions are cost effective.

•  -ursing eucation#

 – n education it helps the students to gain more insight

causes of anxiety, stress C other emotional problems of old

age people, how to reduces C come out from stress C

anxiety.

IMP;ICATIONS

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•  -ursing aministration#

 – "he community health centre !edical $fficer can plan

continuing nursing education programs to nurses and

include such topics to enhance knowledge of nurses. – 0ommunity Health Nurses should motivate the people to

involve in practicing the interventions.

 – "ake necessary actions for publishing the articles related to

 progressive muscle relaxation techni#ue on anxiety toreduce the anxiety level of old age people.

•  -ursing research

 – "he study will be valuable reference and pathway for

future researcher  – "he findings can be generali(ed with the public in general

and health professional to understand more about the

importance regarding progressive muscle relaxation

techni#ue on anxiety.

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• "he study was limited only to %& C above %& years old

age people.• $nly to sample si(e of %& old age people.

• "he study was limited only to selected areas at 'onnur.

;IMITATIONS

• $n the basis of findings of the study the following

recommendations have been made-8

•* similar study can be replicated on large sample, in differentsettings with in different population as long term study.

• "he study can be conducted for old age people who are %& or

above %& years in old age home and hospital set up.

RECOMMENDATIONS

CO C S O

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The purpose of the study was to assess the effectivenessof progressive muscle relaxation technique on anxiety, in

terms of practice among old age people in a selected

community areas at Guntur. The pretest was conducted

and the score was inadequate. So it highlights the need for education and the researcher has conducted

 progressive muscle relaxation technique teaching &

demonstration programme. After progressive muscle

relaxation technique of teaching & demonstration themean post-test showed adequate practice that proved the

effectiveness of progressive muscle relaxation technique.

CONC;2SION

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