RESEARCH PROPOSAL PRESENTATION

NAME OF GUIDE- Mrs.JYOTHI DIVAKARAN

Asst.PROFESSOR

Govt.COLLEGE OF NURSING

NAME OF RESEARCHER- AISWARYA S KUMAR

1ST YEAR Msc.NURSING

Govt.COLLEGE OF NURSING

TITLE

Effect of Jacobsons progressive muscle relaxation technique on anxiety among primigravida

BACKGROUND OF THE STUDY

Women encounter physical, emotional, and psychological changes during pregnancy. The literature indicates that some women find these changes to be stressful. They may respond to this stress by feeling anxious. The frequency and intensity of the anxiety reaction depends on how women perceive these stressors and on their ability to cope with the anxiety

Antenatal anxiety has received increased attention with regards to both its impact on infant outcomes and as a risk factor for postnatal depression

Preterm labour and low birthweight for gestational age are the outcomes linked most consistently with antenatal stress or anxiety in humans .

• The studies of the effects of antenatal stress and anxiety in humans have concentrated on obstetric outcome. A study found that women who experienced severe life events in the first trimester of pregnancy had a 50% increase in the rate of congenital abnormalities in cranial—neural crestderived organs (e.g. cleft palate). Even greater risk was associated with the most severe and rare stress, the unexpected death of a child1.

• Another study says that preterm labour and low birthweight for gestational age are the outcomes linked most consistently with antenatal stress or anxiety in humans2. In one study of 8719 women, it was reported a significant association between selfreported general distress at 30 weeks and an increased risk of preterm delivery, defined as <37 weeks3.

• Another study have shown that individuals who experienced severe stressful events during pregnancy showed a 50% increase in marked premature delivery (babies born at <34 weeks).

• In a cohort study conducted by Avon Longitudinal Study of Parents and Children (ALSPAC)it was found that there was a strong link between maternal anxiety in the third trimester and behavioural/emotional problems in the resulting children at 4 years.It was found that self-reported antenatal anxiety at 32 weeks' gestation predicted severe behavioural/emotional problems in both boys and girls4.

NEED AND SIGNIFICANCE OF THE STUDY

• Depressive and anxiety disorders are the most common psychiatric illnesses during pregnancy and the postpartum period. According to international data the prevalence of antenatal depression is between 7% and 17% and approximately 10% of pregnant women suffer from some kind of anxiety disorder5.

• More women with lower anxiety levels and a more positive state of mind had normal deliveries. Anxiety was related to lower birth weight and to difficult delivery. A positive state of mind and emotional stability were associated with having a normal delivery. Therefore, moderate levels of anxiety were associated with complications during delivery and poorer foetal outcomes, whereas a positive state of mind was associated with better childbirth experiences

• Relaxation exercises have become a standard intervention for individuals with anxiety disorders. Relaxed muscles bring on a more serene state with less physical and psychological tension, according to the University of Missouri report. In 2010 study reported by the National Institutes of Health shows that progressive muscle relaxation can significantly alleviate stress among pregnant women6.

• Progressive muscle relaxation techniques have been utilized to effectively control stress, fear, anxiety, insomnia and chronic pain. This procedure can also be effectively applied to natural childbirth. Through conditioned practice this can be quickly learnt to recognize -and differentiate-  a tensed muscle from a completely relaxed muscle.

• With this simple awareness, physical muscular relaxation can be induced at the first signs of tension caused by anxiety.  Physical relaxation enables mental peace-in any situation, even natural childbirth7.

PURPOSE OF STUDY

The purpose of the study is to assess the level of anxiety among primigravida, evaluate the effect of Jacobsons progressive muscle relaxation technique on anxiety among primigravida, find out the association between anxiety among primigravida and selected sociodemographic variables.

STATEMENT OF THE PROBLEM

A study to assess the effect of Jacobsons progressive muscle relaxation technique on anxiety among primigravida admitted in TDMCH, Alappuzha.

OBJECTIVES

To assess the level of anxiety among primigravida.

Evaluate the effect of Jacobsons progressive muscle relaxation technique on anxiety among primigravida.

Find out the association between anxiety among primigravida and selected sociodemographic variables.

OPERATIONAL DEFINITIONS

Effect

Effect refers to the change in the level of anxiety of primigravida brought about by progressive muscle relaxation as measured by the anxiety assessment tool.

Jacobsons progressive muscle relaxation technique

In this study Progressive muscle relaxation (or PMR) refers to a technique for reducing anxiety related to pregnancy in primigravidas by alternately tensing and relaxing the muscles.

 

Anxiety

A feeling of worry, nervousness, or unease, typically about pregnancy and its outcome,and which is measured using spielberger anxiety inventory.

 Primigravida

A woman who is pregnant for the first time.

 

Socio personal variables Refers to the data regarding the age, socio

economic status,occupation, educational status, gestational age etc.

 

Low risk Primi gravid women between 18-35yrs, without

any diseases complicating pregnancy

 

CONCEPTUAL FRAMEWORK

Roys adaptation model

ASSUMPTIONS

The study assumes that

All primigravida experience some level of anxiety.

Primigravida are willing to learn progressive muscle relaxation exercise.

PMR exercise has no known harmful effect on pregnancy.

 

HYPOTHESIS

 H1 There is significant difference between the level of anxiety of primigravida in the experimental and control group before and after intervention.

H2 There is significant association between the socio personal variables and levelof anxiety among primigravida.

RESEARCH APPROACH

Experimental approach is adopted

RESEARCH DESIGN

Quazi experimental with non equivalent control group design

STUDY PERIOD

2MONTH

TOOL

Spielberger anxiety inventory

SETTING OF THE STUDY 

The Antenatal ward (Ward 2) of MCH Alappuzha was selected for the study.

 

POPULATION 

The population for the study is low risk primigravida of ward 2 admitted at MCH, Alappuzha

SAMPLE AND SAMPLING TECHNIQUES 

The sample size is 60 primigravida, 30 each in experimental and control group. The criteria for selection of subjects are the following

INCLUSION CRITERIA  primigravida

Admitted in the MCH Alappuzha.

Primi gravid women in third trimester after 36 weeks of gestation.

With low risk pregnancy.

Willing to participate in the study.

Able to read and write Malayalam.

EXCLUSION CRITERIA  

primigravida With impairment in vision and hearing.

With psychiatric illness.

With disease complicating pregnancy.

THE SAMPLING TECHNIQUE 

non probability convenient sampling.

PLAN FOR DATA ANALYSIS

Data was analysed using descriptive and inferential statistics.

PILOT STUDY

Pilot study undertaking 6 primigravida admitted in antenatal ward TDMCH Alappuzha.

REFERENCES

• 1,Carmen Hernandez Martinez,Victoria Arija Val,Michelle Murphy,Pere Cavalle Busquets,;Relation Between Positive And Negative Maternal Emotional States And Obstetrical Outcome;Journal-Women And Health,Vol51,No.2,Pp124-135,2011

• 2,Vivette Glover,Thomas G O Connor,Effects Of Antenatal Stress And Anxiety,Abstracts From Workshop Presentation In Manchester 15 Oct 2008

• 3,Vivette Glover,Thomas G O Connor,Effects Of Antenatal Stress And Anxiety,Abstracts From Workshop Presentation In Manchester 15 Oct 2008

• 4,niloufer S Ali,iqbal S Azam,badar S Ali,ghurnata Tabbusum,sana S Moin,frequency And Associated FACTORS For Anxiety And Depression In Pregnant Women;a Hospital Based Cross Sectional Study,january22,2002.

• 5, P H C Rondó, R F Ferreira, F Nogueira, M C N Ribeiro, H Lobert, R Artes Maternal Psychological Stress And Distress As Predictors Of Low Birth Weight, Prematurity And Intrauterine Growth Retardation(Citations: 81)

• Journal: European Journal Of Clinical Nutrition - Eur J Clin Nutr , Vol. 57, No. 2, Pp. 266-272, 2003

• 6, Alder J, Urech C, Fink N, Bitzer J, Hoesli Iresponse To Induced Relaxation During Pregnancy: Comparison Of Women With High Versus Low Levels Of Anxiety. Source:ob/Gyn, University Hospital Basel, Basel, Switzerland. Jalder@uhbs.Ch 2011 Mar;18(1):13-21.

• 7, Farideh Bastani, Msc, ,Author VitaeAlireza Hidarnia, PhdAuthor Vitae, Anoshirvan Kazemnejad, PhdAuthor Vitae, Maryam Vafaei, PhdAuthor Vitae, Maryam Kashanian, MD A Randomized Controlled Trial Of The Effects Of Applied Relaxation Training On Reducing Anxiety And Perceived Stress In Pregnant Women. Journal Of Midwifery & Women's Healthvolume 50, Issue 4, July–August 2005, Pages E36–E4

•