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RESEARCH PROBLEM STATEMENT

A Quasi Experimental Study to Assess the Impact of


Yoga Therapy on Stress Level Among Nursing Students
At SGRD College of Nursing, Vallah, Amritsar.

PRESENTEE:-
ROLL NO: 92831210
M.Sc.(N) 2nd YEAR
MENTAL HEALTH NURSING
OBJECTIVES

1) To assess the stress level among nursing students.

2) To assess the impact of yoga therapy on stress level


among nursing students

3) To find out the association of stress level among


nursing students with selected socio-demographic
variables.
OPERATIONAL DEFINITIONS

IMPACT– refers to the effect of yoga therapy measured by


change in stress level scores in nursing students by comparing
post test scores with pre test scores.

STRESS– refers to the response of the B.Sc. nursing students to


situation that disrupts their physical, physiological, intellectual,
emotional and social aspects will be measured by using
standardized perceived stress scale (PSS-14).
OPERATIONAL DEFINITIONS
YOGA THERAPY– refers to a set of yoga practices consisting -
yoga asana- Tadasan, Ardhachakrasana, Trikonasan,,
Paschimottasana, Vajrasana Sarvangasan, Shavasan, pranayama-
Deep breathing exercise, Anulomvilom, Bhramari pranayama,
Meditation that would be carried on the students on a schedule
time and as per mention procedure.

NURSING STUDENTS- Refers to individual who have joined


B.Sc. Nursing programs in Sri Guru Ram Das College of
Nursing, Vallah, Amritsar.
INTRODUCTION
“Prayer is when you talk to God, meditation is when God talks to you”

Nursing is a profession which came into existence during the


Crimean war and is continuing till date. Nursing students
constitute the backbone of the nursing profession. Entering the
world of nursing presents the new students with a formidable
array of changes. Often still in their teens they are often asked to
transform from adolescent to adult and from lay person to
professional1.
INTRODUCTION
On entering into the professional college the student
is in a new challenging and stressful environment.
Factors contributing to high levels of stresses in
professional colleges could be highly competitive
curriculum, intense academic competition,
excessive demands coping abilities in physical,
emotional, intellectual, financial and social terms2 .
INTRODUCTION
Globally, nursing students are under tremendous amounts of stress
especially during clinical settings3. Among all health care professions,
nurses have been found to have some of the highest levels of stress5.
Factors leading to stress in nurses include; a highly demanding job with
poor support, workload of patient care, rapidly changing circumstances,
shortage of resources, professional conflict of staff, and emotional
demands of caring for patients including dealing with death and dying6.
NEED OF THE STUDY

Stress, a disease of the 21st century is usually ignored in daily


life due to busy lifestyle and it is a modern disease of civilization
.As long as one is alive, there is always some stress; this positive
stress is necessary as it motivates and gives physical and
emotional strength to perform well7. However, an excess of stress
leads to negative effects that manifest in the form of a headache,
infections, anger, low self-esteem and anxiety, weight loss and
addiction and so on.
NEED OF THE STUDY

Nursing students share similar stressors as their professional

counterparts in a clinical setting; in addition, they also endure

stress related to academics, personal and social factors. Stress of

students in nursing schools is now a widely accepted problem

that negatively impacts their performance in academics and

clinical duties; adversely affecting their physiological and

psychological well-being8

.
NEED OF THE STUDY
Yoga is more than just exercise. Its benefits can be realized
from within the body and from without the body. A
consistent yoga practice can have a positive impact on body
chemistry, disease prevention, symptom reduction or
alleviation, and emotional health. Yoga promotes a strong
mind-body connection, which improves overall mood and
well-being. Meditation and yoga brings a positive vibes
among the students and if they do it regularly it will help in
bringing positive outcomes which is advantageous for the
scholars.
HYPOTHESIS

H1– There is a significant impact of yoga therapy on stress


level among nursing students.

H0-There is no significant impact of yoga therapy on stress


level among nursing students
DELIMITATIONS

Study is limited to-


• B.Sc. Nursing students.
• Students willing to participate.
• Students limited to age group 18-26 years.
REVIEW OF LITERATURE

Michael Christine (2017) conducted the experimental study to assess the


Effect of Yoga Nidra on Stress among Nursing Students in selected Colleges of
Nursing in Hyderabad. Sample consists of 40 nursing students each in
experimental group and control group. Sample was selected by stratified
random sampling technique and data was collected by using set administered 4
point likert scale. The findings of the study revealed that there was significant
difference in the pretest and post test stress among nursing students in the
experimental group. The study concluded that stress among nursing students
was decreased with the practice of Yoga Nidra9 .
REVIEW OF LITERATURE
Mr. Rawal Rajesh et al. (2017) conducted a study on Effectiveness of raja yoga
meditation on perceived level of stress among nursing students at selected nursing
institute in Mangalore. Purposive sampling technique was used to select the nursing
institute for Raja yoga meditation and 130 samples were selected by using simple
random sampling method. The stress areas covered were physical, emotional, social,
cognitive and spiritual. Pre-test and post test was administered by using Perceived
Stress Scale for stress and participants attended daily session of 20 minutes Raja
yoga meditation practice for 21 days. The results of the study revealed that there
was significant difference between the pre and post-test stress scores of the
participants after Raja yoga meditation. (t=17.497, P<0.05). Thus it can be
concluded that the Raja yoga meditation was found to be effective in all areas of
stress among nursing students. 10
CONCEPTUAL
FRAMEWORK
CONTEXT INPUT PROCESS PRODUCT

ENVIRONMENT AND NEED YOGA THERAPY


Sri Guru Ram Das College of PROTOCOL
Nursing, Vallah, Amritsar, Punjab.

SOCIO - DEMOGRAPHIC Yoga therapy given by ACTION


VARIABLES practicing OUTCOME
•Age •SukshmaKriya, Allocation of eligible
•Year of course •yogaasana-Tadasan, sample to the
•Marital status •Trikonasan, experimental group by
It is expected
•Educational status of father •Ardhachakrasana simple random
to reduce the
•Educational status of mother •Paschimottanasana, technique.
level of stress
•Occupational status of father •Vajrasan, Assess the pre-test
in post test
•Occupational status of mother •Sarvangasan, level of stress among
level as
•Family income monthly(in •Shavasan, nursing students
compared to
rupees) •pranayama, pre test level.
Implement the yoga
•When stress which social •Anulomvilom, therapy for once a time
Yoga therapy
system used •Bhramari pranayam was effective
in a day, an hour in
•Source of recreation •Deep breathing exercie and five days a week for
in reducing
•Type of family Meditation one month.
the level of
•Habitat. students practice once a time After one month assess
stress among
in a day. Nursing
LEVELS OF STRESS
the post-test level of
Duration of every session of Students.
•Minimum stress
•Mild yoga therapy is 60 minutes
•Moderate in five days a week for for
•Severe 30 days.

Stufflebeam “CIPP Evaluation Model 2003”.


RESEARCH METHODOLOGY
RESEARCH APPROACH
(Quantitative Research Approach)

RESEARCH DESIGN
(Quasi Experimental Study Design-One Group Pre-test Post-test Design)

RESEARCH SETTING
(SGRD College of Nursing, Vallah, Amritsar)

TARGET POPULATION
(B. Sc Nursing Students of SGRD College of Nursing, Amritsar)

SAMPLING TECHNIQUE
Simple Random Sample Technique (Lottery Method)

SAMPLE SIZE
(60 Nursing Students)

(100 Patients, 50 InDESCRIPTION


Experimental Group And 50 In Control Group)
OF TOOL
Part (A) Socio-Demographic Variables
SAMPLE
Part (B) Perceived stress SIZE
scale-(PSS-14)
(100 Patients, 50 In Experimental Group And 50 In Control Group)
METHOD OF DATA COLLECTION
(Self Administered Questionnaire Method)

Intervention: Yoga Therapy for One Month.

Assessment of Yoga Therapy Impact on Stress level

DATA ANALYSIS AND INTERPRETATION OF DATA


(Descriptive and Inferential Statistics)

DISSEMINATION OF FINDINGS
PROTOCOL OF YOGA THERAPY
• The permission was obtained from the principal college of nursing and
chairperson of the ethical committee of Sri Guru Ram Das College & Research
Centre, Amritsar.
• Informed consent was obtained from the students after explaining their role in
the study.

• The students were screened for the stress from 202 students by using the scale
( PSS-14)
• After the screening high level of stress was found in 2nd year and 4th year B.Sc.
Nursing students.
• sixty students were selected by simple random sampling technique by using
lottery method
• Sixty students were allocated into three groups.
• yoga therapy was given to each group for one month, five days
per week for 60 minutes.

• Then post test was taken by using the same scale ( PSS-14)
after one month.
Tool For Data Collection
Part A – Demographic Variables
1.Age (in years):-
• 18-20
• 21-23
• 24-26
2.Year of course
• 1st year
• 2nd year
• 3rd year
• 4th year
3.Marital status
• Unmarried
• Divorced
• Widowed
4.Educational status of father
• Primary
• Secondary
• Graduation
• Post-graduation & above
Demographic Variables
5. Educational status of mother
• Primary
• Secondary
• Graduation
• Post-graduation & above
6.Occupational status of father
• Government employee
• Private employee
• Unemployed
• Self-employed
7. Occupational status of mother
• Government employee
• private employee
• Housewife
• Self-employed
Demographic Variables
8. Family income (in rupees per monthly)
• 5001-10,000
• 10001-15000
• 15001-20,000
• >20,000
9.When stress which social support system used
• Roommates
• faculty
• spiritual leader
• No one
10. Sources of recreation
• T.V
• Radio
• Social-media
• Reading books
Demographic Variables

11.Type of family
• Nuclear family
• Joint family
• Extended family
12. Habitat
• Rural
• Urban
PART –B PERCEIVED STRESS SCALE-14
S. Question items Never Almost never Some Fairly Very often
No. times often
0 1 2 3 4
1 In the last month, how often have you been
upset because of something that happened
unexpectedly?

2 In the last month, how often have you felt that


you were unable to control important things in
your life?

3 In the last month, how often have you felt


nervous and “stressed”?

4 In the last month, how often have you dealt


successfully with irritating life hassles?

5 In the last month, how often have you felt that


you were effectively coping with important
changes that were occurring in your life?
S. Question items Never Almost Some Fairly Very often
No
never times often 4
0 1 2 3
6 In the last month, how often have you
felt confident about your ability to
handle your personal problems?

7 In the last month, how often have you


felt that things were going your way?

8 In the last month, how often have you


found that you could not cope with all
the things that you had to do?

9 In the last month, how often have you


been able to control irritations in your
life?
10 In the last month, how often have you
felt that you were on top of things?
S. Question items Never Almost never Some Fairly often Very often
No 1 times 3 4
0 2
11 In the last month, how often have you been
angered because of things that happened that
were outside of your control?
12 In the last month, how often have you found
yourself thinking about things that you have to
accomplish?
13 In the last month, how often have you been
able to control the way you spend your time?
14 In the last month, how often have you felt
difficulties were piling up so high that you
could not overcome them?

•The positive items are 4,5,6,7,9,10 and 13.


•The negative items are 1,2,3,8,11,12 and 14.
For positive items the scoring was Never-4, Almost never-3, Sometines-2, Fairly
often-1, very often-0.
For negative items the scoring was Never-0, Almost never-1, Sometines-2, Fairly
often-3, very often-4.
SAMPLING CRITERIA
Inclusion criteria:-The study included the students who were

• studying in Sri Guru Ram Das College of Nursing, Vallah, Amritsar

• Residing in nursing hostel.

• Present during data collection and

• Willing to participate in the study.

Exclusive criteria:-The study excluded students who were

• Suffering from any medical or mental illness

• Practice yoga or any other relaxation therapy

• Students who are day scholars.

• Not willing to participate in the study.


ANALYSIS
Table 1: frequency and percentage distribution of demographic variables
N=60

S. No Frequency Percentage
Demographic variables
(f) (%)
1 Age in years
a. 18-20 26 43.3
b. 21-23 34 56.7
2 Year of course
31 51.7
a. 2nd year
29 48.3
b. 4th year
3
Marital status
60 100
a. Unmarried

Educational status of father


4 a. Primary 3 5
b. Secondary 22 36.7
c. Graduation 32 53.3
d. Post-graduation & above 3 5
Table 1: frequency and percentage distribution of demographic variables
N=60
S. No Frequency Percentage
Demographic variables
(f) (%)
5 Educational status of mother
a. Primary 3 5
b. Secondary 31 51.7
c. Graduation 23 38.3
d. Post-graduation & above 3 5
6 Occupational status of father
a. Government employee 28 46.7
b. Private employee 8 13.3
c. Unemployed 3 5
d. Self-employed 21 35
7 Occupational status of mother
a. Government employee 8 13.3
b. Private employee 9 15
c. Housewife 38 63.3
d. Self-employed 5 8.3
8 Family income (in rupees per monthly)
a. 5001-10,000 7 11.7
b. 10001-15000 8 13.3
c. 15001-20,000 10 16.7
d. >20,000 35 58.3
Table 1: frequency and percentage distribution of demographic variables
N=60
S. No Frequency Percentage
Demographic variables
(f) (%)
9 when stress which social support system used
a. Roommates 14 23.3
b. Faculty 1 1.7
c. Spiritual leader 16 26.7
d. No one 29 48.3
10 Sources of recreation
a. T.V 15 25
b. Social-media 43 71.7
c. Reading books 2 3.3
11 Type of family
a. Nuclear family 47 78.3
b. Joint family 13 21.7
12 Habitat
a. Rural 33 55.0
b. Urban 27 45.0
Table 2:Comparison of Pre-test and post-test level of stress
among nursing students
N=60
Pre-test Post-test
S. NO LEVEL OF STRESS

f % f %

1 Minimum (0-14) 0 0 3 5

2 Mild (15-28) 3 5 56 93.3

3 Moderate (29-42) 51 85 1 1.7

4 Severe (43-56) 6 10 0 0
Table 3: Comparison of stress level among nursing students regarding impact of
yoga therapy in pre-test and post test
N=60

Level of Range Mean SD Mean ‘t’ value df ‘p’ value


Stress %

Pre-test 26-44 39.02 3.77 69.68


34.79 59 0.000 *
Post-test 11-29 19.88 2.98 35.50

*Highly Significance p<0.01

Table 3 shows the effectiveness of yoga therapy on stress level among nursing students in
pre-test mean score was 39.02 and SD was 3.77 and post-test mean score was 19.88 and SD
was 2.98. there is statistically highly significant difference between pre-test and post-test
stress level (t=34.79, df=59, p=0.000) indicates that yoga therapy was effective in reducing the
stress level among nursing students.
Table 4: Association between pre-test level of stress among nursing students with
demographic variables N= 60

S. No X2 value
Demographic variables df
Mild Moderate Severe P value
1 Age in years 4.38
a. 18-20 1 20 5 2
b. 21-23 2 31 1 0.112 NS
2 Year of course 0.95
a. 2nd year 2 25 4 2
b. 4th year 1 26 2 0.621 NS
3 Marital status 6
3 51
a. Unmarried
4 Educational status of father
a. Primary 0 2 1 2.58
b. Secondary 1 19 2 6
c. Graduation 2 27 3 0.860 NS
d. Post-graduation & above 0 3 0
S. No X2 value
Demographic variables df
Mild Moderate Severe P value
5 Educational status of mother
2
a. Primary 0 1 8.16
29
b. Secondary 0 2 6
17
c. Graduation 3 3 0.227 NS
3
d. Post-graduation & above 0 0

6 Occupational status of father


a. Government employee 3 24 1 11.57
b. Private employee 0 5 3 6
c. Unemployed 0 3 0 0.072 NS
d. Self-employed 0 19 2
7 Occupational status of mother
a. Government employee 2 5 1 12.48
b. Private employee 1 6 2 6
c. Housewife 0 35 3 0.052 NS
d. Self-employed 0 5 0
8
Family income (in rupees per monthly)
a. 5001-10,000
1 5 1 5.04
b. 10001-15000
0 6 2 6
c. 15001-20,000
0 9 1 0.538 NS
d. >20,000
2 31 2
Table 4: Association between pre-test level of stress among nursing students with
demographic variables N= 60

S. No X2 value
Demographic variables df
Mild Moderate Severe P value
9
when stress which social support system used
a. Roommates
0 13 1 12.45
b. Faculty
0 0 1 6
c. Spiritual leader
1 15 0 0.053 NS
d. No one
2 23 4
10 Sources of recreation
a. T.V 2 13 0 15.00
b. Social-media 0 37 6 4
c. Reading books 1 1 0 0.005 *
11 Type of family 0.85
a. Nuclear family 2 41 4 2
b. Joint family 1 10 2 0.654 NS
12 Habitat 1.38
a. Rural 2 29 2 2
b. Urban 1 22 4 0.503 NS

*<0.05 Level of significance NS-Non Significant


Table 5: Association between post-test level of stress among nursing students with demographic
variables N= 60

S. No X2 value
Demographic variables df
Minimum Mild Moderate P value
1 Age in years 4.80

a. 18-20 3 23 0 2

b. 21-23 0 33 1 0.091 NS

2 Year of course 3.94

a. 2nd year 3 28 0 2

b. 4th year 0 28 1 0.140 NS

3
Marital status
a. Unmarried 3 56 1

4 Educational status of father


a. Primary 0 3 0 20.56

b. Secondary 2 20 0 6

c. Graduation 1 31 0 0.002 *

d. Post-graduation & above 0 2 1


Table 5: Association between post-test level of stress among nursing students with demographic
variables N= 60
S. No X2 value
df
Demographic variables
Moderate P value
Minimum Mild
5
Educational status of mother
0 19.71
a. Primary 0 3
0 6
b. Secondary 2 29
0 0.003 *
c. Graduation 1 22
1
d. Post-graduation & above 0 2

6 Occupational status of father


a. Government employee 1 26 1 2.36
b. Private employee 1 7 0 6
c. Unemployed 0 3 0 0.884 NS
d. Self-employed 1 20 0
7 Occupational status of mother
a. Government employee 0 7 1 8.34

b. Private employee 0 9 0 6

c. Housewife 3 35 0 0.214 NS

d. Self-employed 0 5 0
Table 5: Association between post-test level of stress among nursing students with demographic
variables N= 60

S. No X2 value
df
Demographic variables
Moderate P value
Minimum Mild
8
Family income (in rupees per monthly)
a. 5001-10,000
1 6 0 3.24
b. 10001-15000
0 8 0 6
c. 15001-20,000
1 9 0 0.778 NS
d. >20,000
1 33 1
9
when stress which social support system used
a. Roommates
0 14 0 3.89
b. Faculty
0 1 0 6
c. Spiritual leader
1 14 1 0.692 NS
d. No one
2 27 0
10 Sources of recreation
a. T.V 0 15 0 1.69
b. Social-media 3 39 1 4
c. Reading books 0 2 0 0.792 NS
Table 5: Association between post-test level of stress among nursing students with demographic
variables N= 60

S. No X2 value
Demographic variables df
Minimum Mild Moderate P value
11 Type of family 0.52
a. Nuclear family 2 44 1 2
b. Joint family 1 12 0 0.771 NS
12 Habitat 3.72
a. Rural 3 30 0 2
b. Urban 0 26 1 0.155 NS

*<0.05 Level of significance NS-Non Significant


DISCUSSION
To assess the stress level among nursing students

RESULTS OF PRESENT STUDY RELATED LITERATURE

The results of pre-test level of stress The supported study was conducted by
among nursing students reveals that Rani Ruchika in 2013. The stress level is
3(5%) had mild stress, 51(85%) had categorized in to severe, high, moderate,
moderate stress and 6(10%) had severe low and very low. The findings of the
stress with an average mean of study reveals that mean stress score after
39.02±3.77. Yoga Nidra (17.8) was lesser than the
mean stress score before Yoga Nidra
(28.82). This indicates decrease in stress
scores of B.Sc. nursing first year students.
To assess the impact of yoga therapy on stress level among nursing
students
RESULTS OF PRESENT STUDY RELATED LITERATURE

The results of post-test level of stress among nursing The supported study was conducted by Rawal
students reveals that 3(5%) had minimum stress, Rajesh in 2017. The results of the study revealed
56(93.3%) had mild stress and 1(1.7%) had that the post-test stress scores were lower than the
moderate stress with and average mean of mean pre-test stress scores. There was significant
19.88±2.98. difference between the pre and post-test stress
The impact of yoga therapy on level of stress among scores and the study was found to be significant at
nursing students reveals that pre-test mean score and (t=17.497, P<0.05). The study concluded that the
SD was 39.02±3.77 and post-test mean score and Raja yoga meditation was found to be effective
SD was 19.88±2.98. pre-test and post-test mean was reducing the stress among nursing students.
statistically tested by using paired t-test. The result
reveals that t value (t=34.79) and p value (p=0.000)
which was highly significant at 0.01 level of
significance and indicates that yoga therapy was
effective in reducing the level of stress among
To find out the association of stress level among nursing students
with selected socio-demographic variables.
RESULTS OF PRESENT STUDY RELATED LITERATURE
The results of association between pre-test level of stress No supported study was found.
among nursing students with demographic variables which
was statistically tested using chi-square. The result reveals
that Sources of recreation was significantly associated with
pre-test stress level at 0.05 level of significance. The other
demographic variables were not significantly associated
with pre-test stress level among nursing students.
The results of association between post-test level of stress
among nursing students with demographic variables which
was statistically tested using chi-square. The result reveals
that educational status of father and mother was
significantly associated with post-test stress level at 0.05
level of significance. The other demographic variables was
not significantly associated with post-test stress level among
nursing students.
CONCLUSION
The findings of the present study concludes that nursing students
experience stress due to various reasons which affects their
performance and activities carried out during their nursing
programme may result in various physiological and psychological
health problems. The study concludes that yoga therapy was effective
in reducing the stress level among nursing students. It is important to
emphasize on coping to manage the stress among nursing students
contributing to prevention and health promotion in improving the
quality of life of students.
RECOMMENDATIONS
The following recommendations are made on the basis of the study:-
 The study can be conducted on large samples.
 The study can be conducted to assess the impact of other
interventions on stress among nursing students.
 The study can be conducted to assess the stress among nurses
working in clinical areas.
 Comparative study can be conducted on nursing students and
academic students.
IMPLICATIONS
Nursing Practice
• The nursing students recognize the benefit of yoga therapy and its value in speeding
up the recovery process of minor ailments and disorders. It helps to improve the
creativity of the nursing students.

• Nursing students experience stress due to various stressors which can be managed
by practicing yoga.

• Physical and psychological wellbeing is more important to nursing students to show


their performances during their nursing programme which can be improved by
practicing yoga in their daily life.

• Yoga helps the nursing students to prevent from stress and promotion of healthy
wellbeing.

• During clinical duties nursing students can teach yoga to patients to improve their
wellbeing.
IMPLICATIONS
Nursing Education

• Stress is more common among nursing students which can be


relieved by adequate training of yoga.

• Teach the nursing students regarding yoga which helps them in


stressful situations

• Nursing educational system can incorporate yoga in advancement in


nursing sciences into curriculum.

• The nurse educator can create awareness about the therapeutic


benefits of yoga therapy.
IMPLICATIONS

Nursing Administration

• Nurse administrator can plan for in-service education and training


programme on yoga for nursing students and staff nurses.

• Nurse administrator can organize awareness campaign on yoga.

• Nurse administrator can encourage the staff nurses to practice yoga


which helps them to reduce stress and to promote healthy wellbeing
IMPLICATIONS

Nursing Research
• Findings of the study can be implemented in nursing institutions to
reduce the stress among nursing students.
• Research studies can be conducted to evaluate the impact of yoga on
stress among nurses.
• Yoga can be implemented to reduce the stress among nursing
students, staff nurses and patients and family members. Research
studies can be carried out to evaluate the stress levels and its impact
on health.
LIMITATIONS

 The present study was limited to 2nd year and 4th year B.Sc
Nursing students.
 The present study was limited to 60 nursing students.
 The present study was limited to SGRD College of Nursing,
Vallah, Amritsar
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