International Journal of Nursing and Health Research

International Journal of Nursing and Health Research

www.nursingjournal.in
Online ISSN: 2664-6420; Print ISSN: 2664-6412
Received: 19-06-2020; Accepted: 08-07-2020; Published: 23-07-2020
Volume 2; Issue 1; 2020; Page No. 54-56

Effectiveness of relaxation technique in reducing stress among nursing students

Jyothimol PV1, Sonia Maria Lobo2*
1
MSc Student, Department of Mental Health Nursing, Athena College of Nursing, Mangaluru, Karnataka, India
2
Associate professor and HOD, Department of Mental Health Nursing, Athena College of Nursing, Mangaluru, Karnataka, India

Abstract
Introduction: Stress may be viewed as an individual’s reaction to change that requires an adjustment or response, which can be physical
mental or emotional1. Responses directed at stabilizing internal biological process and preserving self-esteem can be viewed as healthy
adaptation to stress1. The stress levels of nursing students is higher than those in most other academic programs and some studies have
been suggested that their stress levels are higher than their counterparts in medical school social work and Pharmacology programs2.
Objectives: To assess the stress of first year BSc nursing students. To assess the effectiveness of relaxation technique in terms of
reduction in the mean post-test stress score. To find out the association between mean pre-test stress score and selected demographic
variables.
Methodology: An evaluative approach was used for this study. Quasi-experimental one group pre-test post-test design was adopted for
the study. 30, Ist year B.Sc. nursing students were selected using simple random sampling method from a selected college of nursing
Mangalore. Baseline proforma and stress rating scale were the tools used and the data was analysed using descriptive and inferential
statistics.
Results: The results of the study showed that the mean pre-test stress level score (44.10) was more than the mean post- test score (23.20).
The computed‘t’ value (t29=9.03) was higher than that of the table value (t29=2.05, p<0.05). There was no significant Association between
the pre- test level of stress score and selected demographic variables.
Conclusion: Findings of the study revealed that progressive muscle relaxation technique was effective to reduce the stress among student
nurses. They must be motivated to learn and practice progressive muscle relaxation to promote their level of wellbeing. This study
suggested the need for progressive muscle relaxation in the reduction of stress

Keywords: effectiveness, progressive muscle relaxation, stress, student nurses

Introduction
Stress has been defined as a barrier to concentration, problem changes in life in addition to academic pressure. The adolescent
solving, decision making and other necessary abilities for phase is manifested by upheaval of hormonal changes resulting
student’s learning; it also has some symptoms and illness in the in an increased level of internal tension [6]. Academic stress
students such as depression and anxiety [3]. Stress may influence among college students has been a topic of interest for many years
[7]
the health directly or indirectly. Stress has been called the . Nursing students often experience immense amount of stress
"disease of Civilization". Stress refers to the strain from the during clinical course and encounter various factors for pressure.
conflict between our external environment and us, leading to Factors such as exams, preparation of articles, and clinical
emotional and physical pressure [4].The brain prepares the body experiences can generate anxiety in nursing students.
for defensive action - the fight or flight response by releasing Relationship with colleagues and patients has also proven
stress hormones namely cortisone and adrenaline. These significant stressors for many students [8].
hormones raise the blood pressure and the body prepares to react The workload of nursing students is profound not only
to the situation. With the concrete defensive action, the stress maintaining academic studies and a clinical practice, but also a
hormones in the blood gets used up, entailing reduce stress effects work life balance that is important to both young students and
and symptoms of anxiety [5]. those who are more mature, when they achieve degree. Many
The degree of stress in our lives is highly dependent upon nursing students today are" Re- careerers" and have multiple
individual factors such as our physical health, quality of our family concerns including coping with adolescent children and
interpersonal relationships, number of commitments and caring for elderly patients [2].
responsibilities we carry, degree of others dependence upon us, Therefore the present study aimed to realize that stress is a
expectations of us, amount of support we receive from others, and common problem experienced by nursing students.
the number of changes or traumatic events that have recently
occurred in our lives [5]. Student life coincides with adolescence Objectives
and stress, and can manifest in children as a reaction to the 1. To assess the stress of Ist year BSc nursing students using a

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stress rating scale. area of adjustment. (Table 2).

2. To assess the effectiveness of relaxation technique in terms
of reduction in mean post-test stress score. Table 2: Area-wise mean percentage and mean reduction of pre-test
3. To find out the association between mean pre-test stress and post-test stress score n=30
score and selected demographic variables. Pre-test Post-test Pre-test Post-test
Max. Actual
Methodology Area Mean Mean% Mean Mean%
Score reduction
An evaluative approach and a quasi-experimental one group pre- Academic 51 18.03 35.36 9.27 18.17 17.19
test post-test design was adopted for the study. The setting was a Hostel aspects 21 10.17 48.41 5.20 24.76 23.65
selected college of nursing at Mangalore. Simple random Health related 9 3.27 36.30 1.53 17.04 19.26
sampling technique was used to select 30, first year B.Sc. nursing Financial 9 5.57 61.85 4.17 46.30 15.55
students based on inclusion criteria. Demographic proforma and Adjustment 15 7.07 47.11 3.03 20.22 26.89
stress rating scale were used for data collection. Demographic Max. Score 105
proforma consisted of 9 items and stress rating scale consisted of
35 items. The resulting stress scores were categorised as mild 3. Effectiveness of Jacobson progressive muscle relaxation
stress (0-33%), moderate stress (34-66%) and severe stress (67- on student nurses in terms of reduction in mean Post-test
100%). Validity of the tools were established by 11 experts. stress level score.
Reliability of the stress rating scale was established using split The mean post-test stress score (23.20) was lower than the mean
half method and it was found to be r=0.78 (Sphearman’s Brown pre-test stress score (44.10). The Computed‘t’ value (t29=9.03)
Prophesy formula).Permission was obtained from the concerned was higher than that of the table value (t29=2.05, p<0.05). Hence
management of the college of nursing to conduct the study. Pilot it can be inferred that the Jacobson progressive muscle relaxation
study was conducted and was found to be feasible and was highly effective in reducing stress among student nurses.
practicable. Informed consent was obtained from year B.Sc (Table 3)
nursing students for data collection. After collection of baseline
data and stress level of students, progressive muscle relaxation Table 3: Paired‘t’ test to test the significant difference between the
mean pre-test and post-test stress score. n=30
was administered for 7 days. Post- test was conducted on the 7th
day using the same rating scale. Mean score Mean difference SD Difference t value
Pre-test 44.10
20.90 12.68 9.03
Results Post-test 23.20
1. Description of baseline variables Maximum score = 105, t29=2.05, p<0.05
Majority of the Ist year B.Sc. nursing students (53.4%) were in the
age group of 19 years and 43.3% were in the age group of 18 4. Association between pre-test stress score and selected
years. Majority (96.7%) student nurses were from nuclear baseline variables
families, 66.7% of student nurses’ fathers had high school The chi square value was computed to find association between
education where as 46.7% of student nurses’ mothers had high mean pre-test stress score and selected baseline variables such as
school education. Most of their father’s occupation was age, type of family, education of father and mother, occupation
agriculture, 50% of the student nurses had two siblings and only of father and mother, family income, number of siblings, birth
10% had three siblings. Most of the (56.7%) student nurses were order in the family. The calculated chi – square value was less
first born child in their family. than the table value (3.84) at 0.05 level of significance except for
number of siblings (5.000). Hence it was inferred that there was
2. Stress level of Ist year B.Sc. nursing students no significant association between the mean pre- test level of
In the pre-test, majority (90%) had moderate stress and only 10% stress score and selected demographic variables except for
had mild stress. In the post-test majority (90%) had mild stress number of siblings.
and 10% had moderate stress level (Table 1)
Discussion
Table 1: Frequency and percentage distribution of pre-test and post-test Majority of the student nurses (53.4%) belonged to the age group
stress level of student nurses n=30 of 19 years, 43.3% were in the age group of 18 years, only 3.3 %
Pre-test Post-test
were in the age group of 20 years. Majority (96.7%) of the student
Grading Stress level Percentage f % f % nurses lived in nuclear families. Most of the (66.7%) student
Mild 0-35 0-33% 3 10 27 90 nurses fathers’ had high school education, where as 46.7% of the
Moderate 36-70 34-66% 27 90 3 10 student nurses mothers had high school education. Most of their
Severe 71-105 67-100% - - - - fathers’ (70%) occupation was agriculture and majority of the
Maximum score: 105 student nurses mothers were home makers (93.4%). Half (50%)
of the student nurses had two siblings and majority (56.7%) of
In the area wise analysis, the mean post-test score {academic student nurses were first born in their families.
(9.27), hostel aspects(5.20),health related (1.53), financial (4.17), The present study findings showed the mean post-test stress score
adjustment in general(3.03)} were significantly lower than the (23.20) was lower than the mean pre-test stress score (44.10). The
mean pre-test stress score[Academic(18.03), hostel aspects findings of the present study are consistent with the findings of
(10.17), health related(3.27),financial(5.57),adjustment in other studies where it was found that the mean percentage of
general(7.07)] in all the domains. Maximum reduction was in the stress score in the post-test is reduced after administering Jacob

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sons progressive muscle relaxation. The study conducted at 6. Christine M, Tamil Mani R. The effect of yoga nidra on
Mangalore among 40 B.Sc. nursing students showed that 55% of stress among nursing students in selected colleges of nursing,
the sample experienced severe stress, 12.5% of the sample Hyderabad. The Nurse. 2010; 2(1):3-6.
experienced moderate stress, 32.5% of the sample experienced 7. Ahmadnejad S, Monjamed Z, Pakravannejad M, Malekian
mild level of stress6. A. The effect of relaxation training on first year nursing
The findings of the present study showed that Jacob sons students’ anxiety in clinical setting. World Academy of
progressive muscle relaxation is effective in reducing stress Science, Engineering and Technology 2011 [online].
among student nurses. The mean post-test stress score (23.20) Available from: URL:http://www.waset.org//journals/
was lower than the mean pre-test stress score (44.10). These waset/v59/v59-130.pdf. [Accessed on 9.8.2013].
findings were statistically significant at 0.05 level. The 8. Sunder R. Effectiveness of progressive muscle relaxation
Computed‘t’ value (t29=9.03) was higher than that of the table technique on examination stress among adolescents in
value (t29=2.05, p<0.05). This shows that Jacobson’s progressive selected high school of Mangalore, 2010.
muscle relaxation was highly effective in reducing stress among
student nurses. The findings of this study are consistent with the
study conducted to identify the effectiveness of progressive
muscle relaxation technique on examination stress among
adolescents in selected high schools of Mangalore, Karnataka
showed that the mean pre-test stress score was 111.67 which was
more than the mean post-test stress score 74.33. The computed‘t’
value was (t35=17.57) was higher than that of the table value
(t35=1.69, p<0.05). Progressive muscle relaxation technique was
effective to reduce examination stress among adolescents9.
There was no significant association between selected
demographic variables except for number of siblings in the family
and the pre-test stress score (χ2<3.84, P≤0.05). The findings of
the study showed that Jacob sons progressive muscle relaxation
was effective in reducing stress among Ist year B.Sc. nursing
students.

Conclusion
Progressive muscle relaxation was effective in reducing stress
among student nurses. It has no side effects and is cost effective.
Implementing techniques to cope with stress in the nursing
programme has an effect on retention and academic
performances. A reduction in stress can bring about changes in
life and in turn it will provide proper protection to self.

Conflict of Interest
None

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