Ms Liji Raichel Kurian, Caritas

college of nursing
JOURNAL CLUB
PRESENTATION

Ms Liji Raichel Kurian

Dept of OBG
Caritas CON

Ms Liji Raichel Kurian, Caritas

college of nursing
Indexed peer-reviewed open access
journal which publishes original scientific
articles.
The journal publishes papers based on
original research that are judged by
critical reviews, to make a substantial
contribution in the field.

International Journal of Health

Sciences and Research (IJHSR) Ms Liji Raichel Kurian, Caritas
college of nursing
 A Study to Assess the
Effectiveness of Progressive
Muscle Relaxation on Stress
among Nursing Students in
a Selected Nursing College,
Bangalore

TITLE
Ms Liji Raichel Kurian, Caritas
college of nursing
 Ms. Gayatri Maharjan , Assistant Associate
Professor, Kathmandu Model Hospital,School
of Nursing, Swoyambhu, Nepal

Leeba Baby, Assistant Professor, Krupanidhi

college of Nursing, Bangalore, India

AUTHOR
Ms Liji Raichel Kurian, Caritas
college of nursing
 Gayatri
Maharjan

CORRESPONDING AUTHOR
Ms Liji Raichel Kurian, Caritas
college of nursing
 International Journal of
Health Sciences & Research
(www.ijhsr.org) Vol.9;
Issue: 11; page no 150-158.

Paper accepted on
November 2019 ,

SOURCE
Ms Liji Raichel Kurian, Caritas
college of nursing
Nursing students face immense stress in their
journey to become a nurse.

Potential sources of stress for nursing students

include excessive homework, unclear
assignments and shift duties
This stressful schooling and emotional toll can
affect the student’s performance if he/she
does not use effective stress management
strategies.

ABSTRACT-Background:
Ms Liji Raichel Kurian, Caritas
college of nursing
Progressive muscle relaxation is
one of the most effective techniques
for reducing stress.

It reduces the individual’s arousal

levels when exposed to stressors
and bring about calmer
physiological and psychological
state.

Ms Liji Raichel Kurian, Caritas

college of nursing
 • To identify the level of stress among nursing
students

• To assess the effectiveness of Progressive

Muscle Relaxation on stress among nursing
students

• To find out the association between level of

stress and selected demographic variable
among nursing student

Abstract -Objectives:
Ms Liji Raichel Kurian, Caritas
college of nursing
A quasi-experimental, one group pre-test
and post-test design was used

Study setting was Krupanidhi College of

Nursing, Carmelaram, Bangalore which offers
diploma, BSc and MSc nursing courses.

Study sample includes 70 nursing students

staying in hostel.

Abstract -Materials and Methods

Ms Liji Raichel Kurian, Caritas
college of nursing
Purposive sampling technique was
used to select the samples.

Progressive muscle relaxation was

taught to the subjects for 10
consecutive days.

The post test was done on 11th

day.

Tool used includes Modified Student

Nurse Stress Index.

Ms Liji Raichel Kurian, Caritas

college of nursing
 The study findings highlights
that the mean stress score of
post test was lower than mean
pre test score of the subjects.

Thus it was concluded that the

Progressive Muscle Relaxation
was effective in reducing the
stress among nursing students

Abstract -Results:
Ms Liji Raichel Kurian, Caritas
college of nursing
Ms Liji Raichel Kurian, Caritas
college of nursing
• Stress is needed for creativity, learning, and for our
very survival.

• Stress is only harmful when it becomes

overwhelming and interrupts the healthy state
of equilibrium that our nervous system needs to
remain in balance.

• When stress overwhelms the nervous system, our

body is flooded with chemicals that prepare us
for "fight or flight."

Ms Liji Raichel Kurian, Caritas

college of nursing
While the stress response
can be lifesaving in
emergency situations
where we need to act
quickly, it wears our body
down when constantly
activated by the stressors
of everyday life.

Ms Liji Raichel Kurian, Caritas

college of nursing
 Evidences indicate that most of
the human successes are
created in stressful
conditions; but high rate of
stress would followed by
consequences, including mental
and physical illnesses,
dysfunction and adjustment
disorder and ultimately reduction
of individuals quality of life.

Ms Liji Raichel Kurian, Caritas

college of nursing
Nursing is a high stress level profession.

Some studies recognize that nursing education is

stressful, where the student faces challenging
situations that often influence both learning
process and health conditions

Relaxation is a process that decreases the effects

of stress on our mind and body

Progressive muscle relaxation is a systematic

technique for managing stress and achieving a deep
state of relaxation
Ms Liji Raichel Kurian, Caritas
college of nursing
 Dr. Edmund Jacobson in 1930,
discovered that a muscle could be
relaxed by first tensing it for a few
seconds and then releasing it. Tensing
and releasing various muscle groups
throughout the body produces a state
of relaxation of mind.

Thus, the investigator was motivated

to assess the effectiveness of
progressive muscle relaxation which
can be easily practice to reduce stress.

Ms Liji Raichel Kurian, Caritas

college of nursing
 RESEARCH
METHODOLOGY

Ms Liji Raichel Kurian, Caritas

college of nursing
 • An evaluatory approach was used to assess the
effectiveness of progressive muscle relaxation on stress
Research
Approach

• Quasi-experimental, one group pre-test – post-

test design was used.
Research
Design

• The study was conducted in Krupanidhi College of

Nursing, located in Carmelaram, Bangalore.
• The college offers diploma, BSc and MSc nursing
courses.
Setting • During study, the strength of student was 184
which include GNM, BSc, and MSc. nursing students.
Ms Liji Raichel Kurian, Caritas
college of nursing
 Sample and sample size

The sample size consisted of 70 nursing students, who fulfilled

the inclusion and exclusion criteria.

Sampling Technique

Purposive sampling technique was used. The samples were

handpicked based on inclusion and exclusion criteria. After
obtaining informed consent, they were included in the study
Ms Liji Raichel Kurian, Caritas
college of nursing
 Section I: Baseline Proforma to
assess sample characteristics
 The baseline characteristics of the
subjects such as age, gender, marital
status, course of study, year of the study,
type of family, source of financial support
to study and previous alternative therapy
attended were dealt.

Description of Tool
Ms Liji Raichel Kurian, Caritas
college of nursing
 Section II: Modified Student Nurse
Stress Index (SNSI)
It consists of 24 items comprising of 3
domains.
Scoring was based on 1 to 5 scale.
The Modified SNSI consists of three
factors (domains) with Academic load,
Clinical concern and Personal problems.

Ms Liji Raichel Kurian, Caritas

college of nursing
 1-24 as Not
stressful

97-120 as 25-48 as
Extremely Mild
Severe stress

73-96 as 49- 72 as
severe Moderate
stress and stress

The total score is arbitrarily graded

Ms Liji Raichel Kurian, Caritas
college of nursing
 The reliability was computed using
Split half method, using Karl
Person‟s coefficient of
correlation and the spearman
Brown’s Prophecy formula.

The obtained value of coefficient of

correlation r‟ was 0.93.

Hence the tool was highly reliable.

Ms Liji Raichel Kurian, Caritas

college of nursing
 At first baseline information and Pre-test was
done by using modified student nurse stress
index.

From the same day following the pre-test,

subjects were made to do Progressive muscle
relaxation once a day for 10 days consecutively
in a sessions lasting for 30 minutes.

On the 11th day, the post- test stress level was

assessed by using the same scale.

Technique of Data collection

Ms Liji Raichel Kurian, Caritas
college of nursing
ANALYSIS AND RESULT

Ms Liji Raichel Kurian, Caritas

college of nursing
68% of the subjects were in the age group of 21 to 24 years

66% were females

72% of the subjects were doing GNM course.

76% of subjects were in second year.

76% were in joint family

72% were getting Scholarship for the study.

100% of the subjects were unmarried and not practicing

alternative therapy, for stress relief.

Section 1: Description of baseline

characteristics of nursing students. Ms Liji Raichel Kurian, Caritas
college of nursing
 The posttest mean score (65.74
± 15.05) was lesser than the
pretest mean score (89.56 ±
13.94) of stress.

So it was inferred that the stress

was decreased among nursing
students after administering PMR
for 10 consecutive days.

Section 2: Description of stress

among nursing students.
Ms Liji Raichel Kurian, Caritas
college of nursing
Ms Liji Raichel Kurian, Caritas
college of nursing
 There was a reduction
of stress among nursing
students with regard to
academic, clinical and
personal problems.

Ms Liji Raichel Kurian, Caritas

college of nursing
Section 3 : Effectiveness of progressive
muscle relaxation on stress among nursing
students. Ms Liji Raichel Kurian, Caritas
college of nursing
 It was
concluded
that there
There was
The was a
significant
computed ‘t’ significant
difference
value was relationship
between the
greater than between
mean stress
the table Progressive
score of pre-
value at 0.05 muscle
test (89.56)
level of relaxation
and the post-
significance and stress
test (65.74).
among
nursing
students.

Ms Liji Raichel Kurian, Caritas

college of nursing
 The computed ᵪ²
test value was
lesser than table
value at 0.05 level of
significance.

There was no
significant association
between selected
demographic variables
and stress among nursing
students.

Section 3 : Association between selected

demographic variables and pretest
stress score among nursing students.
Ms Liji Raichel Kurian, Caritas
college of nursing
Discussion

Ms Liji Raichel Kurian, Caritas

college of nursing
68% of the subjects were between the age group of 21-24 years

66% of subjects were females.

72% were doing GNM course.

76% of subject were in second year as most of the subjects from second
year stayed in hostel during the study period

The study did not include 1st year BSc/ GNM, the nursing students
because they were not exposed to the clinical areas during the study
period.

Description of baseline
characteristics of nursing students Ms Liji Raichel Kurian, Caritas
college of nursing
The results demonstrated that the mean
stress scores of post-test (65.74±15.05) was
lesser than the pre-test score, which showed
that the stress was decreased among nursing
students after administration of PMR.
The study indicated that, the academic load,
clinical concern and personal problems were
the major sources of stress among nursing
students.

Description of stress among

nursing students
Ms Liji Raichel Kurian, Caritas
college of nursing
 The findings were consistent with the :

Study which was done in two nursing

training colleges in Ghana among 273
State Registered Nursing, Community
Health Nursing, and Midwifery students.
Study which was done in university in
Jordan to assess the association between
perceived stressor, stress related
factors, and students’ clinical
performance.

Ms Liji Raichel Kurian, Caritas

college of nursing
  The PMR was effective in reducing stress
in terms of academic load, clinical
concerns and personal problems among
nursing students
The present study is supported by :
 Study that was conducted on 36 students
to determine the effectiveness of
progressive muscle relaxation for
examination stress.

Effectiveness of progressive muscle

relaxation on stress among nursing
students. Ms Liji Raichel Kurian, Caritas
college of nursing
Nursing students are subjected to different kinds of
stressors, such as the pressure of academics with
an obligation to succeed, difficulties of
integrating into the system, learning to become
more responsible and getting acceptance from
their peer.

By using progressive muscle relaxation, nursing

student can achieve a “relaxation state”.

Conclusion
Ms Liji Raichel Kurian, Caritas
college of nursing
 Robinson L, Segal R, et.al. Relaxation Techniques for
Stress Relief. HelpGuide.org 2016 March.

Segal J, Smith M, Segal R, Robinson L. Stress

symptoms, signs, and causes. HelpGuideorg
International. 2016 Apr.

Labrague LJ. Stress, stressors, and stress responses of

student nurses in a government nursing school. Health
Science Journal. 2013 Oct;7(4):424-35.

Abazari F, Abaszadeh A, Arab M. Evaluation and

sources of stress in nursing students. Journal of
Medical Education Development steps. 2004;1(1):23-
31.

References Ms Liji Raichel Kurian, Caritas

college of nursing
Title

Simple and concise

Variables are specific
Contains independent and dependent
variable

May also reflect study design

Critique/Evaluation of the article

Ms Liji Raichel Kurian, Caritas
college of nursing
Leeba baby has also conducted a study on
the effect of selected strategies to
improve well being status of elderly
inmates of selected old age homes in
bangalore

Critique- Previous work of the

author
Ms Liji Raichel Kurian, Caritas
college of nursing
Condensed form of whole article
Format is as per journal guidelines

Critique- Abstract
Ms Liji Raichel Kurian, Caritas
college of nursing
Objective of the study is clearly stated
Need of the study is justified

Critique- Introduction
Ms Liji Raichel Kurian, Caritas
college of nursing
Study design

Randomized controlled trial study would

have been done
Post test could have done repeatedly to
note the changes in mean scores over 3
or more time points by repeated
measures of ANOVA to find out till how
long the effectiveness of PMR remained.

Critique- Materials and methods

Ms Liji Raichel Kurian, Caritas
college of nursing
GCP guidelines were followed
Respect for persons
Beneficence
Justice

Critique- GCP guidelines

Ms Liji Raichel Kurian, Caritas
college of nursing
Inference drawn form the study
Study was consistent with other two
studies which indicates that students have
severe level of stress
Study suggest that it should be
implemented for all to manage stress

Critique- Results and discussion

Ms Liji Raichel Kurian, Caritas
college of nursing
Objective of the study was achieved
It can be practiced in colleges

Critique- Conclusion
Ms Liji Raichel Kurian, Caritas
college of nursing
Ms Liji Raichel Kurian, Caritas
college of nursing
Ms Liji Raichel Kurian, Caritas
college of nursing